Association of Cancer Prevention-Related Nutrition Knowledge, Beliefs, and Attitudes to Cancer Prevention Dietary Behavior

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Abstract

Objective To examine the relationship of cancer prevention-related nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior.

Subjects/setting Noninstitutionalized US adults aged 18 years and older.

Methods Data collected in the 1992 National Health Interview Survey Cancer Epidemiology Supplement were analyzed. The supplement included questions to ascertain knowledge, beliefs, and attitudes and a food frequency questionnaire to ascertain nutrient intake.

Statistics Multivariate linear regression modeling was conducted to assess the hypothesized relationships.

Results After adjustment for relevant covariates (age, sex, education, total energy, perceived barriers to eating a more healthful diet), knowledge and belief constructs were predictive of dietary behavior. Specifically, fat, fiber, and fruit and vegetable intakes more closely approximated dietary recommendations for persons with more cancer-prevention knowledge. The strength of the associations between these constructs and dietary behavior varied in some cases according to level of education and perceived barriers to eating a healthful diet. Of the perceived barriers to eating a healthful diet, perceived ease of eating a healthful diet was most strongly and consistently predictive of intake.

Conclusions Research findings challenge dietetics practitioners to design diet- and health-promotion programs and activities that not only educate the public about the importance of diet to health, but also address barriers to dietary change.

Section snippets

Methods

Data used in this study were collected for the 1992 National Health Interview Survey Cancer Epidemiology Supplement (17). The supplement was completed by 12,005 adults, with an overall response rate of 86.1%. The sample for the survey was, for the most part, a nationally representative sample of civilian, noninstitutionalized households. Blacks and Hispanics, however, were oversampled. In-home interviews were conducted by experienced Census Bureau interviewers. Interviewing, field work, and

Results

Those with an ethnic identification other than black, Hispanic, or white were excluded from all analyses (n=362). Those with missing, incomplete, or suspect dietary data (n=904) or missing data for one or more of the predictor variables (n=453) were also excluded from all analyses, resulting in a final sample of 10,286. Those excluded because of missing, incomplete, or suspect data were more likely to be older, living in poverty, female, and black or Hispanic than those included in the final

Discussion

Findings indicate that for the most part cancer prevention-related nutrition knowledge and beliefs correspond to cancer prevention-related dietary behavior in the general population, although the strength of these associations varies, in some cases, according to education level.

Other investigators, in comparable studies, have found that many factors influence dietary behavior, including confusion over dietary recommendations (5), (20), (33), perception of cost (20), (34), taste (20), (33), and

Implications

Findings of this research challenge dietetics practitioners to design diet and health-promotion programs and activities for the general public that not only educate people about the importance of diet to health, but address barriers to dietary change. For example, because those who believe it is difficult to eat a more healthful diet are less likely to do so, nutrition messages should focus on providing simple and practical advice about dietary change.

More research is needed to determine why

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