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Social Network Index Developed to Assess the Support Resources of Adolescent and Young Adult Cancer Survivors

A functional social network index was developed that is specific for adolescent and young adult survivors of cancer
20 Mar 2018
Cancer in Special Situations / Population

Investigators found that adolescent and young adult (AYA) survivors had better emotional and tangible support resources than matched controls without a history of cancer, according an article published online on 8 March 2018 in Cancer, the journal of the American Cancer Society. 

In order to compare emotional and social support between AYA survivors and controls having no history of cancer, I‐Chan Huang, of the Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, in Memphis, USA and colleagues developed and validated a functional social network index (FSNI) for AYA survivors. 

The FSNI contained information on the participants´ marital status, frequency of contact with friends and relatives, available resources for emotional and tangible support, and the available resources for physical activity and weight management advice, as reported by the survivors. The study comprised 102 AYA survivors who were matched for age, sex, and race for comparison to 102 controls who had no history of cancer and were recruited from an Internet panel. Each participant reported relationships with up to 25 close friends and/or relatives. 

The performance of the FSNI was compared with two traditional indices in terms of density and betweenness centrality. Linear regression was used to analyze the association between the FSNI and cancer diagnoses, treatments, and coping skills. 

Adolescent and young adult survivors of cancer have stronger support than similar controls in the overall population 

The analysis done from the FSNI data revealed that AYA survivors had significantly more available support resources overall than the control participants. Compared to controls, AYA survivors had more resources for emotional support (beta = 3.02; p = 0.003) and tangible support (beta = 4.17; p< 0.001), as well as advice on physical activity (beta = 3.94; p < 0.001), and advice regarding weight management (beta = 4.10; p < 0.001). 

The largest FSNI was observed with AYA survivors of lymphoma while the smallest FSNI was observed in AYA survivors of central nervous system malignancies (beta = 2.77; p = 0.02). 

AYA cancer survivors with higher FSNI scores demonstrate improved coping mechanisms 

Associations were demonstrated between having a higher FSNI and better coping skills, including less denial (beta = 0.10; p = 0.01), using emotional support (beta = 0.08; p = 0.04), and using instrumental support (beta = 0.12; p <0.001). AYA survivors with higher FSNI also displayed less behavioral disengagement (beta = 0.08; p = 0.04), and venting of emotions (beta = 0.10; p = 0.004). Additional significant associations were found between higher FSNI and positive reframing (beta = 0.12; p = 0.003), planning for the future (beta = 0.08; p = .03), and religious engagement (beta = 0.16; p <0.001). 

No significant differences between the social network indices of cancer survivors and controls regarding density and betweenness centrality (all p-values > 0.05) nor were significant associations with coping skills found (all p-values > 0.05). 


The authors stated that, to their knowledge, social network status in AYA survivors have not been adequately studied. This study of the FSNI appears to provide a better social network assessment for AYA cancer survivors than traditional indices. 


No external funding was disclosed. 


Huang IC,Jones CM,Brinkman TM, et al. Development of the functional social network index for adolescent and young adult cancer survivors. Cancer;First published 8 March 2018. https://doi.org/10.1002/cncr.31278

Last update: 20 Mar 2018

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