부산대학교 도서관

1. Understand the relationship between household material hardship, social needs, and social determinants of health. 2. Describe the prevalence of household material hardship among families of children with advanced cancer care. Unmet social needs are independently associated with severe parental distress in upfront childhood cancer treatment. We demonstrate the feasibility of systematic social needs screening in advanced cancer as an essential first step to identifying and addressing similar disparities. In this single center cohort, over half of participants have unmet needs. Parent caregivers living in poverty experience more distress during their child's cancer treatment compared to parents without poverty exposure. Our prior research demonstrates that household material hardship (HMH) – a modifiable measure of poverty including housing, food, transportation, and utility insecurities – is independently associated with severe psychologic distress among parents of children with newly diagnosed acute leukemia. The feasibility of systematic social needs screening to identify and address similar disparities in pediatric advanced cancer has not been established. Our primary aim was to demonstrate the feasibility of systematic social needs screening in pediatric advanced cancer. We hypothesized that systematic screening would be feasible as defined as >/= 75% consent rate and >/= 75% complete household material hardship data. Parents of children (< 18 years) with advanced cancer (defined as poor prognosis, new relapse/progression, early phase trial enrollment, or new palliative care consult) receiving care at a large pediatric cancer center were approached for participation following permission from the primary palliative care and/or oncology teams. Enrolled participants completed a two-timepoint social needs evaluation at enrollment and 12-weeks from initial survey completion. Surveys were completed electronically and are available in English and Spanish (and other languages with an interpreter). Feasibility was defined as >75% consent rate and >75% complete HMH data. Study opened to accrual in January 2023 and is ongoing. From January through September 2023, N=37 potentially eligible participants were identified; primary teams declined approach for 5 participants. Among 32 eligible participants, 28 consented to participation (88%) and 27 have completed initial surveys (96%) with no missing HMH data. Participants include 22 mothers (81%). Self-reported racial/ethnic identities include 6 Asian participants (22%), 3 Black/African American participants (11%), and 5 Hispanic participants (19%). Over half of participants (N=14) report HMH. All eligible participants completed 12-week follow-up (N=9); 4 participants were ineligible due to their child's death. Systematic social needs screening is feasible in pediatric advanced cancer. Over half of families in this cohort report unmet basic resource needs compared to 1 in 3 families at childhood cancer diagnosis. Unmet social needs are highly prevalent in families of children with advanced cancer. Interventions to address social needs are urgently needed in pediatric advanced cancer. Pediatrics/Under served, under resourced populations [ABSTRACT FROM AUTHOR]