Tapping Into the Health Benefits of Social Networks Among Cancer Survivors

Scientists at St. Jude Children’s Research Hospital have developed a new tool to measure the impact of social networks on the coping skills of adolescent and young adult (AYA) cancer survivors.

Called the functional social network index (FSNI), researchers evaluated data from an internet survey conducted among a panel of 102 AYA survivors and 102 noncancer controls; the 2 groups were matched for sex, age, and race. Survivors were between 15 and 30 years old when their cancer was diagnosed and at least 5 years from completed therapy. The survey required the participants to report on relations with up to 25 close relatives and/or friends.

“Cancer survivors need healthy social connections, and to the best of our knowledge this is the first published study to quantify social networks of adolescent and young adult cancer survivors compared to their peers,” said lead author I-Chan Huang, PhD, associate member of the St. Jude Department of Epidemiology and Cancer Control, in a statement.

Social isolation has been recognized as a significant problem in society with healthcare implications. Speaking at the 30th US Psychiatric and Mental Health Congress in New Orleans, Vladimir Maletic, MD, MS, clinical professor of psychiatry and behavioral science at the University of South Carolina School of Medicine in Greenville, said that loneliness can dwarf the impact of well-known risk factors that are scrutinized by public health officials.

Payers are paying increasing attention to this risk factor, especially among the elderly population. CareMore, an Anthem subsidiary, has developed interventions to combat loneliness among seniors in an effort to reduce the risk of Alzheimer’s disease, stroke, obesity, and premature death. CareMore has also created the position of a Chief Togetherness Officer, and the company plans to track the impact of the program on health outcomes, readmissions, and other quality indicators.

For their current study, published in Cancer,¹ in addition to measuring the structure of social networks, marital status, and membership in church or community groups, the FSNI measured social networks as a source of emotional and practical support from friends and relatives, and as a resource on weight management and physical activity.

Compared with the control group, survivors had significantly higher access to resources for emotional support (beta [b] = 3.02; P = .003), tangible support (b = 4.17; P <.001), physical activity advice (b = 3.94; P <.001), and weight management advice (b = 4.10; P <.001). However, the strength of the support network was determined by the cancer diagnosis, with survivors of lymphoma showing the highest FSNI, followed by survivors of leukemia and solid tumors. Survivors of brain and central nervous system tumors had the lowest FSNI.

According to Huang, neurocognitive effects of treatment might have a significant impact on the social skills of survivors of brain tumors.

The authors conducted a linear regression analysis that showed a higher FSNI was associated with better coping skills: less denial (b = 0.10; P = .01), using emotional support (b = 0.08; P = .04), using instrumental support (b = 0.12; P <.001), less behavioral disengagement (b = 0.08; P = .04), venting of emotions (b = 0.10; P = .004), positive reframing (b = 0.12; P = .003), planning for the future (b = 0.08; P = .03), and religious engagement (b = 0.16; P <.001).

Ongoing efforts from Huang and his colleagues are focused at streamlining FSNI for ease of use by healthcare providers so they can assess support for cancer survivors of all ages.

“Once we identify the mechanism between social connections and health outcomes, we can start designing interventions to use social networks to improve health outcomes of cancer survivors,” Huang said.

Reference

1. Huang IC, Jones CM, Brinkman TM, et al. Development of the functional social network index for adolescent and young adult cancer survivors [published online March 8, 2018]. Cancer. doi: 10.1002/cncr.31278.