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Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors: “Cascade”



The aim of this study was to evaluate the feasibility and acceptability of “Cascade”: an online, group-based, cognitive behavioral therapy intervention, delivered “live” by a psychologist, to assist parents of children who have completed cancer treatment.


Forty-seven parents were randomized to Cascade (n = 25) or a 6-month waitlist (n = 22). Parents completed questionnaires at baseline, 1–2 weeks and 6 months post-intervention. Thirty parents completed full evaluations of the Cascade program (n = 21 randomized to Cascade, n = 9 completed Cascade post-waitlist).


Ninety-six percent of Cascade participants completed the intervention (n = 24/25). Eighty percent of parents completed every questionnaire (mean completion time 25 min (SD = 12)). Cascade was described as at least “somewhat” helpful by all parents. None rated Cascade as “very/quite” burdensome. Parents reported that the “online format was easy to use” (n = 28, 93.3 %), “I learnt new skills” (n = 28, 93.3 %), and “I enjoyed talking to others” (n = 29, 96.7 %). Peer-to-peer benefits were highlighted by good group cohesion scores.


Cascade is highly acceptable and feasible. Its online delivery mechanism may address inequities in post-treatment support for parents, a particularly acute concern for rural/remote families. Future research needs to establish the efficacy of the intervention.

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The authors thank Dr. Antoinette Anazodo, Dr. Belinda Barton, Dr. Luciano Dallo-Pozza, Dr. Peter Downie, Prof. Afaf Girgis, Dr. Martha Grootenhuis, A/Prof. Madeleine King, Ms. Cherie Lowe, Dr. Maria McCarthy, Mr. Gordon Miles, Dr. Michael Osborn, Dr. Pandora Patterson, Dr. Nicole Schneider, Prof. Rosalie Viney, and Ms. Helen Wilson.

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Correspondence to Claire E. Wakefield.

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This work is supported by Cancer Australia (grant number: APP1065428); the National Health and Medical Research Council of Australia (grant number: APP1067501), to CW; Cancer Institute of New South Wales (grant number: 11/ECF/3-43), to CW; and Cancer Institute of New South Wales (grant number: 14/ECF/1-11), to USD. The Behavioural Sciences Unit is supported by the Kids with Cancer Foundation.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Wakefield, C.E., Sansom-Daly, U.M., McGill, B.C. et al. Acceptability and feasibility of an e-mental health intervention for parents of childhood cancer survivors: “Cascade”. Support Care Cancer 24, 2685–2694 (2016).

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  • Cancer and oncology
  • Coping skills and adjustment
  • Parents
  • Computer applications/eHealth