Mobility Impairments (MI) and Associated Distress Domains in African American and Caucasian Older Adults with Cancer in a Multisite Lay Navigation Program (LNP) (S793)

Abstract

•Identify the incidence of mobility impairments in onco-geriatric in lay navigation program.•Describe the associated distress level and domains from data collected by distress thermometer for African Americans and Caucasians enrolled in a lay navigation program. Mobility impairments (MI) have a strong negative influence on quality of life (QOL). The Patient Care Connect Program (PCCP) trained 39 lay navigators (LNs) on fundamentals of onco-geriatrics, navigation, and using a Distress Thermometer (DT) to guide patient interactions across the cancer continuum. To describe (1) incidence of mobility impairments (MI), and (2) associated distress level and domains among African Americans (AA) and Caucasians enrolled in the PCCP LNs routinely utilized a modified National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) in the LNP. Patients were 65 years old and older, AA or Caucasian, and diagnosed with cancer in 2008-2015 in five southeastern states. We analyzed data from DTs administered in the quarter of enrollment. MI was defined as any difficulty with balance/walking/mobility, getting around inside/outside, moving in/out of chair/bed. An average score >3 indicated high distress. Distress causes were categorized in 6 domains: emotional, information, cognitive, practical, family, and spiritual. Chi square tests were used to determine differences across patients with and without MI, and across races. Among 4916 patients, 10% reported MI, the third highest ranked distress item after pain and fatigue. Compared to patients without MI, those with MI were more likely to report high stress (51.9% vs. 22.1%), and distress in each domains (p<.0001): emotional (41.7% vs 14.1%), information (39.9% vs, 24.2%), cognitive (29.1% vs 3.9%), practical (27.2% vs. 10.8%), family (6.8% vs. 2.4%), and spiritual (4.4% vs 0.7%). AAs reported more MI than Caucasians (13.2% AAs, 9.7% Caucasians, p = 0.005). Similar associations of MI with distress level and domains were found for AAs and Caucasians. AA onco-geriatric patients have a higher incidence of MI that impact well-being.