Associations of Demographic and Social Factors on Health-Related Quality-of-Life Changes Among Older Women With Breast or Gynecologic Cancer.

OBJECTIVES: To examine associations of sociodemographic factors and social limitations with health-related quality of life (HRQOL) from pre- to postdiagnosis in older female cancer survivors. SAMPLE & SETTING: 9,807 women aged 65 years or older with breast or gynecologic cancer from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey. METHODS & VARIABLES: Physical and mental HRQOL were assessed using the physical component summary (PCS) and mental component summary (MCS) of the Veterans RAND 12-Item Health Survey. Descriptive statistics and mixed-effects models for repeated measures were used. RESULTS: Social limitations were the only significant factor associated with changes in MCS scores. Race and ethnicity, rurality, and social interference were associated with significant decreases in PCS scores. IMPLICATIONS FOR NURSING: Nurses can assess mental and physical HRQOL after diagnosis and advocate for appropriate referrals. Oncology care should be tailored to cultural considerations, including race and ethnicity, rurality, and social support.

Addressing the Impact of Race and Ethnicity on Musculoskeletal Spine Care in the United States.

➤ Despite being a social construct, race has an impact on outcomes in musculoskeletal spine care.➤ Race is associated with other social determinants of health that may predispose patients to worse outcomes.➤ The musculoskeletal spine literature is limited in its understanding of the causes of race-related outcome trends.➤ Efforts to mitigate race-related disparities in spine care require individual, institutional, and national initiatives.

Social factors and age play a significant role in cervical cancer and advanced-stage disease among Danish women.

BACKGROUND: For cervical cancer (CC), the implementation of preventive strategies has the potential to make cervical cancer occurrence and death largely avoidable. To better understand the factors possibly responsible for cervical cancer, we aimed to examine possible differences in age and social parameters as well as screening status between women with low- or high-stage cervical cancer and matched controls. METHODS: Through the Danish Cancer Registry (DCR), women diagnosed with cervical cancer in Denmark between 1987 and 2016 were included. These were age- and residence-matched in a 1:5 ratio with controls from the general female population. The study population was sub grouped into a low-stage subpopulation with women with early-stage cervical cancer and matched controls and a high-stage subpopulation with women with late-stage cervical cancer and matched controls. Age and social parameters were compared within the subpopulations as well as between low- and high-stage cases. For part of the study population, screening attendance was examined to compare differences in adherence. RESULTS: Overall, we found that the risk of cervical cancer is significantly increased in socially disadvantaged women and not least non-attenders in screening. Interestingly, the high-stage subpopulation was significantly older than the low-stage subpopulation (p < 0.001), and when examining the impact of age further, we found that for cervical cancer cases, the risk of having low-stage disease decreases significantly with increasing age, whereas the risk of having high-stage disease increases significantly with increasing age. In the screening cohort, significantly less cases than controls were attenders in screening with the most pronounced differences seen in the old subpopulation (women aged 50-64 years) and in the high-stage subpopulation (p-values all < 0.001). Interestingly, when examining the risk of CC for attenders and non-attenders, we demonstrated that many social parameters continue to influence the risk of cervical cancer, even in women attending screening. CONCLUSIONS: Older women, socially disadvantaged women, and non-attenders in screening are particularly vulnerable in terms of developing cervical cancer, especially high-stage disease. Therefore, improvements in the participating rate in screening as well as a revision of the current screening guidelines are needed.

Measuring Associations Between Community-Level Social Determinants of Health and Bariatric Surgery Weight Loss Outcomes.

Bariatric surgery is a crucial intervention in managing obesity and related conditions. However, weight loss outcomes can vary significantly, and social determinants of health (SDoH) at the community level may play a role. Our objective is to identify community-level SDoH factors associated with reduced weight loss after bariatric surgery. We conducted an analysis of electronic health records and the social vulnerability index (SVI) of 3,800 patients who underwent bariatric surgery at Vanderbilt University Medical Center. We measured the associations between SVI social factors and the percent change in body mass index three months after surgery using linear regression. The SVI factors with a false discovery rate-adjusted p-value < 0.05 were deemed significant. Statistical results show that patients who reside in communities with racial minority groups or lower insurance rates had reduced weight loss three months after surgery.

Social Determinants of Health and Preoperative Care.

Preoperative care exists as part of perioperative continuum during which anesthesiologists and surgeons optimize patients for surgery. These multispecialty efforts are important, particularly for patients with complex medical histories and those requiring major surgery. Preoperative care improves planning and determines the clinical pathway and discharge disposition. The role of nonmedical social factors in the preoperative planning is not well described in anesthesiology. Research to improve outcomes based on social factors is not well described for anesthesiologists but could be instrumental in decreasing disparities and advancing health equity in surgical patients.

Does the number of social factors affect long-term patient-reported outcomes and satisfaction in those with cervical myelopathy? A QOD study.

OBJECTIVE: It is not clear whether there is an additive effect of social factors in keeping patients with cervical spondylotic myelopathy (CSM) from achieving both a minimum clinically important difference (MCID) in outcomes and satisfaction after surgery. The aim of this study was to explore the effect of multiple social factors on postoperative outcomes and satisfaction. METHODS: This was a multiinstitutional, retrospective study of the prospective Quality Outcomes Database (QOD) CSM cohort, which included patients aged 18 years or older who were diagnosed with primary CSM and underwent operative management. Social factors included race (White vs non-White), education (high school or below vs above), employment (employed vs not), and insurance (private vs nonprivate). Patients were considered to have improved from surgery if the following criteria were met: 1) they reported a score of 1 or 2 on the North American Spine Society index, and 2) they met the MCID in patient-reported outcomes (i.e., visual analog scale [VAS] neck and arm pain, Neck Disability Index [NDI], and EuroQol-5D [EQ-5D]). RESULTS: Of the 1141 patients included in the study, 205 (18.0%) had 0, 347 (30.4%) had 1, 334 (29.3%) had 2, and 255 (22.3%) had 3 social factors. The 24-month follow-up rate was > 80% for all patient-reported outcomes. After adjusting for all relevant covariates (p < 0.02), patients with 1 or more social factors were less likely to improve from surgery in all measured outcomes including VAS neck pain (OR 0.90, 95% CI 0.83-0.99) and arm pain (OR 0.88, 95% CI 0.80-0.96); NDI (OR 0.90, 95% CI 0.83-0.98); and EQ-5D (OR 0.90, 95% CI 0.83-0.97) (all p < 0.05) compared to those without any social factors. Patients with 2 social factors (outcomes: neck pain OR 0.86, arm pain OR 0.81, NDI OR 0.84, EQ-5D OR 0.81; all p < 0.05) or 3 social factors (outcomes: neck pain OR 0.84, arm pain OR 0.84, NDI OR 0.84, EQ-5D OR 0.84; all p < 0.05) were more likely to fare worse in all outcomes compared to those with only 1 social factor. CONCLUSIONS: Compared to those without any social factors, patients who had at least 1 social factor were less likely to achieve MCID and feel satisfied after surgery. The effect of social factors is additive in that patients with a higher number of factors are less likely to improve compared to those with only 1 social factor.

"Cê anda igual bandido!": o que dizem os jovens sobre a construção midiática do criminoso? / "You look like a thug!": how do young people view the media's construction of the criminal? / « "T'as l'air d'un voyou! ¼: comment les jeunes perçoivent-ils la construction médiatique du criminel? / "¡Pareces un bandido!': ¿qué dicen los jóvenes sobre la construcción del criminal en los medios de comunicación?

Resumo A partir do cenário brasileiro, marcado por diferentes expressões da violência, são construídas práticas midiáticas que representam a juventude pauperizada de forma a criminalizar tal grupo. Este artigo apresenta uma discussão a respeito dos sentidos produzidos por jovens de 14 a 16 anos sobre as representações midiáticas expressas por setores da mídia hegemônica. Trata-se de uma pesquisa participante, delineada a partir da perspectiva do sociólogo Orlando Fals-Borda e da ideia de coautoria de Mikhail Bakhtin. A pesquisa foi realizada em uma cidade do estado de Minas Gerais, e foram construídos sete grupos de discussão, em que reportagens nas quais jovens são associados a episódios tidos como criminosos foram discutidas. Por meio dos diálogos construídos, foi possível identificar que o conteúdo midiático pode resultar em uma série de violências nas vidas desses jovens, que resistem através da busca por estratégias criativas, envolvendo a arte e mídias alternativas.

Abstract From a scenario marked by different expressions of violence emerge media practices set on criminalizing impoverished youth. This article examines the meanings produced by youth aged 14 to 16 years about the media representations broadcasted by hegemonic sectors. A participative research designed based on sociologist Orlando Fals-Borda's work and Mikhail Bakhtin's co-authorship was conducted with youth from the state of Minas Gerais. Seven discussion groups were created to debate the association between youth and criminal activity on the news. Analysis of the dialogues showed that media content can impart a series of violence in their lives. However, they resist through creative strategies involving art and alternative media.

Résumé A partir d'un scénario marqué par différentes expressions de la violence ressortent des pratiques médiatiques visant à criminaliser la jeunesse appauvrie. Cet article discute les significations produits par des jeunes de 14 à 16 ans à propos des représentations médiatiques formulées par les secteurs hégémoniques. Une recherche intervenante, esquissée d'après la perspective du sociologue Orlando Fals-Borda et du concept de cocréation de Mikhail Bakhtin, a été réalisée dans une ville de l'État du Minas Gerais. Sept groupes de discussion ont été créé pour débattre des reportages où des jeunes sont associés à des épisodes criminels. L'analyse des dialogues a montré que le contenu des médias peut mener à une série de violences dans leur vie. Pourtant, ils résistent grâce à des stratégies créatives faisant appel à l'art et aux médias alternatifs.

Resumen A partir del escenario brasileño, marcado por diferentes expresiones de violencia, se construyen prácticas mediáticas, para criminalizar a la juventude más pobre. Este artículo discute los sentidos producidos por jóvenes de 14 a 16 años respecto a las representaciones mediáticas, expressadas por sectores de los medios hegemónicos. Se trata de una investigação participante, diseñada a partir de la perspectiva del sociólogo Orlando Fals-Borda y la idea de coautoría de Mikhail Bakhtin. La investigación fue realizada en una ciudad del estado de Minas Gerais, mediante siete grupos de discusión, donde se analizaron las asociaciones que hacen de los jóvenes con episodios delictivos. A partir de los diálogos establecidos, se encontró que lo proyectado por los medios de comuncación puede resultar de considerables violencias en la vida de aquellos jóvenes, quienes se resisten a través de la búsqueda de estrategias creativas como el arte y medios alternativos.

Focus on the impact of social factors and lifestyle on the disease burden of low back pain: findings from the global burden of disease study 2019.

BACKGROUND: Low back pain (LBP) is one of the leading causes of disability worldwide. Differences in social backgrounds and lifestyles in various regions and countries may contribute to the discrepancies in the disease burden of LBP. METHODS: Based on the GBD 2019, we collected and analyzed numbers and age-standardized rates (ASR) of LBP disability-adjusted life years (DALYs). Temporal trends in ASR were also analyzed using estimated annual percentage change (EAPC). The Age-period-cohort (APC) model was used to estimate age, period and cohort trends in DALYs of LBP. An autoregressive integrated moving average (ARIMA) model was used to forecast DALYs of LBP trends from 2020 to 2035. RESULTS: The DALYs due to LBP increased from 1990 to 2019. The APC model showed that the risk of DALYs for global LBP increased with age and year and that the risk of DALYs was lower in the later-born cohort than in the earlier-born cohort. The main risk factors which GBD estimates were available for DALYs of LBP include smoking, occupational ergonomic factors and high BMI. It is expected that DALYs of LBP will continue to rise until 2035. CONCLUSION: From 1990 to 2019, the global disease burden of LBP remained high. It is necessary to pay attention to the influence of social factors and lifestyle on LBP. Focusing on the impact of social factors as well as lifestyle on the prognosis of LBP and targeting interventions may further reduce the disease burden of LBP.

Substance Use Patterns and Their Association with Depression and Social Factors During COVID-19 Among Harlem Residents in New York City.

This study aimed to identify the prevalence of substance use before and during COVID-19; and examined its association with depression and social factors among 437 residents from the neighborhood of Harlem in Northern Manhattan, New York City. Over a third of respondents reported using any substance before COVID-19, and initiating/increasing substance use during COVID-19. The most common substances used before COVID-19 and initiated/increased during COVID-19 were smoking (20.8% vs. 18.3%), marijuana (18.8% vs. 15.3%), and vaping (14.2% and 11.4%). The percentages of any hard drug use were 7.3% and 3.4%, respectively. After adjustment, residents with mild (Prevalence Ratio [PR] = 2.86, 95% CI 1.65, 4.92) and moderate (PR = 3.21, 95% CI 1.86, 5.56) symptoms of depression, and housing insecurity (PR = 1.47, 95% CI 1.12, 1.91) had at least a 47% greater probability of initiating and/or increasing substance use. Conversely, respondents with employment insecurity (PR = 0.71, 95% CI 0.57, 0.88) were 29% less likely to report such patterns. No association was found between substance use initiation and/or increase and food insecurity. High prevalence of substance use during COVID-19 may lead residents to turn to substance use as a coping mechanism for psychosocial stressors. Thus, it is essential to provide accessible and culturally sensitive mental health and substance use services.

Impact of social determinants of health on individuals living with generalized myasthenia gravis and implications for patient support programs.

Introduction: Social determinants of health (SDOH) are important contributors to health outcomes, and better understanding their impact on individuals diagnosed with rare, chronic diseases with high burden and unmet need is critical. Characterizing SDOH burden can help improve the design of patient support programs (PSPs), using targeted approaches to remove barriers to access. Methods: This study used a mixed-methods strategy employing a quantitative survey, which was designed based on qualitative interviews, to understand the unmet needs and awareness/utilization of PSPs among individuals living with generalized myasthenia gravis (gMG) and experiencing SDOH barriers. The survey was completed by 38 individuals living with gMG, of which the majority were non-White/Caucasian, unemployed, low income, and enrolled in public insurance. Common SDOH challenges, awareness/utilization of available PSPs, and unmet needs were identified. Results: Financial and mental health concerns were the most common among individuals living with gMG and experiencing SDOH barriers throughout diagnosis, accessing treatment, initiating treatment, and continuing treatment. Awareness and utilization of existing support services were low, especially when accessing treatment. Educational, financial, and personalized support with high "human touch" were commonly perceived as the most valuable resources. Implications: To better serve the needs of individuals with gMG experiencing SDOH barriers, PSPs should use a targeted approach to offer services tailored to harder-to-reach populations. Further, providers, advocacy groups, manufacturers, and public organizations in the gMG ecosystem should strengthen collaborations with PSPs to enable individuals living with gMG to access the services they need to improve their health outcomes.

Prostate cancer in New York City: impact of neighborhood level social determinants of care.

Social determinants of health may impact prostate cancer presentation. Since neighborhoods may influence adjacent neighborhoods across often porous and arbitrary borders, we performed generalized spatial two stage least squares cross sections regression to assess direct and indirect (via adjacent neighborhoods) impact of neighborhood level independent variables. Using the New York State Public Access Cancer Epidemiology Data and the NYC Open neighborhood-level dataset, we discovered a direct association between Race and poverty with the likelihood of presenting with advanced prostate cancer. There were no indirect impacts of neighborhood variables, indicating the need to directly target neighborhoods to improve outcomes.

The Impact of Social Determinants of Health on Vision Loss From Cataracts and Cataract Surgery Utilization in the United States-A National Health Interview Survey Analysis.

PURPOSE: To investigate the association of social determinants of health (SDOH) factors and cataract-related outcomes disparities. DESIGN: Cross-sectional, with a nationally representative sample. METHODS: We used publicly available data from the 2008, 2016, and 2017 National Health Interview Survey data sets. Outcome measures included self-reported prevalence for ever been diagnosed with cataract, vision loss secondary to cataracts, and the likelihood of undergoing cataract surgery. Survey-weighted, multivariable logistic regression models, adjusted for age, race and ethnicity, and other relevant covariates, were used to examine the association between SDOH factors and cataract-related outcomes. RESULTS: A total of 81,551 participants were included, who were predominantly between 18 and 44 years of age (49.6%), female (51.7%), and White (74.8%). Multivariable regression models with age as a covariate showed that individuals who were not working were more likely to report having cataracts than those who were working (P < .001). Those who needed but could not afford medical care in the past year were more likely to report vision loss secondary to cataracts than their counterparts (P < .001). Uninsured participants were less likely to report undergoing cataract surgery than those with private insurance (P = .03). Individuals with higher income (poverty-income ratio: 1.00-2.99 vs <1.00) were more likely to report undergoing cataract surgery (P = .04). CONCLUSIONS: Several SDOH factors were associated with disparities in rates of cataract-related outcomes. These findings highlight the importance of ophthalmologists screening for social risks in patients with cataract, as these social factors are important barriers for access to care.

Tumor, Patient, and Social Determinants of Health Affecting Survival in Patients With Anal Cancer Treated By Chemoradiation.

PURPOSE: Anal cancer (AC) is a rare disease with scarce evidence from developing countries. We performed a population-based cohort study to investigate the relationship between tumor, patient, and social determinants of health with treatment outcomes of AC treated by chemoradiation (CRT). METHODS AND MATERIALS: Patients who received a diagnosis of AC from 1999 to 2020 were identified from the Fundação Oncocentro de São Paulo database. Only patients with AC stage I-III treated by CRT were included. Age, sex, tumor category (T), nodal category (N), education level, practice setting, time to radiation therapy, histology, and treatment local data were extracted. With the Cox proportional hazard model, the hazard ratio and 95% confidence interval were used to test the relationship between tumor, patient, and social factors with overall survival (OS) and cancer-specific survival (CSS). RESULTS: With 1462 patients assessed, the median follow-up was 72 months, and the OS and CSS at 5/10 years were 61%/46% and 67%/60%, respectively. In the univariate analysis, T category, N category, sex, practice setting, and education level were associated with OS and CSS (P < .05). In the multivariate analysis, female sex, T1/2 category, N0 category, and private service were independently associated with OS (P < .05). For CSS, female sex, T1/2 category, private service, and N0 category remained significant (P < .05). CONCLUSIONS: CRT produced satisfactory rates of OS and CSS in patients with AC, with tumor, patient, and social determinants of health influencing the outcomes. These data could help mitigate the effects of social distortions on the survival of AC.

Factores socioafectivos y su influencia en la actividad sexual de adolescentes / Socioemotional Factors and Their Influence on Sexual Activity Among Adolescents / Fatores socioafetivos e sua influência na atividade sexual de adolescentes

durante la adolescencia se adquieren conocimientos y se desarrollan actitudes hacia el sexo, la anticoncepción y la reproducción, aspectos que influirán en el comportamiento sexual que repercute directamente en la calidad de vida. Por tanto, el objetivo de este estudio fue determinar los factores sociales y emocionales asociados al inicio de la actividad sexual, así como sus consecuencias como el embarazo y las enfermedades de transmisión sexual en adolescentes y adultos jóvenes. Materiales y métodos: estudio descriptivo, transversal y correlacional de una muestra de 1191 estudiantes de secundaria que recibieron cuestionarios sobre factores socioemocionales e iniciación sexual. Los datos se procesaron mediante estadística descriptiva y la prueba chi-cuadrado de Pearson para determinar la asociación entre los factores evaluados. Resultados: la tasa de inicio de la actividad sexual entre los adolescentes fue del 45 %, de los cuales el 14 % utilizaba protección. El 88,8 % de los adolescentes dice recibir apoyo de los padres, el 39 % acepta tratos violentos en el hogar y el 47 % tuvo una madre adolescente embarazada, entre otros aspectos. Conclusiones: existe una relación significativa (con p < 0.05) entre los factores socioemocionales de género, proyectos de vida, actividades extracurriculares, apoyo de los padres, violencia intrafamiliar y maltrato, con respecto a las madres con antecedente de embarazo precoz e inicio de la actividad sexual en la adolescencia.

During adolescence, knowledge is acquired and attitudes toward sex, contraception, and reproduction are developed, aspects that will influence sexual behavior, which has a direct impact on quality of life. Therefore, this study was designed to determine the social and emotional factors associated with the onset of sexual activity and its consequences, such as pregnancy and sexually transmitted dis-eases, among adolescents and young adults. Materials and Methods: A descriptive, cross-sectional, and cor-relational study involving 1,191 high school students was conducted. A questionnaire containing questions on socio-emotional factors and sexual initiation was administered. Data were processed using descriptive statistics and Pearson's chi-square test to determine the association between the evaluated factors. Results:The initiation rate of sexual activity among adolescents was 45%, of whom 14% used protection. However, 88.8% of the adolescents received parental support, 39% accepted violent treatment at home, and 47% had a pregnant adolescent mother, among other aspects. Conclusions: There is a significant relationship between the socio-emotional factors of sex, life projects, extracurricular activities, parental support, intra-family violence, and mistreatment. Having a mother with a history of early pregnancy is associated with the onset of sexual activity among adolescents.

durante a adolescência, são adquiridos conhecimentos e desenvolvidas atitudes em relação ao sexo, contracepção e reprodução, aspectos que irão influenciar o comportamento sexual que afeta diretamente a qualidade de vida. Portanto, o objetivo deste estudo foi determinar os fatores sociais e emocionais associados ao início da atividade sexual, bem como suas consequências, como a gravidez e doenças sexualmente transmissíveis em adolescentes e jovens adultos. Materiais e métodos: estudo descritivo, transversal e correlacional em uma amostra de 1191 estudantes do ensino médio que rece-beram questionários sobre fatores socioemocionais e iniciação sexual. Os dados foram processados por meio de estatística descritiva e teste qui-quadrado de Pearson para determinar a associação entre os fatores avaliados. Resultados: a taxa de início da atividade sexual entre os adolescentes foi de 45%, dos quais 14% utilizavam proteção. 88,8% dos adolescentes afirmaram receber apoio dos pais, 39% recebem tratamento violento em casa e 47% têm mãe adolescente grávida, entre outros aspectos. Conclusões: existe uma relação significativa com p < 0,05 entre os fatores socioemocionais de gênero, projetos de vida, atividades extracurriculares, apoio parental, violência doméstica e maus-tratos. Mães com histó-rico de gravidez precoce e início da atividade sexual na adolescência.

Structural evaluation of child physical abuse in trauma: Social determinants of health at the population level.

PURPOSE: Child physical abuse (CPA) is closely linked to social factors like insurance status with limited evaluation at a structural population-level. This study evaluates the role of social determinants of health within the built environment on CPA. METHODS: A single-institution retrospective review of pediatric trauma patients was conducted between January 2016 and December 2020. Patient address was geocoded to the census-tract level. Socioeconomic metrics, including poverty rate, supermarket access and Social Vulnerability Index (SVI) were estimated from the Food Access Research Atlas. Univariate and multivariable regression analyses were conducted to compare demographics and outcomes. RESULTS: Of 3,540 patients, 317 (9.0%) had concern for physical abuse reported in the registry. CPA patients were younger (7.5 vs 9.6 years, p<0.0001) and more often Black (37.0%, N = 117 vs 23.5%, N = 753; p<0.0001). CPA had higher injury severity scores (ISS) (7.9 vs 5.8, p<0.0001) and longer length of stay (5.3 vs 2.9 days, p<0.0001). CPA had higher Medicaid (73.0%, N = 232 vs 53.8%, N = 1748, p<0.0001) and SVI (0.65 vs 0.59, p<0.0001) with lower median income ($52,100 vs $56,100, p<0.0001) and more low-food access tracts (59.6% vs 53.6%, p = 0.06). Combined low-income and low-food access populations showed widened disparities (40.0% vs 28.9%, p = 0.0002). On multivariate analysis, CPA was associated with poverty (OR 2.3, 95% CI [0.979, 3.60], p = 0.0006), low-access Black share (OR 3.3, 95% CI [1.18, 5.47], p = 0.002) and urban designation (OR 1.5, 95% CI [1.13, 1.87], p = 0.004). CONCLUSION: The built-environment and population-level social determinants of health are related to child physical abuse and should influence advocacy and prevention. LEVEL OF EVIDENCE: Level III. TYPE OF STUDY: Retrospective.

Social and Cultural Factors, Self-efficacy, and Health in Latino Cancer Caregivers.

BACKGROUND: Latino cancer caregivers are at risk of physical, mental, and emotional health issues. Sociocultural factors such as informational support, Anglo orientation, and spiritual practice may compound or protect against these risks. OBJECTIVE: The purpose of this research project was to examine self-efficacy as a mediator between sociocultural factors and health outcomes in Latino cancer caregivers. METHODS: This is a secondary analysis of baseline caregiver data from an experimental study testing two psychoeducational interventions in Latina individuals with breast cancer and their caregivers. Caregivers (N = 233) completed items assessing self-efficacy, informational support, Anglo orientation, spiritual practice, depression, and global health. Caregiver data were analyzed using hierarchical linear regression and mediation analysis. RESULTS: Spiritual well-being was not significantly associated with health outcomes or self-efficacy. In regression analysis, both informational support ( b = 0.32; 95% confidence interval [CI], 0.20 to 0.45; P < .001) and Anglo orientation ( b = 0.15; 95% CI, 0.11 to 2.48; P < .05) were significant predictors of global health, but informational support ( b = -0.43; 95% CI, -0.55 to -0.30; P < .001) was the only significant predictor of depression. There were indirect relationships through self-efficacy for symptom management for both informational support and Anglo orientation and health outcomes. CONCLUSIONS: Informational support and Anglo orientation were significantly related to health outcomes directly and indirectly through self-efficacy in Latino cancer caregivers. IMPLICATIONS FOR PRACTICE: Informational support through the health system and community, when provided with attention to culture and Spanish language translation, can increase Latino cancer caregivers' self-efficacy to care for themselves and improve health outcomes.

Social determinants of health: does socioeconomic status affect access to staging imaging for men with prostate cancer.

Socioeconomic status (SES), race and geographical factors are known to impact prostate cancer management and outcomes. We aimed to assess these factors with regard to access to novel imaging in prostate cancer. Using the Prostate Cancer Outcomes Registry of Victoria (PCOR-Vic) we identified 5256 men diagnosed with prostate cancer via biopsy. Following the introduction of government rebate, the access to MRI improved with respect to SES. Access to PET imaging remains poor with respect to SES and geographical location in the absence of Federal funding. Further improvements for men with low SES and regional areas to access PET staging.