Quality of Life for Rural and Appalachian Pediatric Brain Tumor Survivors in Ohio and Kentucky

Objective: Previous work has suggested disparities for survivors of pediatric cancer who live in rural or Appalachian areas relative to those in more well-resourced communities. Limited research exists for pediatric brain tumor survivors, who are at risk for poorer quality of life (QOL) due to the location of their tumor and treatments directed toward the central nervous system. We examined how geographic region related to QOL for survivors. Method: Survivors of pediatric brain tumor (N = 41; ages 10-25) and their caregivers recruited from the cancer registry and clinics in 2018 at a Midwest children's hospital completed measures of QOL (Patient-Reported Outcomes Measurement Information System Profile). Demographic/treatment factors were extracted from medical records. Addresses were categorized as rural/nonrural using the Rural-Urban Commuting Area Codes and Appalachian/non-Appalachian with the Appalachian Regional Commission boundaries. Independent samples t tests compared geographic groups and to measure norms. Results: Rural and Appalachian survivors reported significantly lower social QOL compared to their nonrural/non-Appalachian counterparts and norms (ds = 1.25-1.33). Appalachian survivors reported lower physical mobility than norms (d = 0.81). Conclusions: Results suggest reduced social QOL for both Appalachian and rural survivors and lower physical mobility for Appalachian survivors. Future research should prioritize partnership with stakeholders to explore factors that may contribute to poorer QOL for Appalachian survivors and potential solutions for improving social engagement and physical functioning. Implications for Impact Statement Findings suggest that rural and Appalachian survivors of pediatric brain tumor report largely equivalent quality of life to their nonrural and non-Appalachian counterparts, except for physical mobility and social engagement. Additional research should be dedicated to investigate underlying causes to improve survivor well-being.