Exploring the Utility of Temperament and SDOH C4921 - FY25 Temperament, SDOH, & PMTS

Children with cancer are faced with substantial rates pediatric medical traumatic stress (PMTS). The importance of guidelines on how to mitigate mental health challenges via screening, psychological interventions, pharmacological treatments, and future research are well recognized within the Standards of Psychosocial Care of Children with Cancer and Their Families. However, identifying which youth will develop significant PMTS is challenging. To continue work towards optimizing care for youth with cancer (including mental health), more research is needed on identifying risk and protective factors. It is important to examine multiple domains of risk factors, including individual characteristics and social context, when examining mental health risk and tailoring interventions. The proposed project will implement two multi-site studies utilizing a mixed methods design to examine temperaments and social determinants of health (SDOH) and their relationships with PMTS in youth with cancer. Study 1 will include 80 youth (40 per site) ages 7-17 years recently diagnosed with cancer and at least one caregiver per child to complete quantitative measures of temperament, SDOH, and PMTS at baseline and follow-up measures of PMTS 3-months later. In Study 2, we will conduct qualitative individual interviews with a subsample of 24 youth (12 per site) and their caregivers from Study 1 with at risk temperaments and SDOH to identify patterns of screening and treatment needs of youth with cancer. Results will provide pilot data for potential new screening tools, which will allow us to identify youth with cancer at risk of developing PMTS, and new interventions tailored to specific temperaments and SDOH that are associated with risk. The overarching overarching long-term goals of this research is improving psychological outcomes for children with cancer through 1) refined screening to better identify children most at risk of PMTS, 2) reducing disparities through equitable dissemination of resources for PMTS, and 3) increasing treatment efficacy by providing tailored interventions for PMTS.