PROJECT SUMMARY/ABSTRACT
Although second-hand tobacco smoke is recognized as a cancer risk, the possibility that living with a smoker
fosters a broad household culture of cancer-relevant negative health behaviors is unstudied. Dynamic models
of health behavior have considered clustering of different behaviors within individuals and contagion of the
same behavior between individuals. Here, we combine these two areas of discovery in proposing a novel
process—the possibility that an individual's health behavior may influence another individual's health behavior
in a different domain. The proposed project tests an innovative model linking living with a smoker to low
physical activity, sedentary behavior, unhealthy diet, and overweight/obesity among middle-aged and older
women, a population at risk of exposure to passive-smoking. Our longer-term goal is to develop an R01
application to test a household-level intervention tailored to cross-domain health behaviors among
demographically disadvantaged families with a smoker. The objective for the proposed research is to lay a
foundation for this planned work by prospectively examining between-individual, cross-domain linkages in
overweight/obesity and associated health risk behaviors using data from the Women's Health Initiative (WHI)
Observational Study. Our central hypothesis is that individuals' exposure to a household smoker is linked to
their own low physical activity, sedentary behavior, unhealthy diet, and overweight/obesity. The rationale for
this project is that more rigorous tests of the links between living with a smoker and cancer-relevant negative
health behaviors in other domains will provide a foundation for developing more effective cancer prevention
strategies. We plan to pursue three specific aims: (1) Examine the role of living with a smoker in predicting
overweight/obesity; (2) Identify underlying mechanisms involving health risk behaviors linking living with a
smoker to overweight/obesity; and (3) Apply the model to groups of women at increased health risk associated
with health disparities and history of cancer. The proposed research is innovative because we examine a
neglected social-behavioral pathway in the risk for cancer. Results are expected to have a broader positive
impact because understanding the role of social ties in communicating multiple cancer-relevant health habits
has potential to advance population health and to reduce health disparities. The contribution of the proposed
research is its potential to redirect research and intervention efforts on cancer to an aspect of health behavior
change that has been overlooked. This contribution will be significant because it can substantially broaden the
reach and effectiveness of preventive efforts for cancer.
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