ASPO Abstracts
Characterizing the role of multilevel social factors on rural cancer survivors’ quality of life: Findings from the Illinois Rural Cancer Assessment
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose: There will be 18 million cancer survivors in the US by 2020. Although life expectancy has improved, rural residents, versus urban, experience disparities in quality of life (QOL). The purpose of this study is to characterize multilevel (contextual, network, interpersonal) social factors of rural survivors and to describe associations on mental (MHQOL) and physical health QOL (PHQOL). Methods: The statewide, cross-sectional Illinois Rural Cancer Assessment surveyed the health status and needs of adult, rural-dwelling cancer survivors. We used the Short Form Health Survey (SF-12) to assess the primary outcomes, MHQOL and PHQOL. We examined associations between contextual (county disadvantage, rurality), network (survivor-caregiver integration and demographics), and interpersonal (patient-provider communication (PPC), social well-being (SWB), intimate relationships) factors. Results: 139 rural survivors from 52 counties participated. Regarding context, mean county-level poverty and high school graduation rates were 15% + 5 and 89% + 4, and the median household income was $51K + 11K. Regarding networks, survivors reported on average 1.8 + 1.7 caregivers, 48% reported speaking to most of their network daily, and 70% had known most of their network for >6 years. Regarding interpersonal factors, 68% reported low/medium PPC, 70% were married, and SWB and relationship satisfaction scores were 19 + 5 (range 4-24) and 28 + 8 (range 1-35). In bivariate associations between social factors and QOL, SWB (B=.496, p=<.0001) and intimate relationships (B=.261, p=.004) were positively associated with MHQOL. In multivariate models, SWB (B = .469, p =<.0001) continued to be positively associated with MHQOL, but relationship satisfaction was not. There were no associations with PHQOL.Conclusion: This work suggests a relationship between interpersonal, but not contextual or network, social factors and rural survivors’ MHQOL. Understanding determinants of QOL can aid intervention planning and implementation to improve long-term holistic health outcomes and reduce disparities among rural survivors. Given persistent disparities and limitations of individual-level interventions to improve QOL, continued exploration of network and contextual factors is warranted.
Keywords: Rural, Quality of life, Survivorship, Disparities