title: Age- and treatment-related associations with health behavior change among breast cancer survivors.
abstract: OBJECTIVE
  The aim of this study was to identify demographic and treatment-related factors associated with health-promoting behavior changes after a breast cancer diagnosis. Changes in health behaviors were also evaluated according to weight, exercise, diet and alcohol consumption patterns before breast cancer diagnosis.
  
  
  METHODS
  We examined self-reported behavior changes among 1415 women diagnosed with breast cancer in the NIEHS Sister Study cohort. Women reported changes in exercising, eating healthy foods, maintaining a healthy body weight, drinking alcohol, smoking, getting enough sleep, spending time with family and friends, and participating in breast cancer awareness events.
  
  
  RESULTS
  On average, women were 3.7 years from their breast cancer diagnosis. Overall, 20-36% reported positive changes in exercise, eating healthy foods, maintaining a healthy weight, or alcohol consumption. However, 17% exercised less. With each 5-year increase in diagnosis age, women were 11-16% less likely to report positive change in each of these behaviors (OR = 0.84-0.89; p < 0.05), except alcohol consumption (OR = 0.97; CI: 0.81, 1.17). Women who underwent chemotherapy were more likely to report eating more healthy foods (OR = 1.47; 95% CI 1.16-1.86), drinking less alcohol (OR = 2.01; 95% CI: 1.01, 4.06), and sleeping enough (OR = 1.41; 95% CI: 1.04, 1.91). The majority of women (50-84%) reported no change in exercise, eating healthy foods, efforts to maintain a healthy weight, alcohol consumption, sleep patterns, or time spent with family or friends.
  
  
  CONCLUSIONS
  Many women reported no change in cancer survivorship guideline-supported behaviors after diagnosis. Positive changes were more common among younger women or those who underwent chemotherapy.
authors.affiliation: Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Anderson
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.affiliation: Biostatistics Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
authors.forename: Clarice R
authors.initials: CR
authors.lastname: Weinberg
authors.affiliation: Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Houck
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
authors.forename: Minal
authors.initials: M
authors.lastname: Chunduri
authors.affiliation: Social and Scientific Systems, Inc., Durham, NC, USA.
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Hodgson
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Sabatino
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: White
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Juan L
authors.initials: JL
authors.lastname: Rodriguez
authors.affiliation: Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA. Electronic address: hazel.nichols@unc.edu.
authors.forename: Hazel B
authors.initials: HB
authors.lastname: Nichols
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000523:psychology; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D000073116:Cancer Survivors / Q000523:psychology*; D015331:Cohort Studies; D004032:Diet / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D057566:Self Report; D012907:Smoking / Q000523:psychology; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents
keywords: Breast cancer; Cancer survivors; Exercise; Health behavior