TY - JOUR
T1 - Influence of neighborhood-level factors on social support in early-stage breast cancer patients and controls
AU - Thompson, Tess
AU - Rodebaugh, Thomas L.
AU - Pérez, Maria
AU - Struthers, James
AU - Sefko, Julianne A.
AU - Lian, Min
AU - Schootman, Mario
AU - Jeffe, Donna B.
N1 - Funding Information:
This study was supported in part by grants from the National Cancer Institute (NCI) and Breast Cancer Stamp Fund ( R01 CA102777 ; PI: Jeffe, DB) and the NCI Cancer Center Support Grant ( P30 CA091842 ; PI: Eberlein, T) to the Alvin J. Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis, Missouri. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCI or Breast Cancer Stamp Fund. We thank our participants, the interviewers, and the Siteman Cancer Center's Health Behavior, Communication, and Outreach Core for data management services. We also thank the physicians at Washington University School of Medicine and Saint Louis University School of Medicine who helped us recruit their patients for this study. The Beck Anxiety Inventory ® and BAI ® (copyright 1990, 1993 by Aaron T. Beck) are trademarks of The Psychological Corporation, a Harcourt Assessment Company. The BAI ® was adapted and used by permission of the publisher, The Psychological Corporation. All rights reserved.
Publisher Copyright:
© 2016 Elsevier Ltd.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Rationale: Low social support has been linked to negative health outcomes in breast cancer patients. Objective: We examined associations between perceived social support, neighborhood socioeconomic deprivation, and neighborhood-level social support in early-stage breast cancer patients and controls. Methods: This two-year longitudinal study in the United States included information collected from telephone interviews and clinical records of 541 early-stage patients and 542 controls recruited from 2003 to 2007. Social support was assessed using the Medical Outcomes Study Social Support Survey (MOS-SS). Residential addresses were geocoded and used to develop measures including neighborhood social support (based on MOS-SS scores from nearby controls) and neighborhood socioeconomic deprivation (a composite index of census tract characteristics). Latent trajectory models were used to determine effects of neighborhood conditions on the stable (intercept) and changing (slope) aspects of social support. Results: In a model with only neighborhood variables, greater socioeconomic deprivation was associated with patients' lower stable social support (standardized estimate = -0.12, p = 0.027); neighborhood-level social support was associated with social support change (standardized estimate = 0.17, p = 0.046). After adding individual-level covariates, there were no direct neighborhood effects on social support. In patients, neighborhood socioeconomic deprivation was associated with support indirectly through marriage, insurance status, negative affect, and general health. In controls, neighborhood socioeconomic deprivation was associated with support indirectly through marriage (p < 0.05). Conclusion: Indirect effects of neighborhood socioeconomic deprivation on social support differed in patients and controls. Psychosocial and neighborhood interventions may help patients with low social support, particularly patients without partnered relationships in deprived areas.
AB - Rationale: Low social support has been linked to negative health outcomes in breast cancer patients. Objective: We examined associations between perceived social support, neighborhood socioeconomic deprivation, and neighborhood-level social support in early-stage breast cancer patients and controls. Methods: This two-year longitudinal study in the United States included information collected from telephone interviews and clinical records of 541 early-stage patients and 542 controls recruited from 2003 to 2007. Social support was assessed using the Medical Outcomes Study Social Support Survey (MOS-SS). Residential addresses were geocoded and used to develop measures including neighborhood social support (based on MOS-SS scores from nearby controls) and neighborhood socioeconomic deprivation (a composite index of census tract characteristics). Latent trajectory models were used to determine effects of neighborhood conditions on the stable (intercept) and changing (slope) aspects of social support. Results: In a model with only neighborhood variables, greater socioeconomic deprivation was associated with patients' lower stable social support (standardized estimate = -0.12, p = 0.027); neighborhood-level social support was associated with social support change (standardized estimate = 0.17, p = 0.046). After adding individual-level covariates, there were no direct neighborhood effects on social support. In patients, neighborhood socioeconomic deprivation was associated with support indirectly through marriage, insurance status, negative affect, and general health. In controls, neighborhood socioeconomic deprivation was associated with support indirectly through marriage (p < 0.05). Conclusion: Indirect effects of neighborhood socioeconomic deprivation on social support differed in patients and controls. Psychosocial and neighborhood interventions may help patients with low social support, particularly patients without partnered relationships in deprived areas.
KW - Breast cancer
KW - Health disparities
KW - Longitudinal cohort study
KW - Neighborhood socioeconomic deprivation
KW - Perceived social support
UR - http://www.scopus.com/inward/record.url?scp=84962571436&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2016.03.023
DO - 10.1016/j.socscimed.2016.03.023
M3 - Article
C2 - 27017091
AN - SCOPUS:84962571436
SN - 0277-9536
VL - 156
SP - 55
EP - 63
JO - Social Science and Medicine
JF - Social Science and Medicine
ER -