Prevalence and correlates of healthy lifestyle behaviors among early cancer survivors

Abstract

BackgroundHealthy lifestyle behaviors have been demonstrated to be beneficial for positive health outcomes and the quality of life in cancer survivors. However, adherence to recommendations is low. More insight is needed in factors that may explain engagement in lifestyle behaviors to develop effective cancer aftercare interventions. This study assessed different factors, namely socio-demographic, cancer-related, psychological, social cognitive factors (attitude, social support, self-efficacy) and intention, in relationship to five lifestyle behaviors (smoking, physical activity, alcohol, and fruit and vegetable consumption).MethodsEarly survivors of various types of cancer were recruited from eighteen Dutch Hospitals (n = 255). Distal factors (socio-demographic, cancer related, psychological), proximal factors (social cognitive), intention and five lifestyle behaviors (smoking, physical activity, alcohol, fruit and vegetable consumption) were assessed through a self-reported questionnaire. Cross-sectional analyses (correlations and regression analyses) were conducted.ResultsThe lifestyle of a small group (11 %) of the cancer survivors was coherent with all five health recommendations, the majority (>80 %) adhered to two, three of four recommendations, and only few (<7 %) adhered to one or none recommendation. The highest prevalence in followed recommendations have been detected in physical activity (87.4 %), refrain from smoking (82 %), and alcohol consumption (75.4 %). There was low adherence to the fruit recommendation (54.8 %) and to the vegetable recommendation (27.4 %). Only weak associations were found between the different behaviors. Each separate lifestyle behavior was influenced by different patterns of correlates. Self-efficacy, attitude, and intention were the strongest correlates in all examined behaviors, although with various contributions, while socio-demographic, cancer-related and psychological factors provided a much smaller contribution.ConclusionsOutcomes of engagement in healthy lifestyle behaviors were more positive in this study compared to other research in cancer survivors; however, there is room for improvements in adherence to all five lifestyle behaviors. Especially fruit consumption was poor and vegetable consumption even worse. Our findings emphasized that all examined lifestyle behaviors need to be encouraged, with taken into account that each lifestyle behavior may be influenced by a specific set of mainly social cognitive factors or intention.

Psychometric properties of the Dutch extended Cancer Survivors’ Unmet Needs measure (CaSUN-NL)

“…During this process, the CaSUN‐NL was extended with five items on return to work and four on lifestyle, because return to work and lifestyle are prominent issues among cancer survivors and cancer survivors may also experience unmet needs in these domains (Demark‐Wahnefried & Jones, 2008; Duijts et al., 2014; Harding, 2012; Küsters, Lechner, Willems, Bolman, & Mesters, 2012; Stergiou‐Kita et al., 2014; Wolin & Colditz, 2013). The CaSUN‐NL was subsequently applied in the two Dutch studies (hereafter called “first study” and “second study”; Kanera, Bolman, Mesters, et al., 2016; Kanera, Bolman, Willems, et al., 2016; Kanera, Willems et al., 2016; Willems et al., 2015, 2016a,b). …”

“…The first study, a paper‐and‐pencil cross‐sectional survey explored the information and support needs of cancer survivors, and its relationships with demographic, disease‐related and psychosocial characteristics, with a follow‐up after 6 weeks (Kanera, Bolman, Mesters, et al., 2016; Willems et al., 2016a). Of the 455 invited cancer survivors, 255 (58.9%) were eligible and consented to participate, and 237 (93%) participated again after 6 weeks.…”

“…Missing data in the first study were handled according to the instrument‐specific manuals (Hodgkinson et al., 2007; Kanera, Bolman, Mesters, et al., 2016; Willems et al., 2016a). In the second study, no data were missing because the online assessment was programmed to avoid non‐response.…”

“…For our two studies (Kanera, Bolman, Mesters, et al., 2016; Willems et al., 2016a), the validated CaSUN was regarded as the most appropriate general questionnaire to specifically investigate the unmet needs of cancer survivors (Bender et al., 2012; Brennan, Butow, Spillane, & Boyle, 2016; Geller et al., 2014; Harrison et al., 2011; Hodgkinson, Butow, Fuchs, et al., 2007; Hodgkinson, Butow, Hunt, et al., 2007; Rowlands, Janda, McKinnon, Webb, & Beesley, 2015; Smith et al., 2013; Urbaniec, Collins, Denson, & Whitford, 2011). Therefore, the CaSUN was translated into Dutch.…”

Interventions developed with the Intervention Mapping protocol in the field of cancer: A systematic review

“…Forty additional publications were retrieved reporting their needs assessment (n = 18), their step 4 (n = 3), their implementation planning (n = 1), their evaluation (n = 17), and their implementation (n = 1).…”