Exploring Grief Through Social Determinants of Health Mechanisms Among Latino Families in the US Who Are Living Through the Loss of a Child to Cancer: A Mixed Methods Study

Latino children in the United States (US), who represent one quarter of all children, are more than 50% more likely to die of their cancer diagnosis than their Non-Latino counterparts. Latino families in the US navigate several adverse healthcare, community, and population health-level indicators that limit their access to quality healthcare and community and population-level resources and in turn may shape their child’s risk of developing and dying from cancer and their ability to advance resilient grief outcomes. Despite higher cancer mortality and limited interventions to address these health disparities, there remains a striking lack of research focused on generating targeted solutions for Latino populations who are living through the loss of a child. Further, the identification of resiliency factors has remained undiscovered because the experience of cancer loss in Latino populations has not yet been explored from a strength-based and multi-level perspective.

The overall purpose of this study is to explore the experiences and grief outcomes of Latino families in the US who are living through the loss of a child to cancer. This study will utilize a modified multi-level version of the Center for Latino Adolescent and Family Health Framework, that has been integrated with empirically driven grief concepts in a mixed methods design that integrates data from validated measures representing the framework’s domains across healthcare, community, and population-levels (n=60), with qualitative descriptive data from individual interviews (n=~20) with the deceased child’s primary caregiver. The aims are to: Aim 1. Examine the relationships among healthcare-level (healthcare access), community-level (grief conventions), population health-level (stress), multi-level resiliency factors (community dynamics) and crucial grief outcomes (coping, mental health, post-traumatic growth, meaning-making) of Latino families in the US who are living through the loss of a child through self-reported measures and questions.

Aim 2. Elucidate the experiences of Latino families in the US who are living through the loss of a child to cancer in the context of the mechanisms of healthcare, community, and population health-level factors through in-depth, individual semi-structured qualitative interviews. Aim 3. Develop a comprehensive understanding of how multi-level resiliency factors across the domains of healthcare, community, and population health influence adaptive grief outcomes among Latino families in the US after the loss of a child to cancer by integrating self-reported measures and interview data.

The findings will enhance the understanding of the mechanisms that may produce adverse outcomes in pediatric oncology bereavement among bereaved Latino families and inform the development of tailored and targeted interventions to address them.

Grant Number: 5F31NR021329-02
NIH Institute/Center: NIH
Principal Investigator: Patricia Buzelli