Promoting Adjustment Among Families Impacted by Non-Curable, Advanced Stage Parental Cancer: A Randomized Controlled Trial of the Enhancing Connections Palliative Care Program

Background: Annually hundreds of thousands of children are impacted by a parent with cancer, and an estimated 25% have advanced stage disease. Programs to assist these families lag far behind the need. Objectives: To test the short-term efficacy of a telephone-delivered cancer parenting program for child-rearing parents with non-curable, advanced-stage cancer, the Enhancing Connections Palliative Care (EC-PC) Program. Design: Two-group randomized controlled trial with assessment at three months. Experimental group parents received five educational counseling sessions by telephone at two-week intervals; participants in the alternative treatment control group were mailed a booklet about ways to communicate and support children’s coping with parental cancer. Setting: The program was delivered centrally from the study center. Subjects: Fifty-six child-rearing parents with non-curable advanced cancer were enrolled from medical providers, service agencies, and cancer centers in the United States. Measurements: Outcomes were parents’ and children’s depressed mood and anxiety, parenting skills, parenting self-efficacy, and children’s behavioral-emotional adjustment. Results: Between-group analysis using Mixed Models showed a significant effect that benefitted the experimental group: parenting skills significantly improved compared with controls. Results were clinically significant in both the intent to treat ( d = 0.54, p = 0.34) and per-protocol analysis ( d = 0.64, p = 0.018). Effect sizes were larger in the experimental group compared with controls. Within-group analysis reflected additional improvements in parents’ self-efficacy, depressed mood, and children’s behavioral-emotional adjustment. Conclusions: EC-PC is a telephone-delivered intervention that significantly improved parenting skills and offers a scalable approach to support families coping with advanced cancer. Larger trials are warranted.