Families of Children with Advanced Cancer: The Impact of Social Determinants of Health
Mentor Name: Cynthia Gerhardt
Despite improved treatments, cancer remains the leading cause of death by disease in childhood. Children with advanced cancer have poor quality of life and average 11 symptoms in the last week of life. Caring for families of children near the end of life remains one of our most difficult challenges as healthcare providers.
Growing evidence suggests a child’s zip code is more predictive of health outcomes than their genetic code. Conditions where individuals live (i.e., social determinants) have a significant impact on outcomes in adults with cancer, but these factors have been largely ignored in childhood cancer. For example, rural and/or Appalachian patients may have different needs and concerns, barriers to care, and lower quality of local services, particularly for pediatric palliative care. Given evidence of worse outcomes for certain underserved communities (e.g., urban minority, rural/Appalachian), it is essential to identify social determinants of health as a unique risk factor for children with advanced cancer. We must ensure that all children regardless of background receive the highest possible quality of care at the end of life.
The goal of this 9-week summer program (05/09/22-07/11/22) is to provide intensive, interdisciplinary training and mentoring for a promising URM undergraduate in the: (a) physical and psychosocial impact of childhood cancer; (b) health disparities in pediatrics; (c) behavioral research methods; and (d) professional development. This training will occur in the context of Dr. Gerhardt’s existing ALSF funded study examining outcomes among families of children with advanced cancer. Given the candidate’s interest in social determinants of health in childhood cancer, she will learn to incorporate indices of community-level risk (e.g., CDC Social Vulnerability Index, RUCA codes, Appalachian county designation) in the larger study. In addition, she will gain hands-on experience with recruitment; data collection, management, and analyses; as well as direct interaction with families during follow-up visits. To meet these objectives, we assembled a multidisciplinary team of mentors, including hands-on experience, clinical shadowing, didactic seminars, and workshops. Thus, the candidate will be well prepared to submit an abstract to a national conference and apply to medical school upon graduation.
This award will also provide the candidate with much needed hands-on experience with recruitment; data collection, management, and analysis; as well as direct exposure to working with families in oncology, research ethics, and health disparities. With access to additional mentors, didactic seminars, shadowing experiences, and guided readings, this award will provide multiple, rich opportunities essential to improving the diversity of healthcare providers in pediatric oncology. The individualized training plan also intersects with the candidate’s research activities to optimize her training over the 9-week period. The end goal is to ensure her success in submitting an abstract for a national conference and in applying to medical school following graduation.
