Purpose Feminine breasts cancer tumor survivors an evergrowing and huge population experience impaired physical working following treatment. Hypothesized mediators Rabbit Polyclonal to RCL1. included scientific and treatment factors psychosocial elements (depression stress sociable support) perceived neighborhood characteristics behavioral risk factors (physical activity smoking body mass index alcohol use) and comorbidity. Results In unadjusted analysis ladies living in neighborhoods with higher poverty were more likely to statement lower physical functioning at Y2 (β= ?.19 pathways that related all measures (mediators confounders or covariates) to the predictor (neighborhood poverty) and/or the outcome (physical functioning). Mediators are variables that are hypothesized to be caused or affected from the predictor that in turn cause or influence the dependent (end result) variable. Confounders while also associated with both the predictor and end result do not lay inside a hypothesized causal pathway unlike mediators. Covariates are associated with either variable but not both. Physical Functioning We select Physical Functioning as our QOL end result because it is definitely a frequently used end result in other studies and because it is definitely closely linked to both comorbidity and survival. [8 9 Physical Functioning was measured at Y2 using the RAND 36-Item Health Survey 1.0.[33 34 The 10-item level measures physical aspects of health-related QOL including walking climbing stairs daily maintenance activities such as transporting groceries and bathing oneself and participation in vigorous (e.g. operating) and moderate (e.g. vacuuming) activities. Scores are standardized and INO-1001 range from 0 to 100; higher scores indicate better functioning. Neighborhood Poverty INO-1001 The predictor neighborhood poverty rate was measured using 2000 U.S. Census data which was several years prior to the Y1 survey and was defined as the continuous percentage of the population living below the federal poverty level in the participant’s census tract of residence. Because it is definitely unknown whether the mechanisms linking neighborhood SES and physical functioning differ based on the selected SES indication we opted to use a commonly used solitary item measure. We specifically select neighborhood-level poverty rate as the optimal single-item indication of neighborhood SES for our study based on the literature indicating its powerful association with a variety INO-1001 of health results in varied populations because it is definitely a standard measure that is very easily interpreted across locations and over time it has been identified as an upstream determinant of downstream health and social factors in additional longitudinal studies and for its relevance for policy makers.[21 35 36 Potential Mediators Multiple hypothesized mediators measured at Y1 were considered including clinical and treatment INO-1001 variables comorbidity perceived neighborhood conditions psychosocial variables and behavioral risk factors. Clinical and treatment variables included a surgical side effects index as well as the following yes/no variables: axillary lymph node removal chemotherapy radiotherapy ever using hormonal therapy (i.e. Tamoxifen Raloxifene or aromatase inhibitors) and type of surgery (lumpectomy vs. mastectomy [the 24 women with no surgery were omitted from this comparison]). Self-reported treatment has been shown to be accurate relative to medical record review. For the surgical side effects index women rated how often each of 5 breast-surgery-associated side effects (e.g. arm weakness arm lymphedema) affected them in the previous month using a 5-point scale ranging from “not at all” (1) to “all of the time” (5). This measure includes 5 of the 8 items from a previously developed and validated index (alpha=0.74).[38-41] Cormorbidity was measured using Katz’s validated self-report adaptation of the Charlson comorbidity index [42 43 which captures the presence and/or history of multiple chronic conditions (e.g. myocardial infarction diabetes and other cancers). A weighted score accounts for both the presence and severity of comorbidities. Three perceived neighborhood conditions were measured. Using 4-point scales (strongly agree to strongly disagree) Physical Disorder/Decay (6 items) and Social Disorder (9 items) captured the extent to which respondents’.