Health Behavior Profiles of Young Adult Cancer Survivors: A Novel Analytic Approach

Background: Young adult cancer survivors (YACS) are vulnerable to adverse health outcomes that may be amplified by health behaviors. This study aimed to define health behavior profiles of YACS using a cluster analysis, and characterize associated sociodemographic and psychosocial characteristics.  Methods: We collected cross-sectional surveys from 106 YACS and assessed sociodemographics, cancer treatment, health behaviors, healthcare provider interaction, and psychosocial factors using the Profile of Mood States. We conducted a k-means cluster analysis, clustering on health-related behaviors, then characterized these clusters in relation to sociodemographics and psychosocial factors. Results: Overall, the sample was 51.0% male, 78.8% white, with a mean age of 22.13 (SD=3.18). The cluster analysis yielded three distinct health behavior profiles: Transitioning High Risk (THR) (n=25), Post-Collegiate Moderate Risk (PCMR) (n=39), and Collegiate Low Risk (CLR) (n=40). THRs had the highest current alcohol, tobacco, and marijuana use; PA; and number of sexual partners (p<0.001). They had higher symptoms of tension-anxiety; depression-dejection; fatigue-inertia; and confusion-bewilderment (p<0.05). PCMRs had lowest PA, highest FV intake, were oldest, most likely to be employed and had most time passed since their initial diagnosis (p<0.05). CLRs had the lowest current alcohol, tobacco, and marijuana use; fewest sexual partners; and least FV intake. This group was youngest, most recently diagnosed, and most likely to be students (p<0.05). They had the lowest levels of tension-anxiety; depression-dejection; fatigue-inertia; and confusion-bewilderment (p<0.05). Conclusions: This innovative analytic approach suggests that assessing health behavior profiles, rather single health behaviors, is an informative approach for characterizing YACS and tailoring survivorship care.