Evidence map›Paper›PMID 40358766›Full record

Trial reportEuropean journal of pediatrics2025

Influence of pediatric advance care planning on the secondary outcomes of the BOOST pACP trial: determinants of communication between parents and adolescents with cancer.

Anne van Driessche, Kim Beernaert, Luc Deliens, Marijke C Kars, Steven Wallaert, Leen Willems, Hanne Morren, Gertrui Vercruysse, Aithne Van den Bossche, Aline De Vleminck and 1 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anne van DriesscheEnd-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels Health Campus, Laarbeeklaan 103 building K, 1090, Brussels, Belgium. Anne.van.Driessche@vub.be.
Kim BeernaertEnd-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels Health Campus, Laarbeeklaan 103 building K, 1090, Brussels, Belgium.
Luc DeliensEnd-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels Health Campus, Laarbeeklaan 103 building K, 1090, Brussels, Belgium.
Marijke C KarsCenter of Expertise Palliative Care Utrecht, Julius Center of Health and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands.
Steven WallaertBiostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Leen WillemsDepartment of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium.
Hanne MorrenDepartment of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium.
Gertrui VercruysseDepartment of Pediatric Hematology-Oncology, University Hospital Leuven, Leuven, Belgium.
Aithne Van den BosscheNeonatal Intensive Care Unit and Maternal Intensive Care, University Hospital Antwerp, Antwerp, Belgium.
Aline De VleminckEnd-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels Health Campus, Laarbeeklaan 103 building K, 1090, Brussels, Belgium.
Joachim CohenEnd-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels Health Campus, Laarbeeklaan 103 building K, 1090, Brussels, Belgium.

Funding

Fonds Wetenschappelijk Onderzoek G.0194.18N
6 · The paper itself

Abstract

This study explores the impact of a pediatric advance care planning program (BOOST pACP) on adolescents with cancer and their parents, focusing on behavioral determinants such as attitudes, self-efficacy, intention, and behavior regarding the discussion of ACP topics. A multi-center, parallel-group superiority trial was conducted with adolescent-parent dyads recruited from four pediatric oncology wards in Belgium. The intervention group received four structured ACP sessions facilitated by an external professional, while the control group received care as usual. The acquired insights were shared with their oncologist. The behavioral determinants were measured through self-developed questionnaires based on the Theory of Planned Behavior (TPB) at baseline (T0), 3 months (T1), and 7 months (T2). This secondary data analysis used exploratory factor analysis and linear mixed models to assess the impact of the intervention. Forty-nine families were enrolled and randomized to the BOOST pACP group (n=24) or care-as-usual (n=25). At T1, fathers in the intervention group had significantly lower negative attitudes towards discussing ACP topics than their counterparts in the control group; mothers in the intervention group had increased intentions to discuss end-of-life care topics; and adolescents had reduced intentions to discuss ACP topics with their oncologist. No significant differences between intervention and control were observed in self-efficacy and mothers' attitudes.

conclusionOur RCT suggests a limited effectiveness of a pediatric ACP intervention in changing behavioral determinants associated with ACP communication. As the study was eventually underpowered, these findings underscore the need for a better understanding of the mechanisms driving or hindering outcomes and impact of pediatric ACP and highlight the complexity of influencing ACP behaviors within the pediatric oncology setting.

trial registrationISRCTN, number 33228289 10.1186/ISRCTN33228289. Registration date: 22/01/2021. WHAT IS KNOWN: • Pediatric advance care planning (pACP) helps families and healthcare professionals discuss future care but is challenging due to evolving decision-making capacity, family dynamics, and parental distress. • Healthcare professionals also report barriers to engage in pACP. WHAT IS NEW: • This study evaluated the impact of a structured pACP intervention (BOOST pACP) on behavioral determinants of ACP communication from the perspective of the adolescents, mothers, and fathers separately. • Findings highlight the complexity of influencing ACP behaviors and contributes to the important discussion on what ACP for this target group should look like.

Indexed as

Advance Care PlanningCommunicationNeoplasmsParentsProfessional-Family RelationsAdolescentAdultBelgiumChildFemaleHumansMaleSelf EfficacySurveys and QuestionnairesAdvance care planningBehavioral determinantsCancerCommunicationPediatric oncology

Identifiers

PMID40358766

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.