title: Feasibility and acceptability of a remotely administered computerized intervention to address cognitive late effects among childhood cancer survivors.
abstract: BACKGROUND
  Childhood cancer survivors frequently develop working memory (WM) deficits as a result of disease and treatment. Medication-based and therapist-delivered interventions are promising but have limitations. Computerized interventions completed at home may be more appealing for survivors. We evaluated the feasibility and acceptability of a remotely administered, computerized WM intervention (Cogmed) for pediatric cancer survivors using a single-blind, randomized, wait-list control design.
  
  
  METHODS
  Of 80 qualifying patients, 12 were excluded or declined to participate. Participants randomized to intervention (n= 34/68) included survivors of childhood brain tumors (32%) or acute lymphoblastic leukemia (ALL; 68%) between the ages of 8 and 16 years ([Formula: see text] = 12.2) who were at least 1 year post therapy ([Formula: see text] = 5.0). The majority of brain tumor participants were treated with cranial radiation therapy (72.7%), whereas most of the ALL participants were treated with chemotherapy only (87%). Participants completed 25 WM training sessions over 5-9 weeks at home with weekly phone-based coaching.
  
  
  RESULTS
  Participants lived in 16 states. Compliance was strong, with 30 of the 34 participants (88%) completing intervention. Almost all participants completed pre- and postintervention neuroimaging exams (91% and 93%, respectively). Families had the necessary skills to utilize the computer program successfully. Caregivers reported they were generally able to find time to complete training (63%), viewed training as beneficial (70%), and would recommend this intervention to others (93%).
  
  
  CONCLUSIONS
  Cogmed is a feasible and acceptable intervention for childhood cancer survivors. It is a viable option for survivors who do not live in close proximity to cancer care centers. Efficacy and neural correlates of change are currently being evaluated.
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Cox
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Jason M
authors.initials: JM
authors.lastname: Ashford
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Kellie N
authors.initials: KN
authors.lastname: Clark
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Karen
authors.initials: K
authors.lastname: Martin-Elbahesh
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Kristina K
authors.initials: KK
authors.lastname: Hardy
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ogg
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Sima
authors.initials: S
authors.lastname: Jeha
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Victoria W
authors.initials: VW
authors.lastname: Willard
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Lu
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Psychology , St Jude Children's Research Hospital , Memphis, Tennessee (L.E.C., J.M.A., K.N.C., K.M-E., V.W.W., H.M.C.); Division of Radiation Oncology , St. Jude Children's Research Hospital, Memphis, Tennessee (T.E.M.); Division of Translational Imaging Research , St Jude Children's Research Hospital , Memphis, Tennessee (R.J.O.); Department of Oncology , St Jude Children's Research Hospital , Memphis, Tennessee (S.J.); Department of Biostatistics , St Jude Children's Research Hospital , Memphis, Tennessee (L.H., H.Z.); Center for Neuroscience and Behavioral Medicine , Neuropsychology Division, Children's National Medical Center , Washington, DC (K.K.H.); Department of Psychiatry and Behavioral Science , George Washington University School of Medicine , Washington, DC (K.K.H).
authors.forename: Heather M
authors.initials: HM
authors.lastname: Conklin
keywords: Cogmed; childhood cancer; computerized training; intervention; late effects