Abstract A81: Examining racial differences in social support needs among women diagnosed with ovarian cancer

Abstract

Abstract Purpose: To examine the social support needs of women diagnosed with ovarian cancer (OvCa) and to understand how these needs differ by race. Background: For women, OvCa is the leading cause of death among cancers of the reproductive system. Moreover, marked disparities exist. African-American (AA) women are diagnosed with more advanced stages of OvCa and have lower survival rates when compared to their White (W) counterparts. These disparities persist after controlling for age at diagnosis, stage, and surgical treatment. Women diagnosed with OvCa experience high rates of depression and anxiety which adversely impact their immune system, the primary mechanism of defense against malignant diseases. Evidence suggests that a high level of social support protects individuals from the adverse effects of stressful circumstances. In OvCa patients, social support has been associated with both lower psychological distress and increased immunity. Social support has also been linked to lower rates of morbidity and mortality, and better physical health outcomes for chronic diseases, including cancer. However, little is known about social support among OvCa patients, and whether differences exist by race. This study serves as a first step in understanding this relationship as it seeks to identify the unique racial differences in social support needs of OvCa patients. Methods: This study reports findings from the Ruth Research to Understand Treatment Choices in Ovarian Cancer study. We examined preliminary survey data for 72 female participants diagnosed with OvCa in the past year and treated at a local urban teaching hospital. Support was measured using an adapted version of the Medical Outcomes Study Social Support Survey Instrument. Scale items were grouped into four domains: 1) emotional support, 2) instrumental support at home (e.g., someone to help you if you were confined to bed), 3) instrumental support in health care settings (e.g., someone to take you to the doctor if you needed it), and 4) informational support. Responses ranged from 1 for having support all the time, to 5 for having it none of the time. Given the skewness of the data, we dichotomized the responses into scores ≤ 2 and scores > 2. We ran logistic regressions to identify the independent effect of race on support adjusting for age, education, marital status, income, and months since diagnosis. Results: Women surveyed were 33% AA, 40% aged 65 or above, 45% married, 25% with income insufficient to meet basic needs, and 9.7 months from diagnosis on average. The percentage of women with support scores ≤ 2 (i.e., higher levels of support) were: 62.5% AA vs 77.1% W for Emotional support, 58.3% AA vs 68.8% W for Instrumental support at home, 79.2% AA vs 87.5% W for Instrumental support in health care settings, and 54% AA vs 64.6% W for Informational support. The logistic regressions indicated that race was not associated with the support domains (p-values>0.05). Participants aged 65 or above were more likely to have instrumental support in the health care setting than younger participants (p=0.090). Participants with inadequate income were less likely to have emotional support (p=0.054). Conclusions: We did not find a statistically significant association of support with race. However, results are limited by the small sample size. Larger samples of AA OvCa patients are necessary to better investigate potential disparities in social support. Results suggest that other disparities in support may exist, and thus the need to pay attention to younger women and those women with lower incomes to make sure they have adequate instrumental and emotional support. Funding: Centers for Disease Control & Prevention (3U48DP001915-03S2), National Cancer Institute (U54 CA118948) Citation Format: Will Tarver, Michelle Martin, Ronald Alvarez, Ellen Funkhouser, Kerri Bevis, Maria Pisu. Examining racial differences in social support needs among women diagnosed with ovarian cancer. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A81. doi:10.1158/1538-7755.DISP13-A81