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Grant Details

Grant Number: 5R01CA098954-04 Interpret this number
Primary Investigator: Sahler, Olle Jane
Organization: University Of Rochester
Project Title: Maternal Problem-Solving Training in Childhood Cancer
Fiscal Year: 2006


Abstract

DESCRIPTION (provided by applicant): Research and experience document that caregivers, especially, mothers of children with cancer encounter extraordinary stresses during the child's illness. These stresses are particularly severe during diagnosis and induction therapy and can interfere significantly with caregivers' ability to make reasoned and timely decisions on their children's behalf. With increasing survivor rates, it has become evident that decisions made in the early stages of cancer management can have profound, long-term effects, adding to the distress caregivers feel trying to make the "right" decisions. To help mothers of newly diagnosed children cope more effectively with these challenges, we conducted two randomized trials as part of our previous work (R25-CA65520) to develop, field test, and evaluate the efficacy of problem-solving skills training (PSST), a cognitive behavioral therapy shown to decrease anxiety and depression --- two symptoms of post-traumatic stress commonly experienced among this group of mothers. We also pilot tested a multimedia, technology-based PSST enhancement, Carmen's Bright IDEAS. Our findings clearly show that PSST significantly increases problem-solving skills (primary effect) and decreases negative affectivity (secondary effect) in mothers from a variety of racial, ethnic, and socioeconomic backgrounds. Particularly powerful and long-lasting effects were noted in Spanish-speaking mothers, an especially underserved population. At this stage, it is essential that we investigate PSST as rigorously as possible by testing its clinical effectiveness against an active control and that we intensify the intervention to extend its duration of action among all users. These goals are the basis for the 4-5 aims of the proposed project. Aim 1" To develop a time-and-attention control condition to better assess the direct and mediational effects of PSST independent of social support (placebo). Aim 2: To develop a personal digital assistant hand-held supplement to standard PSST to provide real-time training, reinforcement, and on-the-spot documentation of PSST usage. Aim 3 A, B: To develop independent measures of the application of problem-solving strategies in everyday life. Aim 4: To measure utilization of and satisfaction with other resources accessed by mothers as independent indicators of the usefulness and cost-effectiveness of PSST. (Aim 5) To incorporate a maintenance phase into the PSST protocol to promote longer term change.



Publications

Evaluation Of The Psychometric Properties Of The Pediatric Parenting Stress Inventory (ppsi)
Authors: Devine K.A. , Heckler C.E. , Katz E.R. , Fairclough D.L. , Phipps S. , Sherman-Bien S. , Dolgin M.J. , Noll R.B. , Askins M.A. , Butler R.W. , et al. .
Source: Health Psychology : Official Journal Of The Division Of Health Psychology, American Psychological Association, 2014 Feb; 33(2), p. 130-8.
PMID: 23544994
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Specificity Of Problem-solving Skills Training In Mothers Of Children Newly Diagnosed With Cancer: Results Of A Multisite Randomized Clinical Trial
Authors: Sahler O.J. , Dolgin M.J. , Phipps S. , Fairclough D.L. , Askins M.A. , Katz E.R. , Noll R.B. , Butler R.W. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2013-04-01 00:00:00.0; 31(10), p. 1329-35.
PMID: 23358975
Related Citations

Report From A Multi-institutional Randomized Clinical Trial Examining Computer-assisted Problem-solving Skills Training For English- And Spanish-speaking Mothers Of Children With Newly Diagnosed Cancer
Authors: Askins,M.A. , Sahler,O.J. , Sherman,S.A. , Fairclough,D.L. , Butler,R.W. , Katz,E.R. , Dolgin,M.J. , Varni,J.W. , Noll,R.B. , Phipps,S. .
Source: Journal Of Pediatric Psychology, 2009 Jun; 34(5), p. 551-63.
PMID: 19091804
Related Citations

Qualitative Analysis Of The Role Of Culture In Coping Themes Of Latina And European American Mothers Of Children With Cancer
Authors: Johns,A.L. , Oland,A.A. , Katz,E.R. , Sahler,O.J. , Askins,M.A. , Butler,R.W. , Dolgin,M.J. .
Source: Journal Of Pediatric Oncology Nursing : Official Journal Of The Association Of Pediatric Oncology Nurses, 2009 May-Jun; 26(3), p. 167-75.
PMID: 19398713
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Genes Encoding Adrenergic Receptors Are Not Clustered On The Long Arm Of Human Chromosome 5
Authors: Loftus S.K. , Shiang R. , Warrington J.A. , Bengtsson U. , McPherson J.D. , Wasmuth J.J. .
Source: Cytogenetics And Cell Genetics, 1994; 67(2), p. 69-74.
PMID: 8039425
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