# Biologic Mechanisms and Dosing of Active Music Engagement to Manage Acute Treatment Distress and Improve Health Outcomes in Young Children with Acute Lymphoblastic Leukemia and Parents

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2021 · $394,228

## Abstract

PROJECT SUMMARY
Music therapy has become a standard palliative care service in many pediatric and adult hospitals. However, a
majority of music therapy research has focused on the use of music to improve psychosocial dimensions of
health, without considering biological dimensions. In addition, few studies have examined dose-response
relationships. Cancer treatment is an inherently stressful experience, and a significant number of young
children and parents (caregivers) experience persistent, interrelated emotional distress and poor quality of life.
Many parents also experience traumatic stress symptoms because of their child's cancer diagnosis and
treatment. Our previously tested Active Music Engagement (AME) intervention uses active music play to
diminish stressful attributes of cancer treatment to help manage emotional/traumatic distress experienced by
young children (ages 3-8) and parents and improve quality of life. A recent AME trial is examining psychosocial
mechanisms of action responsible for change in child/parent outcomes. The current study expands on this
work by examining AME's effects on several biomarkers to povide a more holistic understanding about how
active music interventions work to mitigate cancer-related stress and its potential to improve immune function.
The purposes of this two group, randomized controlled trial are to examine biological mechanisms of effect and
dose-response relationships of AME on child/parent stress during the consolidation phase of Acute
Lymphoblastic Leukemia (ALL) treatment. Specific aims are to: 1) establish whether AME lowers child and
parent cortisol, 2) examine cortisol as a mediator of AME effects on child and parent outcomes, and 3)
examine the dose-response relationship of AME on child and parent cortisol. Child/parent dyads (n=228) will
be stratified (by age, site, ALL risk level) and randomized in blocks of four to AME or attention control. Each
group will receive one 45-minute session during weekly clinic visits for the duration of ALL consolidation (4
weeks standard risk; 8 weeks high risk). Parents will complete measures at baseline and following the last
study session. Child and parent salivary cortisol samples will be taken pre and post-session for the first 4 AME
or attention control sessions. Child blood samples will be reserved from routine blood draws prior to sessions 1
and 4 (all participants) and session 8 (high risk participants). Linear mixed models will be used to estimate
AME's effect on child and parent cortisol. Examining child and parent cortisol as mediators of AME effects on
child and parent outcomes will be performed in an ANCOVA setting, fitting the appropriate mediation models
using MPlus and then testing indirect effects using the percentile bootstrap approach to estimate the indirect
effect. Graphical plots and non-linear repeated measures models will be used to examine the dose-response
relationship of AME on child and parent cortisol. Findings will increase mecha...

## Key facts

- **NIH application ID:** 10181082
- **Project number:** 5R01NR019190-03
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Sheri L Robb
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $394,228
- **Award type:** 5
- **Project period:** 2019-09-19 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10181082

## Citation

> US National Institutes of Health, RePORTER application 10181082, Biologic Mechanisms and Dosing of Active Music Engagement to Manage Acute Treatment Distress and Improve Health Outcomes in Young Children with Acute Lymphoblastic Leukemia and Parents (5R01NR019190-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10181082. Licensed CC0.

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