African American Families Fighting Parental Cancer Together

The investigators will offer a 10-week prevention program to help African American parents
and caregivers (e.g., grandparents) diagnosed for the first time with Stages I, II, or III
solid tumor cancer in the last 12 months who are caring for a 12-18 year old child at home
who has been told about the parent's cancer diagnosis. Parents and their adolescent
child(ren) will first be asked to complete a set of questionnaires that takes about 60
minutes and then will be told within 2 to 4 weeks whether they have been assigned to 1 of 2
programs that will get chosen by chance, like flipping a coin. Neither the families nor the
researchers will choose what program is assigned. Both programs are designed to offer help
coping with cancer. Both short- and long-term effects of the program will be evaluated.

Program A involves just parents attending five educational sessions every other week (1
hour/session) with a group of parents who are also coping with cancer with specially trained
group leaders. Adolescent children will not participate in these group sessions; this is the
treatment as usual comparison group as most cancer centers do not meet with adolescent
children who have parents diagnosed with cancer.

Program B involves five group sessions (2 hours/session) every other week with other families
like them that include adolescents in some of the sessions and parents and adolescents
together in other sessions with specially trained group leaders.

The primary, secondary, and exploratory aims of this research are:

Primary Aim:

Aim 1. Compare the efficacy of Families Fighting Cancer Together (FFCT) to Treatment-as-Usual
(TAU) in reducing depressive symptoms (CDI) in AA adolescents at post-treatment using an
intention-to-treat (ITT) analysis.

Secondary Aim:

Aim 2. Compare the efficacy of Families Fighting Cancer Together (FFCT) to Treatment-as-Usual
(TAU) in reducing parental stress (PCQ) in AA parents at post-treatment using ITT analysis.

Exploratory Aims:

Aim 3a. Determine trajectories of adolescent depressive symptoms (CDI), anxiety (RCMAS), and
parental stress (PCQ) from baseline to 12-month follow-up.

Aim 3b. Determine whether perceived levels of group support (HGE), adolescent gender and age,
parent's marital and socioeconomic status, and parent's cancer staging modify the effects of
treatment on adolescent depression (CDI) and anxiety (RCMAS).

Aim 3c. Determine whether pre-post changes in parent-adolescent attachment and communication
mediate the association between treatment and adolescent depressive symptoms (CDI) and
anxiety (RCMAS) at 6- and 12-month follow-ups.

Inclusion Criteria:

- Parents must identify as non-Hispanic Black

- Must be diagnosed for the first time with stage I, II, or III solid tumor cancer
(e.g., breast, prostate, colorectal, lung) in the last 12 months

- Must be parent or primary caregiver of at least 1 adolescent living (target child) at
home (ages 12-18) who has been told about the diagnosis

Exclusion Criteria:

- Parents with serious mental health illness that prevents them from participating in
the group sessions (e.g., clinically relevant depressive symptomatology as evidenced
by the Center for Epidemiological Studies Depression Scale >27)

- Parents with psychotic features or severe cognitive impairment

- Parents not fluent in English.

- Severely depressed adolescents (CDI-2; T-scores of 70 and higher on the total 28-item
CDI-2 scale

- Severely anxious adolescents (RCMAS-2; We will use a cutoff score of 71 (T-score) or
higher to screen out African American adolescents with severe anxiety) at baseline

- Adolescents with psychotic features

- Adolescents with cognitive impairment (e.g., mental retardation, severe developmental
disorders) as evidenced by educational records, parental report and/or clinical
impression

- Adolescents currently in active outpatient mental health treatment.