Enhancing the utilization of healthy living interventions among cancer survivors in historically underserved populations and communities

Authors: RABER, MARGARET - Children'S Nutrition Research Center (CNRC); RECHIS, RUTH - Md Anderson Cancer Center; LARUE, DENISE - Harris Health System; HO-PHAM, THY - Harris Health System; OESTMAN, KATHERINE - Md Anderson Cancer Center; WALSH JR, MICAHEL - Md Anderson Cancer Center; KIZUB, DARYA - Md Anderson Cancer Center; MA, HILARY - Md Anderson Cancer Center; GALVAN, ESPERANZA - Harris Health System; ZHAO, HUI - Md Anderson Cancer Center; GONZALEZ, JENNIFER - Harris Health System; LEI, XIUDONG - Md Anderson Cancer Center; HU, JINGFAN - Md Anderson Cancer Center; BASEN-ENGQUIST, KAREN - Md Anderson Cancer Center

Submitted to: Cancer Causes and Control
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/10/2023
Publication Date: 5/10/2023
Citation: Raber, M., Rechis, R., Larue, D.M., Ho-Pham, T.T., Oestman, K., Walsh Jr, M.T., Kizub, D., Ma, H., Galvan, E., Zhao, H., Gonzalez, J., Lei, X., Hu, J., Basen-Engquist, K. 2023. Enhancing the utilization of healthy living interventions among cancer survivors in historically underserved populations and communities. Cancer Causes and Control. https://doi.org/10.1007/s10552-023-01701-2.
DOI: https://doi.org/10.1007/s10552-023-01701-2

Interpretive Summary: Both physical activity and diet quality have been associated with reduced cancer mortality. However, many survivors do not meet established physical activity or nutrition recommendations and is even more pronounced in historically underserved populations and communities. The goal of this study was to identify opportunities to increase cancer survivorship through healthy eating and active living interventions aligned to cancer center community outreach and engagement efforts. This study was conducted in Acres Homes, a historically Black neighborhood in Houston, Texas, with areas of persistent poverty. We found that Acres Homes survivors have high rates of co-occurrent obesity (45.0%), diabetes (30.8%), and other related risk factors as well as treatment-related symptoms. Four major concepts emerged from interviews: 1) Factors that influence survivors' ability to eat well and exercise; 2) Current usage of community resources; 3) Interest in relevant programming; and 4) Specific programming preferences. Strategically tailoring community resources for cancer survivors can provide a more robust network of support to promote healthy eating and active living in this population and may enhance future community-led cancer prevention efforts in historically underserved communities.

Technical Abstract: This study aimed to describe the clinical characteristics and wellness programming preferences of cancer survivors from Acres Homes, a historically Black neighborhood in Houston, Texas, with areas of persistent poverty. The goal of this study was to identify opportunities to increase cancer survivor utilization of healthy eating and active living interventions aligned to cancer center community outreach and engagement efforts. This multiple methods study included a retrospective review of electronic health record data (n=413) and qualitative interviews with cancer survivors (n=31) immediately preceding initiation of healthy eating, active living programming in Acres Homes. This study found Acres Homes survivors have high rates of co-occurrent cardiometabolic disease including obesity (45.0%), diabetes (30.8%), and other related risk factors as well as treatment-related symptoms. Four major concepts emerged from interviews: (1) Factors that influence survivors' ability to eat well and exercise, (2) Current usage of community resources, (3) Interest in relevant programming, and (4) Specific programming preferences. Opportunities for current and future health promotion programming for cancer survivors were explored. Strategically tailoring community resources for cancer survivors can provide a more robust network of support to promote healthy eating and active living in this population. This work informed community implementation of evidence-based health interventions in Acres Homes and may support future projects aiming to enhance community-led cancer prevention efforts in historically underserved communities.