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Family Psychosocial Risk, Neighborhood Opportunity, and Language in Pediatric Cancer.

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Summary

Psychosocial risk in pediatric cancer patients is linked to neighborhood opportunity. Higher neighborhood opportunity (COI) correlated with lower risk for English-speaking families, but not for Spanish-speaking families using the Psychosocial Assessment Tool (PAT).

Keywords:
Child Opportunity Index (COI)Psychosocial Assessment Tool (PAT)childhood cancerneighborhoodpsychosocialrisksocial determinants of health

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Area of Science:

  • Pediatric Oncology
  • Psychosocial Health
  • Health Disparities

Background:

  • Pediatric cancer psychosocial risk assessment requires considering family and environmental factors.
  • The Psychosocial Assessment Tool (PAT) screens for family psychosocial risk, categorizing scores into Universal, Targeted, and Clinical tiers based on the Pediatric Psychosocial Preventative Health Model (PPPHM).
  • This study examines the relationship between PAT scores and neighborhood characteristics for newly diagnosed pediatric cancer patients.

Purpose of the Study:

  • To investigate the association between neighborhood risk levels and psychosocial risk tiers identified by the Psychosocial Assessment Tool (PAT) in families of children with cancer.
  • To compare these associations between English- and Spanish-speaking families.

Main Methods:

  • De-identified PAT data from 457 English- and 81 Spanish-speaking families were analyzed.
  • Neighborhood risk was assessed using the Child Opportunity Index (COI 3.0) by linking patient zip codes to COI levels.
  • Ordinal logistic regression (OLR) was used to test the association between COI level and PAT tier.

Main Results:

  • PAT score distributions were 61.0% Universal, 30.9% Targeted, and 8.2% Clinical.
  • Spanish-language PATs showed higher proportions of Targeted (42.0%) and Clinical (9.9%) risk tiers compared to English-language PATs (28.9% Targeted, 7.9% Clinical).
  • A statistically significant association was found between COI level and PAT tier (OR = 0.850), with higher COI linked to lower psychosocial risk for English PATs (OR = 0.804), but not for Spanish PATs.

Conclusions:

  • The PAT effectively identifies clinically relevant psychosocial risk information related to families' neighborhoods.
  • For English-speaking families, higher neighborhood opportunity (COI) generally correlated with lower psychosocial risk.
  • Spanish-speaking families may experience unique psychosocial risks not fully captured by environmental factors alone, highlighting potential disparities.