Modeling pathways to health behaviors of young-adult survivors of childhood cancer
Currently there are over 300,000 childhood cancer survivors living in the United States, many of whom face serious or life-threatening late effects as a result of their cancer treatment. The current study sought to examine the pathways that lead to various health behaviors related to tobacco and alcohol use, diet, exercise, sunscreen use, medication compliance and follow-up screening practices in young-adult survivors of childhood cancer. Data was collected from a sample of 18 to 30 year old cancer survivors (N=125) who completed an online questionnaire and was used to test a causal model examining the main and mediating roles of interpersonal support and nonsupport, personal agency, avoidance, depressive symptoms and self-efficacy as they related to and were predictive of health behaviors. A preliminary factor analysis indicated a three-factor solution for all reported health behaviors, with the three factors being tobacco use, unhealthy lifestyle behaviors, and risk/neglectful behaviors. Path analyses were utilized to test three separate models predictive of each health behavior factor. Findings indicated direct causal effect between avoidance and tobacco use, avoidance and unhealthy lifestyle behaviors, and depressive symptoms and unhealthy lifestyle behaviors. Smaller, indirect effects from variables support, nonsupport, and personal agency were observed for tobacco use and unhealthy lifestyle behaviors. No support for the model including risk/neglectful behaviors was found. Tests of mediation indicated that depressive symptoms mediated the relationships between support and unhealthy lifestyle behaviors and personal agency and unhealthy lifestyle behaviors, and also indicated that self-efficacy mediated the relationships between support and unhealthy lifestyle behaviors, depression and unhealthy lifestyle behaviors, and personal agency and unhealthy lifestyle behaviors. Findings form this study may be used to guide health promotion program development in survivorship provider agencies and long-term follow-up clinics. Results indicate a number of recommendations for health behavior promotion intervention.
Vuotto, Stefanie C, "Modeling pathways to health behaviors of young-adult survivors of childhood cancer" (2014). ETD Collection for Fordham University. AAI3684490.