Health behaviors and weight status of childhood cancer survivors and their parents: similarities and opportunities for joint interventions

Abstract

Childhood cancer survivors are at increased risk for chronic health conditions that may be influenced by their cancer treatment and unhealthy lifestyle behaviors. Despite the possibility that interventions targeting the survivor-parent dyad may hold promise for this population, a clearer understanding of the role of family factors and the lifestyle behaviors of both survivors and parents is needed. A mailed cross-sectional survey was conducted in 2009 to assess weight status (body mass index), lifestyle behaviors (eg, diet, physical activity), and the quality of the parent-child relationship among 170 childhood cancer survivors who were treated at MD Anderson Cancer Center and 114 of their parents (80% mothers). Survivors were more physically active and consumed more fruits and vegetables than their parents. However, fewer than half of survivors or parents met national guidelines for diet and physical activity, and their weight status and fat intakes were moderately correlated (r=.30-.57; P<0.001). Multilevel models showed that, compared with survivors with better than average relationships, those with poorer than average relationships with their parents were significantly more likely to consume high-fat diets (P<0.05). Survivors and their parents may thus benefit from interventions that address common lifestyle behaviors, as well as issues in the family environment that may contribute to an unhealthy lifestyle.

Figure 1

Graphical depiction of the different effects of parent-child relationship quality on dietary fat intake among childhood cancer survivors (N=170) and their parents (N=114)^a * To assess fat intake, the 17-item NCI multifactor screener was used. ** To assess the quality of the parent-child relationship, five items rated on a four-point Likert-type scale were adapted from Lawrence (33) that asked about general closeness, communication, similarity of views about life, degree of getting along, and similarity of views about diet and exercise. ^a The figure shows that survivors reporting better than average parent-child relationship quality were significantly more likely to consume low-fat diets than those reporting poorer than average relationship quality. Parents who reported better than average relationship quality reported slightly lower levels of fat intake than those with poorer than average relationship quality, but the difference was not significant. Because relationship quality was grand-mean centered, −2 and 2 are the upper and lower possible values and 0 represents the mean.