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Mediators of Dietary Change among Hispanic Breast Cancer Survivors in a Culturally-based Dietary Intervention
S64 Poster Abstracts
Journal of Nutrition Education and Behavior Volume 45, Number 4S, 2013
P158 (continued) respectively; increase in preference for spinach significant at.05 level). Conclusions and Implications: HOPE2 shows positive effects of nutrition components of obesity interventions in elementary schools resulting from policies and curricula that support such efforts – namely, increases in consumption by children and menuing of items as part of government feeding programs. Funding: Center for Disease Control and Prevention, W.K. Kellogg Foundation.
P159 Mediators of Dietary Change among Hispanic Breast Cancer Survivors in a Culturally-based Dietary Intervention John Richardson, MS, [email protected], Columbia University, Department of Epidemiology, Mailman School of Public Health, 722 W. 168th Street, New York, NY 10032; H. Lee, PhD, RD; P. Koch, EdD, RD; I. R. Contento, PhD, CDN; A. Ogden Gaffney, Cook for Your Life; C. Aycinena, MS, RD, Columbia University; H. Greenlee, ND, PhD Objective: To identify mediators of dietary change among Hispanic breast cancer survivors participating in a culturally-based intervention designed to increase fruit/vegetable intake and decrease fat intake. Theory, Prior Research, Rationale: Cocinar Para Su Salud! (CPSS!) is a theory-based program designed using social cognitive theory and the transtheoretical model of behavior change to promote dietary change. Study Design, Setting, Participants, and Intervention: Randomized controlled trial of Hispanic breast cancer survivors (n¼70) in New York City participating in either CPSS! or receiving written dietary guidelines for cancer survivors. CPSS! is a 9-week culturally-based nutrition education program designed to increase daily servings of fruit/vegetables and reduce fat consumption by increasing self-efficacy and outcome expectations, decreasing perceived barriers, and teaching food preparation skills. Outcome, Measures and Analysis: At baseline and 6-months, dietary intake was assessed using 3 24-hour recalls and potential mediators were measured using a self-reported questionnaire. McKinnon’s 4-step analytical process was used to identify psychosocial variables that mediated change in dietary behaviors. Results: At 6-months, the intervention group (n¼34) increased daily servings of fruit and vegetables (P<0.001) but did not decrease fat intake (P¼0.314), when compared to controls (n¼36). Self-efficacy and preferences for fruits and vegetables were significant mediators of the intervention effect on fruit/vegetable intake (p¼0.004 and p¼0.040, respectively). Outcome expectations were not found to mediate the effect. Conclusions and Implications: Among Hispanic breast cancer survivors participating in a culturally-based
dietary intervention, increasing self-efficacy and decreasing perceived barriers (e.g., taste of fruits/vegetables) mediated an increase in fruit/vegetable consumption. Future programs can target these specific mediators to promote further dietary change. Funding: NIH.
P160 Beliefs about Diet and Colorectal Cancer (CRC) Prevention in a Diverse Urban Population Margot Zaharek, MS, MA, RD, [email protected], Teachers College, Columbia University, 313 Munger Lane, Bethlehem, CT 6751; R. L. Wolf, PhD, MPH; P. Zybert, PhD; C. E. Basch, PhD Objective: To explore beliefs related to diet and CRC prevention in an asymptomatic population of urban, ethnically diverse men and women over age 50. Theory, Prior Research, Rationale: Blacks have the highest CRC incidence and mortality rates than any other racial and ethnic group. Epidemiological data suggests diet can play an important role in prevention. An understanding of dietary beliefs about CRC prevention is necessary to plan effective interventions. Study Design, Setting, Participants, and Intervention: The study design was cross-sectional with data drawn from baseline surveys of a randomized control trial. Participants (n¼169) resided in greater New York City and were members of the 1199 service workers union. Seventy-nine percent were female, 68% were Black, 9.5% were Hispanic, 78.7% were born outside the United States and 71.2% had a household annual income below $50,000. Outcome, Measures and Analysis: Dietary beliefs about CRC prevention were measured with qualitative open-ended questions. Data was analyzed by content analysis of qualitative responses, descriptive statistics of demographic data, and Chi-square analysis to determine statistical differences. Results: One hundred and eleven (65.7%) reported they believed diet can prevent CRC. Common beliefs were: Increase fiber (71.2%), vegetables (46.8%) and fruits (25.2%); and decrease meat (21.6%) and fat (16.2%). Characteristics associated with dietary beliefs included increased education (p<.001), increased income (p<.019), lower BMI (p<.015), previous CRC screening test (p<.024) and having a physician discuss CRC (p<.049). Gender, race/ethnicity and birthplace were not associated with beliefs. Conclusions and Implications: There are a variety of demographic characteristics associated with the perception that diet is a factor in CRC prevention. These characteristics should be considered when targeting nutrition education interventions. Funding: American Cancer Society.
Journal of Nutrition Education and Behavior Volume 45, Number 4S, 2013
P158 (continued) respectively; increase in preference for spinach significant at.05 level). Conclusions and Implications: HOPE2 shows positive effects of nutrition components of obesity interventions in elementary schools resulting from policies and curricula that support such efforts – namely, increases in consumption by children and menuing of items as part of government feeding programs. Funding: Center for Disease Control and Prevention, W.K. Kellogg Foundation.
P159 Mediators of Dietary Change among Hispanic Breast Cancer Survivors in a Culturally-based Dietary Intervention John Richardson, MS, [email protected], Columbia University, Department of Epidemiology, Mailman School of Public Health, 722 W. 168th Street, New York, NY 10032; H. Lee, PhD, RD; P. Koch, EdD, RD; I. R. Contento, PhD, CDN; A. Ogden Gaffney, Cook for Your Life; C. Aycinena, MS, RD, Columbia University; H. Greenlee, ND, PhD Objective: To identify mediators of dietary change among Hispanic breast cancer survivors participating in a culturally-based intervention designed to increase fruit/vegetable intake and decrease fat intake. Theory, Prior Research, Rationale: Cocinar Para Su Salud! (CPSS!) is a theory-based program designed using social cognitive theory and the transtheoretical model of behavior change to promote dietary change. Study Design, Setting, Participants, and Intervention: Randomized controlled trial of Hispanic breast cancer survivors (n¼70) in New York City participating in either CPSS! or receiving written dietary guidelines for cancer survivors. CPSS! is a 9-week culturally-based nutrition education program designed to increase daily servings of fruit/vegetables and reduce fat consumption by increasing self-efficacy and outcome expectations, decreasing perceived barriers, and teaching food preparation skills. Outcome, Measures and Analysis: At baseline and 6-months, dietary intake was assessed using 3 24-hour recalls and potential mediators were measured using a self-reported questionnaire. McKinnon’s 4-step analytical process was used to identify psychosocial variables that mediated change in dietary behaviors. Results: At 6-months, the intervention group (n¼34) increased daily servings of fruit and vegetables (P<0.001) but did not decrease fat intake (P¼0.314), when compared to controls (n¼36). Self-efficacy and preferences for fruits and vegetables were significant mediators of the intervention effect on fruit/vegetable intake (p¼0.004 and p¼0.040, respectively). Outcome expectations were not found to mediate the effect. Conclusions and Implications: Among Hispanic breast cancer survivors participating in a culturally-based
dietary intervention, increasing self-efficacy and decreasing perceived barriers (e.g., taste of fruits/vegetables) mediated an increase in fruit/vegetable consumption. Future programs can target these specific mediators to promote further dietary change. Funding: NIH.
P160 Beliefs about Diet and Colorectal Cancer (CRC) Prevention in a Diverse Urban Population Margot Zaharek, MS, MA, RD, [email protected], Teachers College, Columbia University, 313 Munger Lane, Bethlehem, CT 6751; R. L. Wolf, PhD, MPH; P. Zybert, PhD; C. E. Basch, PhD Objective: To explore beliefs related to diet and CRC prevention in an asymptomatic population of urban, ethnically diverse men and women over age 50. Theory, Prior Research, Rationale: Blacks have the highest CRC incidence and mortality rates than any other racial and ethnic group. Epidemiological data suggests diet can play an important role in prevention. An understanding of dietary beliefs about CRC prevention is necessary to plan effective interventions. Study Design, Setting, Participants, and Intervention: The study design was cross-sectional with data drawn from baseline surveys of a randomized control trial. Participants (n¼169) resided in greater New York City and were members of the 1199 service workers union. Seventy-nine percent were female, 68% were Black, 9.5% were Hispanic, 78.7% were born outside the United States and 71.2% had a household annual income below $50,000. Outcome, Measures and Analysis: Dietary beliefs about CRC prevention were measured with qualitative open-ended questions. Data was analyzed by content analysis of qualitative responses, descriptive statistics of demographic data, and Chi-square analysis to determine statistical differences. Results: One hundred and eleven (65.7%) reported they believed diet can prevent CRC. Common beliefs were: Increase fiber (71.2%), vegetables (46.8%) and fruits (25.2%); and decrease meat (21.6%) and fat (16.2%). Characteristics associated with dietary beliefs included increased education (p<.001), increased income (p<.019), lower BMI (p<.015), previous CRC screening test (p<.024) and having a physician discuss CRC (p<.049). Gender, race/ethnicity and birthplace were not associated with beliefs. Conclusions and Implications: There are a variety of demographic characteristics associated with the perception that diet is a factor in CRC prevention. These characteristics should be considered when targeting nutrition education interventions. Funding: American Cancer Society.