Document Type

Dissertation

Date of Award

2025

Degree Name

Doctor of Philosophy (PhD)

Department

Health Science

First Advisor

John Korkow

Abstract

Cancer is the second leading cause of death in the United States disproportionately affecting rural communities. This dissertation study investigates the involvement of rural communities in lifestyle behaviors associated with increased risk of cancers, the impact of socioeconomic factors, and what influences their behavior and the impact of political party affiliation. The study was conducted using a mixed-method quantitative data analysis enhanced by qualitative interviews. It began with an extensive literature review to identify existing research, and evidence gaps on the topic. Data collection involved retrospective quantitative extraction from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS) to quantify involvement of rural populations in lifestyle behaviors, followed by qualitative interviews to gather insights influencing barriers and motivators to engage in these behaviors. Demographic accounted for 8.9% of the variation in smoking behavior, while Social Determinants of Health (SDOH) explained 11.7%. Demographics explained 2.0% and SDOH explained 5.4% of the variation in physical activity levels. Consumption of fruits and vegetables was significantly associated with sex, age, Hispanic origin, education, and employment status. Females, older individuals, Hispanics, and those with higher education levels exhibited lower odds of drinking compared to racial minorities such as Blacks, American Indians or Alaskan Natives, and Asians who had higher odds. Cancer, health concerns, and social stigmas emerged as primary motivators for avoiding or quitting tobacco. Dietary decisions and weight management were influenced more by general health and weight management than cancer risk. Participants’ knowledge of the relationship between exercise, alcohol use and cancer risk varied, with some expressing some knowledge and others expressing little to no understanding. For some participants, the awareness between infections and cancer risk influenced decisions to adopt preventive measures while others relied on general health behaviors or expressed skepticism towards vaccination and other interventions. Knowledge of risks associated with cancer and sun exposure influenced sun protection behaviors. Family and personal history of cancer was also influential in motivating behaviors to reduce cancer risk. Political affiliation played a nuanced role in how participants interpreted perceived risks, motivators, and challenges related to lifestyle behaviors associated with cancer risk

Subject Categories

Life Sciences

Keywords

behavioral risk factors Cancer prevention Cancer risk Lifestyle Behaviors Modifiable risk rural health

Number of Pages

166

Publisher

University of South Dakota

Included in

Life Sciences Commons

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