Examining Sociodemographic Differences in Response to Resilience Coaching for Adolescents and Young Adults Receiving Hematopoietic Cell Transplantation—A Post Hoc Analysis of the PRISM Intervention

IF 2.3 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-08-31 DOI:10.1002/pbc.31998

Adam René P. Rosenbaum, Molly Ream, Kaitlyn M. Fladeboe, Nancy Lau, Joyce P. Yi-Frazier, Abby R. Rosenberg

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引用次数: 0

Abstract

Background

Adolescents and young adults (AYAs) receiving hematopoietic cell transplantation (HCT) for malignancy are at risk for poor psychological outcomes. Promoting Resilience in Stress Management (PRISM) is an early palliative care intervention that has previously been evaluated in a randomized trial among AYAs receiving HCT; results suggested the intervention's effect was limited to AYAs with baseline psychological symptoms.

Objective

We performed a post hoc analysis of these same data to explore differences in response based on sociodemographic factors.

Methods

AYA participants were eligible for the trial if they were 12–24 years old, English-speaking, cognitively able, and within 4 weeks of HCT for malignancy or bone marrow failure. Enrolled AYAs reported their symptoms of anxiety, depression, hope, cancer-related quality of life, and resilience using standardized instruments at baseline and 6 months. We explored intervention effect sizes (Cohen's d) among groups stratified by gender, age, race, zip-code-based community distress (Distressed Community Index, with scores 3–5 indicating distressed communities), and baseline psychological symptoms.

Results

Of 94 participants (50 PRISM, 44 Usual Care), 46% were female, 44% were 18–24 years old, 60% identified as non-Latino White, and 49% lived within distressed communities. Among AYAs 18–24 years old, those with baseline psychological distress tended toward gaining resilience, while those without baseline psychological symptoms seemed to gain hope. AYAs of all ages from distressed communities and with high baseline psychological burden seemed to gain both resilience and hope.

Discussion

AYAs with different ages, backgrounds, and psychological symptoms may have different responses to programs like PRISM.

Clinical Trial Registration Number

NCT03668223.

Abstract Image

查看原文本刊更多论文

接受造血细胞移植的青少年和年轻人对恢复力训练反应的社会人口统计学差异——PRISM干预的事后分析

背景：青少年和年轻人（AYAs）接受恶性肿瘤造血细胞移植（HCT）有不良心理预后的风险。在压力管理中促进恢复力（PRISM）是一种早期姑息治疗干预措施，此前在接受HCT的aya中进行了随机试验评估；结果表明，干预的效果仅限于有基线心理症状的青少年。目的：我们对这些相同的数据进行了事后分析，以探索基于社会人口因素的反应差异。方法：12-24岁、会说英语、有认知能力、在HCT治疗恶性肿瘤或骨髓衰竭4周内的AYA参与者符合试验条件。在基线和6个月时使用标准化仪器报告了他们的焦虑、抑郁、希望、癌症相关生活质量和恢复能力的症状。我们探讨了按性别、年龄、种族、基于邮政编码的社区困扰（贫困社区指数，得分3-5表示贫困社区）和基线心理症状分层的群体的干预效应大小（Cohen’s d）。结果：在94名参与者（50名PRISM， 44名常规护理）中，46%为女性，44%为18-24岁，60%为非拉丁裔白人，49%生活在贫困社区。在18-24岁的青少年中，有基线心理困扰的人倾向于获得恢复力，而没有基线心理症状的人似乎获得了希望。来自贫困社区和有高基线心理负担的所有年龄段的AYAs似乎都获得了恢复力和希望。讨论：不同年龄、背景和心理症状的青少年对PRISM等项目可能有不同的反应。临床试验注册号：NCT03668223。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.