Adapting an executive function coaching intervention for paediatric brain tumour survivors

Abstract

Objective: Empirical evidence demonstrates that executive function is impaired following paediatric brain tumour (pBT), negatively affecting the individual’s quality of life. Executive Function Coaching Interventions have led to improvements in executive function for individuals with ADHD. Given the commonalities in executive function difficulties, this study aimed to systematically adapt, pilot, and evaluate an Executive Function Coaching Intervention for paediatric brain tumour survivors. To aid self-management between sessions, the intervention was paired with Brain in Hand, personal smart technology. Methods: The intervention was adapted using the Intervention Mapping-adapt (IM-adapt) framework. This comprised: assessing population need; determining what needs to change; and piloting the intervention and gathering feedback. Six adolescent survivors of paediatric brain tumour and three of their parents piloted the Executive Function Coaching Intervention plus Brain in Hand. Qualitative methodology of semi-structured interviews was used to gather feedback on their experiences of executive dysfunction and the intervention. Reflexive thematic analysis was used to find patterns across these experiences. Results: The needs assessment determined that those who had survived a paediatric brain tumour experience a range of difficulties with executive function. Three over-arching themes relating to executive function and the intervention were developed from the reflexive thematic analysis: ‘everyday life challenges,’ ‘engagement’ and ‘improving executive function.’ These themes informed the logic model of change, a representation of the mechanisms through which the intervention worked. Suggestions for further adaptations to the interventions were made. ADAPTING AN EFC NTERVENTION FOR PBT SURVIVORS 87 Conclusion: Survivors of paediatric brain tumour experience difficulties with executive function in adolescence. Overall, Executive Function Coaching supported by Brain in Hand was considered by participants a useful and relevant intervention to support them. Future research could proceed to the next steps of the IM-adapt approach for this intervention, which is implementation and evaluation.