Feasibility and acceptability of the “Day 100 Talk”: An interdisciplinary communication intervention during the first six months of childhood cancer treatment

Abstract

Background Communication gaps arise early in the childhood cancer trajectory and may persist. The authors conducted a pilot study of the feasibility and acceptability of a communication intervention, the Day 100 Talk (D100). D100 involves an interprofessional family conference during initial months of treatment between oncologists, psychosocial clinicians, and parents, facilitated by a 3‐part conversation tool. Methods The authors enrolled English‐speaking parents of children with nonrelapsed, nonprogressive cancer who were receiving continuity care from enrolled pediatric oncologists and psychosocial clinicians at a single site. The a priori feasibility threshold was 60% parent completion of the D100 intervention. Surveys from parents and professionals and debrief interviews with professionals assessed D100 acceptability. Results Thirty‐seven parents (77%) and 38 oncology professionals (67%) enrolled. Twenty of 33 evaluable parents (61%) participated in a D100 family conference. Most commonly, parents did not complete the D100 intervention because of scheduling difficulties related to clinical team constraints. All 17 parents who completed a post‐D100 survey agreed or strongly agreed that D100 participation was helpful. In debrief interviews, professionals identified D100 benefits, namely, stepping back to the big picture and getting on the same page, and barriers related to logistical challenges and professionals' anticipatory dread. Conclusions The D100 intervention pilot demonstrates high acceptability among parents of children with cancer. Despite meeting the prespecified feasibility threshold, findings highlight important barriers to D100 dissemination, namely, perceived burdens on professionals. Potential strategies to reduce burden may include using virtual visit platforms, incorporating D100 elements across multiple visits, or prioritizing intervention delivery to parents with the greatest need for enhanced communication.

Adaptation of the Day100 Talk communication intervention for Spanish‐speaking families of children with cancer

“…A bilingual interviewer trained in medical sociology conducted parent interviews 8 . Parents described communication experiences receiving childhood cancer care and reviewed/gave feedback on Spanish language Day100 materials, including the three‐part communication tool (preparatory family worksheet, conversation guide, and family summary sheet), 3 and parent surveys. Interpreters and clinicians discussed experiences communicating with Spanish‐speaking parents and identified benefits and potential barriers to conducting Day100 with Spanish‐speaking families.…”

“…The Day100 Talk (Day100) is an intervention to bridge communication gaps between parents and clinicians through an interprofessional family conference facilitated by communication tools during the initial months of childhood cancer care. Day100 provides families of children with cancer an opportunity to regroup with their child's care team to address unanswered questions, concerns, and future goals 3 . In a recent study, Day100 exceeded predetermined feasibility thresholds (60% parent intervention completion) and was highly acceptable to families and clinicians 3 .…”

“…Day100 provides families of children with cancer an opportunity to regroup with their child's care team to address unanswered questions, concerns, and future goals 3 . In a recent study, Day100 exceeded predetermined feasibility thresholds (60% parent intervention completion) and was highly acceptable to families and clinicians 3 . Sixteen million people in the United States speak primarily Spanish with limited English proficiency, forming the third largest linguistic population 4 .…”

Differences in palliative opportunities across diagnosis groups in children with cancer

“…For patients who receive diagnoses with extremely poor prognosis, many families are open to PC integration at diagnosis. 16,[23][24][25][26][27] In practice, pediatric oncologists often wait for a precipitating event such as relapse or code status discussion to introduce PC. 2,12,17,28 However, many events arise during a child's cancer course that cause distress.…”

“…Multiple studies have shown that families are accepting of PC within the first few months following diagnosis, as symptom‐related suffering begins early during treatment. For patients who receive diagnoses with extremely poor prognosis, many families are open to PC integration at diagnosis 16,23–27 …”