Leslie R Carnahan1,2, Garth H Rauscher3, Karriem S Watson4,5, Susan Altfeld4, Kristine Zimmermann4,6, Carol E Ferrans7, Yamilé Molina4,6. 1. Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA. lcarna2@uic.edu. 2. Center for Research on Women and Gender, University of Illinois at Chicago, Rm 536A, 1640 W. Roosevelt Rd., MC 980, Chicago, IL, 60608, USA. lcarna2@uic.edu. 3. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA. 4. Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA. 5. University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA. 6. Center for Research on Women and Gender, University of Illinois at Chicago, Rm 536A, 1640 W. Roosevelt Rd., MC 980, Chicago, IL, 60608, USA. 7. Department of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave., Chicago, IL, 60612, USA.
Abstract
PURPOSE: Rural women, compared to urban, experience worse survivorship outcomes, including poorer health-related quality of life (QOL). There is a need to characterize the role of multilevel social factors that contribute to QOL, including context, networks, and functioning. Our objectives were to (1) use latent class analysis to identify distinct classes of social context and social networks and (2) examine how multilevel social factors (context, networks, and functioning) are associated with health-related QOL. METHODS: We recruited self-identified rural survivors to the Illinois Rural Cancer Assessment (2017-2018), via community-based sampling methods, and participants completed the survey online, by phone, or on paper. We used latent class analysis to generate multidimensional variables for contextual and network factors. We next modeled each social factor sas a predictor in separate, bivariable linear regressions for the QOL outcomes, followed by multivariable, adjusted regressions. RESULTS: For our first objective, there were three classes each of county-level contexts (1, highly rural, socioeconomically disadvantaged, and mostly lacking in cancer-related services; 2, mostly rural, moderately disadvantaged, and underserved; 3, mostly metropolitan, less disadvantaged, and most-resourced) and social networks (1, no caregivers; 2, only spousal caregivers with whom they communicated daily; 3, multiple caregivers with varying daily communication). For our second objective, among all social factors, only functioning was associated with better mental health-related QOL. No factors were associated with physical health-related QOL. CONCLUSIONS: Our findings suggest a rich diversity of social context and networks among rural female cancer survivors, and social functioning is particularly important for mental health-related QOL.
PURPOSE: Rural women, compared to urban, experience worse survivorship outcomes, including poorer health-related quality of life (QOL). There is a need to characterize the role of multilevel social factors that contribute to QOL, including context, networks, and functioning. Our objectives were to (1) use latent class analysis to identify distinct classes of social context and social networks and (2) examine how multilevel social factors (context, networks, and functioning) are associated with health-related QOL. METHODS: We recruited self-identified rural survivors to the Illinois Rural Cancer Assessment (2017-2018), via community-based sampling methods, and participants completed the survey online, by phone, or on paper. We used latent class analysis to generate multidimensional variables for contextual and network factors. We next modeled each social factor sas a predictor in separate, bivariable linear regressions for the QOL outcomes, followed by multivariable, adjusted regressions. RESULTS: For our first objective, there were three classes each of county-level contexts (1, highly rural, socioeconomically disadvantaged, and mostly lacking in cancer-related services; 2, mostly rural, moderately disadvantaged, and underserved; 3, mostly metropolitan, less disadvantaged, and most-resourced) and social networks (1, no caregivers; 2, only spousal caregivers with whom they communicated daily; 3, multiple caregivers with varying daily communication). For our second objective, among all social factors, only functioning was associated with better mental health-related QOL. No factors were associated with physical health-related QOL. CONCLUSIONS: Our findings suggest a rich diversity of social context and networks among rural female cancer survivors, and social functioning is particularly important for mental health-related QOL.
Entities:
Keywords:
Cancer survivors; Latent class analyses; Quality of life; Rural health; Sociological factors
Authors: Tim Luckett; David Goldstein; Phyllis N Butow; Val Gebski; Lynley J Aldridge; Joshua McGrane; Weng Ng; Madeleine T King Journal: Lancet Oncol Date: 2011-10-11 Impact factor: 41.316
Authors: Phyllis N Butow; Fiona Phillips; Janine Schweder; Kate White; Craig Underhill; David Goldstein Journal: Support Care Cancer Date: 2011-09-29 Impact factor: 3.603
Authors: Candyce H Kroenke; Marilyn L Kwan; Alfred I Neugut; Isaac J Ergas; Jaime D Wright; Bette J Caan; Dawn Hershman; Lawrence H Kushi Journal: Breast Cancer Res Treat Date: 2013-05-09 Impact factor: 4.872
Authors: D F Cella; D S Tulsky; G Gray; B Sarafian; E Linn; A Bonomi; M Silberman; S B Yellen; P Winicour; J Brannon Journal: J Clin Oncol Date: 1993-03 Impact factor: 44.544
Authors: Ellen K Barnidge; Pamela R Hipp; Amy Estlund; Kathleen Duggan; Kathryn J Barnhart; Ross C Brownson Journal: Int J Behav Nutr Phys Act Date: 2013-11-19 Impact factor: 6.457