While psychosocial services for children with cancer and their families are available in most cancer treatment centers, this care may be enhanced and delivered with greater effectiveness with systematic assessment instruments that can accurately identify risk factors for ongoing psychosocial adjustment or difficulties. We have developed and conducted a preliminary feasibility pilot study of a 20 item screening instrument, the Psychosocial Assessment Tool (PAT) for families of children newly diagnosed with cancer. The PAT includes questions for l 0 domains of risk, based on the research literature and clinical practice: Family Structure; Family Resources; Social Support; Child Knowledge; School; Child Emotional and Behavioral Concerns; Child Maturity for Age; Marital/Family Problems; Family Beliefs; and Other Stressors. In the present study we propose to develop scoring criteria for the PAT and to evaluate it by determining its psychometric properties (short-term and 6 month test-retest reliability and concurrent, construct, and predictive validity). 140 families of children newly diagnosed with cancer at The Children's Hospital of Philadelphia (CHOP) will be recruited and asked to complete the PAT and questionnaires assessing parental, child and family functioning at diagnosis and 6 months subsequently. Data will also be obtained from oncologist and nurse ratings of family risk and function. We will also measure hospital resource utilization (e.g., social work and psychological interventions, extent/intensity of nursing/medical attention to psychosocial issues, and use of other hospital resources). An external panel of multidisciplinary experts in pediatric oncology will assist in determining the scoring and weighting of items. Our hypotheses and related statistical analyses will test associations among parent and staff assessments of family risk and the predictive ability of the PAT to identify those families with ongoing psychosocial difficulty and elevated levels of resource utilization. The PAT is novel in its brief empirical approach to determining family risk in pediatric oncology. By reliably identifying families with varying levels of risk at diagnosis we may develop subsequent interventions which match their level of need over the course of treatment.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Aziz, Noreen M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Children's Hospital of Philadelphia
United States
Zip Code
Kazak, Anne E; Schneider, Stephanie; Didonato, Stephen et al. (2015) Family psychosocial risk screening guided by the Pediatric Psychosocial Preventative Health Model (PPPHM) using the Psychosocial Assessment Tool (PAT). Acta Oncol 54:574-80
Alderfer, Melissa A; Mougianis, Ifigenia; Barakat, Lamia P et al. (2009) Family psychosocial risk, distress, and service utilization in pediatric cancer: predictive validity of the Psychosocial Assessment Tool. Cancer 115:4339-49
Patino-Fernandez, Anna Maria; Pai, Ahna L H; Alderfer, Melissa et al. (2008) Acute stress in parents of children newly diagnosed with cancer. Pediatr Blood Cancer 50:289-92
Pai, Ahna L H; Patino-Fernandez, Anna Maria; McSherry, Mary et al. (2008) The Psychosocial Assessment Tool (PAT2.0): psychometric properties of a screener for psychosocial distress in families of children newly diagnosed with cancer. J Pediatr Psychol 33:50-62
Kazak, Anne E; Rourke, Mary T; Alderfer, Melissa A et al. (2007) Evidence-based assessment, intervention and psychosocial care in pediatric oncology: a blueprint for comprehensive services across treatment. J Pediatr Psychol 32:1099-110
Kazak, Anne E; Baxt, Chiara (2007) Families of infants and young children with cancer: a post-traumatic stress framework. Pediatr Blood Cancer 49:1109-13