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Feasibility and acceptability of the promoting resilience in stress management-parent (PRISM-P) intervention for caregivers of children with craniofacial conditions

Fladeboe, Kaitlyn; Stock, Nicola; Heike, Carrie; Evans, Kelly; Junkins, Courtney; Stueckle, Laura; O'Daffer, Alison; Rosenberg, Abby; Yi-Frazier, Joyce


Kaitlyn Fladeboe

Nicola Stock
Occasional Associate Lecturer - HAS - HSS

Carrie Heike

Kelly Evans

Courtney Junkins

Laura Stueckle

Alison O'Daffer

Abby Rosenberg

Joyce Yi-Frazier


Objectives: Few evidence-based psychosocial programs exist within craniofacial care. This study (a) assessed feasibility and acceptability of the Promoting Resilience in Stress Management-Parent (PRISM-P) intervention among caregivers of children with craniofacial conditions and (b) described barriers and facilitators of caregiver resilience to inform program adaptation.
Design: In this single-arm cohort study, participants completed a baseline demographic questionnaire, the PRISM-P program, and an exit interview.
Participants: Eligible individuals were English-speaking legal guardians of a child <12-years-old with a craniofacial condition.
Intervention: PRISM-P included 4 modules (stress-management, goal-setting, cognitive-restructuring, meaning-making) delivered in 2 one-on-one phone or videoconference sessions 1-2 weeks apart.
Main Outcome Measures: Feasibility was defined as >70% program completion among enrolled participants; acceptability was defined as >70% willingness to recommend PRISM-P. Intervention feedback and caregiver-perceived barriers and facilitators of resilience were summarized qualitatively.
Results: Twenty caregivers were approached and 12 (60%) enrolled. The majority were mothers (67%) of a child <1-year-old diagnosed with a cleft lip and/or palate (83%) or craniofacial microsomia (17%). Of these, 8 (67%) completed PRISM-P and 7 (58%) completed interviews; 4 (33%) were lost-to-follow-up before PRISM-P and 1 (8%) before the interview. Feedback was highly positive, with 100% willing to recommend PRISM-P. Perceived barriers to resilience included uncertainty about their child’s health; facilitators included social support, parental identity, knowledge, and control.
Conclusions: PRISM-P was acceptable among caregivers of children with craniofacial conditions but not feasible based on program completion rates. Barriers and facilitators of resilience support the appropriateness of PRISM-P for this population and inform adaptation.


Fladeboe, K., Stock, N., Heike, C., Evans, K., Junkins, C., Stueckle, L., …Yi-Frazier, J. (in press). Feasibility and acceptability of the promoting resilience in stress management-parent (PRISM-P) intervention for caregivers of children with craniofacial conditions. Cleft Palate-Craniofacial Journal,

Journal Article Type Article
Acceptance Date Jan 18, 2023
Deposit Date Jan 24, 2023
Journal Cleft Palate-Craniofacial Journal
Print ISSN 1055-6656
Electronic ISSN 1545-1569
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Keywords Visible difference; Psychosocial Adjustment, Parental Perception, Social Support, Quality of Life; resilience
Public URL
Additional Information Published as part of a project externally funded by Seattle Children's Hospital.