Mental health and health behaviors of parents of survivors of childhood cancer in the early COVID-19 pandemic: Exploring the role of intolerance of uncertainty

Abstract Introduction: Parents of survivors of childhood cancer may be particularly vulnerable to the experience of poor mental health amid the COVID-19 pandemic. This study aimed to (1) describe the mental health of parents of childhood cancer survivors; (2) explore the role of intolerance of uncertainty (IU) in mental health; and (3) explore the associations of parent mental health and health behaviors with IU. Methods: A cross-sectional, quantitative assessment of parents of survivors of childhood cancer (younger than 18 years) was conducted between May and June 2020. Participants completed an online questionnaire regarding their mental health (PROMIS anxiety, depression), IU (Intolerance of Uncertainty Scale), and health behaviors. Recruitment was conducted through social media and community organizations using convenience and snowball sampling. Results: Seventy-two participants from 6 countries completed the study (99% mothers, mean age of survivors = 11.4 years). Fifty percent of participants reported that their mental health had declined since the start of the COVID-19 pandemic, whereas 46% reported their mental health did not change. More than half of the participants (56%) reported decreased physical activity and 38% reported increased alcohol use. Exploring associations of parent mental health and health behaviors with IU, parent depression, and hours of exercise emerged as significant predictors (B = 3.62, P < .01; B = –1.58, P < .01, respectively), whereby higher depression and less exercise was associated with higher IU. Conclusions: At the height of the COVID-19 global pandemic, some parents of survivors of childhood cancer experienced poor mental health. IU plays a significant role in mental health outcomes, but this does not translate to health behaviors.