title: Exploring the relationship between physical well-being and healthy lifestyle changes among European- and Latina-American breast and cervical cancer survivors.
abstract: BACKGROUND
  Cancer and its treatments have a lingering and often negative impact on survivors' physical well-being. The physical sequelae impinge on daily functioning and overall HRQOL, and perhaps influence lifestyle changes post-cancer. This study aims to examine: (1) physical well-being items that are associated with low overall health-related quality of life; and (2) the relationship between physical well-being outcomes and healthy lifestyle changes by cancer type.
  
  
  METHODS
  This study employed a cross-sectional design with mixed sampling methods. In total 922 European- (n=452) and Latina-American (n=470) breast (BCS) or cervical cancer survivors (CCS) were recruited from the California Cancer Surveillance Program and Los Angeles area hospital registries. Item responses from survivors in the lowest quartile of total quality of life scores and percentages reflecting low physical well-being levels were calculated.
  
  
  RESULTS
  A statistical approach to individual items provides unique and valuable measurement and clinical information above and beyond physical well-being total scores. Physical well-being item responses varied according to ethnicity, income, and education. BCS and CCS showed different patterns in the relationship between physical well-being items and lifestyle changes. Specifically, exercise was significantly related to physical well-being items for BCS, while diet changes were significantly associated with physical well-being for CCS.
  
  
  CONCLUSIONS
  Results reveal unique correlates of physical well-being items by cancer type, ethnicity, and lifestyle changes. Clinically, this study highlights the need for greater consideration of individual and medical characteristics in developing culturally sensitive and patient responsive interventions to promote healthy lifestyles and improve survivorship outcomes.
authors.affiliation: Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope, Duarte, CA 91010-3000, USA. KAshing@coh.org
authors.forename: Kimlin T
authors.initials: KT
authors.lastname: Ashing-Giwa
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Lim
authors.forename: Patricia
authors.initials: P
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D044465:White People / Q000523:psychology