{"doi":"10.1093/jnci/djad099","title":"Disparities in parental distress in a multicenter clinical trial for pediatric acute lymphoblastic leukemia","abstract":"BACKGROUND: Parent psychological distress during childhood cancer treatment has short- and long-term implications for parent, child, and family well-being. Identifying targetable predictors of parental distress is essential to inform interventions. We investigated the association between household material hardship (HMH), a modifiable poverty-exposure defined as housing, food, or utility insecurity, and severe psychological distress among parents of children aged 1-17 years with acute lymphoblastic leukemia (ALL) enrolled on the multicenter Dana-Farber ALL Consortium Trial 16-001. METHODS: This was a secondary analysis of parent-reported data. Parents completed an HMH survey within 32 days of clinical trial enrollment (T0) and again at 6 months into therapy (T1). The primary exposure was HMH at T0 and primary outcome was severe parental distress at T0 and T1, defined as a score greater than or equal to 13 on the Kessler-6 Psychological Distress Scale. Multivariable models were adjusted for ALL risk group and single parent status. RESULTS: Among 375 evaluable parents, one-third (32%; n = 120/375) reported HMH at T0. In multivariable analyses, T0 HMH was associated with over twice the odds of severe psychological distress at T0 and T1 HMH was associated with over 5 times the odds of severe distress at T1. CONCLUSIONS: Despite uniform clinical trial treatment of their children at well-resourced pediatric centers, HMH-exposed parents-compared with unexposed parents-experienced statistically significantly increased odds of severe psychological distress at the time of their child's leukemia diagnosis, which worsened 6 months into therapy. These data identify a high-risk parental population who may benefit from early psychosocial and HMH-targeted interventions to mitigate disparities in well-being.","journal":"JNCI Journal of the National Cancer Institute","year":2023,"id":344449,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9572,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":810791,"name":"Victoria Koch","orcid":null,"position":1,"is_corresponding":false},{"id":459492,"name":"Yael Flamand","orcid":"0000-0003-2150-6732","position":2,"is_corresponding":false},{"id":1001171,"name":"Rahela Aziz‐Bose","orcid":"0000-0003-4753-5144","position":3,"is_corresponding":false},{"id":1001172,"name":"Lenka Ilcisin","orcid":"0000-0001-8934-5029","position":4,"is_corresponding":false},{"id":1001494,"name":"Ariana Valenzuela","orcid":null,"position":5,"is_corresponding":false},{"id":321127,"name":"Peter D. Cole","orcid":"0000-0002-3525-8015","position":6,"is_corresponding":false},{"id":321128,"name":"Lisa Gennarini","orcid":"0009-0009-3888-2997","position":7,"is_corresponding":false},{"id":321129,"name":"Justine M. Kahn","orcid":"0000-0003-3330-6754","position":8,"is_corresponding":false},{"id":321130,"name":"Kara M. Kelly","orcid":"0000-0003-1473-3937","position":9,"is_corresponding":false},{"id":759919,"name":"Thai Hoa Tran","orcid":"0000-0002-8712-6233","position":10,"is_corresponding":false},{"id":1082863,"name":"Bruno Michon","orcid":"0009-0007-1804-6487","position":11,"is_corresponding":false},{"id":321134,"name":"Jennifer Welch","orcid":"0000-0001-9117-4812","position":12,"is_corresponding":false},{"id":652934,"name":"Joanne Wolfe","orcid":"0000-0002-4406-7413","position":13,"is_corresponding":false},{"id":321136,"name":"Lewis B. Silverman","orcid":"0009-0007-7275-7650","position":14,"is_corresponding":false},{"id":585552,"name":"Kira Bona","orcid":"0000-0001-5602-7059","position":15,"is_corresponding":false},{"id":785077,"name":"Puja J. Umaretiya","orcid":"0000-0002-7587-4875","position":0,"is_corresponding":true}],"reference_count":49,"raw_metadata":null,"created_at":"2026-07-19T01:11:30.951510Z","pmid":"37261858","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}