A longitudinal analysis of social networks and patient-reported outcomes among young adult cancer survivors.

Abstract

12111 Background: Nearly 80,000 young adults (YAs; aged 18-39) are diagnosed with cancer each year in the United States with > 80% expected to survive beyond 5 years. Social connectedness (connections/relations with others) is one of the most documented psychosocial factors cited as influencing health and well-being among YA survivors. However, given cancer diagnosis, treatment, and the challenging late effects, the social networks of YA survivors invariably change, including the quantity, quality, and types of relationships. Limited work has focused on identifying the extent of changes within YA survivors’ social networks, such as the social network structure (network size) and social network composition (sociodemographic characteristics) that may confer risk. To understand this, we present preliminary data mapping the social networks of YA survivors, analyzing network changes over a 3-month period and associations with depression and anxiety. Methods: YAs ( N = 25) completed a baseline social network questionnaire capturing social network structure (number of network members), composition (network member characteristics), and types of support each network member provides. YA survivors also completed measures of depression and anxiety at 3 months post baseline. Wilcoxon signed-rank tests assessed changes in social network metrics; correlations examined associations between baseline social network metrics and depression and anxiety at 3 months. Results: YA survivors ( M age = 27.0, SD = 5.4, range = 18-37) were majority female (56%) and white (56%). YA survivors reported a wide range of cancer diagnoses (leukemia, lymphoma, testicular, thyroid, breast) and were on average 2 years since diagnosis ( M = 22 months). On average YA survivors’ networks over 3 months contracted by 0.96 people ( Z = -2.09, p = 0.036). Social networks changed compositionally over time, with a decrease in second degree relatives ( Z = -2.066, p = 0.039) and male network members ( Z = -2.17, p = 0.03), but no change in the mean age or in the number of female network members. The types of support that YA survivors received over time also changed, with a decrease in the amount of emotional support ( Z = -2.03, p = 0.04). Only the number of parental network members at baseline was positively associated with depression ( r = 0.53, p = 0.007) and anxiety ( r = 0.51, p = 0.009) at 3 months. There were no other significant associations between baseline social network metrics on depression and anxiety scores at 3 months. Conclusions: Despite networks getting smaller and less heterogeneous over time, this was not associated with later depression or anxiety in our preliminary sample. More work is needed to inform the development and delivery of targeted social network interventions focused on intervening upon social network indicators to improve the long-term health and well-being of this vulnerable YA survivor population.