(PS6-C61) The Impact of Mental Health & Social Determinants of Health on Adolescent Transition Readiness in Childhood Cancer Survivors

Introduction: Childhood cancer survivors (CCS) require long-term follow-up for potential late-effects secondary to cancer treatment. The transition from pediatric to adult care is characterized by increased autonomy in healthcare management for CCS. Understanding factors predictive of transition readiness in this population is essential, given the importance of long-term follow-up for CCS.

Method: Fifty adolescents (Age: M = 14.75; SD = 1.81; Race/Ethnicity: white = 80%; non-Hispanic = 92%; Diagnosis: solid tumor = 34%, CNS tumor = 32%; leukemia/lymphoma = 34%) recently completing cancer treatment (3-12 months off treatment) completed the Transition Readiness Questionnaire (TRI) and the PROMIS Pediatric Profile-49. Demographic variables, treatment duration, and prior mental health diagnoses were obtained through review of the medical chart.

Results: Two multiple regression models were utilized to examine predictors of transition readiness. The first model [F(8,38) = 8.74, p < .001; R² = .65] predicted disease-based knowledge (TRI Knowledge) based on other TRI domains (skills/self-efficacy, p < .05; beliefs/expectations, ns; goals/motivation, ns; relationships/communication, ns), demographic factors (ethnicity, p = .05; gender, p < .05), treatment duration (p < .05), and prior mental health diagnoses (p < .05). Results suggest decreased skills/self-efficacy, shorter duration of treatment, pre-morbid mental health diagnoses, Hispanic ethnicity, and female sex assigned at birth negatively predicted disease-specific knowledge. The second model [F(7,39) = 5.47, p < .001; R² = .41] predicted relationships/communication with healthcare professionals (TRI Relationships/Communication) based on other TRI domains (skills/self-efficacy, ns; beliefs/expectations, ns; goals/motivation, ns; knowledge, ns; psychosocial/emotional functioning, ns) and PROMIS sub-scales (depression, p < .05; anxiety, ns). Results suggest clinically significant depression symptoms negatively predicted communication with healthcare professionals.

Conclusion: Results point to the importance of considering mental health and demographic variables in CCS transition readiness. CCS from under-represented groups and those with pre-morbid mental health conditions were less likely to have the disease-specific knowledge to effectively transition to adult care and manage long-term sequelae of their cancer diagnosis/treatment. CCS with clinically significant depression symptoms were less likely to perceive positive relationships and have open communication with their healthcare team, which may impact effective transition to adult care. Interventions and support for CCS from under-represented groups and those with significant mental health concerns is needed to promote a successful transition to adult care and survivorship.