Healthy Behaviors Among Non-Hispanic Black and Hispanic People Affected by Cancer During the Posttreatment Survivorship

Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors. 9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma). Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health. 2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer. 1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis. The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals. 11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living. Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis. The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used. The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined. 1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health. 4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors.17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.Background There are disparities in health behaviors across racial and ethnic groups. However, limited studies focus on cancer survivors' experiences developing and maintaining healthy behaviors, particularly in non-Hispanic Black (NHB) and Hispanic people.This study aimed to understand the experiences of NHB and Hispanic people affected by cancer in developing and maintaining positive health behaviors beyond a cancer diagnosis.The data were collected in a mixed-method study through semistructured interviews with 29 NHB and Hispanic cancer survivors between June and October 2022. Conventional content analysis was used.The lived experiences of cancer survivors were narrated in 3 themes: impact of a cancer diagnosis on oneself, facilitators and barriers to health and health behaviors, and utilization of available sources for health. Facilitators and barriers to health and health behaviors were further explored as biological (eg, symptoms, comorbidities), behavioral (eg, help-seeking behavior, sleep pattern), physical/built (eg, available sources, neighborhood), and sociocultural environment (eg, income, transportation, knowledge, culture, upbringing, household and community composition, social and family network), and healthcare system-related factors (eg, insurance coverage, personal preferences, perceived discrimination, and stigma).Non-Hispanic Black and Hispanic people, specifically those living in disadvantaged neighborhoods with limited sources or where they feel discriminated and stereotyped, those with limited income and transportation, and those with physical, social, or mental health problems, seemed to have challenges prioritizing health behaviors and maintaining healthy living.Biological, behavioral, and psychosocial determinants of health behaviors should be addressed through multilevel collaborations among different levels of partners.Non-Hispanic Black (NHB) and Hispanic people have the highest incidence rate and the highest mortality rates for major cancers and all cancers combined.1,2 Previous research indicates cancer health disparities in the United States are driven mainly by delays in diagnosis and treatment due to differences in insurance status and access to care.1,3 However, even when insurance status, age, and disease severity are equal across racial/ethnic groups, NHB and Hispanic cancer survivors often receive lower quality healthcare than non-Hispanic White (NHW) people.1Excess body weight, physical inactivity, malnutrition, or poor diet are associated with increased cancer risk, high mortality, and morbidity related to cancer.1,4 Although health behaviors are often labeled a personal choice, social determinants of health (SDOH) affect people's choices by creating facilitators or barriers to adopting health behaviors.5,6 Social and structural inequities are associated with SDOH such as education, employment, income, and housing. Emerging evidence suggests that chronic exposure to psychosocial stressors (eg, social and structural inequities) increases risk-enhancing behaviors and can directly affect well-being and overall health.4,7,8 A systematic review on psychosocial determinants of lifestyle changes among cancer survivors reported a variety of SDOH such as age, sex/gender, employment, job position, income, cohabitation/ living alone, social support, psychosocial distress, depressive and anxiety symptoms, and stressful life events, affecting health behaviors.9 Racial/ethnic minoritized people historically experience inequities and are disproportionately affected by suboptimal body weight, diet, and sedentary lifestyle.1,10,11 Non-Hispanic Black and Hispanic people were more likely to experience excess weight/obesity, and NHB people also had significantly higher nonadherence to diet and physical activity guidelines than NHW individuals.11Among the extant literature that focused on the perception of health behaviors,12 familial support for behavioral change,13 dietary drivers and challenges,14 barriers to exercise,15 and adopting a healthy lifestyle16 after a cancer diagnosis, there is little evidence focusing on disparities in health behaviors. Most evidence came from quantitative studies that focused on the long-term and late effects of cancer treatment and quality of life (QOL) challenges among cancer survivors. 17,18 Evidence related to cancer survivors' experiences in developing and maintaining health behaviors beyond a cancer diagnosis, particularly in NHB and Hispanic people, is limited.2,19,20 Moreover, health disparities are multifaceted, and multiple types of determinants contribute to overall health and adopting healthy behaviors.2,4 There is a need to understand complex and interacting factors at multiple levels of influence affecting health.2,21,22 Racially minoritized people historically are at risk for health disparities, requiring a strategic focus to understand motivators, facilitators, and barriers to developing effective strategies for improving health behaviors. Therefore, this study aimed to understand the multifaceted experiences of NHB and Hispanic people affected by cancer in developing and maintaining health behaviors beyond a cancer diagnosis.The data collected through a mixed-method study aimed to identify bio-socio-behavioral factors that impacted the QOL among NHB and Hispanic cancer survivors. The mixed-method study focused on the interactions of biological (inflammatory response) and behavioral (ie, physical activity and diet) factors in the context of SDOH. This analysis only included qualitative data focusing on the experiences of NHB and Hispanic people affected by cancer in developing and maintaining healthy behaviors.