A Randomized Controlled Trial of Animal-assisted Activities for Pediatric Oncology Patients: Psychosocial and Microbial Outcomes.

Only 26 patients were randomized instead of the planned 40 because recruitment was slow and stopped during the COVID-19 pandemic, so the study was underpowered. Primary patient outcomes were measured only after the first visit, so effects of repeated visits were not tested. Discharge and follow-up surveys had low response and were not presented, so longer-term patient and parent outcomes cannot be judged. The control group received usual care with no matched activity, so the study compares dog visits with no intervention rather than with another specific activity. Participants were not blinded to group after pre-visit data, and chart abstraction was done by staff who collected surveys, so subjective outcomes may be influenced by awareness. Infection and pathogen findings were descriptive and not powered for comparison, so they do not show whether infection risk changes. The microbial noninferiority margin was based on baseline sample standard deviation because no pediatric safe hand microbial load was known, and only hands were sampled, not nares, dogs, or the hospital environment. Patients on the bone marrow transplant service, those with isolation precautions, dog allergy or fear, non-intact hands, or no English-speaking parent were excluded, so results do not apply to those groups. The sample was English-speaking inpatients at one hospital, so generalizability is limited.

The National Institutes of Health and Kaiser Permanente funded the study but did not participate in other ways.

Do not read the lower parental anxiety or no increase in hand microbes as proof that dog visits with hand sanitization improve patient functioning or prevent infection. The patient primary outcome was null, the study was underpowered, and infection outcomes were not powered for comparison.