A qualitative study of childhood cancer families’ post‐treatment needs and the impact of a community‐based organization in a rural, socioeconomically disadvantaged, majority Hispanic/Latino region

Author:

Smith Stephanie M.1ORCID,Teer Anmol2,Tolamatl Ariceaga Evelyn3,Billman Elle45ORCID,Benedict Catherine6,Goyal Anju1,Pang Emily M.4,Pecos‐Duarte Caroline47,Lewinsohn Rebecca8,Smith Mary9,Boynton Heidi9,Montes Sandy9,Rivera Esmeralda9,Ramirez Daniela9,Schapira Lidia310

Affiliation:

1. Division of Hematology, Oncology, Stem Cell Transplantation & Regenerative Medicine Department of Pediatrics, Stanford University School of Medicine Palo Alto California USA

2. UC Berkeley School of Public Health Berkeley California USA

3. Stanford Cancer Institute Stanford California USA

4. Stanford University School of Medicine Stanford California USA

5. Icahn School of Medicine at Mount Sinai New York New York USA

6. Department of Psychiatry and Behavioral Science Stanford University School of Medicine Palo Alto California USA

7. University of New Mexico School of Medicine Albuquerque New Mexico USA

8. Department of Medicine Stanford University School of Medicine Stanford California USA

9. Jacob's Heart Children's Cancer Support Services Watsonville California USA

10. Department of Medicine Division of Oncology Stanford University School of Medicine Palo Alto California USA

Abstract

AbstractBackgroundIndividual‐ and population‐level socioeconomic disadvantages contribute to unequal outcomes among childhood cancer survivors. Reducing health disparities requires understanding experiences of survivors from historically marginalized communities, including those with non‐English language preference.ProcedureWe partnered with a community‐based organization (CBO) serving families of children with cancer in a rural region in California with low socioeconomic status and majority Hispanic/Latino (H/L) residents. We interviewed English‐ and Spanish‐speaking adolescent/young adult (AYA) childhood cancer survivors (≥15 years old, ≥5 years from diagnosis), parents, and CBO staff to evaluate post‐treatment needs and impact of CBO support. Data were analyzed qualitatively using applied thematic analysis. Themes were refined through team discussions with our community partners.ResultsTwelve AYAs (11 H/L, 11 bilingual), 11 parents (eight H/L, seven non‐English preferred), and seven CBO staff (five H/L, five bilingual) participated. AYAs (five female, seven male) were of median (min–max) age 20 (16–32) and 9 (5–19) years post diagnosis; parents (nine female, two male) were age 48 (40–60) and 14 (6–23) years post child's diagnosis. Themes included challenges navigating healthcare, communication barriers among the parent–AYA–clinician triad, and lasting effects of childhood cancer on family dynamics and mental health. Subthemes illustrated that language and rurality may contribute to health disparities. CBO support impacted families by serving as a safety‐net, fostering community, and facilitating H/L families’ communication.ConclusionsChildhood cancer has long‐lasting effects on families, and those with non‐English language preference face additional burdens. Community‐based support buffers some of the negative effects of childhood cancer and may reduce disparities.

Funder

Stanford Maternal and Child Health Research Institute

Publisher

Wiley

Subject

Oncology,Hematology,Pediatrics, Perinatology and Child Health

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