Parent decision-making about support for siblings of children with cancer: Sociodemographic influences

Siblings of children with cancer have elevated psychosocial risk. Sociodemographic factors (e.g., non-White race, low income, and low caregiver education) are associated with increased risk. Little is known about how sociodemographic factors influence families' decisions to participate in sibling support services. This convergent mixed-methods study characterizes how sociodemographic factors influence parent decision-making to engage siblings in support. Method: A purposive sample of parents of children with cancer (N = 28) participated in semistructured interviews that queried their perceptions of sibling support, including preferences for ideal support and perceived barriers to accessing support. Qualitative findings were merged with quantitative data to stratify by sociodemographic categories (ethnicity, parent-reported financial hardship, parent education). Applied thematic analysis was used to distill findings. Results: Sociodemographic differences emerged across parents' decisionmaking on whether to engage with sibling support services. Some cross-cutting barriers to accessing sibling support were described by all groups. However, differences across sociodemographic groups emerged for other barriers to care and for preferences for sibling support. Conclusions: These findings inform the design and implementation of sibling support programs. Providers can work with families to craft individualized sibling support plans that align with the family's preferences and circumvent perceived barriers, which may improve acceptability and use of support programming and ultimately improve siblings' psychosocial outcomes. This article offers an overview of sociodemographic variables (ethnicity, financial hardship, parent education) associated with parents' decision to engage in support for siblings of children of cancer. An understanding of these factors can support clinicians in the design and implementation of programs that are acceptable and accessible for all families of children with cancer.