CancerNCT03640325
The PRISM Intervention for Adolescents and Young Adults Receiving Hematopoietic Cell Transplantation
A study testing PRISM (Promoting Resilience in Stress Management) in people with Cancer and Bone Marrow Neoplasms, run by Seattle Children's Hospital at 5 sites in United States.
Trial summary
Multisite Randomized Controlled Trial (RCT) testing the efficacy of the Promoting Resilience in Stress Management (PRISM) intervention among Adolescents and Young Adults receiving hematopoietic cell transplantation for hematology malignancy. Read more about this study
- Who is it for?
- Ages 12 to 24 years
- Conditions the study is for
- Cancer, Bone Marrow Neoplasms, Anxiety
- What is being tested?
- PRISM (Promoting Resilience in Stress Management)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 143 participants
- Where
- 5 sitesUnited States
- Study dates
- 1 Apr 2019to 31 Mar 2024
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 12 to 24 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- AYA Child of caregiver agreed to participate
- One caregiver per patient-caregiver dyad
- Parent/guardian cognitively and physically able to participate
- Parent/guardian is able to speak/read English or Spanish
Who cannot join
- Patient refusal
- Cognitively or physically unable to participate in interviews
- Unable to speak English
- Unable to read English or Spanish
- For enrolled caregivers of AYA patient (no age limit):
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
United States5 sites
University of Alabama, Birmingham
Birmingham, Alabama, 35233
Dana-Farber/Harvard Cancer Center
Boston, Massachusetts, 02215
Children's Hospital of Los Angeles
Los Angeles, California, 90027
St. Jude Children's Research Hospital
Memphis, Tennessee, 38105
Seattle Children's Hospital Cancer and Blood Disorders Center
Seattle, Washington, 98145
About this study
Official title: The Promoting Resilience in Stress Management (PRISM) Intervention: a Multi-site Randomized Controlled Trial for Adolescents and Young Adults Receiving Hematopoietic Cell Transplantation
Multisite Randomized Controlled Trial (RCT) testing the efficacy of the Promoting Resilience in Stress Management (PRISM) intervention among Adolescents and Young Adults receiving hematopoietic cell transplantation for hematology malignancy.
Read the detailed description
The experience of hematopoietic cell transplantation (HCT) for malignancy or cancer predisposition among Adolescents and Young Adults (AYAs) is particularly difficult because age-related developmental challenges of identity, relationships, and vocation may add to the burden of cancer. Compared to other age-groups, AYAs have poorer psychosocial outcomes including increased anxiety and depression and poorer adherence to oral immunosuppressive medications. These outcomes may, in turn, predispose AYAs to disease-related morbidity and mortality such as graft-versus-host disease (GVHD) and/or cancer-relapse. A potential barrier to improving these experiences may be that AYAs have few opportunities to develop the personal resources needed to handle adversity. We have previously developed the "Promoting Resilience in Stress Management" (PRISM) intervention for AYAs with serious illness. This manualized, brief intervention is delivered in 4, 30-60 minute, one-on-one sessions, followed by a Parent/ Caregiver/ Spouse/ significant other inclusive meeting. It targets skills in stress-management and mindfulness, goal-setting, positive reframing, and meaning-making. All of these skills are associated with improved patient well-being in other populations, and preliminary findings from a recently closed phase II randomized controlled trial among AYAs with newly diagnosed cancer suggest PRISM is associated with improved health-related quality of life. This study will build on our prior experience and fill a critical knowledge gap regarding PRISM's impact among AYAs receiving HCT. Thus, we will conduct a multi-site randomized controlled trial with the primary trial outcome of patient-reported symptoms of anxiety and depression. Secondary and exploratory outcomes will include the cost-effectiveness of the intervention in this population, the impact of the intervention on parent well-being, and patient adherence to oral graft-versus-host-disease medications. We hypothesize that AYAs who receive PRISM will report fewer mixed affective symptoms, while their parents report improved quality of life and psychological distress. We also anticipate the intervention will positively impact adherence and be cost-effective. In sum, this study offers an opportunity to expand the body of knowledge regarding methodologically rigorous and evidence-based psychosocial interventions and standards of care for AYAs with hematologic malignancies. Ultimately, this research has the potential to reduce the burden of cancer in these vulnerable populations.
- Conditions
- Cancer, Bone Marrow Neoplasms, Anxiety, Depression, Quality of Life, Adherence, Medication
- Being tested
- PRISM (Promoting Resilience in Stress Management)
- Medical subject headings
- Neoplasms, Bone Marrow Neoplasms, Anxiety Disorders, Depression, Medication Adherence, Adolescent Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PRISM (Promoting Resilience in Stress Management)Behavioural
Manualized Skills-Training Program targeting resilience resources: stress-management, goal-setting, cognitive reframing, and meaning-making
| Study group | Role | What they receive |
|---|---|---|
| PRISM (Promoting Resilience in Stress Management) | Experimental | Resilience Skills Training Receives: Behavioral: PRISM (Promoting Resilience in Stress Management) |
| Usual Care | No intervention | Usual psychosocial care (control arm, no intervention) |
| Caregivers | No intervention | Caregivers of participants, no intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Hospital Anxiety & Depression Scale (HADS) Score - Depression Sub-score
The Hospital Anxiety and Depression Scale -Depression sub scale assesses mixed affective symptoms in patients with serious illness. The scale consists of 7 questions for depression. Each is scored from 0-3, for a total range of 0-21 points. "Caseness" of depression is defined as ≥8 points, with sensitivity/specificity of 0.8/0.8 for depression. The depression sub-scale will be measured as a continuous variable. Higher scores indicate more symptoms.
Measured: 6-months
Secondary outcomes (7)
PedsQL Generic Core and Cancer-Related Quality of Life Score
The PedsQL 4.0 Generic and 3.0 Cancer Module include 50 items evaluating health-related quality of life of adolescents and young adults (AYAs) with cancer. Items are rated on a 5-point Likert scale and total scores transformed to a 0-100 scale with higher scores representing better HRQOL. Internal consistency ranges from 0.75 to 0.92.
Measured: 6-months
Connor-Davidson Resilience Scale
The Connor-Davidson Resilience Scale (CD-RISC) measures inherent resiliency. The 10-item instrument has high internal consistency. Each item consists of a 5-point Likert scale (scored from zero to four). ranging from 0-40 with higher scores reflecting greater perceived resilience.
Measured: 6-months
Hope Scale Scores
The Snyder "Hope" Scale measures "the overall perception that one's goals can be met." The instrument scored on an 8-point Likert scale (score range 0-64). Higher scores imply greater levels of hopeful thought patterns.
Measured: 6-months
Hospital Anxiety & Depression Scale Score - Anxiety Sub-score
The Hospital Anxiety and Depression Scale - Anxiety sub scale assesses mixed affective symptoms in patients with serious illness. It consists of 7 questions on a 3 point Likert scale for a total range of 0-21. Higher scores indicate higher anxiety.
Measured: 6-months
Generalized Anxiety Disorder Screener (GAD7)
7-item survey used to assess anxiety symptoms. Scored from 0-21 with higher scores indicated higher anxiety.
Measured: 6-months
Patient Health Questionnaire-8
8-item survey assessing depression severity. Each item scored on a 4-point Likert scale with a range of 0-27. Higher scores indicate higher depression.
Measured: 6-months
Medical Outcomes Study Rand 36-item Health Survey
This is a measure of health-related quality of life. Scores range from 0-100 and higher scores indicate better health status
Measured: 6-months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Aug 2018
- Study start1 Apr 2019
- Primary completion31 Mar 2023
- Study completion31 Mar 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for CancerStudies of the same condition, open and under way.
- More trials run by Seattle Children's HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 143 participants (actual)
Sponsor and investigators
- Lead sponsor
- Seattle Children's Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Children's Hospital Los Angeles, St. Jude Children's Research Hospital, University of Alabama at Birmingham, National Cancer Institute (NCI)
- Responsible party
- Principal investigator, Abby Rosenberg, Dana-Farber Cancer Institute
- Investigators
- Abby R Rosenberg, MD, MS, MA, Principal investigator, Dana-Farber Cancer Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03640325
- Sponsor's protocol ID
- STUDY00001077 (SC-N126)
- Other IDs
- R01CA225629
- Status last verified
- Oct 2024
- First submitted
- 15 Aug 2018
- Last updated
- 26 Oct 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: All IPD will be protected and maintained by the study team
Publications
Taylor MR, Cole SW, Bradford MC, Zhou C, Fladeboe KM, Knight JM, Baker KS, Yi-Frazier JP, Rosenberg AR. Resilience Intervention Improves Stress-Related Gene Expression in Adolescent and Young Adult HCT Recipients. Transplant Cell Ther. 2024 Dec;30(12):1209.e1-1209.e7. doi: 10.1016/j.jtct.2024.09.014. Epub 2024 Sep 19.
PubMed 39303988Fladeboe KM, Scott S, Comiskey L, Zhou C, Yi-Frazier JP, Rosenberg AR. The Promoting Resilience in Stress Management (PRISM) intervention for adolescents and young adults receiving hematopoietic cell transplantation: a randomized controlled trial protocol. BMC Palliat Care. 2022 May 19;21(1):82. doi: 10.1186/s12904-022-00966-9.
PubMed 35585525
Study at a glance
From the registry record, last updated by the sponsor on 26 Oct 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Promoting Resilience in Stress Management (PRISM) Intervention: a Multi-site Randomized Controlled Trial for Adolescents and Young Adults Receiving Hematopoietic Cell Transplantation
- ClinicalTrials.gov ID
- NCT03640325
- Acronym / sponsor ID
- STUDY00001077 (SC-N126)
- Conditions
- Cancer, Bone Marrow Neoplasms, Anxiety, Depression, Quality of Life, Adherence, Medication
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 143 participants (actual)
- Lead sponsor
- Seattle Children's HospitalUniversity, hospital or other
- Collaborators
- Children's Hospital Los Angeles, St. Jude Children's Research Hospital, University of Alabama at Birmingham, National Cancer Institute (NCI)
- Study start
- 1 Apr 2019 (actual)
- Primary completion
- 31 Mar 2023 (actual)
- Study completion
- 31 Mar 2024 (actual)
- First posted
- 21 Aug 2018 (actual)
- Results
- Posted 26 Oct 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Multisite Randomized Controlled Trial (RCT) testing the efficacy of the Promoting Resilience in Stress Management (PRISM) intervention among Adolescents and Young Adults receiving hematopoietic cell transplantation for hematology malignancy.
Detailed description
The experience of hematopoietic cell transplantation (HCT) for malignancy or cancer predisposition among Adolescents and Young Adults (AYAs) is particularly difficult because age-related developmental challenges of identity, relationships, and vocation may add to the burden of cancer. Compared to other age-groups, AYAs have poorer psychosocial outcomes including increased anxiety and depression and poorer adherence to oral immunosuppressive medications. These outcomes may, in turn, predispose AYAs to disease-related morbidity and mortality such as graft-versus-host disease (GVHD) and/or cancer-relapse. A potential barrier to improving these experiences may be that AYAs have few opportunities to develop the personal resources needed to handle adversity. We have previously developed the "Promoting Resilience in Stress Management" (PRISM) intervention for AYAs with serious illness. This manualized, brief intervention is delivered in 4, 30-60 minute, one-on-one sessions, followed by a Parent/ Caregiver/ Spouse/ significant other inclusive meeting. It targets skills in stress-management and mindfulness, goal-setting, positive reframing, and meaning-making. All of these skills are associated with improved patient well-being in other populations, and preliminary findings from a recently closed phase II randomized controlled trial among AYAs with newly diagnosed cancer suggest PRISM is associated with improved health-related quality of life. This study will build on our prior experience and fill a critical knowledge gap regarding PRISM's impact among AYAs receiving HCT. Thus, we will conduct a multi-site randomized controlled trial with the primary trial outcome of patient-reported symptoms of anxiety and depression. Secondary and exploratory outcomes will include the cost-effectiveness of the intervention in this population, the impact of the intervention on parent well-being, and patient adherence to oral graft-versus-host-disease medications. We hypothesize that AYAs who receive PRISM will report fewer mixed affective symptoms, while their parents report improved quality of life and psychological distress. We also anticipate the intervention will positively impact adherence and be cost-effective. In sum, this study offers an opportunity to expand the body of knowledge regarding methodologically rigorous and evidence-based psychosocial interventions and standards of care for AYAs with hematologic malignancies. Ultimately, this research has the potential to reduce the burden of cancer in these vulnerable populations.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| PRISM (Promoting Resilience in Stress Management) | Experimental | Behavioral: PRISM (Promoting Resilience in Stress Management)Resilience Skills Training |
| Usual Care | No intervention | –Usual psychosocial care (control arm, no intervention) |
| Caregivers | No intervention | –Caregivers of participants, no intervention |
Who may qualify
- Ages
- 12 to 24 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (4 listed)
- AYA Child of caregiver agreed to participate
- One caregiver per patient-caregiver dyad
- Parent/guardian cognitively and physically able to participate
- Parent/guardian is able to speak/read English or Spanish
Key exclusion criteria (5 listed)
- Patient refusal
- Cognitively or physically unable to participate in interviews
- Unable to speak English
- Unable to read English or Spanish
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PRISM (Promoting Resilience in Stress Management)Manualized Skills-Training Program targeting resilience resources: stress-management, goal-setting, cognitive reframing, and meaning-making | Behavioural | PRISM (Promoting Resilience in Stress Management) |
Primary outcome
Hospital Anxiety & Depression Scale (HADS) Score - Depression Sub-score
Time frame: 6-months
The Hospital Anxiety and Depression Scale -Depression sub scale assesses mixed affective symptoms in patients with serious illness. The scale consists of 7 questions for depression. Each is scored from 0-3, for a total range of 0-21 points. "Caseness" of depression is defined as ≥8 points, with sensitivity/specificity of 0.8/0.8 for depression. The depression sub-scale will be measured as a continuous variable. Higher scores indicate more symptoms.
7 secondary outcomes
PedsQL Generic Core and Cancer-Related Quality of Life Score
Time frame: 6-months
Connor-Davidson Resilience Scale
Time frame: 6-months
Hope Scale Scores
Time frame: 6-months
Hospital Anxiety & Depression Scale Score - Anxiety Sub-score
Time frame: 6-months
Generalized Anxiety Disorder Screener (GAD7)
Time frame: 6-months
Patient Health Questionnaire-8
Time frame: 6-months
Medical Outcomes Study Rand 36-item Health Survey
Time frame: 6-months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Oct 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39303988Taylor MR, Cole SW, Bradford MC, Zhou C, Fladeboe KM, Knight JM, Baker KS, Yi-Frazier JP, Rosenberg AR. Resilience Intervention Improves Stress-Related Gene Expression in Adolescent and Young Adult HCT Recipients. Transplant Cell Ther. 2024 Dec;30(12):1209.e1-1209.e7. doi: 10.1016/j.jtct.2024.09.014. Epub 2024 Sep 19.
- Derived from this study: PubMed 35585525Fladeboe KM, Scott S, Comiskey L, Zhou C, Yi-Frazier JP, Rosenberg AR. The Promoting Resilience in Stress Management (PRISM) intervention for adolescents and young adults receiving hematopoietic cell transplantation: a randomized controlled trial protocol. BMC Palliat Care. 2022 May 19;21(1):82. doi: 10.1186/s12904-022-00966-9.
- Individual participant dataSharing planned: No. All IPD will be protected and maintained by the study team
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Abby R Rosenberg, MD, MS, MA principal investigator
Dana-Farber Cancer Institute
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing PRISM (Promoting Resilience in Stress Management) in people with Cancer and Bone Marrow Neoplasms, run by Seattle Children's Hospital at 5 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 26 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Hospital Anxiety & Depression Scale (HADS) Score - Depression Sub-score (time frame: 6-months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03640325, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2024.