(P24-04-26) Developing a Diet-Related Cancer Nutrition Behavior Matrix to Inform EFNEP Cost-Benefit Analysis

Objectives: Identify optimal nutrition-related behaviors that are measured by the Expanded Food and Nutrition Education Program (EFNEP) and preventative of diet-related cancers to inform a national EFNEP cost-benefit analysis.

Methods: Guidelines and position statements from national organizations (e.g., American Cancer Society) were used to elicit preventative diet and lifestyle behaviors for colorectal, aerodigestive, breast, endometrial, kidney, and liver cancers. When no specific consumption amounts were suggested, we defaulted to the 2020-2025 Dietary Guidelines for Americans 2000-calorie U.S.-Style Healthy Dietary Pattern. Dietary behaviors were mapped to indicators from the EFNEP 24-hour recall; other relevant behaviors (e.g., exercise) were mapped to the EFNEP Adult Questionnaire. We codified the selected behaviors in a Microsoft Excel matrix.

Results: Colorectal, aerodigestive, and breast cancers had robust diet-related preventative guidelines, and we identified 6-9 behavioral indicators measured by EFNEP for these diseases. Endometrial, kidney, and liver cancers had fewer diet-related preventative guidelines, and 1-3 behavioral indicators were identified for these cancers. Commonly selected behaviors (for ³3 cancers) included increased fruit and vegetable consumption, increased cardiovascular exercise, and reduced alcohol intake.

Conclusions: These optimal nutrition-related behaviors will inform our cost-benefit model to estimate EFNEP education’s impact on healthcare cost savings related to diet-related cancers. Our next steps are to analyze the distributions of these behaviors in a national EFNEP sample to determine cut-off points for our models and to calculate nationally applicable models based on a reference EFNEP participant (i.e., a woman of reproductive age).

Funding Sources: Hatch Multistate Research NC3169