Predictors and consequences of cumulative stress among Black breast cancer survivors in the Women’s Circle of Health Follow-Up Study
Citation & Export
Hide
Simple citation
Xing, Cathleen Y..
Predictors and consequences of cumulative stress among Black breast cancer survivors in the Women’s Circle of Health Follow-Up Study. Retrieved from
https://doi.org/doi:10.7282/t3-nvc4-kb15Export
Description
TitlePredictors and consequences of cumulative stress among Black breast cancer survivors in the Women’s Circle of Health Follow-Up Study
Date Created2019
Other Date2019-05 (degree)
Extent1 online resource (x, 140 pages) : illustrations
DescriptionSpecific Aims: This doctoral dissertation project was designed to examine two major aims among Black breast cancer (BrCa) patients enrolled in the Women’s Circle of Health Follow-Up Study (WCHFS): 1) to define and quantify cumulative stress as an adapted measure of allostatic load (AL) using two computational methods, and identify predictors of AL as measured by both computational methods; and 2) to evaluate the consequences of cumulative stress by examining relationships between AL and BrCa clinicopathological features and quality of life (QoL).
Methods: Black WCHFS participants who were diagnosed with non-metastatic BrCa, completed baseline and follow-up (F/U) interviews, and agreed to release of medical records were included in this study. Data were obtained from in-person interviews and medical records requested from multiple healthcare providers and hospitals. Multivariable adjusted regression analyses were performed to test the associations among all predictor and outcome variables listed under each specific aim.
Results: AL measure 1 (lipid profile-based measure – assessed by systolic and diastolic blood pressure [SBP, DBP], high-density lipoprotein [HDL], total cholesterol and/or low-density lipoprotein [LDL], triglycerides and glucose levels, waist circumference, and use of medications to treat diabetes, hypertension, or hypercholesterolemia) and AL measure 2 (inflammatory index-based measure – assessed by SBP, DBP, glucose and albumin levels, estimated glomerular filtration rate [eGFR], body mass index [BMI], waist circumference, and use of medications described above) demonstrated moderate-to-fair agreement (kappa=50.4%). No significant associations between socioeconomic status (SES), perceived neighborhood characteristics, lifestyle and behavioral factors, and food and nutrient intake with AL measure 1 were observed. Lower SES (namely education and annual household income) was a significant predictor of AL measure 2. With regards to the associations with tumor clinicopathological features, higher AL was found to be a significant predictor of higher tumor grade irrespective of the AL computational methods used. Additionally, larger tumor size was associated with higher AL measure 2. Ultimately, lower QoL assessed by physical well-being (PWB), functional well-being (FWB), and Functional Assessment of Canter Therapy-General (FACT-G) scales were associated with higher AL among women in AL measure 2.
Conclusions: Lower individual-level SES is a significant predictor of AL; aggressive tumor clinicopathological features and lower QoL are some of the potential consequences of higher AL among Black women. Research on the causes and consequences of higher cumulative stress will be particularly useful in elucidating poorer BrCa outcomes among Black women, and findings from this study may be useful in developing interventional strategies to reduce poorer outcomes among Black women with BrCa.
NotePh.D.
NoteIncludes bibliographical references
Genretheses, ETD doctoral
LanguageEnglish
CollectionSchool of Graduate Studies Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
Statistical Profile