Receipt of work accommodations related to longer job tenure among working breast cancer survivors.

Abstract

485 Background: Receiving accommodations at work (e.g. flexible hours) can help cancer survivors transition to and maintain employment. There is limited knowledge, however, about occupational and personal factors that influence receiving accommodations. We hypothesize that the longer an employee worked at an organization, the higher the odds of receiving accommodations likely due to enhanced awareness (e.g. policies, processes) and interpersonal connections (e.g. relationships, managerial support). Methods: We analyzed data from the PinkWorks Study, a self-reported, cross-sectional online survey of 154 female breast cancer survivors. Participants were ≥18 years of age, fluent in English, had completed treatment within the past 36 months, and were working ≥ 20 hours per week at the time of cancer diagnosis and currently. Logistic Regression was performed to evaluate if job tenure (< 5 yrs, versus ≥ 5 yrs) was associated with receipt of accommodations (yes, no) in the full sample and then stratified by having taken leave from work (n=79) or not (n=77) based on our prior work. Due to small sample sizes in key cells, however, only exploratory multivariate analyses were conducted. Results: In analyses of the total sample, there was a suggested association of higher job tenure (≥5 years) with receipt of accommodations compared to those with fewer years (< 5 yrs) at the company (OR=1.76, 95% CI 0.72-4.22, p=0.22). Among those who took a leave of absence, participants with higher job tenure (≥5 years) were far more likely to receive work accommodations (OR = 3.50 95% CI 1.04-11.8, p=0.04). In contrast, among those who did not take a leave, there was no evidence of an effect related to job tenure (p=0.58). Analysis from preliminary multivariate adjustment (e.g., age, stage of disease, race) did not appreciably vary from the univariate results. However, we did observe that participants identifying as non-Hispanic white were more likely to receive accommodations than other race/ethnic groups (OR = 3.42 95% CI 0.90-12.9, p=0.07) in multivariate analyses of the entire sample. Conclusions: Our findings suggest that length of time with an employer predicts receipt of work accommodation possibly limited to those who took medical leave. This difference in work leave suggests preferential awarding of real-time accommodations and leave. From a clinical perspective, these results should guide discussions about work accommodations, especially early in treatment and for patients with shorter job tenure or from diverse racial backgrounds. They underscore the critical need for organizational policy interventions to ensure equal support for all employees following a cancer diagnosis. The cross-sectional design and small sample sizes in this exploratory study limit interpretation. Future analyses are suggested to explore underlying reasons (e.g., enhanced awareness of policies) and racial disparities in receiving accommodations.