Families Addressing Cancer Together (FACT): A Pilot Study Testing Individually Tailored Communication Guidance for Parents with Cancer

Friday, November 12, 2021

4:00 PM - 5:00 PM US Eastern Time

Background: Serious illness in a parent threatens the mental health of the entire family. When a parent has cancer, their children experience increased short- and long-term risk for emotional and behavioral problems (Krattenmacher, 2012). Parents with cancer experience more depression and anxiety and lower quality of life than patients with cancer and no minor children (Nilsson, 2009). Parents’ concerns about discussing their illness with their children contribute to their distress (Semple, 2010), but widespread interventions to support their communication concerns are lacking. The aims of this study are to assess the feasibility, acceptability and potential efficacy of the Families Addressing Cancer Together (FACT) intervention. FACT is a theory-informed, individually tailored psycho-educational intervention for parents with cancer to improve communication with their children.

Methods: This is a single group pilot study using a pretest-posttest design. Eligible participants were adult patients with a solid tumor who identified as a parent of a child age 3-18 years old. After completing baseline assessments and a brief tailoring questionnaire, participants received FACT’s customized communication guidance materials. Participants completed follow-up assessments 2- and 12-weeks post-intervention. We assessed study feasibility by enrollment and retention rates; we assessed acceptability using a 4-point satisfaction scale ( >75% acceptability threshold) and semi-structured interviews. We used paired t-tests to examine changes from baseline to 2-weeks post intervention for anxiety and depression symptoms, communication self-efficacy, quality of life, and communication behaviors. This study was IRB-approved and registered with clinicaltrials.gov (NCT04342871).

Results: Participants (n=44) were predominantly White (82%), with a mean age of 43.7 years (SD=6.8); 63% were female. Among eligible participants approached about the study, 83% consented to enrollment and 68% completed follow-up assessments. Most participants reported FACT was helpful (90%), relevant (95%), and easy to understand (100%). All participants reported satisfaction with the intervention. Communication self-efficacy scores significantly increased from pre- to post-intervention (t(23)= -2.4, p=0.02). Anxiety and depression scores did not change.

Discussion: FACT demonstrated feasibility, acceptability, and promising effects to improve parental communication self-efficacy. This study provides support for future research to test the potential impact of FACT to reduce parental anxiety and improve quality.

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Conclusion: Individually tailored communication guidance may assist parents with cancer with their communication concerns with their children.

References:
1. Krattenmacher T, et al. Parental cancer: Factors associated with children’s psychosocial adjustment – a systematic review. J Psychosom Res. 2012; 72(5):344-356.
2. Nilsson ME, et al. Mental health, Treatment Preferences, Advance Care Planning, Location, and Quality of Death in Advanced Cancer Patients with Dependent Children. Cancer 2009;115:399-409.
3. Semple CJ, et al. Parents’ Experience of Cancer Who Have Young Children. Cancer Nursing 2010; 33(2):110-118.

Learning Objectives:

Participants will be able to identify the communication concerns that contribute to parental distress in cancer
Participants will be able to describe strategies for the assessment of feasibility and acceptability in pilot trials

Presenting Author(s)

Eliza Park, MD, FACLP

Assistant Professor
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States

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Co-Author(s)

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Allison Deal, MS

Biostatistician
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Savannah Bowers

Clinical Research Coordinator
Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, United States
Justin Yopp, PhD

Psychologist | Associate Professor
University of North Carolina
Raleigh, North Carolina, United States
BO

Brandon Oby

Clinical Research Assistant
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
AC

Anna Cassidy

Clinical Research Assistant
Department of Psychiatry
Chapel Hill, NC, North Carolina, United States
Brian Yi

Clinical Research Assistant
University of North Carolina at Chapel Hill
Carrboro, North Carolina, United States
Samantha Yi

Clinical Research Assistant
UNC-Chapel Hill
Chapel Hill, North Carolina, United States
RC

Riley Craig

Research Assistant
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
RM

Rahul Mehra

Research Assistant
University of North Carolina at Chapel Hill
Germantown, Tennessee, United States
DG

Dallis Guilliams

Clinical Research Assistant
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Ahrang Jung, PhD, RN

Postdoctoral Fellow
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Donald L. Rosenstein, MD, FACLP

Division Head, General Adult Psychiatry
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States