Abstract B55: Distinct health behavior and psychosocial profiles of young adult cancer survivors: A mixed methods study
Authors: Berg Carla J. , Lowe Kincaid , Escoffery Cam , Mertens Ann 
Published: May 2016

Abstract
Background: Young adult cancer survivors do not respond similarly to the experience of cancer. Thus, we investigated health behavior profiles of young adult cancer survivors and characterize associated sociodemographic and psychosocial characteristics.
Methods: A cross-sectional survey assessed sociodemographics, cancer treatment, health behaviors (e.g., alcohol use, tobacco use, physical activity [PA]), healthcare provider interaction, and psychosocial factors for 106 participants from a southeastern cancer center. In-depth semi-structured interviews with a sub-sample of 26 participants were conducted.
Results: For the quantitative study, participants were 22.13 (SD=3.18) years old; 51.0% (n=53) male; and 78.8% (n=82) White. They had the following diagnoses: Hodgkin's lymphoma (23.1%); non-Hodgkin's lymphoma (8.7%); Burkitt's lymphoma (3.8%); acute lymphoblastic leukemia (16.3%); acute myelogenous leukemia (2.9%); blastoma (5.8%); sarcoma (10.6%); thyroid cancer (9.6%); and other (19.2%). Average time since diagnosis was 8.42 (SD=5.73) years. A k-means cluster analysis indicated three distinct clusters based on health behavior profiles that corresponded to high, moderate, and low risk behaviors. The clusters differed significantly in relation to current alcohol use, binge drinking, tobacco use, marijuana use, PA, and number of sex partners (p's&lt;0.001). The High Risk group (n=25) had the highest current use of alcohol, tobacco, and marijuana and the most past-year sexual partners (p's&lt;0.001). However, they had the greatest PA (p&lt;0.001). The High Risk cluster was older than the Low Risk group but younger than Moderate Risk group, and gender composition was mostly male. Compared to the other groups, the High Risk were more likely to have significant depressive symptoms per the Patient Health Questionnaire – 9 item (p=0.052) and had the highest Profile of Moods States (POMS) scores for tension-anxiety (p=0.004), depression-dejection (p=0.018), fatigue-inertia (p=0.033), and confusion-bewilderment (p=0.022). The Moderate Risk group (n=39) had the lowest levels of PA (p&lt;0.001) but was not distinct regarding the other health behaviors. They were the oldest (p&lt;0.001), most likely to be female (p=0.005), were the most likely to be employed (p=0.012), were least likely to be on their parent's insurance (p=0.012), and had the most time lapse since their initial diagnosis (p&lt;0.001). This group also had the least depressive symptoms (p=0.052). The Low Risk group (n=40) reported the lowest current alcohol use, binge drinking, tobacco use, and marijuana use, as well as the lowest number of past-year sexual partners (p's&lt;0.001). This group was the youngest (p&lt;0.001), the most likely to be students (p=0.012), the most likely to be on public insurance (p=0.012), and the most recently diagnosed (p&lt;0.001). This cluster had the lowest POMS scores for tension-anxiety (p=0.004), depression-dejection (p=0.018), fatigue-inertia (p=0.033), and confusion-bewilderment (p=0.022). In qualitative interviews, participants reported that their experience with cancer decreased positively or negatively affected their health behaviors, and some reported no impact. Some participants reported minimal or no assessment or intervention related to substance use, physical activity, or nutrition. On the other hand, some reported that providers assessed and intervened on these health behaviors. Many participants expressed interest in having up-to-date information and education available through various reputable sources. Participants discussed a variety of communication channels and the need for expertise and reliability of the material presented.
Conclusions: Greater efforts should be made by providers to routinely and systematically examine substance use, PA, and nutrition as well as mental health and social support among this population. In addition, disseminable and cost-effective programs to support providers in doing so are needed.
Citation Format: Carla J. Berg, Kincaid Lowe, Cam Escoffery, Ann Mertens. Distinct health behavior and psychosocial profiles of young adult cancer survivors: A mixed methods study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B55.