Procedure
Participants were from a pilot study and a multisite study in which both assessed, coping, communication, and adjustment in families of children with cancer from diagnosis to five years post-diagnosis. Following approval from the Institutional Review Board, eligible participants were selected from cancer registries and recruited by research staff at two large pediatric hospitals in the United States (one in the Midwest, one in the Southeast). Participants were recruited following either an initial cancer diagnosis or relapse. Parents were provided with information about the study and gave their written consent for participation. Children also gave their written consent or assent (for ages 10-17). Paper and pencil surveys were then completed at their convenience. After finishing the surveys at initial diagnosis (T1), families were contacted for follow-up assessments at one (T2), three (T3), and five years (T4) post diagnosis or relapse [17]. The families were compensated for their time at each assessment.