ASPO Abstracts
Rural-Urban Differences in Health Outcomes among Older, Overweight, Long-Term Cancer Survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research,
Conference Year: 2018
Abstract Body:
Background: Rural cancer survivors are at increased risk for poorer health outcomes, cancer- related mortality, lower physical functioning and face multiple challenges–limited transportation, education, income, and healthcare access, and older age. Yet, there is little research in rural cancer survivors. The Reach Out to ENhancE Wellness (RENEW) trial was a home-based, diet and exercise intervention among 641 older, breast, prostate, and colorectal cancer survivors that addressed many of these challenges. Methods: Via unadjusted and adjusted (covariates: age, race, sex, education, comorbidity and symptom count, baseline physical function, intervention/waitlist intervention group, and years since diagnosis) analyses, we examined urban-rural differences among RENEW participants in physical functioning, overall physical and mental quality-of-life, intakes of fruits and vegetables (FV) and saturated fat, body mass index (BMI), physical activity, and adverse events (total and serious). Results: Rural, as compared to urban survivors, reported significantly better changes in physical functioning in unadjusted and adjusted comparisons (p-values<0.005); moreover, adjusted models suggest better response for overall physical health [+0.14(0.71) v -0.74(0.50)], and fewer mean(SD) adverse events [1.58(0.08) v 1.64 (0.06)], but less favorable changes in FV intake [+1.47(0.23) v +1.56(0.16)](all p-values<0.04). No rural-urban differences were detected in mental quality-of-life, saturated fat intake, BMI, physical activity, and serious adverse events. Conclusion: The RENEW intervention was associated with greater benefit in rural versus urban cancer survivors and serves as an exemplar to reduce declines in physical health and functioning in this vulnerable population; however, more research is needed among rural cancer survivors to overcome barriers to FV consumption.
Keywords: rural-urban differences, cancer survivors, health outcomes, lifestyle interventions, disparities