Skip to main content

Social networks and social support for healthy eating among Latina breast cancer survivors: implications for social and behavioral interventions



Little is known about Latina breast cancer survivors’ social networks or their perceived social support to achieve and maintain a healthy diet. This paper describes the social networks and perceived support for healthy eating in a sample of breast cancer survivors of predominantly Dominican descent living in New York City.


Spanish-speaking Latina breast cancer survivors enrolled in a randomized controlled trial of a culturally tailored dietary intervention. Social networks were assessed using Cohen’s Social Network Index and a modified General Social Survey Social Networks Module that included assessments of shared health promoting behaviors. Perceived social support from family and friends for healthy, food-related behaviors was assessed.


Participants’ networks consisted predominantly of family and friends. Family members were more likely than other individuals to be identified as close network members. Participants were more likely to share food-related activities than exercise activities with close network members. Perceived social support for healthy eating was high, although perceived support from spouses and children was higher than support from friends. Despite high levels of perceived support, family was also identified as a barrier to eating healthy foods by nearly half of women.


Although friends are part of Latina breast cancer survivors’ social networks, spouses and children may provide greater support for healthy eating than friends.

Implications for Cancer Survivors

Involving family members in dietary interventions for Latina breast cancer survivors may tap into positive sources of support for women, which could facilitate uptake and maintenance of healthy eating behaviors.

This is a preview of subscription content, access via your institution.


  1. 1.

    American Cancer Society. Cancer facts & figures for Hispanics/Latinos 2012–2014. Atlanta: American Cancer Society; 2012.

    Google Scholar 

  2. 2.

    American Cancer Society. Cancer treatment and survivorship facts & figures, 2014–2015. Atlanta: American Cancer Society; 2014.

    Google Scholar 

  3. 3.

    Rock CL, Doyle C, Demark‐Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA: Cancer J Clin. 2012;62(4):242–74.

    Google Scholar 

  4. 4.

    World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington DR: AICR2007.

  5. 5.

    Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20(4):1128–43.

    Article  PubMed  Google Scholar 

  6. 6.

    Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23(34):8884–93.

    Article  PubMed  Google Scholar 

  7. 7.

    Division of Nutrition PA, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. Adult obesity facts. 2014. Accessed September 5 2014.

  8. 8.

    U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2010. In: Services USDoAaUSDoHaH, editor. 7th ed. Washington, DC: U.S. Government Printing Office; 2010.

  9. 9.

    Paxton RJ, Jones LA, Chang S, Hernandez M, Hajek RA, Flatt SW, et al. Was race a factor in the outcomes of the women’s health eating and living study? Cancer. 2011;117(16):3805–13.

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med. 2000;51(6):843–57.

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Cohen S, Gottlieb, Benjamin H, Underwood, Lynn G. Social relationships and health. In: Cohen S, Underwood, Lynn G, Gottlieb, Benjamin H, editors. Social support measurement and intervention: a guide for health and social scientists. New York: Oxford University Press; 2000.

    Chapter  Google Scholar 

  12. 12.

    Heaney CA, Israel BA. Social networks and social support. In: Glanz K, Rimer, Barbara K, Lewis, Frances M, editors. Health behavior and health education: theory, research and practice. 3rd ed. San Francisco: Jossey-Bass; 2002. p. 185.

    Google Scholar 

  13. 13.

    Kroenke CH, Kwan ML, Neugut AI, Ergas IJ, Wright JD, Caan BJ, et al. Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Res Treat. 2013;139(2):515–27.

    Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Kroenke CH, Kubzansky LD, Schernhammer ES, Holmes MD, Kawachi I. Social networks, social support, and survival after breast cancer diagnosis. J Clin Oncol. 2006;24(7):1105–11.

    Article  PubMed  Google Scholar 

  15. 15.

    Kroenke CH, Michael Y, Tindle H, Gage E, Chlebowski R, Garcia L, et al. Social networks, social support and burden in relationships, and mortality after breast cancer diagnosis. Breast Cancer Res Treat. 2012;133(1):375–85.

    Article  PubMed  Google Scholar 

  16. 16.

    Pinquart M, Duberstein PR. Associations of social networks with cancer mortality: a meta-analysis. Critical Rev Oncol/Hematol. 2010;75(2):122–37.

    Article  Google Scholar 

  17. 17.

    House JS. Work stress and social support. Massachusetts: Reading, Addison-Wesley; 1981.

    Google Scholar 

  18. 18.

    Robinson E, Thomas J, Aveyard P, Higgs S. What everyone else is eating: a systematic review and meta-analysis of the effect of informational eating norms on eating behavior. J Academy Nut Dietetics. 2014;114(3):414–29.

    Article  Google Scholar 

  19. 19.

    Pachucki MA, Jacques PF, Christakis NA. Social network concordance in food choice among spouses, friends, and siblings. Am J Public Health. 2011;101(11):2170–7.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Coleman S, Berg CJ, Thompson NJ. Social support, nutrition intake, and physical activity in cancer survivors. Am J Health Behav. 2014;38(3):414–9.

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Ashida S, Wilkinson AV, Koehly LM. Social influence and motivation to change health behaviors among Mexican-origin adults: implications for diet and physical activity. Am J Health Promot. 2012;26(3):176–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Sammarco A, Konecny LM, editors. Quality of life, social support, and uncertainty among Latina breast cancer survivors. Oncology nursing forum; 2008: Onc Nurs Society.

  23. 23.

    Lopez-Class M, Perret-Gentil M, Kreling B, Caicedo L, Mandelblatt J, Graves KD. Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care. J Cancer Educ. 2011;26(4):724–33.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Graves KD, Jensen RE, Cañar J, Perret-Gentil M, Leventhal K-G, Gonzalez F, et al. Through the lens of culture: quality of life among Latina breast cancer survivors. Breast Cancer Res Treat. 2012;136(2):603–13.

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Yanez B, Thompson EH, Stanton AL. Quality of life among Latina breast cancer patients: a systematic review of the literature. J Cancer Survivorship. 2011;5(2):191–207.

    Article  Google Scholar 

  26. 26.

    Sammarco A, Konecny LM, editors. Quality of life, social support, and uncertainty among Latina and Caucasian breast cancer survivors: a comparative study. Oncology Nursing Forum; 2010: Onc Nurs Society.

  27. 27.

    Sabogal F, Marín G, Otero-Sabogal R, Marín BV, Perez-Stable EJ. Hispanic familism and acculturation: what changes and what doesn’t? Hisp J Behav Sci. 1987;9(4):397–412.

    Article  Google Scholar 

  28. 28.

    Greenlee H, Gaffney AO, Aycinena AC, Koch P, Contento I, Karmally W et al. ¡Cocinar Para Su Salud!: randomized controlled trial of a culturally based dietary intervention among Hispanic breast cancer survivors. Journal of the Academy of Nutrition and Dietetics. doi:10.1016/j.jand.2014.11.002.

  29. 29.

    Berkman LF, Glass T. Social integration, social networks, social support, and health. In: Berkman LF, Kawachi I, editors. Social epidemiology. New York: Oxford University Press, Inc; 2000. p. 137–73.

    Google Scholar 

  30. 30.

    Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM. Social ties and susceptibility to the common cold. JAMA. 1997;277(24):1940–4.

    CAS  Article  PubMed  Google Scholar 

  31. 31.

    Smith TW, Marsden P, Hout M, Kim J. General social surveys, 1972–2012: cumulative codebook no. 21st ed. Chicago: National Opinion Research Center; 2013.

    Google Scholar 

  32. 32.

    Marin G, Sabogal F, Marin BV, Otero-Sabogal R, Perez-Stable EJ. Development of a short acculturation scale for Hispanics. Hisp J Behav Sci. 1987;9(2):183–205.

    Article  Google Scholar 

  33. 33.

    Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: the newest vital sign. Annals Family Med. 2005;3(6):514–22.

    Article  Google Scholar 

  34. 34.

    NutritionQuest. Assessment & analysis services: questionnaires and screeners, 2011. 2011. Accessed November 1 2011.

  35. 35.

    Aud S, Hussar, W., Johnson, F., Kena, G., Roth, E., Manning, E., Wang, X., Zhang, J. The condition of education 2012. In: U.S. Department of Education NCfES, editor. Washington, D.C.2012. p. 34–7, 109, 15.

  36. 36.

    Bureau USC. Table 697. Money income of families—median income by race and Hispanic origin in current and constant (2009) dollar: 1990 to 2009. 2012.

  37. 37.

    Ashing‐Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psycho-Oncology. 2004;13(6):408–28.

    Article  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Buki LP, Garcés DM, Hinestrosa M, Kogan L, Carrillo IY, French B. Latina breast cancer survivors’ lived experiences: diagnosis, treatment, and beyond. Cult Divers Ethn Minor Psychol. 2008;14(2):163.

    Article  Google Scholar 

  39. 39.

    Marquez B, Elder JP, Arredondo EM, Madanat H, Ji M, Ayala GX. Social network characteristics associated with health promoting behaviors among Latinos. Health Psychol. 2014;33:544–53.

    Article  PubMed  Google Scholar 

  40. 40.

    Erwin DO, Johnson VA, Trevino M, Duke K, Feliciano L, Jandorf L. A comparison of African American and Latina social networks as indicators for culturally tailoring a breast and cervical cancer education intervention. Cancer. 2007;109(S2):368–77.

    Article  PubMed  Google Scholar 

  41. 41.

    Zsembik BA, Fennell D. Ethnic variation in health and the determinants of health among Latinos. Soc Sci Med. 2005;61(1):53–63.

    Article  PubMed  Google Scholar 

Download references


Cocinar Para Su Salud! was supported by the National Cancer Institute/National Institutes of Health R21CA152903 (PI: Greenlee), and in part by Columbia University’s Clinical and Translational Science Award grant no. UL1TR000040 from the National Center for Advancing Translational Sciences/National Institutes of Health. The preparation of this manuscript was also made possible by a Mentored Research Scholar Grant from the American Cancer Society (124793-MRSG-13-152-01-CPPB) (PI: Rachel C. Shelton). We extend our gratitude to the Cook for Your Life staff and participants.

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Author information



Corresponding author

Correspondence to Danielle M. Crookes.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Crookes, D.M., Shelton, R.C., Tehranifar, P. et al. Social networks and social support for healthy eating among Latina breast cancer survivors: implications for social and behavioral interventions. J Cancer Surviv 10, 291–301 (2016).

Download citation


  • Breast cancer
  • Latina
  • Social support
  • Social networks
  • Nutrition
  • Survivorship