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

据估计，美国将有120万学龄儿童的父母被新诊断出患有癌症。 2016年父母癌症会给被诊断的父母双方造成大量的行为和情绪困扰 和孩子.据估计，22 - 33%的儿童在标准化测量中超过了临床截止分数， 痛苦或行为情绪调整。父母，无论教育和社会经济水平， 众所周知，他们在如何和如何告诉他们的孩子关于他们的癌症或如何在癌症期间支持孩子的问题上挣扎。 几个月的治疗。治疗或疾病相关症状和父母抑郁情绪 对儿童与父母的身体和情感接触以及养育质量产生负面影响。尽管 问题的严重性和受影响的人数，只有一个癌症育儿教育计划， 已经通过了有效性测试，加强联系计划。在一项6州随机对照试验中， 项目降低了父母的抑郁情绪和焦虑，提高了父母的养育质量，养育技能， 信心，并增强了孩子的行为-情绪调整。儿童结局在1- 与对照组相比，随访1年。但是这个项目，加强联系项目， 作为一个亲自交付的计划，限制其访问和提供给父母，他们的成本和时间 限制或旅行负担是令人望而却步的。为了提高欧共体的可持续性， 程序，该程序被格式化为组交付。拟议研究的总体目标是测试 在最大的免费团体提供者内，团体提供的EC计划的可行性和短期影响- 在美国提供癌症支持服务，癌症支持社区，一个组织， 健康社区和吉尔达俱乐部的合并 第一阶段将涉及培训6名硕士准备的社会工作者，他们来自 美国癌症支持社区。第二阶段将涉及在这3个国家实施该计划。 Beta测试站点，并获得有关该计划可行性和短期影响的详细数据33 方案参与者。组内（前后测）设计将检查该计划的短期影响。一 将招募总共33名诊断为0 - 3期癌症的父母，从每个Beta研究中心的活跃研究人员中抽取。 招聘渠道。符合条件的父母将有一个孩子5 - 17岁，读，写，说英语，其中 他们选择的语言。在同意并获得基线测量后，研究参与者将获得5 每两周一次的完全手工化的集体教育咨询课程。成果将 在出境时使用与测试EC功效相同的标准化措施进行评估。与 33个父母的样本，效应量范围从中等到大：0.51 - 1.16; p值范围从0.008到 <0.001。从长远来看，结果将用于为更大的实施拨款和临床试验提供信息。

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.