Healthy Lifestyle Behavior Adherence Among Skin Cancer Survivors in Pima County: A Phototype Comparison

Abstract

This study seeks to fill a critical gap in the literature by comparing the lifestyle behaviors of skin cancer survivors with Fitzpatrick Skin Phototypes (FSP) of I and II (comprised of light-skinned, typically White individuals usually of Northern or Central European descent) versus those with an FSP of III and higher - usually comprised of individuals who identify within the Black, Indigenous, or People of Color (BIPOC) community. By investigating dietary habits, physical activity levels, and sun protective behaviors in these groups, the research aims to provide a more comprehensive understanding of the factors influencing survivorship and inform targeted interventions to support healthier outcomes for all skin cancer survivors.This cross-sectional study assessed lifestyle behaviors among skin cancer survivors in Pima County, Arizona. Participants (n = 28) were recruited through local clinics and community outreach programs. Data were collected via self-administered questionnaires (demographics, physical activity, sun exposure behaviors) and a 24-hour dietary recall conducted by trained staff, all of which were stored in REDCap. Physical activity adherence was measured using the CHAMPS survey, and dietary adherence was assessed with the Healthy Eating Index (HEI). Sun protection behaviors were also evaluated through self-reported questionnaires. Statistical analyses, including chi-square tests and ordinal logistic regression, were used to examine associations between skin type and adherence to health recommendations. No significant differences were observed in adherence to physical activity (p = 0.09), sun protection (p = 0.10), or dietary recommendations (p = 0.91) between participants with fair skin (FSP of I-II) and light/medium skin (FSP of III-IV). However, a trend was observed, suggesting that light/medium skin participants may be more likely to meet physical activity recommendations while exhibiting a higher non-adherence to sun protection behaviors. Age was significantly associated with dietary adherence (OR = 0.79, p = 0.01), with older individuals having lower odds of achieving higher grades. While no statistically significant differences were observed in any of the specific lifestyle recommendations when compared to their FSP, these findings suggest potential disparities in the behaviors associated with physical activity, sun protection, and dietary quality that may be worth exploring in future research with larger sample sizes.