Although the importance of psychosocial screening in sickle cell disease (SCD) has been emphasized by the National Heart Lung and Blood Institute and the American Academy of Pediatrics, screening is not currently implemented in a systematic manner, due in part to the lack of reliable, valid, and culturally sensitive screening instruments. The proposed mentored research will investigate the Psychosocial Assessment Tool (PAT) as an acceptable evidence-based caregiver-report screener of psychosocial risk and resilience in pediatric SCD. PAT items reflect theoretically and clinically relevant domains based on social ecological theory and the Pediatric Preventative Psychosocial Health Model. To date, the PAT has been used primarily in the pediatric cancer population. Given potential distinctions between SCD and pediatric cancers, particulariy with respect to socioeconomic characteristics, health disparities, cultural factors, and the ongoing burden of the disease, it is critical to establish reliable and valid aspects of psychosocial risk specific to SCD. Part 1 of this research proposal uses a mixed-methods approach to evaluate the acceptability of completing the PAT in a sample of 30 primary caregivers of children (birth to 21 years) with SCD. These caregivers will be asked to provide qualitative feedback regarding their experience of completing the PAT, to inform the need to modify the PAT to better fit the SCD population, rendering a SCD version of the PAT (PAT-SC). In Part 2, 170 primary caregivers of children (birth to 20 years) will be recruited to complete the PAT-SC and other clinically relevant outcome measures at three time points (baseline, 6-month, and 12-month follow up). Clinically important health and school outcomes will be assessed through the electronic health record and school data, which will also be gathered at the three time points. Data analyses will include exploratory and confirmatory factor analyses, tests of association of the PAT-SC and clinically relevant health outcomes, and psychometric evaluations (reliability, validity). At the conclusion of the study we anticipate having an acceptable and valid psychosocial screener that can enhance the delivery of evidence based care to SCD families in order to reduce health disparities and promote wellbeing.

Public Health Relevance

The importance of screening for psychosocial risk in sickle cell disease (SCD) has long been emphasized by the National Health Institutes. Children and families coping with SCD often deal with many psychosocial difficulties and socioeconomic stressors. Systematic psychosocial screening in SCD is limited by the lack of reliable and valid screeners;the proposed study will establish the acceptability and validity of the Psychosocial Assessment Tool (PAT^ for the SCD population

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Exploratory Grants (P20)
Project #
1P20GM109021-01
Application #
8662856
Study Section
Special Emphasis Panel (ZGM1)
Project Start
Project End
Budget Start
2014-08-01
Budget End
2015-04-30
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Alfred I. Du Pont Hosp for Children
Department
Type
DUNS #
City
Wilmington
State
DE
Country
United States
Zip Code
19803
Bialk, Pawel; Wang, Yichen; Banas, Kelly et al. (2018) Functional Gene Knockout of NRF2 Increases Chemosensitivity of Human Lung Cancer A549 Cells In Vitro and in a Xenograft Mouse Model. Mol Ther Oncolytics 11:75-89
Modarai, Shirin R; Man, Dula; Bialk, Pawel et al. (2018) Efficient Delivery and Nuclear Uptake Is Not Sufficient to Detect Gene Editing in CD34+ Cells Directed by a Ribonucleoprotein Complex. Mol Ther Nucleic Acids 11:116-129
Bloh, Kevin M; Bialk, Pawel A; Gopalakrishnapillai, Anilkumar et al. (2017) CRISPR/Cas9-Directed Reassignment of the GATA1 Initiation Codon in K562 Cells to Recapitulate AML in Down Syndrome. Mol Ther Nucleic Acids 7:288-298
Rivera-Torres, Natalia; Banas, Kelly; Bialk, Pawel et al. (2017) Insertional Mutagenesis by CRISPR/Cas9 Ribonucleoprotein Gene Editing in Cells Targeted for Point Mutation Repair Directed by Short Single-Stranded DNA Oligonucleotides. PLoS One 12:e0169350
Bialk, Pawel; Sansbury, Brett; Rivera-Torres, Natalia et al. (2016) Analyses of point mutation repair and allelic heterogeneity generated by CRISPR/Cas9 and single-stranded DNA oligonucleotides. Sci Rep 6:32681