Rationale and design of Children's Oncology Group (COG) study ACCL20N1CD: financial distress during treatment of acute lymphoblastic leukemia in the United States.

BACKGROUND: The study purpose is to describe trajectories of financial distress for parents of children (ages 1-14.9 years) with newly diagnosed acute lymphoblastic leukemia (ALL). The secondary aim is to identify multilevel factors (child, parent, household, treating institution) that influence change in financial distress over time. METHODS: The study uses a prospective cohort design, repeated measurements, and mixed methods. The settings are Children's Oncology Group (COG) institutions participating in the National Cancer Institute Community Oncology Research Program (NCORP). Eligible participants are English- and/or Spanish-speaking parents or legal guardians (hereafter "parents") of index children. Parents are asked to complete a survey during their child's induction (T1) and maintenance therapy (T2), and near treatment completion (T3). Study surveys include items about (a) the child's cancer and clinical course, (b) parental socio-economic status, financial distress and financial coping behaviors, and (c) household material hardships. At least 15 parents will be invited to participate in an optional semi-structured interview. NCORP institutions that enroll at least one parent must complete an annual survey about institution resources that could influence parental financial distress. DISCUSSION: The results will inform future interventions to mitigate financial distress for parents of children diagnosed with ALL and could be instructive beyond this disease group. TRIAL REGISTRATION: This trial was initially registered with the NCI Clinical Trial Reporting Program ID: NCI-2021-03,567 on June 16, 2021. The study can be found on clinicaltrials.gov, Identifier NCT04928599 .

Seclusion and restraint practices in residential treatment facilities for children and youth.

Policymakers, advocates, and families remain concerned about the use of seclusion and restraint in residential treatment facilities for children and youth. This study used data from 2 national surveys to examine the extent to which residential treatment facilities consistently implement certain practices following incidents of seclusion or restraint. The study found that 76% of facilities reported having secluded or restrained youth in the previous year; 34% of these facilities reported that, following such incidents, they always debrief the youth, family, and staff; notify the attending physician; and record the incident in the treatment plan. Accredited facilities and those that conduct a trauma assessment upon admission were more than twice as likely as others to consistently implement these practices. States and providers should continue to monitor seclusion and restraint practices and identify opportunities for quality improvement.