Advances in the treatment of pediatric cancers have led to dramatic improvements in survival and over 75 percent of children with cancer survive disease-free for more than 5 years. As a result, approximately one in every 900 adults between the ages of 16 and 44 is a survivor of pediatric cancer. Despite advances in treatment, many survivors experience adverse late effects of treatment such as increased risk for cardiovascular disease (CVD) and secondary cancers related to treatment. These late effects may be compounded by lifestyle factors that include obesity, unhealthful diets, inactivity, and smoking. Therefore, adherence to health-promoting practices such as maintenance of a healthy diet and weight, regular physical activity, and avoiding smoking may be particularly beneficial to adult survivors of childhood cancers. Currently, little is known about the lifestyle behaviors of adult survivors of childhood cancers. Studies that have been done include primarily non-Hispanic White samples. Virtually nothing is known about ethnic minority adult survivors. The proposed project is a cross sectional observational study of African-American, Hispanic, and non- Hispanic White adult survivors of childhood cancers and non-cancer controls. The study will describe and compare important health behaviors (diet, physical activity, smoking) and specific health care, sociocultural, cognitive and environmental factors (health status, health care utilization, cultural beliefs/practices, spirituality, health knowledge, attitudes, self-efficacy and social support) hypothesized to influence the identified health behaviors. Using regression analyses we will formulate predictive models that explain the relationships between survivor status, ethnicity and health behaviors, and the sociocultural and cognitive factors that mediate these behaviors. The results from this study will be used to assist in the design of a feasible intervention to increase positive health behaviors in minority survivors.
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