Healthy People 2010 (USDHHS, 2000), highlights critical health objectives for adolescents, including the importance of reducing tobacco use, reducing the proportion who are overweight or obese, increasing the proportion who engage in regular physical activity, and increasing the proportion who engage in sun protection. Given adolescent cancer survivors' increased risk for physical late-effects and their increased vulnerability to additional chronic conditions, these health behaviors are even more critical. Advances in pediatric cancer care have resulted in a growing population of childhood cancer survivors. However, little research to date has investigated the mechanisms that promote or hinder a healthy lifestyle among adolescent cancer survivors. Guided by the Theory of Planned Behavior, and empirically supported cancer-related variables, this study will identify the patterns and covariates of health-protective and health-damaging behavioral intentions and behaviors among adolescent cancer survivors. Specifically, we will investigate survivors' tobacco use, regular exercise, nutritional habits, and sun protection intentions. We will assess 200 adolescents (14-19 years of age), who were diagnosed with cancer during late childhood to early adolescence (8-14 years of age), have no evidence of disease (NED) and are at least 1 year post-treatment. No studies to date have examined theoretically-driven covariates of adolescent survivors' health behavior intentions that may influence their future risk of disease. There is evidence to suggest that life-threatening illness may increase health behavior change among adults, however, the study of health risk behaviors among pediatric cancer survivors is an area that has received little attention. The proposed study will fill a research gap in a high priority area and the findings are likely to have both clinical and theoretical implications. The study findings will address a national priority and advance behavioral science by identifying theory-driven covariates that impact the health-protective and health-damaging behaviors of adolescent cancer survivors.
