Examining Colorectal Cancer Risk Awareness and Food Shelf Use Among Health Center Patients
To employ the Colorectal Cancer Risk Awareness for Public Health Prevention (CRC-PHP) survey to examine how food shelf use and other covariates predict awareness of colorectal cancer (CRC) risk factors among patients of a Federally Qualified Health Center in Minneapolis, Minnesota. Secondary aims included describing the demographic and chronic-disease characteristics of the patient population and assessing their general knowledge of additional CRC risk factors and intent to make healthy food selections in the near future.
Measures included CRC risk awareness, food shelf use, chronic-disease status, and intent to select healthy food options. Regression models and chi-square tests of independence were employed to examine differences among food shelf users and non-users.
Among the 103 patients surveyed, 29% reported using a food shelf in the last 12 months. Forty-seven percent of food shelf users and 38% of non-users reported having at least 1 diet-related condition (e.g., type 2 diabetes mellitus). Food shelf users scored 1.2 points higher than non-users, on average, on the CRC risk-factor awareness scale. They also answered more survey questions correctly regarding fruit and vegetable intake and its effect on CRC risk (p = 0.035). Most participants reported being likely to purchase health-promoting foods in the future. In addition, participants reported being likely to select foods that were labeled as protective against CRC.
Behavioral interventions exist that are focused on preventing and managing type II diabetes among food shelf users. Building off such interventions and incorporating behavioral economics components (such as nudges and product labels) has the potential to reduce food shelf customers’ heightened risk and management of CRC.
KeywordsColorectal cancer Colon cancer Food insecurity Minority health Community health centers Diabetes mellitus
body mass index
- Bowel CAM
Bowel Cancer Awareness Measure
Colorectal Cancer Risk Awareness for Public Health Prevention
Federally Qualified Health Center
type 2 diabetes mellitus
The research team extends gratitude to the participants and the participating Federally Qualified Health Center who made the study possible, to the research assistants (Zahra Mahamed, Jill Sampson, and Musse Hussein) who provided their invaluable time to assist with survey material translation and data collection, Dr. Sarah Gollust for her feedback as a member of the lead author’s thesis committee, and to Eleanor Mayfield who provided editorial assistance, and to ClayVon Lowe with D-Brand Designs who developed the recruitment materials.
JO was responsible for survey development, data collection, data analysis, and manuscript development. In addition to project conception, CRR and CEC assisted in drafting the manuscript and critically revising it for important intellectual content in the following areas: study design, methods, and discussion. All authors read and approved the final manuscript.
Multiple departments at the University of Minnesota supported this research study, including the Division of Health Policy and Management in the School of Public Health, Program in Health Disparities Research (PHDR) in the Department of Family Medicine, and the Community of Scholars Program in the Office for Diversity in Graduate Education. This research was also funded in part by the National Cancer Institute of the National Institutes of Health (K01CA234319). The funding entities, with the exception of PHDR, had no role or influence in the development of the study or the writing of the manuscript. The second author (CRR) was the issuer of PHDR funds.
Compliance with Ethical Standards
This study was reviewed and approved by the University of Minnesota’s Institutional Review Board (IRB #1611E00901).
Verbal informed consent was obtained from all study participants.
Consent for Publication
The authors declare that they have no competing interests.
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