Health Promotion in Minority Childhood Cancer Survivors

描述(申请人提供)：儿科癌症治疗的进步极大地提高了存活率，超过75%的癌症儿童无病存活超过5年。因此，年龄在16岁到44岁之间的成年人中，大约每900人中就有一人是儿童癌症的幸存者。尽管在治疗方面取得了进展，但许多幸存者都经历了治疗的不良后遗症，如心血管疾病(CVD)和与治疗相关的继发性癌症的风险增加。包括肥胖、不健康饮食、不运动和吸烟在内的生活方式因素可能会加剧这些后遗症。因此，坚持健康促进的做法，如保持健康的饮食和体重，定期体育锻炼，避免吸烟，可能对儿童癌症的成年幸存者特别有益。目前，人们对儿童癌症成年幸存者的生活方式行为知之甚少。已经进行的研究主要包括非西班牙裔白人样本。对于少数民族成年幸存者，人们几乎一无所知。这项拟议的项目是对儿童癌症和非癌症对照的非裔美国人、西班牙裔和非西班牙裔白人成年幸存者的横断面观察性研究。这项研究将描述和比较重要的健康行为(饮食、体力活动、吸烟)和特定的保健、社会文化、认知和环境因素(健康状况、保健利用、文化信仰/实践、灵性、健康知识、态度、自我效能和社会支持)，以影响确定的健康行为。利用回归分析，我们将建立预测模型，解释幸存者状态、种族和健康行为之间的关系，以及调节这些行为的社会文化和认知因素。这项研究的结果将被用来帮助设计一种可行的干预措施，以增加少数民族幸存者的积极健康行为。

DESCRIPTION (provided by applicant): 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.