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Vasquez-Trespalacios EM, Rivera Rivera JN, McIntyre M, Santiago-Datil W, Wenham RM, Vadaparampil ST, Buras AL, Conley CC. High Financial Hardship among Patients with Advanced Ovarian Cancer. J Soc Work End Life Palliat Care 2024:1-13. [PMID: 38635421 DOI: 10.1080/15524256.2024.2342285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Ovarian cancer is considered the most fatal and costly gynecologic cancer. Although personalized therapies have improved ovarian cancer prognosis, they have resulted in increased financial toxicity concerns among this population. This study evaluated financial toxicity in patients with advanced ovarian cancer. Using secondary data from a study of barriers to palliative care, financial toxicity (FT) was measured through the Comprehensive Score for Financial Toxicity scale. Univariate and bivariate analyses were used to assess the relationship between selected demographic (i.e., age, race, ethnicity, education, place of birth, insurance type, yearly household income, employment status) and treatment-specific variables (i.e., years since diagnosis, surgery, chemotherapy, radiation, hormonal and targeted therapy) with clinically relevant financial toxicity. Characteristics were compared using Fisher's exact or chi squared tests. A total of 38 participants with advanced ovarian cancer were included in this study; 24% (n = 9) reported clinically significant FT. Income (p = .001), place of birth (p = .048) and employment status (p = .001) were related to FT. Study findings highlight that advanced ovarian cancer patients experience high FT, particularly those with low income, who are not able to work and were born outside the US. Further research using larger datasets and more representative samples is needed to inform intervention development and implementation.
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Affiliation(s)
| | | | - McKenzie McIntyre
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Robert M Wenham
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Andrea L Buras
- Department of Gynecologic Oncology, Lacks Cancer Center, Grand Rapids, MI, USA
| | - Claire C Conley
- Department of Oncology, Georgetown University, Washington, DC, USA
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Rivera Rivera JN, Lacson JCA, Kim Y, Roetzheim RG, Sutton SK, Soto-Torres B, Vadaparampil ST, Kanetsky PA. Sharing and seeking information about skin cancer risk and prevention among Hispanic people from Florida and Puerto Rico. PEC Innov 2023; 3:100232. [PMID: 38028436 PMCID: PMC10679524 DOI: 10.1016/j.pecinn.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/02/2023] [Accepted: 11/11/2023] [Indexed: 12/01/2023]
Abstract
Objective To explore factors associated with communication and information-seeking after receipt of skin cancer prevention information among Hispanic individuals. Methods Multivariable logistic regression was used to analyze existing data on demographics, personal experience, salience, and beliefs variables collected from Hispanic individuals to determine independent associations with sharing and seeking information about skin cancer prevention. Results Of 578 participants, 53% reported any communication about skin cancer prevention behaviors or skin cancer genetic risk; and 31% and 21% sought additional information about preventive behaviors or genetic risk, respectively. Female sex, greater perceived severity, higher comparative chance of getting skin cancer, and lower health literacy were associated with greater communication, while having no idea of one's own skin cancer risk was related to less communication. Greater health numeracy and higher cancer worry were associated with information-seeking about prevention behaviors and genetic risk. Conclusion Up to half of participants reported communication or information-seeking, although factors associated with specific activities differed. Future studies should evaluate how to promote communication behaviors in the Hispanic community and how sharing and seeking information influence an individual's network prevention practices. Innovation Several factors related to communication behaviors among Hispanic people after obtaining skin cancer prevention information were identified.Trial registration: This trial was registered on clinicaltrials.gov (NCT03509467).
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Affiliation(s)
- Jessica N. Rivera Rivera
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
- Health Care Delivery Research, MedStar Health Research Institute, Washington, DC, United States of America
| | - John Charles A. Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Richard G. Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Steven K. Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Brenda Soto-Torres
- Public Health Program, Ponce Health Sciences University, Ponce, PR, United States of America
| | - Susan T. Vadaparampil
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
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Rivera Rivera JN, Conley CC, Castro-Figueroa EM, Moreno L, Dutil J, García JD, Ricker C, Quinn GP, Soliman H, Vadaparampil ST. Behavioral beliefs about genetic counseling among high-risk Latina breast cancer survivors in Florida and Puerto Rico. Cancer Med 2023; 12:4701-4706. [PMID: 35941731 PMCID: PMC9972095 DOI: 10.1002/cam4.5111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 11/12/2022] Open
Abstract
Compared with non-Hispanic White women, Latina women are less likely to receive genetic counseling (GC) and testing (GT) following BC diagnosis. This study used secondary data analysis to explore beliefs about GC among Latina BC survivors in and outside the US mainland. GC/GT-naïve, high-risk, Spanish-preferring Latina BC survivors (n = 52) in FL and PR completed the Behavioral Beliefs about GC scale. Participants reported high positive beliefs about GC (M = 4.19, SD = 0.92); the majority agreed that GC was beneficial to understand cancer risk (90%) and promote discussion (87%) in their family. Participants reported low-to-moderate scores for barriers (Ms = 1.53-3.40; SDs = 0.59-0.90). The most frequently endorsed barriers were desire for additional GC information (M = 3.44; SD = 0.90), and GC logistic concerns (M = 2.71; SD = 0.80). No statistically significant differences for barriers and benefits scales were identified by place of residence (all ps ≥ 0.12). These findings highlight the importance of delivering culturally sensitive GC information to high-risk Latina BC survivors.
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Affiliation(s)
| | - Claire C Conley
- Georgetown University, Washington, District of Columbia, USA
| | | | | | - Julie Dutil
- Ponce Health Sciences University, Ponce, Puerto Rico, USA
| | | | - Charité Ricker
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Gwendolyn P Quinn
- Grossman School of Medicine, Department of OB-GYN New York, New York University, New York, New York, USA
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Conley CC, Rivera Rivera JN, Castro-Figueroa EM, Moreno L, Dutil J, García JD, Ricker C, Quinn GP, Soliman H, Vadaparampil ST. Provider discussion of genetic counseling among high-risk Spanish-preferring Latina breast cancer survivors. Transl Behav Med 2022; 12:900-908. [PMID: 36205471 PMCID: PMC9540969 DOI: 10.1093/tbm/ibac031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Among high-risk breast cancer (BC) survivors, genetic counseling (GC) and genetic testing (GT) may inform cascade testing and risk management. Compared to non-Hispanic White BC survivors, Spanish-preferring Latina BC survivors are less likely to report discussing GC with a healthcare provider. However, few studies have examined Latinas' experiences with GC/GT, particularly outside of the mainland USA. This study aimed to compare frequency of provider discussion of GC between Spanish-preferring Latina BC survivors living in Florida (FL) and Puerto Rico (PR). We conducted secondary data analysis of baseline assessments from a randomized pilot of an educational intervention for Spanish-preferring Latina BC survivors. Participants (N = 52) were GC/GT-naive, but met clinical criteria for GC/GT referral. Participants self-reported sociodemographic, clinical, and cultural variables, including previous provider discussion of GC. Descriptive statistics characterized frequency of GC discussion. Logistic regression examined the relationships between sociodemographic, clinical, and cultural characteristics and GC discussion. Only 31% of participants reported previous GC discussion. More participants from PR reported having GC discussions (43% vs. 21% in the mainland USA). In multivariable analyses, greater likelihood of GC discussion was associated with PR (vs. mainland USA) residence (odds ratio [OR] = 6.00, p = .03), older age at baseline (OR = 1.19, p = .04), and younger age at BC diagnosis (OR = 0.80, p = .03). Few high-risk Spanish-preferring Latina BC survivors in the mainland USA and PR had discussed GC with their providers. These results highlight a gap in the implementation of evidence-based genetics guidelines. Provider-directed interventions may be needed to increase uptake of GC/GT among Latina BC survivors.
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Affiliation(s)
- Claire C Conley
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA
| | | | | | | | - Julie Dutil
- Ponce Health Sciences University, Ponce 00716, Puerto Rico
| | | | - Charité Ricker
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
| | - Gwendolyn P Quinn
- Grossman School of Medicine, New York University, New York, NY 10016, USA
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Borger TN, Puleo GE, Rivera Rivera JN, Montgomery D, Bowling WR, Burris JL. A descriptive study of cervical cancer survivors' persistent smoking behavior and perceived barriers to quitting. Psychol Addict Behav 2022; 36:109-116. [PMID: 33764090 PMCID: PMC8463620 DOI: 10.1037/adb0000692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Cervical cancer survivors (CCS) tend to smoke cigarettes at rates much higher than other cancer survivors and women in the general population. However, few studies take a deep dive into the smoking behavior of cervical cancer survivors and none focus on the barriers they experience related to smoking cessation. This study aimed to describe CCS' tobacco use characteristics, quit attempts, and barriers to quit success. METHOD In a concurrent mixed-method design, 50 CCS (94% White nonHispanic) who were diagnosed in the past 5 years and were current smokers at diagnosis provided data via standardized questionnaire and semi-structured interview. RESULTS More than three-quarters of participants were current smokers at the time of study participation, 25.6% of whom also reported noncigarette tobacco use (e.g., electronic cigarette, cigar, snus). Seventy percent of participants reported making at least one 24 hr quit attempt postdiagnosis, with 61.5% of current smokers preferring to quit without professional advice or counseling and 51.3% preferring to quit without medication assistance. Four themes emerged regarding barriers to smoking cessation: motivation and readiness; confidence and uncertainty; triggers; and social and environmental factors. CONCLUSIONS The rate of smoking in CCS is remarkably high, which may partly be explained by negative attitudes toward and low use of evidence-based treatment as well as multi-level barriers to smoking cessation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Tia N. Borger
- Department of Psychology, University of Kentucky, Lexington KY, USA
| | | | | | | | | | - Jessica L. Burris
- Department of Psychology, University of Kentucky, Lexington KY, USA,Markey Cancer Center, University of Kentucky, Lexington KY, USA
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Rivera Rivera JN, Burris JL. A Systematic Literature Review and Head-to-Head Comparison of Social Support and Social Constraint in Relation to the Psychological Functioning of Cancer Survivors. Ann Behav Med 2021; 54:176-192. [PMID: 31581293 DOI: 10.1093/abm/kaz037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Quality of life is a multidimensional concept that includes perceptions of one's physical, psychological, social, and spiritual functioning, all of which are theorized to be interdependent. The focus of this study is social functioning, which itself is a multidimensional concept that includes social support and social constraint among other things. In cancer survivors, social support receives most of the research attention, but social constraint may have a stronger influence on quality of life. PURPOSE This systematic literature review evaluates which aspect of social functioning-social support or social constraint-has a stronger relationship with the psychological functioning of cancer survivors. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in the identification and review of 32 independent records. Multiple measures of social support and social constraint were used across studies, with most having adequate psychometric properties. Psychological outcomes were divided into (a) general distress, (b) cancer-specific distress, (c) general well-being, and (d) cancer-specific well-being. RESULTS For general and cancer-specific distress, social constraint exhibited a larger association with distress than social support. Similarly, for general well-being, most studies reported a stronger association with social constraint than social support. For cancer-specific well-being, the opposite was true such that associations were stronger for social support than social constraint. CONCLUSIONS Results highlight the importance of considering social constraint when examining quality-of-life outcomes like psychological distress and well-being. Findings support social constraint as a target in interventions to reduce cancer survivors' distress, while social support could be considered in attempts to promote cancer-specific well-being.
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Affiliation(s)
| | - Jessica L Burris
- Department of Psychology, University of Kentucky, Lexington, KY, USA.,Markey Cancer Center, University of Kentucky, Lexington, KY, USA
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Puleo GE, Borger TN, Montgomery D, Rivera JNR, Burris JL. A Qualitative Study of Smoking-Related Causal Attributions and Risk Perceptions in Cervical Cancer Survivors. Psychooncology 2020; 29:500-506. [PMID: 31733086 PMCID: PMC7054153 DOI: 10.1002/pon.5291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The prevalence of smoking among cervical cancer survivors typically exceeds what is found among women in the general population and other cancer survivors. Yet, there is a dearth of literature on risk and protective factors related to smoking among cervical cancer survivors, especially when it comes to identification of variables that are amendable to intervention. To help fill this gap in the literature, this qualitative study examines the nature of smoking-related causal attributions and risk perceptions in cervical cancer survivors who smoked at cancer diagnosis. METHODS Participants are 21 female cervical cancer survivors (M=45.7, SD=8.4 years old), all diagnosed in the past five years. Nearly three-quarters of participants reported smoking in the past month. RESULTS Smoking was not uniformly recognized as a cause of cervical cancer (whether in general or participants' own cancer); the link between smoking and lung, head-neck, and other cancers was more readily accepted. Despite generally weak endorsements of causal attributions, many participants reported smoking significantly increases risk for poor clinical (e.g., recurrence) and quality of life (e.g., pain) outcomes after cervical cancer diagnosis. CONCLUSIONS Findings suggest cervical cancer survivors may not fully understand or appreciate the role of smoking in cervical cancer risk whereas their beliefs about the role of smoking in cervical cancer prognosis are more well-formed. This study highlights the potential role of causal attributions and risk perceptions in understanding and addressing the smoking-related experience of cervical cancer survivors.
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Affiliation(s)
| | - Tia N. Borger
- Department of Psychology, University of Kentucky, Lexington KY, USA
| | | | | | - Jessica L. Burris
- Department of Psychology, University of Kentucky, Lexington KY, USA
- Markey Cancer Center, University of Kentucky, Lexington KY, USA
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