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. 2024 Jun;13(12):e7361.
doi: 10.1002/cam4.7361.

Barriers, facilitators, and other factors associated with health behaviors in childhood, adolescent, and young adult cancer survivors: A systematic review

Ismay A E de Beijer  1 , Eline Bouwman  2 , Renée L Mulder  1 , Philippa Steensma  1 , Morven C Brown  3 , Vera Araújo-Soares  4 , Magdalena Balcerek  5 , Edit Bardi  6   7 , Jeanette Falck Winther  8   9 , Line Elmerdahl Frederiksen  8 , Marloes van Gorp  1 , Sara Oberti  10 , Rebecca J van Kalsbeek  1 , Tomas Kepak  11 , Katerina Kepakova  11 , Hannah Gsell  12 , Anita Kienesberger  12 , Raphaële van Litsenburg  1 , Luzius Mader  8   13 , Gisela Michel  14 , Monica Muraca  10 , Selina R van den Oever  1 , Helena J H van der Pal  1   15 , Katharina Roser  14 , Roderick Skinner  16   17 , Iridi Stolman  2 , Anne Uyttebroeck  18 , Leontien C M Kremer  1   19   20 , Jacqueline Loonen  2 , Elvira C van Dalen  1 , Saskia M F Pluijm  1 ; PanCareFollowUp Consortium
Collaborators, Affiliations

Barriers, facilitators, and other factors associated with health behaviors in childhood, adolescent, and young adult cancer survivors: A systematic review

Ismay A E de Beijer et al. Cancer Med. 2024 Jun.

Abstract

Background: Healthy behaviors are paramount in preventing long-term adverse health outcomes in childhood, adolescent, and young adult (CAYA) cancer survivors. We systematically reviewed and synthesized existing literature on barriers, facilitators, and other factors associated with health behaviors in this population.

Methods: MEDLINE and PsycInfo were searched for qualitative and quantitative studies including survivors aged 16-50 years at study, a cancer diagnosis ≤25 years and ≥2 years post diagnosis. Health behaviors included physical activity, smoking, diet, alcohol consumption, sun exposure, and a combination of these behaviors (defined as health behaviors in general).

Results: Barriers, facilitators, and other factors reported in ≥2 two studies were considered relevant. Out of 4529 studies, 27 were included (n = 31,905 participants). Physical activity was the most frequently examined behavior (n = 12 studies), followed by smoking (n = 7), diet (n = 7), alcohol (n = 4), sun exposure (n = 4), and health behavior in general (n = 4). Relevant barriers to physical activity were fatigue, lack of motivation, time constraints, and current smoking. Relevant facilitators were perceived health benefits and motivation. Influence of the social environment and poor mental health were associated with more smoking, while increased energy was associated with less smoking. No relevant barriers and facilitators were identified for diet, alcohol consumption, and sun exposure. Barriers to healthy behavior in general were unmet information needs and time constraints whereas lifestyle advice, information, and discussions with a healthcare professional facilitated healthy behavior in general. Concerning other factors, women were more likely to be physically inactive, but less likely to drink alcohol and more likely to comply with sun protection recommendations than men. Higher education was associated with more physical activity, and lower education with more smoking.

Conclusion: This knowledge can be used as a starting point to develop health behavior interventions, inform lifestyle coaches, and increase awareness among healthcare providers regarding which survivors are most at risk of unhealthy behaviors.

Keywords: CAYA cancer survivors; barriers; facilitators; factors; health behaviors; healthy lifestyle; pediatric oncology; systematic review.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

FIGURE 1
FIGURE 1
Flowchart of studies included and excluded from the systematic review.
See this image and copyright information in PMC

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