A Latent Class Analysis of Health Behavior Changes after Cancer Diagnosis among Hispanic/Latino Cancer Survivors

Abstract

Abstract Purpose We aimed to identify subgroups of Hispanic/Latino (H/L) cancer survivors with distinct health behavior patterns and their associated sociodemographic, medical, and psychosocial characteristics. Methods Baseline data was used from a randomized clinical trial evaluating the efficacy of an enhanced patient navigation intervention in H/L cancer survivors. Participants (n = 278) completed the Lifestyle Behavior Scale and validated questionnaires on health-related quality of life (HRQOL), supportive care needs, distress, and satisfaction with cancer care. Latent class analysis was used to determine the latent classes and associated characteristics. Results Three latent classes emerged: Class 1 (survivors who increased health behaviors [e.g., exercising and eating healthy] since diagnosis); Class 2 (no changes in health behaviors since diagnosis); and Class 3 (a “mixed class,” with a higher or lower engagement across various health behaviors since diagnosis). Participants in class 1 were significantly more educated and less likely to be foreign born. Participants in class 2 were significantly older and more likely to have prostate cancer. H/L cancer survivors in class 3 had a significantly lower income, were less educated, and reported greater unmet supportive care needs, more distress, and poorer HRQOL. Conclusions Survivors who report engaging in health behaviors less frequently since diagnosis may be experiencing psychosocial challenges and health disparities. Implications for Cancer Survivors: Hispanic/Latino cancer survivors may benefit from screening for social determinants of health and mental health needs, prompt referral to supportive care services, community resources and public services, and participating in culturally-informed psychosocial interventions to address their unique needs.