A Longitudinal Photo-Narrative Exploration of Hope During Phase 1/2 Clinical Trials For Pediatric Cancer

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• Lack the cognitive, communicative, or physical capacity to meaningfully participate in a photo-narrative interview, as determined by the research team in consultation with the patient, caregiver, and primary oncology team. This includes, but is not limited to, individuals with profound neurocognitive impairment, non-responsiveness, or other conditions that preclude the ability to engage in basic reflection, expression, or shared conversation about images.

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• Patients, Caregivers, and Clinicians will be excluded if they:
• Do not meet inclusion criteria.
• Decline, refuse, or are unwilling to participate.
• Are a minor without a legal guardian available or willing to provide informed consent.

• Patient participants must
• Be 12 to 25 years of age.
  • AND
• Have a primary cancer diagnosis that is relapsed, refractory, or without curative standard-of-care options as follows:
  • 'Relapsed' disease is defined as disease recurrence following a prior complete or partial response to initial therapy.
  • 'Refractory' disease is defined as failure to achieve remission or response with standard upfront therapy.
  • Diagnoses will be considered 'without curative standard of care options' if there is no evidence-based curative treatment regimen or where standard therapies offer only palliative or non-curative intent (based on the assessment of the primary attending or division tumor board).
  • AND
• Be enrolled OR planning to enroll in a phase 1 or phase 2 trial for cancer-directed therapy.* Patients will remain eligible until 4 weeks after they begin trial therapy, after which they are no longer eligible unless they subsequently enroll on a different clinical trial.
  • Caregiver participants must
• Be a parent or primary caregiver to a child of any age who
  • Has a primary cancer diagnosis that is relapsed, refractory, or without curative standard-of-care options
  • AND
• Is enrolled OR planning to enroll on a phase 1 or phase 2 trial for cancer-directed therapy.* Parents will remain eligible until 4 weeks after their child begins trial therapy, after which they are no longer eligible unless their child subsequently enrolls on a different clinical trial.
  • Be ≥ 18 years of age or legally emancipated
  • Medical clinician participants (Primary Objectives 1-2) must
• Be a physician, advanced practice provider, or nurse providing direct patient care to the patient participant and/or to the child of the caregiver participant.
  • Psychosocial clinician participants (Primary Objective 2 only) must
• Be a psychosocial clinician (e.g., social worker, psychologist, chaplain, child life specialist, music therapist, cultural navigator, etc.)
  • AND
• Provide direct or consultative care to pediatric or adolescent/young adult patients with relapsed, refractory, or high-risk cancer and/or their families.