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Author Notes:

Sheri L. Robb, PhD, MT-BC, Indiana University School of Nursing, 600 Barnhill Dr, NU 433, Indianapolis, IN 46202. Email: shrobb@iu.edu

J.E.H., K.S., and S.L.R. serve as co-first authors. R.H.P. was affiliated with Cincinnati Children’s Hospital Medical Center at the time the study was conducted. J.S. was affiliated with Aflac Cancer & Blood Disorders at Children’s Healthcare of Atlanta at the time the study was conducted. E.G.-F. was affiliated with the University of Texas Health Science Center at San Antonio at the time the study was conducted.

The authors wish to thank all the members of the SMART II research team who made this study possible including patients/families, board-certified music therapists, nurses, physicians, certified research associates, data managers, and many others.

Special thanks to Jefri Franks (parent consultant), and to the participating hospitals: Riley Children’s Hospital and Indiana University Hospital, Indianapolis, Indiana; Children’s Mercy Hospitals and Clinics, Kansas City, Missouri; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Cook Children’s Medical Center, Fort Worth, Texas; Children’s Hospitals & Clinics of Minnesota, Minneapolis, Minnesota; Christus-Santa Rosa Children’s Hospital, San Antonio, Texas; and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio. In addition, thanks to Dr Ha Dang, COG biostatistician, who provided statistical review of the article.

The authors have no conflicts of interest to disclose.


Research Funding:

This study was supported by NIH/NCI R01CA162181, U10CA180886 (NCTN Operations Center Grant), U10CA098543 (COG Chair’s Grant), UG1CA189955 (NCORP Grant), U10CA095861 (CCOP Grant), and U10CA180899 (NCTN Statistics & Data Center Grant).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • Nursing
  • Adolescents
  • Cancer
  • Communication
  • Family caregiver
  • Parents
  • Self-management
  • Stress
  • Young adults

Randomized Clinical Trial of a Self-care and Communication Intervention for Parents of Adolescent/Young Adults Undergoing High-Risk Cancer Treatment A Report From the Children's Oncology Group

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Journal Title:



Volume 45, Number 4


, Pages 316-331

Type of Work:

Article | Final Publisher PDF


Background Parents of adolescents and young adults (AYAs) with cancer offer primary support to their children and often experience their own high levels of distress, affecting parent-AYA communication and quality of life. Objective To reduce parent distress and improve communication during high-risk cancer treatment, we examined efficacy of a self-care and communication intervention for parents and indirect benefit for AYAs receiving a therapeutic music video (TMV) intervention. Methods In this study, we conducted a multisite, randomized controlled trial with AYAs and parents enrolled as dyads (n = 110). Parents were randomized to intervention or low-dose control; all AYAs received TMV. Data collection occurred at baseline, 2 weeks post intervention (T2), and 90 days post intervention (T3). Results There were no significant between-group differences on primary outcomes for parents or AYAs. We did find significant differences favoring the parent intervention group on parenting confidence at T2 and marginally better outcomes for family adaptability/cohesion at T3. Both groups exhibited significant within-group improvement for parent distress (state anxiety, T3; perceived stress, T2 and T3; mood, T3), state anxiety (T2) intervention only, and family strengths control group only. Qualitative data demonstrate the parent intervention raised self-awareness and parent confidence in the short term. Conclusion Parents found their intervention helpful. Absence of significant results may be due to short intervention duration, need for tailored content, underpowered sample, and potential indirect parent benefit from AYA participation in TMV. The parent intervention did not provide an indirect benefit for AYAs. Implications for Nursing Parents identified their own need for communication and support from nurses. Nurses can optimize AYA care by attending to parent needs through supportive listening and encouraging self-care.

Copyright information:

© 2021 The Authors. Published by Wolters Kluwer Health, Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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