Abstract D032: Characterizing county-level community context, patient-caregiver networks, and social functioning among rural cancer survivors and caregivers: Preliminary data from the Illinois Rural Cancer Assessment
Authors: Carnahan Leslie R , Watson Karriem S , Molina Yamilé 
Published: September 2020

Abstract
Background: Rural cancer survivors and caregivers, compared to urban, experience a number of health disparities, including worse patient-reported outcomes (e.g. quality of life, self-rated health). There is a need to characterize multilevel determinants that may contribute to these inequalities. Objective: In the present study, we characterize rural survivors’ and caregivers’ social contexts, including county-level communities, patient-caregiver networks, and social functioning. Method: The Illinois Rural Cancer Assessment was a descriptive, cross-sectional study for self-identified adult rural cancer survivors and caregivers from rural Illinois. Participants were recruited from 2017-2018 through multiple non-probability-based sampling methods and completed the survey online, by phone, or by self-administration. At the county level, we used 2013 Rural-Urban Continuum Codes for rurality, American Community Survey data for 10 economic indicators, and the American Cancer Society’s cancer resources database to enumerate cancer support services. At the interpersonal level, survivors described their network of caregivers via a modified version of Burt General Social Survey. At the intrapersonal level, survivors completed FACT-G to assess social functioning. Two-step Latent Class Analysis (LCA) was conducted. Results: The final sample included 139 survivors and 88 caregivers. Preliminary analyses suggest four county-level contexts for survivors and caregivers: 1) southern, rural, most economically disadvantaged counties with the fewest support services (30%, n=68); 2) northern, more rural, more economically disadvantaged counties with fewer support services (29%, n=65); 3) central, rural, more economically disadvantaged counties with fewer support services (29%, n=66), and 4) central, metropolitan, most economically advantaged counties with the most and most diverse support services (12%, n=28). There were three types of social network classes among our survivor participants: 1) no caregivers (28%; n=39); 2) only spousal caregivers with constant daily communication (23%; n =32); and, 3) multiple caregivers with variation in daily communication (50%, n = 68). For caregivers, 55% reported caregiving for only 1 patient. Caregiving for a family member was most common and about 40% reported daily communication with patients. About 35% of survivors and 40% of caregivers reported low social functioning. Discussion: Our preliminary findings suggest a rich diversity of social environments at different levels for rural survivors and caregivers. Further, LCA suggests non-linear and linear associations between dimensions underlying these community contexts and networks.
Citation Format: Leslie R Carnahan, Karriem S Watson, Yamilé Molina. Characterizing county-level community context, patient-caregiver networks, and social functioning among rural cancer survivors and caregivers: Preliminary data from the Illinois Rural Cancer Assessment [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D032.