Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Social and Behavioral Health
First Advisor
Dr. Maria Thomson
Abstract
Background
Early onset colorectal cancer (EOCRC) among individuals younger than age-based population prevention screening guidelines has been linked to lifestyle-related risk factors. Emerging adulthood (18-25 years) is when elevated autonomy can alter health behaviors with implications for future health. Greater consideration of future consequences for behavior predicts several lifestyle health behaviors. Future consideration is sensitive to resource availability, and thus may differ between students who are first-generation and/or from low-income households (FGLI) compared to Non-FGLI. This dissertation study aimed to (1) characterize college students’ consideration of future cancer risk (CFC-Cancer), perceived colorectal cancer (CRC) risk and associations with EOCRC risk factors, (2) compare findings by FGLI status, and (3) explore students’ health-related behavioral intentions given consideration of their future cancer risk.
Methods
A sequential mixed methods study utilized a sample of undergraduate students, age 18-25 years, to complete a survey, and follow-up interviews with a subset of participants stratified by low, medium and high CFC-Cancer. Analyses characterized survey results and linear regression models for CFC-Cancer and perceived CRC risk assessed for significant (p≤.05) associations with current behaviors, stress and sociodemographic variables. Bivariate tests and stratified linear regressions models assessed for significant differences between FGLI and Non-FGLI. Follow up interviews explored knowledge, attitudes and health behavioral intentions related to cancer prevention for the present and five years in the future. Interviews were transcribed verbatim for analyses guided by Grounded Theory principles to identify emergent themes.
Results
Students overestimated CRC risk and had moderate CFC-Cancer. Greater CFC-Cancer was associated with higher GPA, CRC knowledge and more protective lifestyle health behaviors. CFC-Cancer and perceived risk did not differ based on FGLI status; but FGLI had significantly more Black and Hispanic students, greater stress, and less CRC knowledge. Across CFC-Cancer groups interview participants expressed a desire to know more about cancer prevention they can implement now. Students with high CFC-Cancer endorsed direct cancer prevention education means such as seminars or individual appointments.
Conclusion
College students sometimes consider their future cancer risk when making current health behavior decisions. Furthermore, students want to know more about cancer and what risk reduction strategies they can implement as emerging adults and sustain into adulthood. More EOCRC risk factors were identified among the FGLI group compared to Non-FGLI which supports the need for health equity initiatives in the college setting. These findings support a paradigm shift for primary cancer prevention strategies to begin earlier in the life course as an upstream approach to impact early onset trends.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
7-25-2024