Examining Gender as a Sociocultural Variable Shaping Health Outcomes of Cancer Caregiving

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PROJECT SUMMARY/ABSTRACT With advances in early detection and novel, targeted cancer treatments, a growing number of individuals provide support for cancer survivors who have completed curative intent therapy (“curvivors”) as well as for those who live for many years with metastatic disease (“metavivors”). Cancer caregiving relationships for curvivors and metavivors alike are associated with high stress, particularly as individuals transition to post- initial treatment survivorship and experience decreased contact with medical providers, continued need for medical symptom monitoring, and evolution in relationship dynamics between caregiver and care recipient. As such, caregivers (partners, family members, close friends) may struggle with unmet needs for their own well- being and healthcare utilization (e.g., attendance at follow-up visits, routine healthcare screenings) while supporting the survivor they care for. Though caregiving roles are disproportionately held by women, little is known about possible gender differences in the health impact of cancer caregiving stress during the transition to post-initial treatment survivorship. No existing interventions provide concurrent but separate support for cancer survivors and caregivers at this critical transition point; as such, the parent R21 (“Building Resiliency Among Caregivers of Curvivors and Metavivors: A Pilot Randomized Trial,” R21 CA273785-01) is highly novel in its aim to evaluate the feasibility, acceptability, and preliminary efficacy of the Stress Management and Resiliency Training-Relaxation Resiliency Response Program (SMART-3RP) as delivered concurrently to separate groups of cancer caregivers and survivors. Building upon the aims of the parent grant, this Administrative Supplement (in response to NOT-OD-22-030) will explicate key indices of feasibility and acceptability by participant gender. Leveraging quantitative self-report and biobehavioral (i.e., hair cortisol) data from 48 cancer caregiver-survivor dyads (N = 96), we will also analyze gender differences in baseline characteristics mapping onto gender as a sociocultural variable (i.e., gender norms, gender-related traits, and gender relations), as well as gender differences in preliminary efficacy of the SMART-3RP for caregivers’ and survivors’ resiliency (primary) and healthcare utilization (secondary). To enrich interpretation of quantitative analyses, we will add 3 questions to the planned qualitative exit interviews, regarding of sociocultural aspects of gender in cancer caregiving. This Administrative Supplement will provide timely support for the research team to meaningfully generate empirical mixed-methods data regarding gender differences in intervention feasibility, acceptability, and preliminary efficacy and promote health equity for women in the growing landscape of cancer caregiving research. Further, this work will provide a critical opportunity for MPIs Park and El-Jawahri to support Dr. Lucy Finkelstein-Fox, a promising junior investigator mentored by Drs. Park and El- Jawahri whose research program is dedicated to women’s health and intimacy in cancer survivorship.