The Impact of Social Determinants of Health Domains on Lung Cancer Surgery Family Caregivers and Patients

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PROJECT SUMMARY The objective of this supplemental application is to promote diversity research and provide a mentored experience in cancer health disparities and cancer control for Dr. Dede Teteh. The purpose of the parent R01 (CA217841-01A1, PI: Sun, Kim) is to test the efficacy of a multimedia self-management intervention on outcomes for lung cancer surgery family caregivers (FCGs) and patients. Research conducted in the R01 is critical because lung cancer patients are discharged from the hospital earlier after surgery despite an aging population that suffers from greater co-morbidities and decreased quality of life (QOL). As a result, the bulk of the caregiving burden after surgery has fallen on FCGs. In addition, social determinants of health (SDH), including social, environmental, behavioral, and spirituality factors, may impact QOL outcomes and caregiving burden for lung cancer surgery FCGs and patients. However, SDH is an understudied topic in lung cancer surgery. Understanding the interaction between SDH domains and QOL outcomes will fill a critical knowledge gap on potential health disparities in lung cancer surgery outcomes and survivorship. Therefore, the purpose of this supplemental application is to determine the impact of SDH domains on outcomes in lung cancer surgery FCGs and patients using a prospective, longitudinal, mixed methods design. Aim 1 will describe the relationship between self-reported SDH domains (economic stability, education, neighborhood and built environment, health/healthcare, social and community context-spirituality) and FCG/patient outcomes before and after surgery. In Aim 2, SDH domains that are potential barriers to FCG/patient outcomes will be explored using focus groups. To achieve her training goals, Dr. Teteh will be mentored by an outstanding team of investigators with complementary expertise in the areas of FCG/QOL research, quantitative/qualitative methodology, lung cancer surgery, SDH, health disparities, and community-based research. The mentoring/career development plan will focus on research design, methodology, study implementation, and data analysis. The proposed research aligns with the parent R01 study and will promote the growth of minority researchers in health sciences. Results from the study will serve as preliminary data for a NIH/NCI K01 award. Dr. Teteh’s long-term goal is to become an independent researcher in health disparities and cancer control, with the aim to design and test interventions that address SDH in lung cancer.