Wonders and Worries: Outcomes of a Program Evaluation for Children Facing Parental Cancer

Background and Purpose:

An estimated 2.85 million U.S. children have a parent diagnosed with cancer.  Stress of a parent’s cancer diagnosis can lead to a variety of psychosocial challenges among children.  Despite the large numbers of families affected by parental cancer, few child-focused interventions exist to help them deal with the stress of a cancer diagnosis.  The purpose of this study is to evaluate child psychosocial outcomes following their participation in a child-focused intervention for families experiencing parental cancer. 

Methods:

This study analyzed cross-sectional secondary data from survey results collected between 2009 - 2015 as part of a program evaluation.  Participants included families (N=165) in which either the father or mother was diagnosed with cancer and whose child(ren) participated in Wonders and Worries, a child-focused intervention designed to improve psychological well-being.  Within 6 months following completion of the intervention, parents reported whether their children demonstrated changes in nine psychosocial domains: sleep behaviors, eating issues, school performance, peer interactions, feeling secure at home, anxiety and nervousness, communication about their parent’s illness, and their ability to separate from their parent.  Logistic regression models were constructed using each of these domains as dependent variables (improved vs. did not improve following the intervention). Predictive covariates used in all models included which parent was diagnosed with cancer, annual income, the child’s age, race, and gender, the child’s ability to communicate about the illness following the intervention (improved vs. did not improve), time between diagnosis and seeking intervention services, and child participation in group or individual support.

Results:

Improvement in the ability of the child to communicate about the illness following the intervention was more likely to be associated with improvement in sleep behaviors [OR 14.6, 95%CI(1.16,185)], improved feelings of security at home [OR 18.33, 95%CI(1.84,182)], and reduced feelings of anxiety or nervousness [OR 12.94, 95%CI(3.14,53.4)].  As compared with families who sought services within 3 months of cancer diagnosis, those who presented for the intervention more than 3 months beyond a diagnosis were less likely to report improvement with a child’s peer interactions [OR .12, 95%CI(.02,.65)] and less likely to report improvement in their relationship with the ill family member [OR .10, 95%CI(.01, .70)].  Improvements in peer interactions were more likely if the parent diagnosed with cancer was the mother [OR.18, 95%CI(.03,.95)].  Families reported that the boys were more likely to demonstrate improvements in sleep behavior than girls [OR .16, 95%CI (,03, .82)].  No significant differences in outcomes associated with participation in either individual or group support were found.   

Conclusions and Implications:

This study demonstrated that parents with cancer report that their children show improved psychological outcomes when participating in a child-focused psychosocial intervention.  Because parents with cancer report that one of their biggest concerns is the well-being of their young children, these results also have the potential to improve the psychological outcomes for parents.  Future intervention studies utilizing control groups and standardized measures are needed to evaluate interventions for children facing parental cancer.