Advisor(s)

Mieke Thomeer

Committee Member(s)

David Warner
J Nicholas Odom
Soumya Niranjan
Verna Keith

Document Type

Dissertation

Date of Award

6-18-2026

Degree Name

Doctor of Philosophy (PhD)

School

College of Arts and Sciences

Department

Social & Behavioral Sciences

Abstract

Caregivers living with cancer face overlapping burdens that are often overlooked in research, policy, and practice, despite the profound implications for their mental health and the care they provide. The main objective of this dissertation is to examine how cancer status, gender, and social support intersect to influence the number of poor mental health days reported by caregivers in the United States and a U.S. territory. Specifically, this study assesses differences in poor mental health days between caregivers with and without cancer and examines whether gender and social support independently and jointly moderate this potential association. Using 2022-2023 data from the Behavioral Risk Factor Surveillance System (BRFSS), this study analyzed N=17,999 adult caregivers both living with and without cancer. Negative binomial regression models with interaction terms were used to estimate the association between caregiver cancer status and poor mental health days and to test whether gender and perceived social support moderated the relationship. In the fully adjusted models, cancer status was not independently associated with poor mental health days, and neither gender nor perceived social support significantly moderated the association in the two-way interaction models. However, perceived social support was strongly associated with fewer poor mental health days across groups, and a statistically significant three-way interaction between cancer status, gender, and perceived social support indicated a more complex pattern. Adjusted predicted values showed that women caregivers living with cancer who reported lower perceived social support had the highest predicted number of poor mental health days, identifying them as a particularly vulnerable subgroup. These findings identify caregivers living with cancer as a distinct and understudied population at the intersection of caregiving and cancer research and highlight social support as a critical, modifiable resource for improving caregiver mental health. More broadly, these findings suggest that interventions should be responsive to the ways gender and access to support resources shape mental health risk among caregivers managing their own serious health conditions.

Keywords

Cancer;Caregiver;Gender;Mental Health;Negative Binomial Regression;Social Support

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