The cancer and diet intervention project: A community-based intervention to reduce nutrition-related risk of cancer

This paper describes a community-based intervention program designed to lower diet-related risk of cancer. The program is one of the first to attempt to make operational cancer-related dietary guidelines. It was designed as a feasibility study for a possible larger-scale multi-community study. The intervention was structured in three parts: mass media, grocery store environment modification including point-of-purchase labelling and a home-based education course, and was undertaken in one rural midwest community with a similar community as a comparison. Formative evaluation was undertaken to define and tune intervention strategies. Community leaders were involved in the intervention from its inception. The initial intense program ran for 3 months with a maintenance period of 12 months. The dietary intervention was focused on an eating pattern message (designed to reduce fat consumption and increase fiber intake) for which criteria for specific foods were developed. Outcome variables included knowledge, attitudes and practices related to diet and cancer. These were measured in a series of cross-sectional samples in each community. The study design allowed estimation of dose-response effects within the intervention community. Novel aspects of the evaluation design included a specific attempt to measure the effect of self-selection into an intense information-giving intervention component and two new ways of measuring community dietary change. Cost-effectiveness evaluation was included.