A prospective analysis of change in multiple risk factors for cancer

Problem: Cancer risk is increased among individuals who have more than one behavioral risk factor. The purpose of this paper is to expand our understanding of how risk factors co-occur by evaluating longitudinal changes in and predictors of naturalistic change in behavioral risk factors. Methods: The data presented in this paper were drawn from 1288 employees in the 12 standard care worksites that participated in the Working Healthy Project (WHP), a large randomized trial of worksite health promotion. Results: At baseline, the majority of the sample had two or more risk factors. At the final survey, there were very small changes in the overall risk factor profile among the entire sample. However, significant change occurred within baseline risk factor groups. Significant relationships between risk factors were also found. Conclusions: Multiple risk factors are prevalent, and little is known about how to best impact on risk profiles. Use of a multiple risk factor index score, that will allow investigators to begin to assess the impact of interventions on change in overall risk, may be an important part of efforts to develop more effective methods for reducing multiple risk factors for chronic disease.