Although social determinants of health (SDOH) components affect patients with cancer, nurses tended not to consider them when speaking with patients or making recommendations about physical activity. These findings were published in the Clinical Journal of Oncology Nursing.

Among staff in the healthcare setting, nurses make unique bonds with patients, often having sensitive and personal conversation about their health status. Recent studies have focused on SDOH, hypothesizing that focusing on these features may improve the patient experience.

SDOH have 5 domains: neighborhood and the built environment; health and healthcare; social and community context; education; and economic status.

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This study was a secondary analysis of data collected by the University of North Carolina that assessed the multilevel factors that influenced discussions with patients and recommendations oncology nurses gave about physical activity.

Of the 75 participating nurses, 74 were women (74), 58 were White, 48 had a bachelor’s degree, 33 were oncology certified, 36 worked in the inpatient setting, and 32 worked in the outpatient setting.

The most frequent considerations made (73) were not based on SDOH, but more traditional factors. Examples included motivation, physical limitations, previous physical activity, knowledge, and age.

Of the SDOH-related factors, social and community context were most frequently taken into consideration. Specific examples included culture, support system, modesty concerns, and beliefs.

The SDOH-related factors that were least likely to be incorporated into dialog and decisions were education; the nurses only provided 2 occasions when they considered these details.

This study was limited as most participants were White women who lived in North Carolina and the findings may not be generalizable.

The study investigators concluded that incorporating SDOH into discussions and decisions about patient care would likely better address patient needs and improve quality of life.


Hirschey R, Tan KR, Petermann VM, Bryant AL. Healthy lifestyle behaviors: nursing considerations for social determinants of health. Clin J Oncol Nurs. 2021;25(5):42-48. doi:10.1188/21.CJON.S1.42-48