Feasibility of oncology clinical trial‐embedded evaluation of social determinants of health

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Household material hardship (HMH)—housing, food, transportation, or utility insecurity—is an adverse social determinant of health that is modifiable in the clinical setting. This mixed‐methods, single‐center study explored the experiences of HMH among Black and Hispanic pediatric oncology parents utilizing a single timepoint survey (N = 60) and semi‐structured interviews (N = 20 purposively sampled subcohort). Forty‐four (73%) parents reported HMH. Qualitatively, participants expressed stress, anxiety, and embarrassment due to unmet basic resource needs, and childcare emerged as an additional important domain of HMH. Participants recommend a standardized approach to HMH screening and resource allocation, offering insight into targets for future intervention.

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“It's a lot of things”: Household material hardship among Black and Hispanic parents of children with cancer

Valenzuela

Hawkins

Revette

et al. 2023

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“…Despite awareness of the multifaceted disparities and inequities in pediatric cancer, the systematic collection of information on SDOH and socioeconomic status has not been included in clinical trials 50 . Collaborative, multidisciplinary research studies within COG are beginning to embed these measures within clinical trials to better understand these factors and design interventions to ensure equitable access to, and benefit from, treatment 51,52 …”

Section: Strategic Plan: Opportunities and Future Directionsmentioning

confidence: 99%

Children's Oncology Group's 2023 blueprint for research: Behavioral science

Embry

Bingen

Conklin

et al. 2023

As survival rates for childhood cancer have improved, there has been increasing focus on identifying and addressing adverse impacts of cancer and its treatment on children and their families during treatment and into survivorship. The Behavioral Science Committee (BSC) of the Children's Oncology Group (COG), comprised of psychologists, neuropsychologists, social workers, nurses, physicians, and clinical research associates, aims to improve the lives of children with cancer and their families through research and dissemination of empirically supported knowledge. Key achievements of the BSC include enhanced interprofessional collaboration through integration of liaisons into other key committees within COG, successful measurement of critical neurocognitive outcomes through standardized neurocognitive assessment strategies, contributions to evidence‐based guidelines, and optimization of patient‐reported outcome measurement. The collection of neurocognitive and behavioral data continues to be an essential function of the BSC, in the context of therapeutic trials that are modifying treatments to maximize event‐free survival, minimize adverse outcomes, and optimize quality of life. In addition, through hypothesis‐driven research and multidisciplinary collaborations, the BSC will also begin to prioritize initiatives to expand the systematic collection of predictive factors (e.g., social determinants of health) and psychosocial outcomes, with overarching goals of addressing health inequities in cancer care and outcomes, and promoting evidence‐based interventions to improve outcomes for all children, adolescents, and young adults with cancer.

“…For example, investigators are currently leveraging CCRN data, which provides an opportunity to examine the influence of small‐area‐based SES and distance to care on outcomes (AEPI21N1, R01CA266105). There are also group‐wide initiatives to embed SES and other social determinants of health data into clinical trials to enable future research 32 …”

Section: Strategic Planmentioning

confidence: 99%

Children's Oncology Group's 2023 blueprint for research: Epidemiology

Lupo

Marcotte

Scheurer

et al. 2023

The Children's Oncology Group (COG) Epidemiology Committee has a primary focus on better understanding the etiologies of childhood cancers. Over the past 10 years, the committee has leveraged the Childhood Cancer Research Network, and now more recently Project:EveryChild (PEC), to conduct epidemiologic assessments of various childhood cancers, including osteosarcoma, neuroblastoma, germ cell tumors, Ewing sarcoma, rhabdomyosarcoma, and Langerhans cell histiocytosis. More recent studies have utilized questionnaire data collected as part of PEC to focus on specific characteristics and/or features, including the presence of congenital disorders and the availability of stored cord blood. Members of the COG Epidemiology Committee have also been involved in other large‐scale National Institutes of Health efforts, including the Childhood Cancer Data Initiative and the Gabriella Miller Kids First Pediatric Research Program, which are improving our understanding of the factors associated with childhood cancer risk. Future plans will focus on addressing questions surrounding health disparities, utilizing novel biospecimens in COG epidemiology studies, exploring the role of environmental factors on the etiologies and outcomes of childhood cancer, collaborating with other COG committees to expand the role of epidemiology in childhood cancer research, and building new epidemiologic studies from the Molecular Characterization Initiative—all with the ultimate goal of developing novel prevention and intervention strategies for childhood cancer.