Seeking Cancer-Related Information From Media and Family/Friends Increases Fruit and Vegetable Consumption Among Cancer Patients

Abstract

Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise, and fruit and vegetable consumption among the general population. The current study builds upon this research by examining the effect of cancer patients' active information seeking from media and (nonmedical) interpersonal sources on fruit and vegetable consumption. The results of this longitudinal study are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry, comprising breast, prostate, and colorectal cancer patients who completed mail surveys in the fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting n = 2013); of those, 1,293 were interviewed one year later and 845 were available for final analyses. We used multiple imputation to replace missing data and propensity scoring to adjust for effects of possible confounders. There is a positive effect of information seeking at baseline on fruit and vegetable servings at follow-up; seekers consumed 0.43 (95% CI: 0.28 to 0.58) daily servings more than nonseekers adjusting for baseline consumption and other confounders. Active information seeking from media and interpersonal sources may lead to improved nutrition among the cancer patient population.

ACKNOWLEDGMENTS

The authors are grateful to Angela DeMichele, Sally Dunlop, Shawnika Hull, Bridget Kelly, Chul-joo Lee, Susan Mello, Michaela Moldovan-Johnson, Susana Ramirez, Aaron Smith-McLallen, Sarah Parvanta, Andy Tan, and Norman Wong for their insightful comments on earlier drafts of the article and/or for contributions to instrument development, data collection, and coding; and to Robin Otto, Craig Edelman, and personnel at the Pennsylvania Cancer Registry for collaboration on sample development. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions. The authors wish to acknowledge the funding support of the National Cancer Institute's Center of Excellence in Cancer Communication (CECCR) located at the Annenberg School for Communication, University of Pennsylvania (grant P50-CA095856-05).

Notes

¹Search term: “fruit or vegetable” and “health” and “benefit.”

²We recognize that the use of a dichotomized measure restricts sensitivity to detect effects. However, in this case, the dichotomized measure permitted us to make use of propensity scoring procedures to fully account for the effects of confounders, and we thought the trade-off worthwhile.

³These variables include participants' age, gender, race, education, employment, and marital status, insurance status, smoking status, height and weight, current exercise, and diet behaviors and future intention to exercise or diet to lose weight. Other confounders include responses to questions about cancer-related treatments heard about and received, as well as self-reported satisfaction with treatments received and with clinical information provided. The model also accounted for patients' responses concerning their experience of physical symptoms, preferences for medical decision-making and actual decision-making practices, concern about cancer recurrence, tendency to avoid health information, and to comply with lifestyle recommendations as well as self-reported feelings of confidence and optimism, and whether participants were assisted by others in their social network in seeking cancer-related information.

⁴An analysis comparing the 845 respondents retained for the analysis with the remainder of the baseline sample showed no substantial differences.