Grant Number:	7R21CA141165-03 Interpret this number
Primary Investigator:	Gage, Elizabeth
Organization:	State University Of New York At Buffalo
Project Title:	Ses, Race, and Patterns of Health Care Navigation of Parents of Pediatric Cancer
Fiscal Year:	2010

DESCRIPTION (provided by applicant): While the positive association between socioeconomic status (SES) and health outcomes has been a consistent finding in health related research, the pathways that produce this association remain imperfectly understood. One pathway that has been hypothesized to be an important link between an individual's SES and their health outcomes are their patterns of health care navigation. While there has been some research on health care navigation and health outcomes in adults, research has not yet examined how these process impact pediatric cancer patients. We also do not know how parents' patterns of health care navigation after a serious pediatric diagnosis vary by race and SES. The goal of this study is to understand how parents' patterns of health care navigation after a child is diagnosed with cancer vary by race and SES, and to translate these findings into evidence based intervention programs. To accomplish this, the proposed study has three specific aims: 1) Conduct 80 in-depth interviews with parents of pediatric cancer patients to document the different characteristics of their patterns of health care navigation; 2) Collect and analyze data on the multiple dimensions of the SES construct to determine what elements of SES are theoretically important for key outcome variables; and 3) Use these data to inform the development of evidence-based, culturally sensitive intervention programs. This study will use a mixed methods approach, combining in-depth interviews with parents and care givers of children with cancer and survey data on socio-demographic variables and family functioning scales. These methods will allow for the collection of nuanced, rich data enabling the definition and understanding of parents' patterns of health care navigation after a child is diagnosed with cancer, and how these patterns vary by race and SES. Since there is not enough existing data to understand the relationship of race, SES, and navigational decisions and barriers of families of pediatric oncology patients, we are not able to do a hypothesis-driven study. This study will build foundational data to inform future research. Results from this study have the potential to make a significant theoretical and practical contribution to scholarship and intervention surrounding pediatric health disparities. Data will be used to define patterns of health care navigation, and identity signature elements of different patterns parents enact. Building upon preliminary data, results will be used to develop a theoretical framework that accounts for the ways that race and SES weave together to affect these patterns of health care navigation. Hypotheses derived from these findings will be tested in a future quantitative longitudinal study of the long term outcomes of pediatric cancer on patients and their families. Findings will also be used to inform the development of culturally sensitive intervention programs aimed to reduce the risks of adverse outcomes of cancer treatment on family members' well being. PUBLIC HEALTH RELEVANCE: Previous research has established that socioeconomic and racial health disparities are a continued problem in the United States; however, little is known about the pathways that produce this link between an individual's race, socioeconomic status (SES), and health. This research will examine how parents navigate the health care community after a child is diagnosed with cancer, and compare the strategies used by parents in four categories: high SES African American, high SES white, low SES African American, and low SES white. Results will add to our understanding of how race and SES affects key components of health care navigation, and will be used to inform evidence-based, culturally sensitive intervention programs aimed to reduce negative outcomes of pediatric cancer.




Social support, flexible resources, and health care navigation.
Authors: Gage-Bouchard E.A. .
Source: Social Science & Medicine (1982), 2017 Oct; 190, p. 111-118.
EPub date: 2017-08-18 00:00:00.0.
PMID: 28858696
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Culture, Styles of Institutional Interactions, and Inequalities in Healthcare Experiences.
Authors: Gage-Bouchard E.A. .
Source: Journal Of Health And Social Behavior, 2017 06; 58(2), p. 147-165.
EPub date: 2017-02-01 00:00:00.0.
PMID: 28661778
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The architecture of support: The activation of preexisting ties and formation of new ties for tailored support.
Authors: Gage-Bouchard E.A. , LaValley S. , Panagakis C. , Shelton R.C. .
Source: Social Science & Medicine (1982), 2015 Jun; 134, p. 59-65.
PMID: 25888807
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Examining parents' assessments of objective and subjective social status in families of children with cancer.
Authors: Gage-Bouchard E.A. , Devine K.A. .
Source: Plos One, 2014; 9(3), p. e89842.
PMID: 24599006
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The relationship between socio-demographic characteristics, family environment, and caregiver coping in families of children with cancer.
Authors: Gage-Bouchard E.A. , Devine K.A. , Heckler C.E. .
Source: Journal Of Clinical Psychology In Medical Settings, 2013 Dec; 20(4), p. 478-87.
PMID: 23670676
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Social networks of experientially similar others: formation, activation, and consequences of network ties on the health care experience.
Authors: Gage E.A. .
Source: Social Science & Medicine (1982), 2013 Oct; 95, p. 43-51.
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The dynamics and processes of social support: families' experiences coping with a serious paediatric illness.
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Source: Sociology Of Health & Illness, 2013 Mar; 35(3), p. 405-18.
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The devil you know: parents seeking information online for paediatric cancer.
Authors: Gage E.A. , Panagakis C. .
Source: Sociology Of Health & Illness, 2012 Mar; 34(3), p. 444-58.
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