Table 2 Changes in poor mental health prior to (2017–2019) and during COVID-19 (2020) among cancer survivors by PCC quality and Online PPC.

			Cancer survivors			U.S. Adults without a history of cancer
	Pre-COVID-19 (odds)	COVID-19 (odds)	Difference (aOR, 95% CI)	Pre-COVID-19 (odds)	COVID-19 (odds)	Difference (aOR, 95% CI)	Difference-In-Difference^a (aOR, 95% CI)	p-value
Overall^b	0.93	1.13	1.21 (0.83–1.76)	0.87	0.98	1.14 (0.97–1.33)	1.07 (0.71–1.60)	0.76
PCC^c
Optimal	0.79	1.03	1.31 (0.76–2.25)	0.68	0.90	1.32 (1.00–1.15)^*	0.99 (0.53–1.81)	0.96
Sup-optimal	0.99	1.13	1.14 (0.73–1.79)	0.99	1.03	1.04 (0.87–1.24)	1.10 (0.68–1.77)	0.71
Online PPC
Email/Internet communication	1.03	1.16	1.13 (0.67–1.92)	1.06	1.20	1.13 (0.91–1.41)	1.00 (0.57–1.75)	0.99
No Email/Internet communication	0.85	1.06	1.26 (0.82–1.93)	0.79	0.86	1.09 (0.89–1.34)	1.15 (0.71–1.86)	0.56
Tablet/Smartphone for discussion	1.21	1.40	1.15 (0.61–2.18)	1.12	1.23	1.10 (0.85–1.41)	1.05 (0.52–2.11)	0.88
No Tablet/Smartphone for discussion	0.84	0.99	1.17 (0.78–1.77)	0.83	0.95	1.14 (0.94–1.38)	1.03 (0.66–1.62)	0.90
EHR message	0.76	0.65	0.85 (0.46–1.57)	0.70	0.87	1.24 (0.94–1.65)	0.68 (0.35–1.32)	0.25
No EHR message	0.97	1.33	1.38 (0.94–2.03)	0.92	1.00	1.09 (0.91–1.31)	1.26 (0.83–1.93)	0.28

aOR adjusted odds ratio, CI confidence interval.
^aRefers to changes in the odds of poor mental health among cancer survivors compared to those with or without a history of cancer during the early COVID-19 pandemic in the generalized linear model using inverse link function to estimate the differences in differences log odds, adjusting for a history of cancer, time period, age, birth gender, education, race/ethnicity, household income, general health status, and chronic disease (lung disease).
^bTotal n = 15,240, the parallel trends assumption was met in pre-COVID-19 checked by visual inspection and quantitative test.
^cOptimal PCC = When all 7 PCC questions were answered ‘always’.
^*Statistically significant (p < 0.05).

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