Health Beliefs and Cancer Preventive Lifestyle Behaviors among Adult Survivors of Adolescent and Young Adult Cancer Survivors: A HINTS Analysis

Authors: Skiba MB, Crane TE, Jacobs ET, Kopp LM, Thomson CA

Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020

Abstract Body:
Purpose: We aimed to evaluate cancer preventive lifestyle behaviors among adolescent and young adult cancer survivors (AYAs; age 15-39 y) compared to older adult cancer survivors (OACs; age ≥40 y) and cancer- free adults (CFAs). The influence health beliefs, including self-efficacy on these behaviors in adults was also examined. Methods: Data available from the Health Information National Trends Survey (HINTS) 5 Cycle 1 was used to characterize lifestyle behaviors and cancer-related health beliefs in a sample of 3285 nationally representative adults. Cancer history was determined from self-report of age at cancer diagnosis. Lifestyle behaviors were defined as meting recommendations established by American Cancer Society Guidelines of ≥5 servings fruit and vegetables/day (FV), ≥150 min moderate physical activity/week (PA), and a body mass index ≤30 kg/m2. Using adjusted logistic regression models with survey weights and jackknife replicates, the lifestyle behaviors of AYAs compared to OACs and CFAs was assessed and the association of cancer-specific health beliefs including health self-efficacy and meeting recommendations was completed. Results: Average age at cancer diagnosis was 30.8 and 60.1 y with a mean time since diagnosis of 3.8 y and 2.7 y for AYAs (n= 114) and OACs (n= 364), respectively. Fewer than half of AYAs met recommendations for FV (43.8%) and PA (31.5%), and 32.5% were obese. There was no difference in meeting FV and PA recommendations among AYAs compared to OACs or CFAs. AYAs had lower odds of obesity compared to OACs and CFAs (OR: 0.41, (95%CI: 0.20-0.83), p= 0.01 and OR: 0.49, (95%CI: 0.26-0.91), p=0.025, respectively). High health self-efficacy was associated with higher odds of meeting FV (OR: 1.89, (95%CI: 1.09-2.31), p= 0.017) and PA recommendations (OR: 1.92, (95%CI: 1.28-2.87), p=0.002). Cancer-specific health beliefs including cues to action and perceived severity, susceptibility, and threat were not associated with meeting recommendations. Conclusions: These results suggest that AYA lifestyle behaviors are similar to OACs and CFAs and many do not achieve established recommendations. Higher self-efficacy supports meeting recommendations for cancer preventive lifestyle behaviors, while other health beliefs may not.

Keywords: Adolescent Young Adult, Cancer Survivorship, Health Behavior, Health Beliefs