Estimated effects of potential interventions to prevent decreases in self-rated health among breast cancer survivors.
OBJECTIVE
To estimate the effect of hypothetical changes in modifiable predictors on the incidence of fair-to-poor self-rated health (SRH) in breast cancer survivors.


METHODS
In 2007-2008, we interviewed 832 breast cancer survivors 1 year after diagnosis (baseline) and 1 year later. First, multivariable logistic regression models estimated the association between the predictors (sociodemographic factors, access to medical care, comorbid conditions, psychosocial factors, perceived neighborhood conditions, cancer-related behaviors, clinical factors) and SRH. Second, we estimated the probabilities of fair-to-poor SRH for values of the predictors for each breast cancer survivor. Third, we estimated the population-wide effect of potential changes in modifiable predictors on the incidence of fair-to-poor SRH.


RESULTS
A total of 7.6% of participants (92.4% white; mean age, 58.0 years) whose SRH was rated good-to-excellent at baseline reported fair-to-poor SRH 1 year later. The largest potential reduction in incidence of fair-to-poor SRH could be obtained by eliminating surgical side effects (27.8% reduction) and comorbidity (21.8% reduction) and by engaging in any physical activity (19.6% reduction).


CONCLUSIONS
A significant portion of the decline in SRH can be avoided by reducing surgical side effects, preventing comorbidity, and improving physical activity with the use of evidence-based strategies.
Departments of Medicine and Pediatrics, Division of Health Behavior Research, Washington University School of Medicine, Saint Louis, MO 63108, USA. mschootm@im.wustl.edu
Mario
M
Schootman
Anjali D
AD
Deshpande
Sandi
S
Pruitt
Rebecca
R
Aft
Donna B
DB
Jeffe
D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000191:economics*; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D008923:Missouri; D009043:Motor Activity; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000517:prevention & control / Q000523:psychology; D057566:Self Report; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology*