Robb, Sheri L.Stegenga, KristinPerkins, Susan M.Stump, Timothy E.Moody, Karen M.Henley, Amanda K.MacLean, JessicaJacob, Seethal A.Delgado, DavidHaut, Paul R.2024-04-252024-04-252023-12-25Robb, S. L., Stegenga, K., Perkins, S. M., Stump, T. E., Moody, K. M., Henley, A. K., MacLean, J., Jacob, S. A., Delgado, D., & Haut, P. R. (2023). Mediators and Moderators of Active Music Engagement to Reduce Traumatic Stress Symptoms and Improve Well-being in Parents of Young Children With Cancer. Integrative Cancer Therapies, 22, 15347354231218266. https://doi.org/10.1177/15347354231218266https://hdl.handle.net/1805/40270Objective: This trial examined the effects of proximal/distal mediators and moderators of an Active Music Engagement (AME) intervention on young child/parent distress, quality of life, and family function outcomes. Methods: Child/parent dyads (n = 125) were randomized to AME or Audio-storybooks attention control condition. Each group received 3 sessions with a credentialed music therapist for 3 consecutive days with data collection at baseline, post-intervention (T2), and 30-days later (T3). Potential proximal mediators included within session child and parent engagement. Potential distal mediators included changes in perceived family normalcy, parent self-efficacy, and independent use of play materials. Potential moderators included parent/child distress with prior hospitalizations, parent traumatic stress screener (PCL-6), and child age. Outcomes included child emotional distress and quality of life; parent emotion, traumatic stress symptoms (IES-R), well-being; and family function. Mediation effects were estimated using ANCOVA, with indirect effects estimated using the percentile bootstrap approach. Moderation effects were tested by including appropriate interaction terms in models. Results: No significant mediation effects were observed. Child distress with prior hospitalizations moderated AME effects for IES-R intrusion subscale scores at T2 (P = .01) and avoidance subscale scores at T3 (P = .007). Traumatic stress screener scores (PCL-6) moderated intervention effects for IES-R hyperarousal subscale scores at T2 (P = .01). There were no moderation effects for child age. Conclusions: AME is a promising intervention for mitigating traumatic stress symptoms and supporting well-being in parents of children with cancer, particularly for parents who screen high for traumatic stress and whose children are more highly distressed with hospitalization.en-USAttribution-NonCommercial 4.0 Internationalchildmusic therapypsychological distresscancerhospitalizationquality of lifeparentsneoplasmsArticle