title: Childhood cancer survivors' perceived barriers to improving exercise and dietary behaviors.
abstract: OBJECTIVE
  To determine childhood cancer survivors' barriers to increasing exercise and consuming less fat and more fruits and vegetables, whole grains, and calcium-rich foods.
  
  
  METHODS
  Mailed survey.
  
  
  METHODS
  Cases from a comprehensive cancer center.
  
  
  METHODS
  Convenience sample of 144 childhood cancer survivors aged 13-35 years identified through previous research. Surveys were returned by 118 participants (82% response rate).
  
  
  METHODS
  Descriptive statistics with chi-square tests were performed between subgroups defined by age (< 18 years and < or = 18 years) and diagnosis (leukemia, lymphoma, and central nervous system cancers).
  
  
  METHODS
  Barriers to exercise, consuming less fat, and eating more fruits and vegetables, whole grains, and calcium-rich foods.
  
  
  RESULTS
  Proportionately more childhood cancer survivors reported barriers to exercise and following a low-fat diet than to consuming more fruits and vegetables, whole grains, and calcium-rich foods. Primary barriers to exercise included being too tired (57%), being too busy (53%), and not belonging to a gym (48%), whereas barriers for restricting high-fat foods were commercials that make high-fat foods look so appealing (58%) and having friends who eat a lot of high-fat foods (50%). Difficulty associated with ordering healthy foods when dining out also was a leading barrier to following a low-fat diet (50%), as well as eating more whole grains (31%), fruits and vegetables (30%), and calcium-rich foods (15%).
  
  
  CONCLUSIONS
  Childhood cancer survivors report several barriers to exercise and consuming a low-fat diet with more fruits and vegetables, whole grains, and calcium-rich foods.
  
  
  CONCLUSIONS
  This study's findings may be helpful to nurses, health educators, and allied health professionals in developing effective interventions that promote healthful lifestyle change among childhood cancer survivors.
authors.affiliation: School of Nursing, Duke University, Durham, NC, USA. whitney.arroyave@duke.edu
authors.forename: Whitney D
authors.initials: WD
authors.lastname: Arroyave
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Clipp
authors.forename: Paige E
authors.initials: PE
authors.lastname: Miller
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.forename: Dianne S
authors.initials: DS
authors.lastname: Ward
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Bonner
authors.forename: Philip M
authors.initials: PM
authors.lastname: Rosoff
authors.forename: Denise Clutter
authors.initials: DC
authors.lastname: Snyder
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D017741:Survivors / Q000523:psychology; D014481:United States