A Multisite RWCT Comparing the Effectiveness of a Goals of Care Video and Navigator Intervention, the VIDEO-PEDS Experience, Versus Usual Care in Pediatric Cancer
Massachusetts General Hospital
Summary
The goal of this clinical trial is to learn if the VIDEO-PEDS intervention works to improve Goals of Care communication between clinicians and parents of children with cancer. The main questions it aims to answer are: Does the intervention improve Goals of Care documentation? Does it improve patient outcomes (including less invasive preferences for resuscitation and interventions, less hospital utilization, and more palliative care and hospice use)? Does it improve parent outcomes (including health satisfaction and feeling heard and understood per survey scores)?
Description
Background Parents of children with advanced cancer often face challenging decisions about goals of care (GOC) amidst high stress and limited understanding of medical interventions. Despite evidence that early and informed GOC discussions improve end-of-life experiences and align care with family values, such conversations remain infrequent in pediatric oncology. Barriers such as communication gaps, literacy challenges, and cultural differences exacerbate disparities, particularly among African American, Hispanic, and rural populations. The Video Images about Decisions for Ethical Outcomes in…
Eligibility
- Age range
- Not specified
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: Patient * Age 0-12 years * Diagnosed with any type or stage of cancer * Receiving cancer directed treatment Parent * Decision maker for the child. * Biological parent, step-parent, legal guardian (e.g., adoptive parent), or grandparent with medical consent authority. * Has a child meeting the child inclusion criteria listed above. * Able to communicate in English or Spanish (the languages of the video decision aids). Exclusion Criteria: Patient * Not receiving primary medical care from the cancer clinic (e.g., second-opinion consultations only) * Already referred to…
Interventions
- OtherVIDEO-PEDS
Following enrollment, parents will receive a link to view the refined video decision aid that is designed to prompt parents to think about their goals of care for their child with cancer, and then to react by engaging in communication with a trained member of the research team called the Navigator and eventually their clinical team over the course of the 9-month study duration.
- OtherVIDEO-PEDS pilot
This is the 3-month pilot version of the intervention, which will be further developed for the eventual RWCT.
- OtherFocus Group
Parents will view the Video aid and provide fascilitated feedback in an audio-recorded virtual group setting.
Locations (4)
- Children's of Alabama at BirminghamBirmingham, Alabama
- Children's Hospital of AtlantaAtlanta, Georgia
- Dana Farber Cancer InstituteBoston, Massachusetts
- Dartmouth Hitchcock Medical CenterLebanon, New Hampshire