Relationship Between Household Material Hardship and Distress in Parents of Children with Advanced Cancer: A Report from the PediQUEST Response Trial (T315A)

Abstract

Objectives: 1. Explain the association between household material hardship and distress in parents of children with advanced cancer. 2. Propose how housing insecurity can be modified for families of children with advanced cancer through providing systematic psychosocial support. Original Research Background: Socioeconomic status (SES) is associated with inferior health outcomes in pediatric cancer, but little is known about SES and distress in parents of children with advanced cancer. Research Objectives: To characterize the relationship between SES as measured by household material hardship (HMH, food, energy and/or housing insecurity) and distress in parents of children with advanced cancer. Method(s): We conducted a preliminary cross-sectional analysis of baseline data from the PediQUEST Response multisite randomized controlled early palliative care trial. Primary outcomes included parental state anxiety (State-Trait Anxiety Inventory-state) and depression (Center for Epidemiologic Studies Depression-10 Scale). Regression models were fitted to characterize the relationship between each HMH domain (food, energy and/or housing insecurity) and the primary outcomes. Result(s): Parent (n=82) mean age was 43.6 years (+/-8.4); most were White, non-Hispanic females (n=62, 76%) and married (n=61, 74%). Child mean age was 11.5 years (+/-6.3); 57% male (n=47), 44% with brain and 44% solid malignancies. Parents reported moderate state anxiety (x = 38.2+/-11.4) and high levels of depressive symptoms (x=10.5+/-4.6). Parental state anxiety and depression were correlated (Spearman rho=.54, p<.0001). Forty percent of parents reported at least 1 HMH insecurity (food, 27%; energy, 13%; housing, 26%). Housing insecurity was significantly associated with increased parental state anxiety (7.7, 95%CI: 1.75, 13.7; p=0.012) and depression (2.7, 95%CI:.479, 5.03; p=0.018) after adjusting for sex, age and marital status. Conclusion(s): HMH and parental distress were highly prevalent in this cohort of parents of children with advanced cancer. Housing insecurity may be an important modifiable driver of parental distress. Implications for Research, Policy, or Practice: Families of children with advanced cancer may benefit from HMH screening, especially for housing insecurity. Early identification of housing insecurity could allow for better support of these families. Copyright © 2021