Health beliefs and preferences for dietary and physical activity interventions of colorectal cancer survivors: results of a questionnaire survey

Abstract

BACKGROUND: Although observational studies suggest that high red/processed meat intake and low physical activity (PA) are associated with colorectal cancer (CRC) occurrence/outcome, there is a lack of RCTs confirming the efficacy of such behavioural modifications. Successful design and implementation of such behavioural interventions requires a preemptive needs assessment. METHOD: A questionnaire survey was conducted on 150 CRC survivors (94 men, 63.7±9.1 years) without recurrent/persistent disease in two public hospitals in Hong Kong to (1) assess their knowledge, beliefs, attitudes and preferences for dietary (reduce/eliminate red/processed meat intake) and PA interventions; and (2) identify facilitators and barriers for intervention participation. Results were summarized by descriptive statistics. Preference scores, on a 0-10 scale, were estimated by 95% confidence intervals. Preference determinants were explored by regression analysis. RESULTS: CRC survivors had fair knowledge about lifestyle factors conferring CRC risk. Under 50% were convinced of the association between high red/processed meat intake and low PA level with cancer outcome; and 55% intended to change their dietary and PA habits to reach the recommended targets. Preference scores for specific dietary and PA interventions were 7.45 (7.00-7.89) and 7.29 (6.77-7.81), respectively. Subjects who preferred receiving lifestyle advices reported more family support, higher perceived benefits, higher motivation, stronger beliefs on the association between diet/meat and CRC risk/outcome, more exercise and a shorter duration from CRC diagnosis. Factors facilitating willingness to participate in an intervention programme included being employed or mobile, scientific evidence supporting the intervention, short duration of intervention, and intervention being conducted at a nearby location. CONCLUSION: CRC survivors are receptive of lifestyle intervention. Improving knowledge and instilling beliefs regarding the associations of specific lifestyle factors with cancer risk/outcome are essential before intervention. The information obtained from this survey facilitates designing a targeted intervention programme that is acceptable to our CRC survivors.