Socioeconomic Factors and Adherence to Health Care Recommendations in Adolescent and Young Adult Cancer Survivors.
Socioeconomic Factors and Adherence to Health Care Recommendations in Adolescent and Young Adult Cancer Survivors.
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社会经济因素以及青少年和年轻成人癌症幸存者对医疗保健建议的遵守情况。
DOI：
10.1089/jayao.2022.0109
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发表时间：
2023
影响因子：
2
通讯作者：
Baker,KScott
中科院分区：
文献类型：
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作者：
Hall,AnurekhaG;Syrjala,KarenL;Ketterl,TylerG;Ganz,PatriciaA;Jacobs,LindaA;Palmer,StevenC;Partridge,Ann;Rajotte,EmilyJo;Mueller,BethA;Baker,KScott
目的：大多数青少年和年轻成人（AYA）癌症幸存者在治疗后没有接受推荐的卫生保健监测。我们采用横断面调查数据，以评估收入，教育，婚姻状况和保险对AYA survivor.Methods的医疗保健依从性的影响：符合条件的幸存者18-39岁，在诊断为浸润性恶性肿瘤，1-5年治疗完成。在线调查评估社会人口因素和自我报告完成推荐的医疗保健服务。诊断和治疗数据从病历中提取。多变量逻辑回归计算的优势比（OR）和95%的置信区间（CI）的依从性有关的社会经济地位和support.Results：344名参与者，36%的人坚持至少80%的建议。癌症类型的依从性不同：乳腺癌为34%，白血病/淋巴瘤为52%，其他肿瘤为23%。白色、亚裔和西班牙裔/拉丁裔患者的依从率相似。较低的依从性与较低的教育程度（OR：0.43; 95% CI：0.23-0.80，<4年大学学位）和较低的年收入（OR：0.51; 95% CI：0.28-0.95，41，000 - 80，000美元; OR：0.40; 95% CI：0.19-0.86，≤ 40，000美元）相关。在确诊后1年至3年内的患者中，依从性随收入水平的降低而降低（81，000 - 120，000美元的OR：0.25; 95%CI：0.07-0.93; 41，000 - 80，000美元的OR：0.24; 95%CI：0.07-0.84; ≤ 40，000美元的OR：0.13; 95%CI：0.03-0.60）。AYA癌症幸存者中不遵守医疗保健指南的风险与低收入和低教育水平相关。确定这些风险和AYA幸存者依从性的相关障碍将为旨在满足这些高危人群需求的干预措施提供信息，特别是在诊断后的第一年。试验注册：NCT 02192333。
Purpose:The majority of adolescent and young adult (AYA) cancer survivors do not receive recommended health care surveillance after therapy. We used cross-sectional survey data to evaluate the impact of income, education, marital status, and insurance on health care adherence among AYA survivors.Methods:Eligible survivors were 18–39 years at diagnosis with invasive malignancy, 1–5 years from therapy completion. Online surveys assessed sociodemographic factors and self-report of completion of recommended health care services. Diagnosis and treatment data were abstracted from medical records. Multivariable logistic regression calculated odds ratios (ORs) and 95% confidence intervals (CIs) for adherence in relation to socioeconomic status and support.Results:Of 344 participants, 36% were adherent to at least 80% of recommendations. Adherence varied by cancer type: 34% for breast cancer, 52% for leukemia/lymphoma, 23% for other tumors. Adherence rates were similar among White, Asian, and Hispanic/Latinx patients. Lower adherence was associated with lower education (OR: 0.43; 95% CI: 0.23–0.80 for <4-year college degree) and lower annual income (OR: 0.51; 95% CI: 0.28–0.95 for $41,000–$80,000; OR: 0.40; 95% CI: 0.19–0.86 for ≤$40,000). Adherence decreased with decreasing income levels among those who were 1 to less than 3 years after diagnosis (OR: 0.25; 95% CI: 0.07–0.93 for $81,000–$120,000; OR: 0.24; 95% CI: 0.07–0.84 for $41,000–$80,000; OR: 0.13; 95% CI: 0.03–0.60 for ≤$40,000).Conclusion:Risk of nonadherence to health care guidelines was associated with lower income and lower education among AYA cancer survivors. Identification of these risks and related barriers to adherence in AYA survivors will inform interventions designed to meet needs of these high-risk groups, particularly during the first years after diagnosis. Trial Registration: NCT02192333.