) Our work to date has shown that PSST is a highly promising educational intervention which reduces negative affectivity (anxiety, stress) experienced by mothers of children newly diagnosed with cancer. The proposed project has 3 primary aims: (1) to identify factors that moderate the feasibility/effectiveness of PSST, (2) to develop and complete a randomized clinical trial of a Spanish-language PSST curriculum, and (3) to develop and complete a randomized clinical trial of an interactive multimedia, technology-based PSST curriculum. The customized PSST curriculum we designed, """"""""Bright IDEAS,"""""""" consists of 8, 1-hr sessions addressing the 5 basic steps of problem-solving: (1) problem orientation, (2) problem identification, (3) generation of alternative solutions, (4) decision-making, and (5) solution implementation and verification of outcome. Support materials include (1) a simple parent brochure, (2) written supplements, (3) a problem-solving index (skill inventory), and (4) an orientation module for PSST trainers. Pilot testing with 36 learners (L) +36 controls (C) (total N=72) used a repeated-measures randomized design to assess the efficacy of PSST on problem-solving ability (primary outcome) and negative affectivity and cancer-related knowledge (secondary outcomes). Data from Time 1 (pre) and Time 2 (immediately post) reveal significant differences in the desired direction between L and C for both skills acquisition and mood state. Limitations include (1) variable ability of mothers to implement PSST; (2) exclusion of Spanish-speaking families; and (3) inability to adapt the current PSST to accommodate the unpredictable competing demands placed on mothers. The proposed project capitalizes on a 10-year research collaboration to enroll 240 Ls and 240 Cs at 7 sites in the U.S. and 1 in Israel. Learning style and stress level will be assessed to identify best candidates for PSST. Spanish translation will increase the eligible Hispanic population from less than 15 percent to 35 percent. An engaging and accessible technology-based prototype will be developed to appeal to low literacy mothers, accommodate multilingual transmission, and permit user-user (mother-mother; mother-instructor) networking for instruction and support.
