Research Project
10238130
? DESCRIPTION (provided by applicant): In 2015, an estimated 340,000 parents of school age children will be newly diagnosed with cancer in the U.S. Parental cancer causes significant emotional distress in both diagnosed parents and children. African American (AA) adults experience a disproportionate burden of solid tumor cancers (e.g., breast, prostate, lung, and colon) which puts AA adolescents, a vulnerable population to begin with, at high risk for parental cancer related distress. Treatments have been somewhat successful for younger school age children (ages 7-12) of cancer patients but most treatment studies have included white middle class samples. Differences in attitudes, daily functioning and levels of distress among different ethnic and racial groups are well-documented, yet few culturally sensitive family intervention programs have been developed for AA families coping with cancer. Building on the PI's previous studies with AA families coping with parental cancer, we propose to conduct a randomized control trial to address this gap. We will of a culturally sensitive family-based intervention that targets the parent child relationship in AA families coping with the impact of solid tumor parental cancer. We will randomize 172 AA families coping with parental cancer to either Families Fighting Cancer Together (FFCT) or to parent psycho-education (TAU). Both manualized treatments include 5 bi-monthly sessions over 10 weeks. Subjects will be African American parents diagnosed for the first time in the past 12 months with Stage I, II, or III solid tumor cancers with at least one child between the ages of 12 and 18 living at home. Patients will be recruited from 3 large inner city cancer centers where there is an estimated 500 eligible low to middle income AA cancer patients a year. Family assessments will be done at baseline, post-treatment (10 weeks), 6-month, and 12-month follow-up. The proposed R01 research has the following aims: Aim 1: Compare the efficacy of FFCT to TAU in reducing depressive symptoms (CDI) and anxiety (RCMAS) in AA adolescents at post-treatment and long term outcome (6 and 12-month follow-up). Aim 2: Compare the efficacy of FFCT to TAU in reducing parental stress (PCQ: impact of illness on child/concerns about parenting) in AA parents at post-treatment and long term outcome (6 and 12-month follow-up). Exploratory Aims: 1. Explore whether moderators identified in Caucasian samples have a similar impact on treatment in AA samples. Specifically, we will examine: a) perceived level of group support, b) gender and age of adolescent, c) parent's marital status, d) SES, and e) stage of parent's cancer on the impact of treatment. 2. Explore whether changes in parent-child attachment and communication mediate the association between treatment and depressive symptoms (CDI) and anxiety (RCMAS) at 6 and12-month follow-up. Treatments to help adolescents cope with the impact of parental cancer are urgently needed, particularly those designed to reach low-income AA populations. Developing effective and transportable family-based interventions for this population could improve developmental adjustment to this significant life stressor at a critical point in the livesof adolescents.
