Abstract B016: Associations between geographic residence, social support and resilience among Kentucky cancer survivors
Authors: Nguyen Hoa , Abraham Stephie , Baumgartner Kathy , Baumgartner Richard , Boone Stephanie 
Published: December 2023

Abstract
Background: Rural and Appalachian cancer survivors have higher rates of invasive stage of disease, increased challenges in accessing health care services, and report poorer health outcomes and greater psychological distress compared to urban cancer survivors. Factors such as resilience-the ability of patients to bounce back after the trauma of a diagnosis- may be an important predictor of well-being, overall cancer experience, and treatment outcomes. In this exploratory study we assess whether residing in urban or rural geographic areas at diagnosis predicts level of self-perceived resilience and correlate relationships with mental and emotional health and social support. Methods: LADDER ‘Life After Diagnosis and Descriptors of Experience and Responses’ (LADDER) Study is an online pilot survey to evaluate experiences of Kentucky adult cancer survivors within the first year of diagnosis. Self-perceived resilience was measured by the 10-item Connor-Davidson Resilience Scale; higher scores indicate better resilience (range 0-40). Multivariable logistic regression was used to estimate Odds Ratios (OR) and 95% Confidence Intervals (CI) for likelihood of low resilience, dichotomized at median score. Spearman Rank Correlation Coefficients (ρ) measured the strength and direction of associations between continuous measures of anxiety, depression, social support, and resilience. Results: Among 46 participants, most were female aged 65 and older, living in non-Appalachian KY with 33% reporting a history of breast cancer. Rural cancer survivors scored 4 points lower in resilience on average than urban cancer survivors. In multivariable models, compared to urban KY survivors, rural KY survivors had a 2-fold higher likelihood of self-perceived low resilience (OR=2.70:95% 0.58-12.5)). Adjusting for age, sex, Appalachian region, and employment partially attenuated the difference in resilience scores; however, estimates were not significant (OR=2.20: 95% 0.24-20.7). Social support, anxiety, and depression were moderately correlated with resilience among both urban (ρ= 0.36 to 0.64) and rural cancer survivors (ρ range: 0.21 to 0.54) Conclusion: The first year after a cancer diagnosis marks the transition into survivorship with major emotional adjustments. Additional recruitment of survivors will allow examination of diverse experiences post-diagnosis which may lead to interventions to improve quality of life in cancer survivors.
Citation Format: Hoa Nguyen, Stephie Abraham, Kathy Baumgartner, Richard Baumgartner, Stephanie Boone. Associations between geographic residence, social support and resilience among Kentucky cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B016.