Feasibility trial of child care as a therapeutic intervention.

Abstract

e24196 Background: The incidence rate of cancer among young adults (ages 20-44) has steadily increased over the past decade. Among them, approximately 18% are parents within two years of initial diagnosis. Work as part of our Young Women Surviving support group identified childcare support as an unmet need. We therefore sought to determine the impact of childcare provision on the timeliness of care among young women undergoing chemotherapy for cancer. Methods: We conducted a pilot feasibility study that enrolled a convenience sample inclusive of parents with histologically confirmed invasive breast or gynecologic cancer receiving system chemotherapy and were caring for children 16 years or younger. Following consent, funds were reimbursed for costs related to their preferred childcare resource, including for travel and infusion time. Therapy assessments and an abridged version of the NCCN Distress Thermometer (score ranging from 0-10 with 0 indicating no distress) were administered at each infusion appointment. Feasibility was measured by acceptance of childcare services by > 25% of patients identified as eligible. Results: This study was offered to 26 eligible patients, of which 23 enrolled (88.5%) and 20 have follow-up data. Among study volunteers, 80% were white, 15% were black; Five percent identified as Hispanic or Latino. The median age was 39 years old (range, 31 to 79). The majority of patients (85%) had breast malignancy, while the remaining 15% had gynecological cancers. The median number of treatment events for which babysitting services were paid for were 6 (range, 2-18). Of 19 patients with distress scores, 4 (21%) reported childcare as a stress for them. The median distress score decreased over time, from 5 at first treatment event to a median score of 3 at the eighth event. All participants who completed end of study surveys (16 patients) reported they “agree” or “strongly agree” with the statements “I would participate in child care again” and “Babysitting allowed you to get to your treatment on time.” Over the duration of study, 95% of this cohort did not have any delays in their cancer-directed therapy due to childcare. Conclusions: This is early evidence to suggest providing childcare to patients who are also undergoing chemotherapy is feasible and may be beneficial in improving impact on cancer outcomes and psychological distress. Further studies should include a comparator arm to better clarify the significant of this supportive measure. It is important to continue investigating the impact of supportive services on the quality of life and of care for this unique cohort.