The Enhancing Connections Program: a six-state randomized clinical trial of a cancer parenting program.
OBJECTIVE
The purpose of this study was to test the efficacy of a cancer parenting program for child rearing mothers with breast cancer, the Enhancing Connections Program. Primary goals were to decrease maternal depressed mood and anxiety, improve parenting quality, parenting skills and confidence, and enhance the child's behavioral-emotional adjustment to maternal breast cancer.


METHODS
A total of 176 mothers diagnosed within 6 months with Stage 0 to Stage III breast cancer and their 8- to 12-year-old child were recruited from medical providers in 6 states: Washington, California, Pennsylvania, Minnesota, Arizona, and Indiana. After consenting and obtaining baseline measures, study participants were randomized into experimental or control groups. Experimental mothers received 5, 1-hr educational counseling sessions at 2-week intervals; controls received a booklet and phone call on communicating and supporting their child about the mother's cancer. Outcomes were assessed at 2 and 12 months.


RESULTS
Compared to controls, at 2 months experimental mothers significantly improved on depressed mood and parenting skills; experimental children improved on behavioral-emotional adjustment: total behavior problems, externalizing problems, and anxiety/depressed mood significantly declined. At 1 year, experimental children remained significantly less depressed than controls on both mother- and child-reported measures. The intervention failed to significantly affect parenting self-efficacy or maternal anxiety.


CONCLUSIONS
The Enhancing Connections Program benefitted mothers and children in specific areas and warrants refinement and further testing.
School of Nursing, University of Washington.
Frances Marcus
FM
Lewis
School of Nursing, University of Washington.
Patricia A
PA
Brandt
School of Nursing, University of Washington.
Barbara B
BB
Cochrane
School of Nursing, University of Washington.
Kristin A
KA
Griffith
City of Hope Cancer Research Center.
Marcia
M
Grant
School of Nursing, Indiana University.
Joan E
JE
Haase
School of Nursing, University of Pennsylvania.
Arlene D
AD
Houldin
School of Nursing, University of Minnesota.
Janice
J
Post-White
School of Nursing, University of Washington.
Ellen H
EH
Zahlis
School of Nursing, University of Washington.
Mary Ellen
ME
Shands
D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D002648:Child; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D012917:Social Adjustment; D016896:Treatment Outcome