Departments of Population Sciences and Supportive Care Medicine, Comprehensive Cancer Center, City of Hope.
Department of Population Sciences, City of Hope.
J Pediatr Psychol. 2020 Sep 1;45(8):921-932. doi: 10.1093/jpepsy/jsaa048.
Survivors of childhood leukemia, especially those from low socioeconomic status households, often experience persistent neurocognitive and academic impairment. This study adapted an existing parent training intervention to improve outcomes for low-acculturated, Spanish-speaking Latino parents of children with leukemia and pilot tested that intervention for feasibility.
Semistructured interviews were conducted with a focus group of 20 Latino parents of children treated for leukemia. Ten Latino families participated in a pilot study of the adapted parenting intervention, consisting of eight sessions over 6 months.
Focus groups revealed that parents unanimously supported a parenting intervention but barriers to participation included time constraints, transportation issues, and anxiety in the hospital environment. The parents also highlighted cultural factors that could contribute to the health disparity, such as lack of knowledge and efficacy in facilitating their child's progress with learning and school. In the pilot study, adherence was 90%, establishing feasibility, and the adapted intervention was considered beneficial. The median parenting efficacy scores improved from preintervention to postintervention (median 3.40 vs. 3.94; p < .011), as did parent-reported school functioning of the child (median 50.00 vs. 60.00; p = .088).
This study addressed a health disparity by culturally adapting a parenting intervention, which was designed to improve school functioning, to meet the needs and preferences of low-acculturated, Spanish-speaking families of children with leukemia in Southern California. The pilot study demonstrated that the adapted intervention is feasible and acceptable in the target population. A larger trial is underway to test the efficacy of this adapted parenting intervention.
儿童期白血病幸存者，尤其是来自社会经济地位较低家庭的幸存者，常常存在持续的神经认知和学业障碍。本研究对现有的家长培训干预措施进行了改编，以改善低融合度、讲西班牙语的拉丁裔白血病患儿家长的结局，并对该干预措施进行了可行性试点测试。
对 20 名接受过白血病治疗的拉丁裔患儿的家长进行了焦点小组访谈。10 个拉丁裔家庭参与了改编后的家长干预措施的试点研究，该措施包括 6 个月内的 8 次会议。
焦点小组揭示，家长们一致支持家长干预措施，但参与的障碍包括时间限制、交通问题以及在医院环境中的焦虑。家长们还强调了可能导致健康差异的文化因素，例如缺乏促进孩子学习和学校进步的知识和效能。在试点研究中，依从性为 90%，确立了可行性，且改编后的干预措施被认为是有益的。家长效能评分从干预前到干预后中位数提高（中位数 3.40 比 3.94；p<.011），儿童家长报告的学校功能也有所改善（中位数 50.00 比 60.00；p=0.088）。
本研究通过对家长干预措施进行文化改编，解决了一个健康差异问题，该干预措施旨在提高学校功能，以满足南加州低融合度、讲西班牙语的白血病患儿家庭的需求和偏好。试点研究表明，改编后的干预措施在目标人群中是可行且可接受的。一项更大规模的试验正在进行中，以测试该改编后的家长干预措施的疗效。
