Abstract

Abstract Despite the major prostate cancer disparities, little research has examined how patients and their partners manage prostate cancer and related issues in the context of Socioeconomic disadvantage at the individual, dyadic, and neighborhood levels. Guided by an adapted stress appraisal and coping model, this study aimed to compare the health outcomes (QOL and symptoms) and psychosocial behavioral factors (appraisals of illness and coping resources) for men with newly treated localized prostate cancer and their partners who lived in neighborhoods with different socioeconomic disadvantage. We examined the baseline data from 273 patients and partners from a randomized controlled trial that tested the efficacy of a tailored eHealth symptom management intervention. FACT-G scale was used to access cancer-related physical, social, emotional, and functional domains of QOL. Financial well-being was assessed using FACIT-COST. Prostate cancer-specific symptoms and general symptoms were measured using the EPIC-26 and PROMIS questionnaires, respectively. Appraisals of illness and coping resources were measured using the Appraisal Scales, Lewis Cancer Self-Efficacy Scale, PROMIS, MOST, and Mediterranean Diet Assessment Tool. We used Multilevel Modelling to examine the role, ADI, and role*ADI interaction effects on QOL, symptoms, appraisal, and coping variables while controlling the effect of race. Area Deprivation Index (ADI) (high vs low) was used to measure the social, economic, and physical conditions in different geographic areas. There were significant but mixed role and ADI effects, but no interaction effects. Compared to the patients, partners had worse emotional QOL (p<.05); lower self-efficacy in symptom management (p<.01); lower emotional and instrumental social support (p<.05 and p<.001, respectively); and more frequent anxiety (p<.001), depression (p<.05), pain (p<.05), and fatigue (p<.01)). Partners also perceived less negative impact of patients' prostate cancer-related urinary and sexual problems, but more negative impact of hormonal problems (all ps<.001). Partners spent fewer hours watching tv (p<.01) and reported healthier eating habits than the patients (p<.05). Compared to those in low ADI neighborhoods, patient-partner couples who lived in more disadvantaged high ADI neighborhoods reported worse overall QOL and subdomains (ps<.05 – 0.001); more negative appraisals (p<.01); less interpersonal support and fewer health behaviors (ps<.05); more bothersome prostate cancer specific bowel and hormonal symptoms (ps<.01); and more frequent anxiety, pain, and fatigue (all ps<.05). This is the first study that used a multilevel approach to comprehensively examine the disparities in the health outcomes and stress-coping related psychosocial behavioral factors among patients with localized prostate cancer and partners who manage cancer and treatment-related stress in the context of neighborhood deprivation. Tailored interventions are needed to best meet the care needs of prostate cancer patients and partners, especially those in deprived neighborhoods. Citation Format: Shenmeng Xu, Peiran Guo, Gail Patricia Fuller, Cloie Ann Dobias, Eno Idiagbonya, Lixin Song. Neighborhood deprivation and living with prostate cancer: Patients' and partners' psychosocial behavioral status, symptoms, and quality of life [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-176.

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