Abstract PR008: The impact of social determinants and neuropsychological factors on healthcare transition readiness among adolescent and young adult childhood cancer survivors
Notice bibliographique
Résumé
Abstract Background: Adolescent and young adult childhood cancer survivors (AYA CCS) reportedly experience at least one severe, disabling, or life-threatening health complication by age 50. Healthcare transition – from pediatric cancer care to adult survivorship care – is vital in ensuring continued follow-up care to screen and manage these complications for this population. This study aimed to examine the impact of neighborhood-level social determinants on healthcare transition readiness among AYA CCS. Additionally, potential mediating and moderating effects of neuropsychological factors such as posttraumatic stress and neurocognitive impairment on the association were also explored. Methods: This study utilized secondary data collected from AYA CCS enrolled in a university-affiliated hospital-based survivorship program. The Readiness for Transition Questionnaire (RTQ) for healthcare transition readiness, the Area Deprivation Index (ADI) for neighborhood social determinants, the Impact of Event Scale-Revised (IESR) for posttraumatic stress, the Childhood Cancer Survivor Study Neurocognitive Questionnaire (CCSS-NCQ) for neurocognitive impairment, and sociodemographic/clinical characteristics (age, sex, race/ethnicity, education, income, insurance, diagnosis, and treatment history and intensity) were included. Mediation and moderated mediation analyses were conducted using Hayes’ bootstrap-based PROCESS Macro with models. Results: Of 113 AYA CCS participants, 54% were female, 71.7% identified as White, and 38.1% were diagnosed with leukemia. AYA CCS residing in more deprived neighborhoods reported higher levels of healthcare transition readiness compared to those in less deprived areas. The average posttraumatic stress level was significantly elevated in more deprived neighborhoods. Neurocognitive impairment was observed in 10.6% of total participants, with no statistical differences in its frequency across ADI quartiles. The mediation analysis showed both significant direct (B = 0.005, SE = 0.002, 95% CI [0.001, 0.009], β = 0.22) and indirect effects (B = 0.001, SE = 0.001, 95% CI [0.0003, 0.0028], β = 0.062) of posttraumatic stress on the relationship between ADI and the RTQ subscale ‘Adolescent Responsibility’, after adjusting for participant’s age, race, diagnosis, and treatment intensity level. There was no mediating effect of posttraumatic stress for other subscales of healthcare transition readiness (‘Parent Involvement’ and ‘Overall Readiness’). The moderated mediation model indicated a significant relationship, with neurocognitive impairment moderating the association between ADI and posttraumatic stress (β = 0.60, SE = 1.17, 95% CI [0.26, 0.95]). Conclusion: The findings suggest that healthcare transition readiness in AYA CCS is influenced by neighborhood-level social determinants and individual neuropsychological factors. Implementing interventions that address these multi-level factors can enhance the transition to adult healthcare for AYA CCS. Citation Format: Gayeong Kim, Jordan Gilleland Marchak, Karen Elizabeth Effinger, Melinda Higgins, Canhua Xiao. The impact of social determinants and neuropsychological factors on healthcare transition readiness among adolescent and young adult childhood cancer survivors [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr PR008.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».