Abstract B133: Social networks: A modifiable mechanism linking socioeconomic factors to cancer outcomes and promising target for intervention
Authors: Bouchard Elizabeth , Prince Mark A. , McCarty Christopher , Collins R. Lorraine , Sahler Olle Jane , Vincent Paula , Patel Hital , LaValley Susan , Krenz Till , Devonish Julia , Kelly Kara 
Published: September 2024

Abstract
Introduction: While socioeconomic disparities in cancer outcomes have been well documented, it is less clear exactly what health care delivery systems can do to mitigate these disparities. To address this gap, we focus on cancer-related social support networks. Social networks are the context in which resources and support are exchanged. Networks can exacerbate inequalities by amplifying differences in access to resources. We examined access to social support and composition of support networks among pediatric cancer caregivers to understand how social network dynamics differ by caregiver income and educational attainment. Design, Setting, Participants, and Measures: Participants were caregivers of children who received cancer treatment at multiple hospital systems in New York State. All families who met eligibility requirements during the recruitment period were invited to participate in the study, and 59% of caregivers contacted enrolled in the study. We used a self-report survey to collect egocentric social network data from 107 caregivers of pediatric cancer patients. We used bivariate logistic regression to examine differences in network support by income and education. We used Bayesian Zero and One Inflated Beta (ZOIB) regression models to examine differences in network composition by income and education. Results: Participants were 89% female, their mean age was 40.4 years old, and 70% were married. Twenty-four percent of participants held a high school degree or less, 51% were in the paid labor force full time, and 17% had a total household income of $34,999 or less. Mean age of the pediatric cancer patient was 9.3 years, and 62% were diagnosed with leukemia or lymphoma. Forty-seven percent of the sample were within 6 months of the child’s first cancer diagnosis. Income was a significant predictor of satisfaction with informational, emotional, and logistical support, while education only significantly predicted satisfaction with informational support. Odds ratios indicated that for each additional income category, the odds of being satisfied with each type of support increased by nearly 1.5 times. Each additional education category was associated with a nearly 2-fold increased likelihood of satisfaction with informational support. Education significantly predicted the proportion of family/kin and health care provider network members. Compared to those with less education, those with higher education reported a relatively lower proportion of family/kin in their network and a relatively greater proportion of health care providers. For each unit increase in education, the odds of observing a higher proportion of family/kin in the network decreased by 10% and the odds of observing a higher proportion of health care providers in the network increased by 14%. Conclusions and Relevance: Our results indicate that caregivers who had lower income and lower education were less likely to access additional resources for support during treatment. Efforts to proactively screen and connect caregivers to resources are recommended.
Citation Format: Elizabeth Bouchard, Mark A. Prince, Christopher McCarty, R. Lorraine Collins, Olle Jane Sahler, Paula Vincent, Hital Patel, Susan LaValley, Till Krenz, Julia Devonish, Kara Kelly. Social networks: A modifiable mechanism linking socioeconomic factors to cancer outcomes and promising target for intervention [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B133.