Cancer Knowledge in Caregivers of Children With Cancer: Associations With Social Determinants of Health

BACKGROUND: While caregivers of children with cancer must understand their child's cancer diagnosis to navigate complex cancer care, research on caregiver cancer knowledge is scarce. METHODS: This cross-sectional study included caregivers of children with newly diagnosed cancer at Rady Children's Hospital-San Diego, a large quaternary academic center, between October 2014 and May 2020. Linear and logistic regression models were used to assess whether caregiver cancer knowledge overall and by domain (cancer stage/risk, key differences between clinical trial vs. standard of care) was associated with Social Determinants of Health (SDOH), including health literacy (HL), and socio-contextual factors. RESULTS: Of 182 caregivers who completed this study, 122 (67.0%) were female, and 86 (47.3%) were Hispanic, of whom 14 (16.3%) used Spanish for medical communication. The average caregiver baseline cancer knowledge score was 40%; IQR [21-59]. In multivariable analysis, limited HL and household income were associated with lower cancer knowledge (for HL: β = -6.60; 95% CI: -12.52, -0.69; p = 0.029; for household income < $60,000: β = -8.14; 95% CI: -13.58, -2.70; p = 0.004) and decreased odds of knowing key differences between clinical trial vs. standard of care (for HL: odds ratio (OR) = 0.27; 95% CI: 0.13, 0.54; p