TY  - EJOU
AU  - Osom, Albert 
AU  - Barton, Krysta S. 
AU  - Sexton, Katie 
AU  - Brumback, Lyndia 
AU  - Yi-Frazier, Joyce P. 
AU  - Rosenberg, Abby R. 
AU  - Engelberg, Ruth 
AU  - Steiner, Jill M. 

TI  - Impact of Social Determinants of Health on Self-Perceived Resilience: An Exploratory Study of Two Cohorts of Adults with Congenital Heart Disease
T2  - Structural and Congenital Heart Disease

PY  - 2024
VL  - 19
IS  - 1
SN  - 3071-1738

AB  - Social determinants of health (SDOH) affect quality of life. We investigated SDOH impacts on self-perceived resilience among people with adult congenital heart disease (ACHD). Secondary analysis of data from two complementary studies: a survey study conducted May 2021–June 2022 and a qualitative study conducted June 2020–August 2021. Resilience was assessed through CD-RISC10 score (range 0–40, higher scores reflect greater self-perceived resilience) and interview responses. Sociodemographic and SDOH (education, employment, living situation, monetary stability, financial dependency, area deprivation index) data were collected by healthcare record review and self-report. We used linear regression with robust standard errors to analyze survey data and performed a thematic analysis of interview data. Survey participants (N = 127) mean age was 42 ± 14 years; 51% were female, 87% white. ACHD was moderate (75%) or complex (25%); 41% functional class C or D. Resilience (mean 30 ± 7) varied by monetary stability: compared to people with difficulty paying bills, resilience was 15.0 points higher (95% CI: 6.9–23.1, <i>p</i> < 0.001) for people reporting having enough money and 14.2 points higher (95% CI: 5.9–22.4, <i>p</i> = 0.001) for those reporting just enough money. Interview participants’ (N = 25) mean age was 32 years (range 22–44); 52% were female, 72% white. ACHD was moderate (56%) or complex (44%); 76% functional class C or D. Participants discussed factors affecting resilience aligned with each of the major SDOH, prominently, economic stability and healthcare access and quality. Financial stability may be important for supporting self-perceived resilience in ACHD. This knowledge can inform the development of resilience interventions for this population.
KW  - Social determinants of health; adult congenital heart disease; resilience; financial stability

DO  - 10.32604/chd.2024.046656