Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Beth B. Jones

Second Advisor

Leah L. Ferrucci


Background: The COVID-19 pandemic has resulted in negative changes in health behaviors related to cancer. Recent studies in adults have identified factors leading to harmful/unhealthy lifestyle changes during the pandemic. However, little is known about the factors that predict worse cancer-related health behaviors among young adults.

Methods: The data used for this analysis were from a cross-sectional online survey conducted in Connecticut in 2021 regarding participant’s lifestyle behaviors during the COVID- 19 pandemic. Participants were recruited through social media networks of community partners and organizations within the Yale Cancer Center (YCC) catchment area. Participants included local minority and low socioeconomic status (SES) high school/college students in YCC cancer research laboratories and/or projects. Multivariable logistic regression models with backward elimination were used to identify significant predictors of increased tobacco use/alcohol consumption or reduced healthy eating/exercise levels since the onset of the COVID-19pandemic. We also evaluated potential interactions between sociodemographic characteristics and significant predictors identified in the final reduced model using cross-product terms.

Results: Among the 231 eligible participants the mean age was 21.2 years (SD=2.1) and 124 (53.7%) were females. Over 50% of the participants self-identified as underrepresented minorities. In the final multivariable model, being mistreated by family or friends (OR=2.74; 95% CI, 1.17–6.37), lacking confidence in a primary health care provider (OR=2.31; 95% CI, 1.06–5.02), believing risk of being infected with coronavirus was low (OR=4.48; 95% CI, 1.95– 10.32), not recognizing the severity of cancer compared to other diseases (OR=1.78; 95% CI, 1.07–2.97), and having less control over recovering from cancer (OR=2.05; 95% CI, 1.23–3.42) were associated with increased tobacco use and/or alcohol consumption during the pandemic. Being of college-age (21-22 years old) (OR=3.08; 95% CI, 1.44–6.61), having transportation difficulties (OR=2.80; 95% CI, 1.18–6.65), experiencing increased stress (OR=1.14; 95% CI, 1.01–1.30) and discrimination (OR=3.68; 95% CI, 1.28–10.63) were associated with reduced exercise levels and/or less healthy eating behaviors during the pandemic.

Conclusions: Lack of health awareness and barriers to health promotion were key contributors to the increase in harmful/unhealthy behaviors during the pandemic. It is crucial for future studies to explore community outreach programs and targeted education campaigns for promoting healthier behaviors related to cancer prevention among young adults.


This is an Open Access Thesis.

Open Access

This Article is Open Access