Health behaviors among young adult cancer survivors and the importance of task self-efficacy

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PURPOSE: To examine the prevalence and predictors of adhering to smoking, diet, exercise, and alcohol guidelines among young adult cancer survivors (cases) and matched controls without a history of cancer (controls) within 5 years post-treatment. METHODS: Cases (N = 335, mean age = 31.8 years, women = 68%) and age-, education-, sex-, and partner-status matched controls (N = 335) from a national online research panel completed measures assessing demographic characteristics, health behaviors (smoking, diet, exercise, alcohol), and task self-efficacy. Conditional logistic regression estimated the difference in health behaviors and self-efficacy between cases and controls. RESULTS: Rates of engagement in health behaviors were suboptimal across groups (Cases: 63% = abstaining from cigarettes or tobacco products daily, 29% = ≥ 5 servings of fruits and vegetables/day (FV intake), 55% = moderate to vigorous exercise for > 30 min for ≥ 5 days/week, 70% = abstaining from alcohol; Controls: 70%, 20%, 39%, 70%, respectively). Compared to controls, cases were less likely to avoid smoking (OR = 0.70, p = .04), more likely to report meeting FV intake (OR = 1.63, p = .01) and exercise (OR = 1.85, p < .001) guidelines and engaged in similar rates of abstaining from alcohol (p = 0.48). Reporting high task self-efficacy was associated with 3.7 to 20.2 times higher odds for meeting recommendations for healthy lifestyle behaviors, regardless of cancer history. CONCLUSIONS: Reported engagement in health behaviors was low, particularly for diet and exercise, and young adult cancer survivors were more likely to report smoking compared to controls. Task self-efficacy was strongly associated with meeting recommendations. IMPLICATIONS FOR CANCER SURVIVORS: Overall engagement in healthy behaviors was suboptimal and interventions that target task self-efficacy may support adherence to healthy lifestyle behaviors.

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