Exploring associations between social determinants of health and patient-reported outcome measures in oncology: Elucidating the disparities to be addressed

Social determinants of health, including income, education, and language, play an important role in cancer outcomes and survival. In Quebec, where nearly one in five residents speaks a first language other than French, language can be a particularly important barrier to accessing healthcare services and communicating effectively with care teams. These barriers may influence patients’ ability to advocate for themselves, ask questions, and engage in shared decision-making—factors that are linked to improved health outcomes.

Patient-reported outcome measures (PROMs) are standardized tools that allow patients to report symptoms and health status directly, and are increasingly used to improve communication, symptom monitoring, and clinical care. However, their effectiveness may vary depending on social factors such as education and language. This PhD project begins by examining how PROM data differ across key social determinants of health. Future phases will explore patients’ lived experiences completing PROMs and assess whether generative AI tools can help reduce barriers—particularly language-related barriers—to improve equitable use of PROMs in cancer care.

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The Meanings and Lived Experiences of Chronic Illness Self-Management for Culturally and Linguistically Diverse (CALD) Individuals and their Female Family Caregivers

The term culturally and linguistically diverse (CALD) refers to first-generation (foreign-born) or second-generation (having at least one immigrant parent) immigrants whose mother tongue or language spoken at home is neither English nor French. Chronic illnesses are leading causes of morbidity and mortality in Quebec, and the risk of chronic illness is increasing for CALD populations with greater time in Canada. In response to the large global burden of chronic illness, self-management has increasingly become recognized as an approach to support patients in partnering with healthcare professionals for improving their outcomes. Self-management involves the tasks (medical, behavioural and emotional), which individuals must undertake to live well with a chronic illness. However, there is limited recognition that self-management also involves family caregivers who provide most of the care to persons with a chronic illness. CALD individuals living with chronic illness face an additional burden of self-management in health care systems due to difficulties arising from culture and language. Women are more likely to be family caregivers in CALD contexts due to cultural and societal obligations, and this can result in another layer of burden for them. In view of these cumulative and intersecting burdens, there is an urgent need for meaningful definitions of chronic illness self-management that include the lived experiences of both CALD individuals and their female family caregivers.

PROJECT OBJECTIVES:

1. Explore and understand the lived experiences and meanings of chronic illness self-management for culturally and linguistically diverse individuals and their female family caregivers; and

2. Provide a critique of the assumption that self-management is not shaped by the social determinants of health, and its consequences for the study population.