Cancer Causes & Control

, Volume 30, Issue 12, pp 1327–1339 | Cite as

Correlates of poor adherence to a healthy lifestyle among a diverse group of colorectal cancer survivors

  • Cindy K. BlairEmail author
  • Jean A. McDougall
  • Vi K. Chiu
  • Charles L. Wiggins
  • Ashwani Rajput
  • Elizabeth M. Harding
  • Anita Y. Kinney
Original Paper



Lifestyle factors may have a synergistic effect on health. We evaluated the correlates of poor adherence to a healthy lifestyle among a diverse sample of colorectal cancer (CRC) survivors to inform future lifestyle promotion programs.


Lifestyle questions from a cross-sectional survey were completed by 283 CRC survivors (41% Hispanic, 40% rural, 33% low income). Adherence to recommendations (yes/no) for physical activity, fruit and vegetable servings/day, avoiding tobacco, and healthy weight was summed to create an overall lifestyle quality score. Polytomous logistic regression was used to evaluate correlates of good (reference group), moderate, and poor overall lifestyle quality. Potential correlates included sociodemographic characteristics, cancer-related factors, and indicators of health and well-being.


CRC survivors with poor adherence were 2- to 3.4-fold significantly more likely to report multiple comorbidities, poor physical functioning, fatigue, anxiety/depressive symptoms, and poor social participation. In multivariable analyses, poor physical functioning was the only significant correlate of poor adherence to lifestyle recommendations, compared to good adherence [OR (95% CI) 3.4 (1.8–6.4)]. The majority of survivors, 71% and 78%, indicated interest in receiving information on exercise and eating a healthy diet, respectively.


Future lifestyle promotion programs for CRC survivors should carefully consider indicators of physical and psychosocial health and well-being, especially poor physical functioning, in the design, recruitment, and implementation of these health programs.


Cancer survivors Colorectal cancer Physical activity Diet Rural Lifestyle behaviors Modifiable risk factors 



This work was supported by the University of New Mexico Comprehensive Cancer Center (P30CA118100) and by Contract HHSN261201800014I, Task Order HHSN26100001 from the National Cancer Institute. CKB is supported by an NIH K07 Grant CA215937.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of New MexicoAlbuquerqueUSA
  2. 2.University of New Mexico Comprehensive Cancer CenterAlbuquerqueUSA
  3. 3.Department of SurgeryUniversity of New MexicoAlbuquerqueUSA
  4. 4.Department of Health, Exercise, and Sports SciencesUniversity of New MexicoAlbuquerqueUSA
  5. 5.Department of Epidemiology, School of Public HealthRutgers UniversityNew BrunswickUSA
  6. 6.Rutgers Cancer Institute of New JerseyNew BrunswickUSA

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