title: Perceptions of barriers and facilitators to health behavior change among veteran cancer survivors.
abstract: OBJECTIVE
  This study aimed to identify barriers and facilitators to health behavior change related to body size in a sample of veteran cancer survivors.
  
  
  METHODS
  A qualitative study was conducted with a sample of 35 male and female cancer survivors receiving care at a Veterans Administration comprehensive cancer center. Participants completed individual interviews regarding barriers and facilitators to lifestyle change and responded to a brief questionnaire regarding current health behaviors.
  
  
  RESULTS
  Participants reported suboptimal adherence to recommended health behavior goals and the majority were overweight or obese (80%). Qualitative analysis revealed numerous barriers and facilitators to health behavior change across six broad categories: environmental factors, health services delivery factors, health-related factors, factors related to attitudes toward change, factors related to enacting change, and motivational factors. Veteran cancer survivors were impacted by common barriers to change affecting the general population, cancer-specific factors related to personal diagnosis and treatment history, and health service delivery factors related to the Veterans Administration health care system.
  
  
  CONCLUSIONS
  There are many barriers and facilitators that exist in diverse domains for veteran cancer survivors, each of which offers unique challenges and opportunities for improving engagement in behavior change following cancer diagnosis and treatment.
authors.affiliation: VA Center for Integrated Healthcare, VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY 14215.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Beehler
authors.affiliation: Behavioral VA Careline, VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY 14215.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rodrigues
authors.affiliation: Behavioral VA Careline, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073.
authors.forename: Morgan A
authors.initials: MA
authors.lastname: Kay
authors.affiliation: School of Public Health and Health Professions, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY 14214.
authors.forename: Marc T
authors.initials: MT
authors.lastname: Kiviniemi
authors.affiliation: Medical VA Careline, VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY 14215.
authors.forename: Lynn
authors.initials: L
authors.lastname: Steinbrenner
mesh_terms: D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance; D036301:Qualitative Research; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*