Feasibility of a Mindfulness-Based Intervention for Children With High Grade/High Risk Cancer and Their Caregivers: Lessons Learned From a Pilot Randomized Control Trial

Background: Children and young adults diagnosed with a high-grade/relapsed-refractory cancer face a poor prognosis given limited curative options. Recent research has indicated that this population of children and adolescents/young adults (AYAs), alongside their parents, experience elevated stress and poorer health-related quality of life (HRQoL) relative to normative samples. Despite this, minimal research has examined supportive care interventions for these populations. The primary objective of this pilot study was to assess the feasibility (primary outcome) and acceptability of an 8-week mindfulness-based intervention (MBI) in this population. Methods: Eligible participants included individuals aged 5-24 years diagnosed with a high-risk cancer characterized by poor prognosis, with an adult caregiver willing to participate in the parallel caregiver arm. A random number generator was used to assign dyads to the MBI (n = 2 dyads) or psychoeducation control group (n = 3 dyads). Results: Five dyads (N = 10) enrolled in the study, with 3 dyads completing the intervention. All participants completed measures of feasibility and emotional-behavioral wellbeing at baseline and the study completers responded to follow-up measures after the 8-week intervention. Due to low enrollment, the study was discontinued and results are presented descriptively along with recommendations for future interventions with this population. Conclusions: This pilot trial of an MBI for children with high-risk cancer and their caregivers demonstrated poor feasibility and highlights challenges in providing supportive care to children with high-risk cancer. The barriers and recommendations are provided to inform future research with this underserved population.