Implementing dietary change among Hispanic Breast Cancer Survivors

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DESCRIPTION (provided by applicant): Hispanic women are 20% more likely to die of breast cancer than non-Hispanic white women who are diagnosed at a similar age and stage. One reason for this disparity may be differences in post- diagnosis dietary behaviors. In order to reduce this disparity, and to improve overall survivorship, culturally appropriate dietary interventions that teach women how to eat a diet high in fruits and vegetables and low in saturated fat need to be developed for Hispanic breast cancer survivors. We propose to conduct a randomized controlled study (n=70, 35 per arm) to test the effects of the !Cocinar para su salud! Program on changing dietary behaviors among Hispanic breast cancer survivors who have recently completed treatment. The !Cocinar para su salud! program is a 12-week course that provides hands-on education and instruction in nutrition education, meal preparation, and food shopping in a group setting. All participants will be followed for a total of 12 months, have clinical assessments at baseline, 6 months, and 12 months, and monthly telephone contacts using motivational interview techniques. The Primary Aims are to determine the effect of the dietary intervention (!Cocinar para su salud! program) vs. control (standard written nutrition education materials for cancer survivors) on 1) daily servings of fruit/vegetable, and 2) daily servings of fat intake from baseline to 6 months. We hypothesize that the dietary intervention will result in a larger increase of fruit and vegetable intake and a larger reduction of fat intake, when compared to the control group. Secondary Aims are to determine the effect of the dietary intervention vs. control on 1) biomarkers of fruit and vegetable intake, molecular biomarkers associated with breast cancer risk, and anthropometric measures at 6 and 12 months; 2) fruit/vegetable and fat intake at 12 months; 3) mediators of dietary change, including readiness to change, outcome expectations, perceived self- efficacy, food and nutrition skills, self-regulation skills, and barriers to adherence; and 4) changes in quality of life and anxiety/depression at 6 and 12 months. If this intervention is successful, we will use study results to 1) implement community-based nutrition education programs for Hispanic breast cancer survivors, and 2) inform the design of an NCI R01 application for a large-scale, multiethnic, multi-center, randomized, controlled trial of a comprehensive dietary intervention that will include breast cancer recurrence and survival as outcomes. PUBLIC HEALTH RELEVANCE: Hispanic women are 20% more likely to die of breast cancer than non-Hispanic white women who are diagnosed at a similar age and stage. One reason for this disparity may be differences in post- diagnosis dietary behaviors. We propose to conduct a randomized controlled study (n=70, 35 per arm) to test the effects of the hands-on nutritional education !Cocinar para su salud! Program on changing dietary behaviors among Hispanic breast cancer survivors who have recently completed treatment.