In 2014, an estimated 1.2 million parents of school age children will be newly diagnosed with cancer in the U.S. 2 Parental cancer causes significant emotional distress in both diagnosed parents and their children. African 3 American (AA) adults experience a disproportionate burden of solid tumor cancers (e.g., breast, prostate, colo- 4 rectal, and lung) which puts AA adolescents; a vulnerable population to begin with, at high risks for parental cancer 5 related distresses. Treatments have been somewhat successful for younger school age children (ages 7-12) of 6 cancer patients but most treatment studies have included white middle class samples. Differences in attitudes, 7 daily functioning and levels of distress among different ethnic and racial groups are well-documented, yet few 8 culturally sensitive family intervention programs have been developed for AA families coping with cancer. 9 Building on the PI's previous studies with AA families coping with parental cancer, we propose to conduct a 10 randomized control trial to address this gap. We will evaluate the efficacy of a culturally sensitive family-based 11 intervention that targets the parent-child relationship in AA families coping with the impact of solid tumor parent- 12 tal cancer. We will randomize 172 AA families coping with parental cancer to either Families Fighting Cancer 13 Together (FFCT) or to parent psycho-education (TAU). Both manualized treatments include 5 bi-monthly ses- 14 sions over 10 weeks. Subjects will be African American parents diagnosed in the past 12 months with Stage I, 15 II, or III solid tumor cancers with at least one child between the ages of 12 and 18 living at home. Patients will 16 be recruited from 3 large urban cancer centers where there is an estimated 500 eligible low to middle income 17 AA cancer patients a year. Family assessments will be done at baseline, post-treatment (10 weeks), 6-month, 18 and 12-month follow-up. The proposed R01 research has the following aims:
Aim 1 : Compare the efficacy of 19 FFCT to TAU in reducing depressive symptoms (CDI) in AA adolescents at post-treatment and long term out- 20 come (6 and 12-month follow-up).
Aim 2 : Compare the efficacy of FFCT to TAU in reducing parental stress 21 (PCQ: parental stress related to coping with cancer) in AA parents at post-treatment and long term outcome (6 22 and 12-month follow-up). Exploratory Aims: 1. Explore whether moderators identified in white samples have a 23 similar impact on treatment in AA samples. Specifically, we will examine: a) perceived level of group support, 24 b) gender and age of adolescent, c) parent's marital status, d) SES, and e) stage of parent's cancer on the im- 25 pact of treatment. 2. Explore whether changes in parent-child attachment and communication mediate the as- 26 association between treatment and adolescent depressive symptoms (CDI) and anxiety (RCMAS) at 6 and12- 27 month follow-up. Treatments to help adolescents cope with the impact of parental cancer are needed, particu- 28 larly those designed to reach low-income AA populations. If the proposed research is successful, it will change 29 the nature of treatment support options available to a group that is overrepresented and underserved by exist- 30 ing interventions and reduce potentially harmful distress among AA adolescents.
This project directly addresses cancer health disparities, which is relevant to NCI's mission. Treatments to help adolescents cope with the impact of parental cancer are urgently needed, particularly those designed to reach low-income African American populations. Developing an effective and transportable family-based intervention for this population could improve developmental adjustment to this significant life stressor at a critical point in the lives of African American adolescents.
| McKinney, Nicole S; Virtue, Shannon; Lewis, Frances Marcus et al. (2018) Study protocol: a randomized control trial of African American families fighting parental cancer together. BMC Cancer 18:1140 |
| Elias, Merrill F; Torres, Rachael V; Davey, Adam (2018) Parameters of Left Ventricular Mass and Dementia: Moving the Literature Forward. Hypertension 71:411-412 |
| Elias, Merrill F; Torres, Rachael V; Davey, Adam (2018) Clinical Trials of Blood Pressure Lowering and Antihypertensive Medication: Is Cognitive Measurement State-of-the-Art? Am J Hypertens 31:631-642 |
