Abstract A060: Socioeconomic status and quality of life among Chinese American breast cancer survivors: The role of post-traumatic growth
Authors: Wang Carol , Lu Qian 
Published: September 2020

Abstract
Purpose: Socioeconomic disparities in psychosocial adjustment to breast cancer has garnered little attention. Those who are medically underserved with little to no access to quality health care are more likely to be diagnosed with late-stage cancer, have more complications, and face psychosocial and cultural factors that impact their quality of life. Socioeconomic status (SES) is a multidimensional construct that is typically comprised of income, education, and occupation. Recent research suggests that these indicators impact cancer health in independent manners. Moreover, increasing evidence supports the health protective features of having meaning in life. A recurrent theme is resilience – the ability to regain or maintain well-being in the face of adversity. The perceived benefits one reports (e.g. better relationship quality, greater sense of self-efficacy, etc.) after experiencing a stressful life event is known as post-traumatic growth (PTG). This study examines the relationships between SES indicators (e.g. education, household income), quality of life (QOL), and the role of PTG as an underlying mechanism in the impact of SES in psychosocial adjustment to breast cancer among Chinese American breast cancer survivors (CABCS). Methods: 136 CABCS completed a baseline questionnaire from a larger, intervention study. Results: Education and household income were all positively related to overall quality of life. Education was positively related to functional QOL and additional breast cancer concerns. Annual household income was positively related to all QOL domains. Regression analyses revealed an association between household income with PTG and PTG with overall QOL. Bootstrapping analyses supported a full mediation as the indirect effect of household income on overall QOL through PTG was statistically significant. Further examining QOL subscales, PTG was associated with better social QOL and household income showed a significant indirect effect on social QOL through PTG suggesting PTG fully mediates the effect of household income on social QOL. PTG was associated with better emotional QOL and less breast cancer concerns. However, the total effect of household income on emotional QOL was non-significant. The total effect of PTG on breast cancer was marginally significant (p = .06). Analyses for education failed to reveal any significant direct or indirect effect on overall QOL and its subscales through PTG. Conclusion: These findings suggest that SES indicators such as household income and educational attainment are differentially related to QOL domains among CABCS. Household income is linked to better social and emotional QOL through reported PTG suggesting that findings benefits within adversity including reported meaning may enhance well-being. This underscores the differential role of socioeconomic indicators when assessing health outcomes and the importance of implementing psychosocial interventions that facilitate PTG in improving QOL among immigrant cancer survivors.
Citation Format: Carol Wang, Qian Lu. Socioeconomic status and quality of life among Chinese American breast cancer survivors: The role of post-traumatic growth [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 A060.