A Field Test of a Group-delivered Enhancing Connections Program: a Partnership Grant with the Cancer Support Community

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An estimated 1.2 million parents of school age children will be newly diagnosed with cancer in the U.S. in 2016. Parental cancer causes substantial behavioral and emotional distress in both the diagnosed parent and child. An estimated 22-33% of the children exceed clinical cut off scores on standardized measures of distress or behavioral-emotional adjustment. Parents, regardless of education and socioeconomic level, are known to struggle with how and what to tell their child about their cancer or how to support the child during the many months of medical treatment. Treatment or disease-related symptoms and parental depressed mood negatively affect the child's physical and emotional access to the parent and the quality of parenting. Despite the magnitude of the problem and numbers affected, there is only 1 cancer parenting education program that has been tested for efficacy, the Enhancing Connections Program. In a 6-state randomized control trial, the program decreased parental depressed mood and anxiety, improved parenting quality, parenting skills and confidence, and enhanced the child's behavioral-emotional adjustment. Child outcomes were significant at 1- year follow up compared to controls. But that program, the Enhancing Connections Program (EC), was tested as an in-person delivered program, constraining its access and availability for parents for whom cost and time constraints or the burden of travel are prohibitive. In order to increase the potential sustainability of the EC Program, the program was formatted for group-delivery. The overall goal of the proposed study is to test the feasibility and short-term impact of the group-delivered EC Program within the largest provider of free group- delivered cancer support services in the United States, the Cancer Support Community, an organization that is a merger of the Wellness Community and Gilda's Club. Phase I will involve training 6 Masters prepared social workers drawn from 3 Beta test sites of the Cancer Support Community in the United States. Phase II will involve implementing the program at these 3 Beta test sites and obtaining detailed data on the feasibility and short-term impact of the program on 33 program participants. A within group (pre-posttest) design will examine short term impact of the program. A total of 33 diagnosed parents with Stage 0-3 cancer will be enrolled, drawn from each Beta site's active recruitment channels. Eligible parents will have a child 5-17 years and read, write and speak English among their languages of choice. After consenting and obtaining baseline measures, study participants will receive 5 fully manualized group-delivered educational counseling sessions at 2- week intervals. Outcomes will be assessed at exit using the same standardized measures as those used to test efficacy of the EC. With a sample of 33 parents, effect sizes will range from medium to large: 0.51-1.16; p values will range from .008 to <.001. Longer term, results will be used to inform a larger implementation grant and clinical trial.