Abstract B006: Association between unmet needs and resilience among cancer survivors in Kentucky
Authors: Abraham Stephie , Nguyen Hoa , Baumgartner Kathy B. , Baumgartner Richard , Boone Stephanie 
Published: December 2023

Abstract
Introduction: Despite efforts to improve patient follow-up care, cancer survivors still face challenges in addressing their mental, physical, and social well-being. Resilience, the patients’ ability to thrive and adapt following cancer diagnosis and treatment, is dynamic and variable within and between populations. Previous literature has reported a low level of resilience among those with higher levels of unmet needs. However, there is a need to assess whether the effect on resilience differs by domain to help tailor interventions. The objective of this exploratory analysis is to measure prevalent unmet needs among cancer survivors in Kentucky and to analyze the association between specific domains of unmet needs and resilience. Methods: LADDER (Life After Diagnosis and Descriptors of Experience and Responses) Study is a pilot project to evaluate the feasibility of online methods of collecting preliminary data for psychosocial factors in cancer survivors. Kentucky residents 18 years and older with a cancer diagnosis within 12 months were eligible to enroll. The CaSUN instrument was used among those who completed active cancer treatment to identify prevalent unmet needs across five domains: Information, Existential Survivorship, Comprehensive cancer care, Quality of Life (QOL), and Relationships. Multivariable logistic regression was used to calculate Odds Ratios (OR) and 95% Confidence Intervals (CI) adjusting for age, sex, education, employment, rural residence, cancer type, and time since diagnosis to estimate the likelihood of self-perceived low resilience, measured by the brief 10-item Connor Davidson Resilience Scale. Results: Of the 57 eligible participants, 46 were included in the analysis (80.7%) after accounting for missing data. A majority (67.4%) reported unmet needs for available information and access to the best medical care. Approximately 88% of those who reported unmet needs regarding cancer care were college graduates. Moreover, the majority who reported unmet needs in all five domains were younger (20-44 years), females, employed, and urban residents. Cancer survivors who reported unmet needs in information (OR: 1.14; 95% CI: 0.19, 6.97), existential survivorship (OR: 2.77; 95% CI: 0.58, 13.16), relationship (OR: 1.17; 95% CI: 0.24, 5.73) and QOL (OR: 2.08; 95% CI: 0.40, 10.82) domains had higher odds of reporting self-perceived low resilience; however, these results were not statistically significant. Negative confounding in adjusted models was observed, where survivors who reported unmet needs related to existential survivorship were 4.9 times more likely to report self-perceived low resilience. Conclusions: Based on this exploratory analysis, unmet needs in the existential survivorship domain, which includes stress reduction, coping mechanisms, and social support, is associated with low resilience. Employment and college education explained more of the likelihood of self-perceived low resilience. Understanding specific needs and factors that affect survivors’ resilience is essential to ongoing survivorship care.
Citation Format: Stephie Abraham, Hoa Nguyen, Kathy B. Baumgartner, Richard Baumgartner, Stephanie Boone. Association between unmet needs and resilience among cancer survivors in Kentucky [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 B006.