Reducing Learning and Psychosocial Disparities in Latino Children with Cancer: A Randomized Intervention Trial

Sunita K Patel; Seong-Hyeon Kim; Kathleen Ingman; Van Huynh; Heather Huszti; Kimberly Kayser; Grace Mucci; Melissa Balderrama; Laura Bava; Abigail Onderwyzer Gold; Alicia Wuth; Nicole Delgado; Alysia Bosworth; Emily Nishimura; Harneet Hara; Anna Pawlowska; Lisa Mueller; F Lennie Wong

doi:10.1093/jnci/djae256

Reducing Learning and Psychosocial Disparities in Latino Children with Cancer: A Randomized Intervention Trial

J Natl Cancer Inst. 2024 Oct 16:djae256. doi: 10.1093/jnci/djae256. Online ahead of print.

Authors

Sunita K Patel^{1

2}, Seong-Hyeon Kim³, Kathleen Ingman^{4

5}, Van Huynh^{6

7}, Heather Huszti^{8

9}, Kimberly Kayser^{4

10}, Grace Mucci^{8

9}, Melissa Balderrama^{4

5}, Laura Bava⁵, Abigail Onderwyzer Gold¹, Alicia Wuth⁸, Nicole Delgado¹, Alysia Bosworth¹, Emily Nishimura¹, Harneet Hara^{7

11}, Anna Pawlowska¹², Lisa Mueller¹³, F Lennie Wong¹

Affiliations

¹ Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
² Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA.
³ Department of Clinical Psychology, School of Psychology & Marriage and Family Therapy, Fuller Theological Seminary, Pasadena, CA, USA.
⁴ Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁵ Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁶ Division of Pediatric Oncology, University of California Irvine College of Medicine, Irvine, CA, USA.
⁷ Division of Oncology, Hyundai Cancer Institute, Children's Hospital Orange County, Orange, CA, USA.
⁸ Department of Pediatric Psychology, Children's Hospital Orange County, Orange, CA, USA.
⁹ Department of Psychiatry & Human Behavior, University of California Irvine College of Medicine, Irvine, CA, USA.
¹⁰ Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA.
¹¹ Pediatric Hematology/Oncology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.
¹² Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
¹³ Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kaiser Permanente Medical Center, Los Angeles, CA, USA.

PMID: 39412495
DOI: 10.1093/jnci/djae256

Abstract

Background: We developed a high-intensity parenting intervention (HIP) to help parents support the academic success of childhood cancer survivors (CCSs), who often face post-treatment challenges affecting their school-related functioning. This randomized controlled trial (NCT03178617) evaluated HIP's efficacy compared to lower-intensity, single-session, treatment-as-usual services (LIP) in Latino families. Primary outcomes were parenting efficacy and CCSs' school functioning; secondary outcomes included parenting knowledge and measures of CCSs' academic performance, attention, and functioning outside of school.

Methods: 106 Latino survivors of childhood leukemia and lymphoblastic lymphoma (aged 6-12 years) and their parents were randomly assigned to HIP (n = 54) or LIP (n = 52). Linear mixed-effects models evaluated group differences across baseline, 6-month (T2), and 12-month (T3) assessments.

Results: Parenting efficacy and knowledge improved significantly in the HIP arm, resulting in higher scores vs LIP at T2 and T3 (P ≤ .01). No significant between-group differences were found in child school functioning; however, HIP children showed significantly better social functioning and performance on one measure of attention (CPT-3 commissions) at T3 (P < .05). While HIP adherence challenges were observed, with only 33 (61%) completing the intervention, exploratory analyses suggest that benefits were most evident among those who fully engaged. Satisfaction and perceived benefit were greater for HIP vs LIP at both time points (P < .05).

Conclusions: Our results suggest the potential value of parent-directed behavioral interventions like HIP for CCSs and their families. Further studies are needed to address participation barriers and enhance engagement to maximize and sustain benefits.