Abby R Rosenberg1,2,3,4, Miranda C Bradford1, Elizabeth McCauley5,6, J Randall Curtis2,7,8, Joanne Wolfe9,10,11, K Scott Baker3,4,12, Joyce P Yi-Frazier1. 1. Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington. 2. Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington. 3. Center for Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, Washington. 4. Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington. 5. Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington. 6. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington. 7. Division of Pulmonary, Critical Care, and Sleep Medicine, Harborview Medical Center, Seattle, Washington. 8. Department of Medicine, University of Washington School of Medicine, Seattle, Washington. 9. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts. 10. Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. 11. Harvard Medical School, Boston, Massachusetts. 12. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Abstract
BACKGROUND: Adolescents and young adults (AYAs) with cancer are at risk for poor psychosocial outcomes. This study aimed to determine whether a novel intervention targeting resilience resources would improve patient-reported resilience, quality of life, and psychological distress. METHODS: In this parallel, phase 2 randomized controlled trial, English-speaking AYAs (12-25 years old) with cancer were randomized to the Promoting Resilience in Stress Management (PRISM) intervention or usual care (UC). PRISM is a brief, skills-based intervention targeting stress management, goal setting, cognitive reframing, and meaning making. Participants completed surveys at enrollment and 6 months. Mixed effects regression models evaluated associations between PRISM and the primary outcome (10-item Connor-Davidson Resilience Scale scores) and secondary outcomes (generic and cancer-related quality of life [Pediatric Quality of Life modules], psychological distress [Kessler-6], and anxiety/depression [Hospital Anxiety and Depression]) at 6 months. RESULTS: Ninety-two AYAs were enrolled, were randomized, and completed baseline surveys (48 in the PRISM group and 44 in the UC group); 73% were 12 to 17 years old, and 62% had leukemia or lymphoma. Attrition was primarily due to medical complications and/or death; 36 PRISM participants and 38 UC participants completed 6-month surveys. PRISM was associated with improved resilience (+3.0 points; 95% confidence interval [CI], 0.5-5.4; P = .02) and cancer-specific quality of life (+9.6; 95% CI, 2.6-16.7; P = .01) and reduced psychological distress (-2.1; 95% CI, -4.1 to -0.2; P = .03) but not generic quality of life (+7.2; 95% CI, -0.8 to 15.2; P = .08). Although anxiety was similar between the groups, 2 PRISM participants (6%) and 8 UC participants (21%) met the criteria for depression at 6 months (odds ratio, 0.09; 95% CI, 0.01-1.09; P = .06). CONCLUSIONS: PRISM was associated with improved psychosocial outcomes in comparison with UC, suggesting that brief, skills-based interventions for AYAs may provide a benefit.
BACKGROUND: Adolescents and young adults (AYAs) with cancer are at risk for poor psychosocial outcomes. This study aimed to determine whether a novel intervention targeting resilience resources would improve patient-reported resilience, quality of life, and psychological distress. METHODS: In this parallel, phase 2 randomized controlled trial, English-speaking AYAs (12-25 years old) with cancer were randomized to the Promoting Resilience in Stress Management (PRISM) intervention or usual care (UC). PRISM is a brief, skills-based intervention targeting stress management, goal setting, cognitive reframing, and meaning making. Participants completed surveys at enrollment and 6 months. Mixed effects regression models evaluated associations between PRISM and the primary outcome (10-item Connor-Davidson Resilience Scale scores) and secondary outcomes (generic and cancer-related quality of life [Pediatric Quality of Life modules], psychological distress [Kessler-6], and anxiety/depression [Hospital Anxiety and Depression]) at 6 months. RESULTS: Ninety-two AYAs were enrolled, were randomized, and completed baseline surveys (48 in the PRISM group and 44 in the UC group); 73% were 12 to 17 years old, and 62% had leukemia or lymphoma. Attrition was primarily due to medical complications and/or death; 36 PRISM participants and 38 UC participants completed 6-month surveys. PRISM was associated with improved resilience (+3.0 points; 95% confidence interval [CI], 0.5-5.4; P = .02) and cancer-specific quality of life (+9.6; 95% CI, 2.6-16.7; P = .01) and reduced psychological distress (-2.1; 95% CI, -4.1 to -0.2; P = .03) but not generic quality of life (+7.2; 95% CI, -0.8 to 15.2; P = .08). Although anxiety was similar between the groups, 2 PRISM participants (6%) and 8 UC participants (21%) met the criteria for depression at 6 months (odds ratio, 0.09; 95% CI, 0.01-1.09; P = .06). CONCLUSIONS: PRISM was associated with improved psychosocial outcomes in comparison with UC, suggesting that brief, skills-based interventions for AYAs may provide a benefit.
Authors: Nancy Lau; Miranda C Bradford; Angela Steineck; Courtney C Junkins; Joyce P Yi-Frazier; Elizabeth McCauley; Abby R Rosenberg Journal: Psychooncology Date: 2019-05-14 Impact factor: 3.894
Authors: Kaitlyn M Fladeboe; Samantha Scott; Miranda C Bradford; Tyler G Ketterl; Joyce P Yi-Frazier; Abby R Rosenberg Journal: J Adolesc Young Adult Oncol Date: 2020-04-21 Impact factor: 2.223
Authors: Abby R Rosenberg; Miranda C Bradford; Krysta S Barton; Nicole Etsekson; Elizabeth McCauley; J Randall Curtis; Joanne Wolfe; K Scott Baker; Joyce P Yi-Frazier Journal: Pediatr Blood Cancer Date: 2018-09-30 Impact factor: 3.167
Authors: Angela Steineck; Krysta S Barton; Miranda C Bradford; Joyce P Yi-Frazier; Abby R Rosenberg Journal: J Adolesc Young Adult Oncol Date: 2021-05-06 Impact factor: 2.223