Objective: To explore the psychosocial experiences of African American families affected by childhood cancer.

Methods: A qualitative investigation was conducted using grounded theory methods. Data collection consisted of in-depth semistructured interviews of purposively sampled participants. Eligible participants were English-speaking parents who self-identified as African American and whose children received cancer care at 3 US cancer centers. Interviews were conducted by a single trained interviewer via telephone or confidential video conference. The research team employed constant comparative analysis to analyze interview transcripts. The analytic process incorporated memoing and regular meetings to discuss the emergent theory.

Results: Enrolled African American parents (n = 45) were primarily college-educated (n = 33; 73%) women (n = 37; 82%) from single-parent households (n = 23; 51%) with a household income of $50 000 or less (n = 26; 58%) from 3 cancer centers in the Eastern and Southern United States. The emergent theory of psychosocial experiences was magnified existential crisis, defined as emotional distress related to the child's illness and intensified by disconnected and discordant health care interactions and economic worries. These external threats (disconnected and discordant care, economic hardships) related to parents' membership within a marginalized population. Parents used coping resources (religiosity, spirituality, optimism, bolstering communication) to buffer the existential crisis.

Conclusion: This sample of African American parents of children with cancer experienced magnified existential crisis. This emergent theory may inform intervention development. Interventions that address both psychosocial and economic needs may be essential to reduce distress among African American parents of children with cancer.