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Mediators of fruit and vegetable consumption among colorectal cancer survivors

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Abstract

Introduction

Due to early detection and treatment, survival from colorectal cancer (CRC) diagnosis has been steadily increasing. A CRC diagnosis could be considered a “teachable moment,” a time when interventionists might successfully promote dietary changes. CRC interventions with tailored print communication (TPC) and telephone motivational interviewing (TMI) have been shown to be effective in promoting fruit and vegetable consumption (FVC) among CRC survivors. However, little is known about how these interventions work to exert their effect. This study investigated whether information processes mediate the relationship between a CRC intervention and FVC among CRC survivors.

Methods

This research used data from NC STRIDES, a study that tested the efficacy of two CRC intervention strategies to promote FVC among CRC survivors. Participants were randomized to control, TPC, TMI, or combined (TPC+TMI). Structural equation models were constructed to analyze data from 266 CRC survivors using two different measures of FVC, a 35-item and a 2-item measure.

Results

Two information processes, relevance of communication and trust in the communication, mediated the effect of TPC+TMI on FVC for both 35-item and 2-item measures. TPC+TMI was significantly associated with relevance of communication, and perceiving greater relevance was significantly related to trust in the communication. Trust was significantly related to FVC.

Discussion

Information processes, including relevance and trust in the communication, serve as mediators of the relationship between the CRC intervention and FVC.

Implications for cancer survivors

Future intervention research should investigate ways to enhance relevance of communication and trust in interventions with CRC survivors.

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Acknowledgments

The NC STRIDES study was supported by grants from the National Cancer Institute (RO1-CA81914). This project was supported in part by the UNC Lineberger Cancer Control Education Program (R25 CA057726), Lawrence G. Branch doctoral student research award from the American Public Health Association, and the Vivian Drenckhan Graduate Student Scholarship from the Society for Public Health Education. The authors would like to acknowledge Dr. Joan F. Walsh and Ms. Carol Carr for their helpful comments on an earlier draft of this article.

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Authors and Affiliations

  1. Lineberger Comprehensive Cancer Center, University of North Carolina, 1700 Martin Luther King Jr. BLVD, CB#7294, Chapel Hill, NC, 27599, USA

    Linda K. Ko, Marci K. Campbell, JoAnne Earp & Brenda DeVellis

  2. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Marci K. Campbell

  3. RTI International, Research Triangle Park, Chapel Hill, NC, USA

    Megan A. Lewis

  4. Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    JoAnne Earp & Brenda DeVellis

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  1. Linda K. Ko
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  2. Marci K. Campbell
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  3. Megan A. Lewis
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  5. Brenda DeVellis
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Correspondence to Linda K. Ko.

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Ko, L.K., Campbell, M.K., Lewis, M.A. et al. Mediators of fruit and vegetable consumption among colorectal cancer survivors. J Cancer Surviv 4, 149–158 (2010). https://doi.org/10.1007/s11764-010-0116-z

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  • DOI: https://doi.org/10.1007/s11764-010-0116-z

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