Development and Pilot‐Testing of a WeChat‐Based Problem‐Solving Skills Training Program for Parents of Children With Cancer: A Nonrandomized Clinical Trial

Problem-solving skills training (PSST) has been shown to improve psychosocial outcomes for parents managing childhood cancer. However, accessibility barriers hinder its in-person delivery, particularly in regions with limited psychological resources. This study aimed to develop a WeChat-based PSST (WB-PSST) intervention and pilot-test its feasibility and preliminary impact. The WB-PSST intervention was developed using an iterative process, including evidence synthesis, stakeholder interviews, intervention modeling, and expert consultation. The intervention included eight weekly sessions delivered via a WeChat mini-program titled "No problem", featuring interactive modules tailored to parents' typical caregiving challenges to practice problem-solving steps. A nonrandomized clinical trial using before-and-after comparisons was then conducted among parents of children with any type of cancer, who were required to own a smartphone with WeChat installed. Outcomes were assessed using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. Twenty parents enrolled and completed the intervention. Parents reported potential signals of improvement in problem-solving skills (difference, 6.95, p < 0.001) and family adaptation (difference, 6.35, p = 0.002) and reductions in depressive symptoms (difference, -2.80, p < 0.001). Parental and pediatric quality of life showed a positive but non-significant trend. Parents logged into "No problem" an average of 33.45 days over 8 weeks, with high satisfaction (8.95-9.35 out of 10) and fidelity (93.0%). Qualitative feedback revealed emotional relief, strengthened decision-making, and a user-friendly design and tailored stepwise practice. The intervention was feasible and showed early indications of improvement in parental problem-solving skills, depressive symptoms, and family adaptation. Further full-scale randomized clinical trials are warranted. ChiCTR2400087599.