Nutrition Literacy among Cancer Survivors: Feasibility Results from the Healthy Eating and Living Against Breast Cancer (HEAL-BCa) Study: a Pilot Randomized Controlled Trial
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Knowledge of nutrition among breast cancer patients is insufficient, despite their motivation to seek valid information about healthy food choices. This study examines the feasibility of nutrition education workshops for cancer survivors, to inform the design of a multi-center intervention. Fifty-nine female English-speaking breast cancer patients, who had completed treatment, were enrolled. Participants were randomized to the intervention or control group. The intervention group attended six nutrition education sessions, and the control group received brochures. Measurements were done at baseline and 3-month follow-up and included the Assessment Instrument for Breast Cancer (NLit-BCa), fruit/vegetable and general health literacy screeners. Height and weight were measured. Changes in nutrition literacy, health literacy, and food intake from baseline to follow-up (within-group change) were calculated for both groups (effect sizes were reported as Cohen’s d). Participants were mostly white, with a mean age of 58 years, BMI of 31.6 kg/m2, and had college degrees. Follow-up rates were high (89% = control and 77% = intervention group). At baseline, participants scored high for most NLit-BCa assessment components except food portions in both groups. At the 3-month follow-up, effect sizes (d) on the NLit-BCa ranged from −0.5 to 0.16. The study met its recruitment goals within 6 months. Focus groups indicated that (a) attending six sessions was acceptable, (b) patients found social/emotional support, (c) improvements should include information for special diets and booster sessions. This pilot study suggests that the intervention was acceptable and that scaling up of this intervention is feasible and could provide benefit to breast cancer survivors.
KeywordsNutrition literacy Breast cancer survivors Nutrition education NLit-BCa
The authors acknowledge New York University’s Perlmutter Cancer Center (PCC) for internal funding for the HEAL-BCa Trial to Drs. Parekh and Krebs, in an effort to make nutrition services and research a priority for their patients. We particularly thank Abraham Chachoua, MD, Associate Director, Cancer Services, Deborah Axelrod, MD, Dr. Adams, MD for patient referrals, and the Breast Cancer Research group for their support. Furthermore, we acknowledge Ms. Amanda Bontempo, MS, RD, CDN at the PCC with patient referral and recruitment, as well as for her participation in the education information sessions; Mrs. Sandy Murzin, Chef at the Institute for Culinary Education and Adjunct Professor at the Department of Nutrition and Food Studies, New York University, for the cooking demonstrations and for coordinating, planning and organizing the Iron Chef competitions; Ms. Hillary Getty, MS, RD, a Community Nutritionist at West Harlem, for developing and delivering the nutrition education sessions.
Finally, we thank the participants, nurses, and staff at PCC for their recruitment efforts.
NP conceptualized the study, supervised all aspects including study design, execution, data collection, data analyses, interpretation, and led the write up of the manuscript. PK, Co-PI worked closely alongside NP on aspects of the study and took the lead on conducting the focus groups and interpreting the qualitative data obtained from it, in addition to the quantitative data. JJ analyzed the data and contributed significantly to the write-up of the manuscript. MB was responsible for the data collection and data entry; MM, assisted with content development and educational sessions, HG developed and validated the NLit-BCa questionnaire and contributed to sections of the manuscript writing. All authors reviewed the contents of the manuscript and contributed to the text.
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