Shared Priorities for Sibling Psychosocial Support in Pediatric Cancer Care: A Value-Weighting Study

BACKGROUND: Although psychosocial support for siblings of youth with cancer is a standard of care, what sibling supportive services should entail remains unclear. Given limited resources for sibling care, establishing clinical and research priorities may guide resource allocation toward supports perceived as holding the greatest potential benefit. The current study used a two-round, value-weighting approach to identify priorities for sibling support services.

PROCEDURE: Participants were recruited from a group of sibling experts (clinicians, researchers, community program leaders, and adults who had a sibling with childhood cancer) invited to attend an international sibling summit. In Round 1, 27 participants provided feedback on a list of potential priorities for sibling psychosocial support. In Round 2, 30 participants completed a web-based value-weighting questionnaire indicating how they would allocate 100 units of hypothetical funding among various priorities and qualitatively described the rationale for their decisions.

RESULTS: Funding allocations generally averaged out across participants, highlighting the need for investments across all domains of sibling support. Participants allocated the greatest proportion of hypothetical funding to community-based sibling supports, which they perceived as more accessible to siblings than hospital-based supports. Participants allocated a particularly high level of funding to sibling supports in local schools. Within sibling subpopulations, bereaved siblings, siblings during active cancer treatment, and siblings with more adverse social determinants of health were allocated the largest proportion of funds.

CONCLUSIONS: Sibling-focused researchers, clinicians, program leaders, and adult siblings endorse broad investments in sibling support. Investments in community-based supports particularly may improve access to sibling support services.