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. 2021;29(3):130-139.
doi: 10.1080/09699260.2020.1826778. Epub 2020 Oct 20.

Improved Parent-Child Communication following a RCT Evaluating a Legacy Intervention for Children with Advanced Cancer

Terrah Foster Akard  1   2 , Mary S Dietrich  1   2 , Debra L Friedman  2   3 , Cynthia A Gerhardt  4 , Barbara Given  5 , Verna Hendricks-Ferguson  6 , Pamela S Hinds  7 , Sheila H Ridner  1 , Nicole Beckmann  1 , Mary Jo Gilmer  1   3
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Improved Parent-Child Communication following a RCT Evaluating a Legacy Intervention for Children with Advanced Cancer

Terrah Foster Akard et al. Prog Palliat Care. 2021.

Abstract

Although legacy-building is a priority for quality palliative care, research has rarely examined effects of legacy interventions in children, particularly their impact on parent-child communication.We examined the impact of a web-based legacy intervention on parent-child communication. We hypothesized that compared to usual care, legacy-making would improve quality of parent-child communication.Between 2015 and 2018, Facebook advertisements were used to recruit families of children (ages 7-17) with relapsed/refractory cancer. Parent-child dyads were randomly assigned to the intervention or usual care group. The intervention website guided children to create digital storyboards over 2 weeks by directing them to answer legacy questions about themselves and upload photographs, videos, and music. Families received a copy of the child's final digital story. Children and parents completed the Parent-Adolescent Communication Scale pre- (T1) and post-intervention (T2). Linear regressions tested for differences in change from T1 to T2 between the groups controlling for T1 values using an alpha of p < .05. Intervention effects were measured using Cohen's d. Ninety-seven parent-child dyads were included for analysis. Changes in parent-child communication were not statistically significantly different between the groups, yet meaningful intervention effects were observed. The strongest effects were observed for improving father-child communication (Cohen's d = -0.22-0.33). Legacy-making shows promise to facilitate improved parent-child communication, particularly for fathers. Future studies should include fathers and measure expression of feelings and parent-child interaction. Providers should continue to facilitate family communication for children with advanced disease and realize that legacy interventions may impact mother-child versus father-child communication differently.

Keywords: cancer; family relationships; father-child relationship; palliative care; parent-child communication; parent-child relationship; pediatric; web-based intervention.

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Conflict of interest statement

Disclosure Statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Conceptual framework (red font notes outcomes reported in this paper)
Figure 2.
Figure 2.
CONSORT Flow Diagram
See this image and copyright information in PMC

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