Health-Promoting Behaviours following Primary Treatment for Cancer: A Rural–Urban Comparison from a Cross-Sectional Study
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Aim: To compare health-promoting behaviours among rural and urban residents following primary treatment for cancer. Methods: A cross-sectional survey collecting demographic variables and data pertaining to health-promoting behaviours, documented using the 52-item Health Promotion Lifestyle Profile II (HPLP-II) measure, which is categorised into six subscales: (1) health responsibility, (2) spiritual growth, (3) physical activity, (4) interpersonal relations, (5) nutrition, and (6) stress management. Residence was defined using the U.K. Office for National Statistics RUC 2011 Rural Urban Classifications. The Index of Multiple Deprivation (IMD) Decile was used to measure deprivation. Quantitative data were analysed using independent samples t-test and multiple linear regression. Qualitative data from open-ended questions were analysed thematically. Results: In total, 227 participants with a range of cancer types completed the questionnaire. Fifty-three percent were residents in urban areas and forty-five percent in rural areas. Rural participants scored significantly higher on health responsibility (p = 0.001), nutrition (p = 0.001), spiritual growth (p = 0.004), and interpersonal relationships (p = 0.001), as well as on the overall HPLP-II (p = 0.001). When controlling for deprivation, age, marital status, and education, rural–urban residence was a significant predictor of exhibiting health-promoting behaviours. A central theme from the qualitative data was the concept of “moving on” from cancer following treatment, by making adjustments to physical, social, psychological, spiritual, and emotional wellbeing. Conclusions: This research revealed, for the first time, differences in health-promoting behaviours among rural and urban U.K. populations who have completed primary cancer treatment. Rural residence can provide a positive environment for engaging with health-promoting behaviours following a cancer diagnosis and treatment.
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Evidence indicates differences in the adoption of health-promoting behaviors between urban and rural contexts.
“Studying measurement invariance based on sociodemographic characteristics is essential, as evidence indicates differences in the adoption of health-promoting behaviors between urban and rural contexts [37], as well as by gender, with lower scores observed particularly among women [40, 41].”
From Psychometric validation and measurement invariance of the Health-Promoting Lifestyle Profile II in Honduran university students (2025) · cites this paper as [37]
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References 49 · Cited by 8
- Authors
- Nelson, D., McGonagle, I., Jackson, C., Tsuro, T., Scott, E., Gussy, M., & Kane, R.
- Affiliations
- Macmillan Cancer Support (GB)
- University of Lincoln (GB)
- Pilgrim Hospital (GB)
- Lincoln County Hospital (GB)
- La Trobe University (AU)
- Corresponding author
- Nelson, David
- Venue
- Current Oncology
- Publisher
- MDPI AG
- Published
- 2023-01-25
- Volume
- 30
- Issue
- 2
- Pages
- 1585-1597
- ISSN
- 1198-0052 (ISSN-L)
- 1718-7729
- PMC
- PMC9955107
- OpenAlex
- W4318052513
- Cited by
- 8
- References
- 49
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 2
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Current Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lincoln Repository (University of Lincoln) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Macmillan Cancer Support
- University of Lincoln
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- health-promoting behaviours, cancer survivors, urban-rural differences, health responsibility, spiritual development, nutrition, interpersonal relationships, stress management, physical activity, socioeconomic deprivation
- MeSH terms
- Cross-Sectional Studies, Health Promotion, Humans, Life Style, Neoplasms, Rural Population, Health Behavior
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