Association between resilience and financial toxicity: The role of age, education, and health insurance.

Abstract

e24124 Background: Women with metastatic breast cancer (MBC) are at high risk of financial toxicity (i.e., disturbed financial well-being). Resilience has been identified as a key protective factor associated with better overall quality of life among cancer population. However, whether resilience is associated with lower financial toxicity is unknown. We sought to examine the association between resilience and financial toxicity in women with MBC and explore age, education and health insurance as potential moderators of this association. Methods: We analyzed cross-sectional data from women with MBC ( N = 209) who completed self-reported questionnaires of Resilience Scale Specific to Cancer (RS-SC), Comprehensive Score for Financial Toxicity (COST-FACIT). COST-FACIT included 11 items rated on a five-point Likert scale (0-4), total score ranged from 0-44 with higher scores indicating better financial well-being (lower financial toxicity). Participants (n = 2) with missing data were excluded from analysis. We conducted multiple linear regression to analyze the association of resilience with financial toxicity. Interaction terms were used to test moderating effects of age (18-39, 40-64 and ≥65 years), education (high school/Some college vs. college/master’s degree or above) and health insurance (public vs. private/marketplace insurance). We adjusted for marital status, income, employment status, time since MBC diagnosis, and treatment types as covariates. Results: Of 209 women, 56.5% were aged 40-64 years, 76.6% were White, and 79.9% had a college or master’s degree or above. The mean RS-SC score was 34.49 ( SD = 6.67) and COST-FACIT score was 20.81 ( SD = 10.67). Adjusting for covariates, higher resilience was linked to better financial well-being (β = 0.21 [95%CI: 0.09, 0.33], P < 0.001). Education (β = 0.28, P = 0.027) and health insurance (β = 0.27, P = 0.025) moderated this relationship, with resilience more strongly associated with better financial well-being among those with college/master’s degree or above and private insurance than other groups. Age did not moderate this association. Conclusions: Women MBC who have higher resilience are more likely to experience better financial well-being, but the strength of this association varied by socioeconomic factors. Further research is needed to determine this finding in longitudinal studies. Our results have important implications for incorporating resilience into financial toxicity interventions and tailoring such interventions based on individuals’ socioeconomic characteristics.