||5R29CA071024-05 Interpret this number
||Virginia Commonwealth University
||Reaching Rural Residents with Nurtition Strategies
DESCRIPTION: Addressing cancer among rural, African American, and
low-income Americans is a high priority for cancer prevention in the U.S.
Cancer mortality rates among these groups are often disproportionately high
compared to urban, Caucasian, and high-income populations. Some of the high
cancer mortality rates in these groups can be slowed by changing the foods
Americans eat. Specifically, government agencies, including the National
Cancer Institute, recommend that Americans consume at least 20 grams of
fiber per day and no more than 30 percent of their daily calories from fat.
We are far from reaching these goals, and rural, low-income individuals are
especially disadvantaged when it comes to dietary programs and knowledge.
These groups are often less ready to change their diets, and in need of both
reading level appropriate material and extra motivation to make changes.
Yet, our educational materials and techniques for changing diet in the
underserved are clearly inadequate.
The investigators propose testing a theoretically guided intervention
package designed to decrease fat and increase fiber consumption in rural,
low-income, low-literacy level individuals in southern Virginia. This
intervention will adapt an effective dietary change booklet entitled "Help
yourself: A Guide to Healthful Eating" to this population. Personalized
dietary feedback and recommendations, and personal physician letters will be
provided for additional motivation for dietary modification.
One thousand and fifty individuals recruited through rural primary care
practices in southern Virginia will participate in this five year study.
Subjects will be randomly assigned to intervention and control conditions.
The revised self-help booklets and motivational materials will be delivered
in the mail to the home of patients. All intervention information will be
provided with the personal rural primary care physician's endorsement.
Study participants will be followed up by telephone at one, six, and twelve
month intervals. Primary outcomes of dietary fat and fiber behavior will be
measured using the Fat and Fiber Behavior Questionnaire (FFB). A sub-study
in the intervention participants will test three different strategies for
presenting personalized dietary feedback based on prior research. This
project will provide new information on motivating this underserved
population toward dietary change. The combined strategies will form a
self-help intervention package that is maximally effective while retaining
the long term, desirable qualities of low intensity and cost.
Differences in response to a dietary intervention between the general population and first-degree relatives of colorectal cancer patients.
, Carcaise-Edinboro P.
, Esinhart H.
, Wilson D.B.
, Bean M.K.
Journal of nutrition education and behavior, 2014 Sep-Oct; 46(5), p. 376-83.
Randomized trial of a low-intensity dietary intervention in rural residents: the Rural Physician Cancer Prevention Project.
, Edinboro P.
, McClish D.
, Manion L.
, Bowen D.
, Beresford S.A.
, Ripley J.
American journal of preventive medicine, 2005 Feb; 28(2), p. 162-8.