Abstract A103: How do coping resources and financial hardship affect rural Latina breast cancer survivors' stress and depressive symptoms: The Nuevo Amanecer Rural Trial
Authors: Napoles Anna M. , Santoyo-Olsson Jasmine , Stewart Anita L. , Ortiz Carmen , Gregorich Steven 
Published: August 2020

Abstract
Introduction: Compared to their white counterparts, Latina breast cancer survivors suffer from greater distress and poorer health-related quality of life. Yet little is known about the determinants of such distress.
Purpose: Examine the independent associations of coping self-efficacy, social support, neighborhood cohesion, engagement with physicians, and financial hardship with depressive symptoms and perceived stress using baseline data from a randomized controlled trial of a stress management intervention among Spanish-speaking rural Latina breast cancer survivors.
Methods: All data were self-reported and collected via in-person interviews in Spanish, except for medical information, which was obtained from medical records review. Bivariate linear models regressed either depressive symptoms (Patient Health Questionnaire-8) or stress (Perceived Stress Scale) on coping self-efficacy, social support, neighborhood cohesion, difficulty engaging with physicians, and financial hardship, controlling for demographic, medical factors, and study site. Hypothesized predictors that were statistically significant at p &lt;0.20 in bivariate analyses were included in multivariate linear models. Higher scores on all measures signify more of the construct.
Results: In bivariate analyses, coping confidence (b = -2.50; p &lt;0.0001) and social support (b = -1.14; p &lt;0.01) were negatively associated with depressive symptoms; difficulty engaging with physicians (b = 1.51; p &lt;0.01) and financial hardship (b = 2.30; p &lt;0.01) were positively associated with depressive symptoms. In multivariate analyses, only coping confidence (b = -2.35; p &lt;0.0001) was negatively and independently associated with depressive symptoms, controlling for covariates. In bivariate analyses, coping confidence (b = -4.10; p &lt;0.0001), social support (b = -2.66; p &lt;0.0001), and neighborhood cohesion (b = -1.83; p &lt;0.01) were negatively associated with stress; difficulty engaging with physicians (b=1.51; p =0.05) and financial hardship (b=4.58; p &lt;0.0001) were positively associated with stress. In multivariate analyses, coping confidence (b = -3.65; p &lt;0.0001) and neighborhood cohesion (b = -1.03; p &lt;0.05) were negatively and independently associated with stress; financial hardship was positively and independently associated with stress (b = 3.44; p&lt;0.01).
Conclusions: Interventions that focus on increasing women's coping confidence and sense of neighborhood cohesion, and services to reduce their financial hardship, could help alleviate psychosocial health disparities among rural Latina cancer survivors.
Citation Format: Anna M. Napoles, Jasmine Santoyo-Olsson, Anita L. Stewart, Carmen Ortiz, Steven Gregorich. How do coping resources and financial hardship affect rural Latina breast cancer survivors' stress and depressive symptoms: The Nuevo Amanecer Rural Trial [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A103.