IMPROVING PROGNOSTIC COMMUNICATION IN PEDIATRIC CANCER

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PROJECT SUMMARY/ABSTRACT My career goal is to develop an independent research program focused on improving communication for children with advancing cancer and their families. When parents understand prognosis, children with advancing cancer are more likely to receive palliative care and interventions to alleviate suffering. Most patients and parents want clear prognostic information, yet our preliminary data show that pediatric oncologists often delay or censor poor prognostic disclosure. This K08 Application describes a career development plan that will enable me to evolve into a successful independent clinical investigator with a career focused on improving communication in pediatric cancer care. The short-term goal of this project is to develop an evidence-based, stakeholder-driven prognostic communication guide and documentation template to support timely prognostic disclosure in the setting of advancing childhood cancer. First, we will interview patients, parents, and oncologists to define stakeholder preferences and recommendations for timing, content, and delivery of prognostic information (Research Aim 1). Second, we will facilitate a Stakeholder Panel to develop a conceptual framework and design a patient/parent- centered prognostic communication guide and documentation template, which will undergo usability and cognitive testing with oncologist beta testers. If advised by stakeholders, we will develop and test patient/parent- centered tools as well (Research Aim 2). Third, we will assess intervention feasibility and acceptability in a single- arm pilot study with pediatric oncologists and advancing cancer patient-parent dyads (Research Aim 3). This career development award will prepare me to achieve my long-term goals as an independent investigator at the intersection of pediatric cancer, palliative care, and communication research. Through structured mentorship, formal coursework, and hands-on clinical research experience, I will expand my training in the science of measuring and modifying communication behaviors (Training Aims 1-3), learn and apply participatory design methods to engage pediatric cancer stakeholders, particularly children, in data synthesis (Training Aim 2), acquire formal training and practical experience with designing interventions for dissemination (Training Aims 2-3), and gain knowledge and skills in clinical trial design and conduct (Training Aim 3). Upon completion of this Award, I will have the data and skills to study this intervention in a multi-site randomized control trial, as the basis for a future R01 submission. The rigorous training provided by this Award will prepare me for a career dedicated to improving communication for children with advancing cancer and their families.