Neuropsychological assessment, intervention, and best practices for women with non-Central nervous system cancer: A scoping review of current standards

Objective: Existing literature has sought to characterize the broad cognitive impact of non-central nervous system cancer and its treatment, including chemotherapy, radiation, surgery, and hormonal regulation. However, despite the frequency of women that are diagnosed with breast and gynecological cancer, there is limited research on the specific cognitive experiences of women undergoing cancer treatment. Presently, the current literature lacks concise guidance for neuropsychologists to support the cognitive health of women facing cancer, despite the acknowledged impact of cancer interventions and chronic illness on cognitive outcomes. Method: Applying scoping review criteria outlined by Peters et al. (2015) and adhering to Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a comprehensive examination of literature spanning multiple databases (Google Scholar, PubMed, PsychINFO) with a focus on the cognitive impact of cancer treatment on women. Conclusions: Women are subject to unique treatment-related outcomes due to the impact of hormonal alterations, differences in metabolization of certain chemotherapies, and psychosocial risk factors. Despite the known impact of cancer intervention, chronic illness, and cancer-related sequelae on cognitive outcomes, the current literature does not parsimoniously outline best practices for neuropsychologists to promote the health of women experiencing cancer. The current paper (1) provides an overview of the cognitive implications of cancer treatment with an intentional focus on cancers that are more prevalent in women versus men, (2) addresses the characteristics of this impact for women undergoing cancer intervention(s), and (3) provides possible intervention and treatment strategies for mental health providers and neuropsychologists.

A-124 Racial Disparities in Health Literacy and Numeracy: The Role of Sociodemographic and Psychological Risk Factors

Objective: Health literacy and numeracy are commonly associated with health disparities and may disproportionately affect minoritized groups. This study assessed racial disparities in health literacy and numeracy and their association to sociodemographic and psychological risk factors among a mixed clinical outpatient sample.

Method: Cross-sectional data from 198 patients who were administered the General Health Numeracy Test-Short Form (GHNT), Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R), Adverse Childhood Experiences Checklist (ACE), Perceived Stress Scale (PSS), and Test of Premorbid Functioning-Predicted FSIQ (TOPF-FSIQ) were examined. Participant characteristics were compared by ethnoracial group status via chi-square and ANOVA tests. Multivariate regression models evaluated associations between health literacy and numeracy with sociodemographic and psychological risk factors across ethnoracial groups.

Results: Subjects were 45% female/55% male, 48% White, 38% Black and 14% Hispanic, with a Mage of 44.7 (SD = 17.3) and Meducation of 13.5 years (SD = 2.8). Black subjects were older, less educated, and had lower TOPF-FSIQ than White subjects, whereas Hispanic subjects were younger with lower TOPF-FSIQ than White subjects. Black subjects had lower GHNT-6 and REALM-R scores than White subjects. No group differences in ACE or PSS were observed. In multivariate analyses, only lower TOPF-FSIQ was significantly associated with lower REALM-R, whereas lower TOPF-FSIQ, older age, and higher ACEs were significantly associated with lower GHNT. No significant interactions with ethnoracial group status were observed.

Conclusion(s): Although health literacy and numeracy differed across ethnoracial groups, this effect was driven by lower TOPF-FSIQ for health literacy, in addition to lower age and higher number of adverse childhood experiences for health numeracy.