Negotiation Between Comfort and Risk Zones: A Focused Ethnography of Healthy Lifestyle Practices in Colorectal Cancer High-Risk Populations

Supporting high-risk populations in adopting healthy lifestyles to reduce colorectal cancer risk is a public health priority. While the importance of maintaining healthy behaviors is widely recognized, little is known about what makes these behaviors meaningful for high-risk individuals within their own lifeworlds or how such behaviors are experienced and enacted. This study employed a focused ethnographic approach to explore in depth the motivations and meanings behind the health behaviors of 24 individuals at high risk for colorectal cancer in their daily living environments. The findings reveal that although individuals' approaches to healthy lifestyles differ based on their perceived risk, they consistently engage in multiple forms of meaning negotiation. Three main themes emerged: (1) The Bodily Negotiation of a Simple yet Habituated Lifestyle: Health choices are often dominated by direct bodily sensations and deeply ingrained life habitus. Professional health advice is frequently reinterpreted or integrated through local concepts such as "huó dòng" (activity). (2) Maintaining and Silencing: The Psychological Order of Lifestyle: Individuals employ psychological adaptation strategies like "xiǎng kāi diǎn" (thinking openly) to downplay risk and often maintain emotional silence within family and social relationships to preserve surface harmony and self-identity. (3) The Dualistic Disease Imagery: Dismissal and Fear: Contradictory perceptions of disease risk coexist-both dismissal and fear-and their dynamic interplay directly determines the decision threshold for screening and healthcare-seeking. The study concludes that practicing a healthy lifestyle is an ongoing negotiation of meaning between a "comfort zone" constituted by bodily habitus, somatic experience, and social connections, and a "risk zone" constructed by abstract medical discourse. These insights provide a foundation for developing and implementing culturally congruent health promotion interventions to support sustainable engagement in meaningful health practices among high-risk populations for colorectal cancer in community settings.