Abstract 1186: Relationships between health literacy, having a cancer care coordinator, and long-term health-related quality of life among cancer survivors
Authors: Vecchio Natalie J. Del , Charlton Mary , Askelson Natoshia , Carter Knute , Chrischilles Elizabeth , Lynch Charles 
Published: September 2020

Abstract
Care coordination has been identified as a strategy to reduce challenges navigating the healthcare system for cancer patients. The objective of this study was to assess the association between cancer patients having a cancer care coordinator during their treatment and their long-term health-related quality of life (HRQoL) after treatment, and whether this association differs by level of health literacy. A population-based sample of patients diagnosed with breast, prostate, or colorectal cancer in 2015 were recruited from the Iowa Cancer Registry and invited by mail to participate in an online survey conducted in 2017-2018 (N=369). Survey and Registry data were analyzed using linear regression to model the association between having a cancer care coordinator during active treatment with post-treatment physical or mental HRQoL, a mean of 2.7 years later, by varying levels of health literacy while controlling for sociodemographic and clinical factors.Most patients (81%) reported having one individual coordinating their cancer care. Overall, having a care coordinator was not significantly associated with physical HRQoL (p=0.113). However, patients (20%) with low health literacy, who had a care coordinator, had significantly higher physical HRQoL scores (mean difference 5.0, p=0.022), while those with medium (29%) and high (51%) health literacy, did not (p=0.223, and p=0.864, respectively). Mental HRQoL scores were not associated with the presence of a care coordinator overall or when stratified by health literacy level. Findings suggested care coordinators improved post-treatment physical HRQoL, particularly for patients with low health literacy. Care coordinators may be beneficial to patients struggling to navigate the complex healthcare system during cancer treatment. Future research should focus on the mechanisms by which care coordination affects post-treatment HRQoL.
PROMIS Physical HRQoL and CCC by Health Literacy LevelPROMIS Physical HRQoLMultivariable-Adjusted means (95% CI)Cancer Care CoordinatorLow Health LiteracyMedium Health LiteracyHigh Health LiteracyYes49.4 (42.7-56.1)48.9 (43.5-54.3)52.5 (46.1-58.8)No or I Don't Know44.4 (36.2-52.5)46.6 (39.3-53.8)52.1 (45.9-58.4p-valuep=0.0223p=0.2231p=0.8640PROMIS Mental HRQoLMultivariable-Adjusted means (95% CI)Cancer Care CoordinatorLow Health LiteracyMedium Health LiteracyHigh Health LiteracyYes49.7 (44.2-55.1)49.0 (45.5-52.5)55.3 (50.1-60.4)No or I Don't Know47.5 (39.9-55.2)48.1 (43.0-53.3)53.3 (48.3-58.2)p-valuep=0.4099p=0.6168p=0.3360
Citation Format: Natalie J. Del Vecchio, Mary Charlton, Natoshia Askelson, Knute Carter, Elizabeth Chrischilles, Charles Lynch. Relationships between health literacy, having a cancer care coordinator, and long-term health-related quality of life among cancer survivors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1186.