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Predictors and consequences of cumulative stress among Black breast cancer survivors in the Women’s Circle of Health Follow-Up Study

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Title
Predictors and consequences of cumulative stress among Black breast cancer survivors in the Women’s Circle of Health Follow-Up Study
Name (type = personal)
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Xing
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Cathleen Y.
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1986-
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cathleen xing
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author
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Adana A. M.
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Adana A. M. Llanos
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Advisory Committee
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chair
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Elisa V.
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Elisa V. Bandera
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Advisory Committee
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internal member
Name (type = personal)
NamePart (type = family)
Lin
NamePart (type = given)
Yong
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Yong Lin
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Advisory Committee
Role
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internal member
Name (type = personal)
NamePart (type = family)
Hong
NamePart (type = given)
Chi-Chen
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Chi-Chen Hong
Affiliation
Advisory Committee
Role
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outside member
Name (type = corporate)
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Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
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School of Graduate Studies
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school
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Text
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theses
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2019
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2019-05
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2019
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English
Abstract
Specific 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.
Subject (authority = local)
Topic
Allostatic load
Subject (authority = RUETD)
Topic
Public Health
Subject (authority = ETD-LCSH)
Topic
Stress (Physiology)
Subject (authority = ETD-LCSH)
Topic
African Amercian women -- Diseases -- Cancer
Subject (authority = ETD-LCSH)
Topic
Breast -- Cancer -- Social aspects
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Rutgers University Electronic Theses and Dissertations
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ETD_9726
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text/xml
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1 online resource (x, 140 pages) : illustrations
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
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School of Graduate Studies Electronic Theses and Dissertations
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rucore10001600001
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Identifier (type = doi)
doi:10.7282/t3-nvc4-kb15
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

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The author owns the copyright to this work.
RightsHolder (type = personal)
Name
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Xing
GivenName
Cathleen
MiddleName
Y.
Role
Copyright Holder
RightsEvent
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Permission or license
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2019-04-08 23:06:03
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Cathleen Y. Xing
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Rutgers University. School of Graduate Studies
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Embargo
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2019-05-31
DateTime (encoding = w3cdtf); (qualifier = exact); (point = end)
2021-05-30
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 30th, 2021.
Copyright
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Copyright protected
Availability
Status
Open
Reason
Permission or license
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