A virtual peer support program created at the Hospital for Sick Children (SickKids) shows significant potential in helping immunocompromised teenagers cope with the challenges of social isolation and physical distancing, positively impacting their well-being, a study finds.
The study - carried out by researchers at SickKids and the University of Toronto and published in the journal Supportive Care in Cancer - examined the impact of a program called Teens4Teens on adolescents undergoing cancer treatment.
A weekly peer support group and patient education program, Teens4Teens was launched at SickKids in 2020 with the goal of supporting the psychosocial and physical health of adolescents with cancer.
According to the study, program participants reported a number of positive impacts that included feeling relatable and understood, conveying their emotions through art, developing coping mechanisms and discussing grief and relationships with family.
"One of the biggest takeaways for teens in our study group was the peer support component," says the study's first author Alicia Kilfoy, a PhD student in the Lawrence Bloomberg Faculty of Nursing. "They wanted a safe space to communicate with other teens with cancer who understood what they were going through."
An unexpected finding was that Teens4Teens also acted as a training ground for broader skills development in realms such as peer mentorship, career planning and applying to post-secondary education opportunities.
For adolescents who are immunocompromised, physical distancing can be important in managing their risk of serious infection, but it can be an especially negative experience during some of their most formative years.
"The cancer situation for teens is very unique, in that the disease hits at a time when they are trying to develop their own sense of autonomy," says Kilfoy's supervisor and study co-author Lindsay Jibb, a scientist in the Child Health Evaluative Services program at SickKids and assistant professor at the Lawrence Bloomberg Faculty of Nursing. "Resources in pediatric oncology are often not tailored to this age group, and so this support program, according to our results, appears to be a step in the right direction."
Teens4Teens was originally designed by Chana Korenblum, a staff physician in SickKids's division of adolescent medicine and assistant professor in the department of paediatrics in U of T's Temerty Faculty of Medicine.
It was implemented for young cancer patients during the COVID-19 pandemic, with the aim of providing teens with a space to connect through virtual sessions with speakers who engaged them on an array of topics related to cancer and also generally on navigating life as a teen.
Sessions were moderated by child life specialists and included guest speakers from various disciplines including nursing and creative art therapy. Each group was involved in addressing coping strategies for grief and navigating difficult feelings using activities such as music and art therapy.
"Teens told us they valued having a space where all thoughts and feelings about cancer were welcome, where they could share their stories and swap coping strategies without judgment - and most importantly, where they felt a strong sense of belonging and connectedness," says Korenblum.
One of the big draws for teens to participate in the program was the desire to regain a sense of control. Many participants in the study reported challenges associated with feeling excluded from decision-making in their own lives - including around their medical treatment - and the negative impact of cancer on their sense of self and relationships with others.
"We also saw teens reporting that the program normalized their cancer experience in a developmentally appropriate way, and changed the way health providers were engaging with them as patients," says Jibb, who also holds the Signy Hildur Eaton Chair in Paediatric Nursing Research at SickKids.
The study also delved into participants' suggestions for improvement, which included making the program hybrid to provide more opportunities for in-person social connection. The researchers say the teens' feedback will help them fine-tune and augment the program to increase recruitment, engagement and impact.
The study comes amid a growing recognition within the oncology field of the need for teen-centred programming, with Teens4Teens showing promise as a low-cost, feasible intervention.
"Adolescence can be tricky to navigate, and a cancer diagnosis can add many bumps to the road," says Jibb. "I'm excited to see how this program continues to grow in support of teens with cancer."
