Background (Background, Rationale, Prior Research, and/or Theory): Programs to help individuals with cancer and their caregivers address nutrition-related behaviors must reflect the needs, interests, and preferences of these unique populations.
Objective: To characterize nutrition-related beliefs, experiences, and behaviors among individuals with cancer and their caregivers, a critical step in development of effective nutrition interventions; and to identify preferences, barriers, and facilitators of engagement in lifestyle modification strategies.
Study Design, Setting, Participants, Intervention: A convergent mixed methods study design was used. Individuals with cancer and their caregivers were recruited from American Cancer Society's Philadelphia Hope Lodge to complete surveys and in-depth interviews. NCI's Food Attitudes and Behaviors Survey was used to assess food-related attitudes, preferences, beliefs and behaviors.
Outcome Measures and Analysis: Descriptive statistics were calculated. Interviews were recorded, transcribed verbatim, and analyzed using inductive thematic analysis.
Results: Thirty-nine individuals with cancer (n = 19, 67% male, 73% > 55 yrs) and their caregivers (n = 20, 31% male, 63% > 55 yrs) completed study activities. Three themes emerged: challenges managing treatment side effects, uncertainty regarding “healthy” foods, and desire for nutrition support for healthy survivorship. Caregivers reported lower nutrition-related self-efficacy compared to patients. Fewer than 20% of caregivers and 33% of patients felt they understood government nutrition recommendations. Sixty-seven percent of patients and 75% of caregivers reported they believed what they eat affects their health, yet there was disagreement among participants regarding what comprises “poor” vs. “good” nutrition. Barriers to eating fruits and vegetables among patients included lack of satiation, availability, and preparation time; and among caregivers included spoilage and availability. Participants reported interest levels in nutrition and cooking classes and therapeutic gardening.
Conclusions and Implications: Nutrition intervention programs should be tailored for cancer survivors and caregivers who are experiencing risks associated with management of treatment side effects, need to improve their understanding of healthy foods to eating during recovery, and for those who are more comfortable with a program that can address specific concerns related to the cancer experience.
Funding: Pennsylvania Department of Health.
