Abstract PO-016: A latent class analysis of communication patterns between Hispanic and non-Hispanic childhood cancer survivors, parents, and medical providers
Authors: Ochoa Carol Y. , Cho Junhan , Miller Kimberly A. , Baezconde-Garbanati Lourdes , Chan Randall Y. , Farias Albert J. , Milam Joel E. 
Published: January 2022

Introduction: The triad of communication between childhood cancer survivors (CCS), their parents, and their medical providers may motivate CCS healthcare engagement but has not been examined. This may be particularly important for Hispanic/Latino populations, who are more likely to trust and receive health information from hospital providers and are less likely to remain engaged in survivorship care compared to non-Hispanic white persons. Methods: We analyzed data from the Project Forward pilot study, a population-based study that evaluated follow-up care among 160 CCS-parent dyads (CCS mean age=20 years, 7 years from diagnosis, and 29% of parents identified as Spanish-speaking Hispanic). Nine indicators representing multiple dimensions of communication were used in latent class analysis to identify distinct classes of communication. These indicators were selected from the parent and CCS survey and asked about communication between CCS, parents, and medical providers. The association between resulting classes and various covariates (e.g., parent ethnicity/language, CCS demographic, clinical characteristics) was examined using multinomial logistic regression. Results: Three classes of the triad of communication were identified: (1) high healthcare-focused communication (37.5%); (2) high comprehensive communication (15.6%); and (3) overall low communication (46.9%). The high healthcare-focused communication class was characterized by patterns of high probability for communication about future health care needs among CCS, parents, and medical providers. The high comprehensive communication class was characterized by a high probability of communication about future healthcare needs and a high probability for parent-CCS communication about different cancer facets. The overall low communication class was characterized by a low probability of endorsing any communication items. Greater time since diagnosis was marginally significantly associated with reduced odds of the dyad's membership in class 2 [OR=0.798, 95% CI=0.635, 1.002, p-value=0.0520], compared to class 3 (low communication). Additionally, dyads with English-speaking non-Hispanic parents were less likely to be in class 2 [OR=0.361, 95% CI=0.130, 1.005, p-value=0.0511], compared to class 3. After adjusting for all covariates simultaneously, greater time since diagnosis was associated with reduced odds of membership in class 2 (vs class 3). Dyads with Spanish-speaking Hispanic parents were more likely to be in classes 1 and 2 (vs. class 3). Discussion: Our results support the need to enhance communication among CCS, parents, and medical providers generally to improve knowledge and understanding about the long-term effects of cancer, treatment, and outcomes. Our study suggests that dyads, where parents were Spanish-speaking Hispanics tended to engage in high communication. Examining language preference provides an important contextual understanding as it supports the notion that Hispanic/Latino cultural values may play a favorable role in high levels of communication.

Citation Format: Carol Y. Ochoa, Junhan Cho, Kimberly A. Miller, Lourdes Baezconde-Garbanati, Randall Y. Chan, Albert J. Farias, Joel E. Milam. A latent class analysis of communication patterns between Hispanic and non-Hispanic childhood cancer survivors, parents, and medical providers [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-016.