Addressing behavioral impacts of childhood leukemia: A feasibility pilot randomized controlled trial of a group videoconferencing parenting intervention

https://doi.org/10.1016/j.ejon.2016.08.008Get rights and content

Highlights

  • Engaging and retaining parents in an intervention in an oncology context is difficult.

  • Parents completing study reported high levels of feasibility, acceptability, and satisfaction.

  • With support, improvements in parenting skills and competence may be achieved.

Abstract

Purpose

Child emotional and behavioral problems constitute significant sequelae of acute lymphoblastic leukemia (ALL) treatment. The aims of this study were to a) examine the feasibility, acceptability and satisfaction of a parenting intervention amongst parents of children with ALL and b) explore whether participation in a parenting intervention shows promise for improvements in child behavior.

Methods

12 parents with a child aged between 2 and 8 years receiving maintenance phase treatment for ALL participated in a phase 2 randomized controlled trial comparing eight weeks of group online participation in Triple P: Positive Parenting Program with no intervention.

Results

The number of eligible parents who completed the intervention was low (31.6%). Main reasons for non-consent or dropout were program time commitment too high or content not relevant. For parents who completed the intervention, satisfaction and acceptability was high. Parents reported the intervention as highly relevant and topical, feasible, helpful and a positive experience. Results indicated a non-significant trend towards improved total child behavioral and emotional difficulties following the intervention. Qualitative results indicated that intervention group parents reported improvements in parenting skills and competence, and decreased child behavioral problems.

Conclusions

These pilot data highlight the difficulties of engaging and retaining parents in an 8-week parenting intervention in this context. For parents who completed the intervention, results indicated high feasibility, acceptability and satisfaction. Suggestions for further research and intervention modifications are provided to enhance uptake and strengthen efforts to assist parents in addressing child behavioral and emotional challenges during ALL treatment.

Section snippets

Background

Despite high survival rates, treatments for pediatric acute lymphoblastic leukemia (ALL), contribute to psychological morbidity. A commonly reported and distressing psychological impact of ALL treatment, occurring in up to 86% of children, is behavioral and mood disturbance (Pound et al., 2012, Williams et al., 2014, Williams and McCarthy, 2015). Child emotional “outbursts” including physical and verbal aggression, anxiety, moodiness, irritability, as well as behavioral difficulties, such as

Participants

Eligible participants were parents with a child aged between 2 and 8 years receiving maintenance phase treatment for ALL at the Children's Cancer Centre, Royal Children's Hospital, Melbourne Australia (RCH CCC). Study exclusion criteria included being a non-English speaking parent and having a child who had a co-existing developmental disorder or disability. Eleven of the 12 participants were in a married/defacto relationship. Maintenance phase treatment typically commences 12 months

Results

There were no group differences in baseline child and parent sociodemographic variables or parent reported total child emotional and behavioral difficulties (Table 1).

Discussion

The purpose of this study was to examine the feasibility, acceptability and satisfaction of a parenting intervention amongst parents of children with ALL. Results indicated that, for parents completing the intervention, satisfaction and acceptability were high. In terms of intervention feasibility, study completion by eligible parents was low (31.6%), and lower than that observed elsewhere (Fedele et al., 2013, Sassmann et al., 2012). The majority of parents who declined to participate or

Conclusion

In conclusion, results of the current study show preliminary support for the feasibility, acceptability and satisfaction of a parenting intervention. The importance of parenting interventions during key stages of child development and when co-occurring with chronic childhood illness cannot be underestimated. Furthering our understanding of not only the type of intervention that may assist families in a pediatric oncology context, but also the feasibility of implementing support, is paramount to

Conflicts of interest

The authors declare there are no conflicts of interest.

Acknowledgements

This study was funded by the Ponting Foundation, Murdoch Childrens Research Institution and the Victorian Government Department of Human Services and Operational Infrastructure Support Program. We gratefully acknowledge the parents who participated in the study, and Madeleine Bowden and Erin Lloyd, the project research assistants who assisted with participant recruitment and provided technical support during video-conference sessions.

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