Prostate cancer research has consistently shown evidence of racial/ethnic disparities across the cancer continuum from detection/screening and treatment-related outcomes to mortality;and socioeconomic status (SES) has been suggested as a substantial factor in the racial differences;yet, the research results for SES disparities i prostate cancer-related outcomes as well as SES as an explanatory factor in racial/ethnic disparities in prostate cancer have been inconsistent. Some have suggested that this inconsistency may be due to imprecise (and inconsistent or incomplete) measurement of socioeconomic circumstances. Thus, there have been calls in the cancer disparities literature for greater clarity on the pathways and mechanisms causing differential cancer outcomes across racial/ethnic and socioeconomic groups. However, relatively little attention has been paid to the conceptualization AND operationalization of socioeconomic circumstances in this literature. An expanded view of the socioeconomic context for prostate cancer patients might uncover socioeconomic factors influencing disparities in treatment-related outcomes over and above the traditional SES measures;and a construct to capture this expanded socioeconomic context is financial well-being (FWB).
The specific aims of the research project are to: 1) Develop and refine a conceptual model of the multidimensional construct FWB using structured interviews with prostate cancer patients and a focus group with clinical social workers;2) Develop and pilot test a measure of FWB;3) Evaluate the psychometric properties of the measure of FWB and investigate the association between components of FWB, socio-demographic characteristics, and treatment selection and adherence and perceived quality of treatment;and 4) Investigate differences in responses to FWB items across racial/ethnic groups and evaluate potential measurement bias across racial/ethnic groups. The successful completion of the research project will result in a valid measurement and causal model of FWB that articulates how the dimensions of FWB are related to prostate cancer treatment-related outcomes. The candidate, Dr. Reginald Tucker-Seeley, is a Research Associate in the Center for Community Based Research at the Dana-Farber Cancer Institute. The proposed five year NCI Mentored Research Scientist Development Award to Promote Diversity (K01) will provide the necessary mentoring, training, and research experiences in cancer care/health services, psycho-oncology, and measures/scale development to implement the proposed research project. His long term career goal is to become an independent investigator developing projects to reduce socioeconomic disparities across the cancer continuum from prevention to end-of-life care. Through this work, he plans to identify the socioeconomic pathways contributing to cancer disparities and to design innovate interventions that help individuals better manage and leverage their socioeconomic and psychosocial resources for improved health.
A more comprehensive view of socioeconomic status (SES) may help us better understand how SES is actually experienced and how it affects prostate cancer treatment and outcomes. Our limited knowledge about both the subjective and objective mechanisms through which socioeconomic experience impacts cancer treatment constrains our understanding of the factors that contribute to cancer disparities. Expanding our conceptualization of SES to include material and psychosocial aspects of individual socioeconomic circumstances may help us begin to unpack the complex association between socioeconomic circumstances and the various types of prostate cancer treatment selected and adherence to treatment.
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