title: Financial strain and cancer risk behaviors among African Americans.
abstract: BACKGROUND
  African Americans suffer disproportionately from the adverse consequences of behavioral risk factors for cancer relative to other ethnic groups. Recent studies have assessed how financial strain might uniquely contribute to engagement in modifiable behavioral risk factors for cancer, but not among African Americans. The current study examined associations between financial strain and modifiable cancer risk factors (smoking, at-risk alcohol use, overweight/obesity, insufficient physical activity, inadequate fruit and vegetable intake, and multiple risk factors) among 1,278 African American adults (age, 46.5 ± 12.6 years; 77% female) and explored potential mediators (stress and depressive symptoms) of those associations.
  
  
  METHODS
  Logistic regression models were used to examine associations between financial strain and cancer risk factors. Analyses were adjusted for age, sex, partner status, income, educational level, and employment status. Analyses involving overweight/obesity status additionally controlled for fruit and vegetable intake and physical activity. Nonparametric bootstrapping procedures were used to assess mediation.
  
  
  RESULTS
  Greater financial strain was associated with greater odds of insufficient physical activity (P < 0.003) and smoking (P = 0.005) and was positively associated with the total number of cancer risk factors (P < 0.0001). There was a significant indirect effect of both stress and depressive symptoms on the relations of financial strain with physical inactivity and multiple risk factors, respectively.
  
  
  CONCLUSIONS
  Future interventions aimed at reducing cancer disparities should focus on African Americans experiencing higher financial strain while addressing their stress and depressive symptoms.
  
  
  CONCLUSIONS
  Longitudinal studies are needed to assess the temporal and causal relations between financial strain and modifiable behavioral cancer risk factors among African Americans.
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, OregonAuthors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: Pragati S
authors.initials: PS
authors.lastname: Advani
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon Lrreitzel@uh.edu.
authors.forename: Lorraine R
authors.initials: LR
authors.lastname: Reitzel
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: Nga T
authors.initials: NT
authors.lastname: Nguyen
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: Felicia D
authors.initials: FD
authors.lastname: Fisher
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: Elaine J
authors.initials: EJ
authors.lastname: Savoy
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: Adolfo G
authors.initials: AG
authors.lastname: Cuevas
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
authors.affiliation: Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon.
authors.forename: Lorna H
authors.initials: LH
authors.lastname: McNeill
mesh_terms: D001741:Black or African American; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000208:ethnology*; D012307:Risk Factors; D012309:Risk-Taking
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