Grant Details
Grant Number: |
1R01CA261793-01A1 Interpret this number |
Primary Investigator: |
Patel, Sunita |
Organization: |
Beckman Research Institute/City Of Hope |
Project Title: |
Leveraging Digital Health Solutions to Reduce Learning and Functional Disparities in Children with Cancer |
Fiscal Year: |
2022 |
Abstract
PROJECT SUMMARY/ABSTRACT
As the population of childhood cancer survivors grows, the impact of long-term treatment-related side effects
also grows. Cancer treatments for children with leukemia and lymphoblastic lymphoma (LL) have long-lasting
toxic effects on the developing brain, known as neurocognitive late effects, which can impact the children’s
learning, function, and ability to achieve independence as adults. However, these problems are often untreated
in leukemia and LL survivors, creating a medically underserved population. Recognizing the impact of familial
factors on survivor outcomes, we designed a parent-directed training intervention (the high-intensity intervention
program, HIP), which teaches parents about brain development and neurocognitive late effects; trains them on
tools to improve their child’s behavior and cognitive functioning; provides tips for establishing better learning
environments and effective study habits; and helps them to manage stress for themselves and their children.
Pilot trials of the HIP in English- and Spanish-speaking families demonstrated efficacy but also revealed critical
barriers to success, including travel time and scheduling challenges. Digital health technologies offer
transformative solutions to improve the efficiency, quality, and convenience of healthcare delivery. However,
“eHealth” has not been applied to a parent-directed intervention to improve educational outcomes for children.
Therefore, we propose to test a new eHealth version of our English/Spanish intervention (HIP-eHealth) in a
randomized clinical trial of 180 parent/child dyads from 4 sites in California. HIP-eHealth addresses the remaining
barriers to HIP access and incorporates improvements recommended by parents in our earlier trials. We will
deliver HIP-eHealth from a single central site (City of Hope) through a HIPAA-compliant study website that hosts
Zoom videoconferencing for HIP sessions; digitized study content; supplemental multimedia content; links to the
award-winning IXL learning environment; gamification features and automated reminders to increase
engagement; and robust user analytics. Other advances include a streamlined 4-session program, an enhanced
booster phase, and greater inclusion of the children. We hypothesize that HIP-eHealth will produce greater
improvements in child and parent outcomes than a lower-intensity program (LIP) that mimics the usual care
provided to survivors of pediatric brain tumors (i.e., a single meeting to discuss the child’s neuropsychological
testing results and provide recommendations for optimal learning). Our study aims to: (1) Evaluate the
effectiveness of HIP-eHealth on the learning and school performance of pediatric cancer survivors; (2) Evaluate
the effectiveness of HIP-eHealth on the “pro-learning” efficacy of their parents; (3) Investigate the extent to which
the parents’ efficacy and/or children’s use of online learning activities is associated with changes in the children’s
school performance; and (4) Assess factors that impact the parents’ ability to complete the intervention. We
anticipate this study will help shape a scalable and effective therapy that is easily integrated into standard care.
Publications
Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study.
Authors: Nakamura Z.M.
, Small B.J.
, Zhai W.
, Ahles T.A.
, Ahn J.
, Artese A.L.
, Bethea T.N.
, Breen E.C.
, Cohen H.J.
, Extermann M.
, et al.
.
Source: Journal Of Cancer Survivorship : Research And Practice, 2023-11-04 00:00:00.0; , .
EPub date: 2023-11-04 00:00:00.0.
PMID: 37924476
Related Citations
Inflammation-related proteins as biomarkers of treatment-related behavioral symptoms: A longitudinal study of breast cancer patients and age-matched controls.
Authors: Patel S.K.
, Breen E.C.
, Paz I.B.
, Kruper L.
, Mortimer J.
, Wong F.L.
, Bhatia S.
, Irwin M.R.
, Behrendt C.E.
.
Source: Brain, Behavior, & Immunity - Health, 2023 Oct; 32, p. 100670.
EPub date: 2023-07-31 00:00:00.0.
PMID: 37637432
Related Citations
Epigenetic aging in older breast cancer survivors and non-cancer controls: preliminary findings from the Thinking and Living with Cancer (TLC) Study.
Authors: Rentscher K.E.
, Bethea T.N.
, Zhai W.
, Small B.J.
, Zhou X.
, Ahles T.A.
, Ahn J.
, Breen E.C.
, Cohen H.J.
, Extermann M.
, et al.
.
Source: Cancer, 2023-06-01 00:00:00.0; , .
EPub date: 2023-06-01 00:00:00.0.
PMID: 37259669
Related Citations
Genetic Variants Associated with Longitudinal Cognitive Performance in Older Breast Cancer Patients and Controls.
Authors: Nudelman K.
, Nho K.
, Zhang M.
, McDonald B.C.
, Zhai W.
, Small B.J.
, Wegel C.E.
, Jacobsen P.B.
, Jim H.S.L.
, Patel S.K.
, et al.
.
Source: Cancers, 2023-05-23 00:00:00.0; 15(11), .
EPub date: 2023-05-23 00:00:00.0.
PMID: 37296840
Related Citations
Plasma levels of interleukin-6 mediate neurocognitive performance in older breast cancer survivors: The Thinking and Living With Cancer study.
Authors: Mandelblatt J.S.
, Small B.J.
, Zhou X.
, Nakamura Z.M.
, Cohen H.J.
, Ahles T.A.
, Ahn J.
, Bethea T.N.
, Extermann M.
, Graham D.
, et al.
.
Source: Cancer, 2023-04-25 00:00:00.0; , .
EPub date: 2023-04-25 00:00:00.0.
PMID: 37096888
Related Citations