Objective: Acute lymphoblastic leukemia (ALL) treatment mandates 2 to 3 years of maintenance therapy that includes daily oral 6-mercaptopurine (6-MP). Unfortunately, 6-MP nonadherence is linked with progressive relapse risk. This study evaluated feasibility, acceptability, and fidelity of a motivational interviewing (MI) intervention targeting 6-MP adherence during pediatric ALL maintenance therapy. Methods: We randomized 80 caregivers to receive a single MI session and 42 to an education-only control condition. Participants completed self-report measures about demographics, 6-MP adherence, and intervention acceptability. MI sessions were delivered during a routine clinic visit and were fidelity-coded using Motivational Interviewing Treatment Integrity 4.2.1 coding. Results: Findings confirmed MI feasibility and acceptability during routine outpatient clinic visits. In the MI condition, 92.5% of caregivers completed the MI session and 96.20% reported strong MI acceptability. We found no differences in enrollment, completion, or MI acceptability by cultural group. All Spanish-delivered MI sessions addressed social
Continuity of care is vitally important and allows families to feel safe and supported in a frequently changing environment. Mental health services across perinatal/neonatal settings can address parental mental health concerns, infant development, and infant–parent relationships. Although an integrated behavioral health clinician is the preferred model, at minimum a consult/liaison behavioral health clinician (BHC) is recommended in order to adequately meet the needs of infants and their parents across the continuum of care. All fetal care centers, neonatal intensive care units (NICUs), and NICU follow-up clinics should have a BHC who can develop programming that supports the patient experience and evaluates program outcomes through research and quality improvement projects. The push for BHCs in these settings is central to ensuring the highest potential is reached for infants and families alike.
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