title: Cancer prevention among working class, multiethnic adults: results of the healthy directions-health centers study.
abstract: OBJECTIVE
  We analyzed outcomes from a study that examined social-contextual factors in cancer prevention interventions for working class, multiethnic populations.
  
  
  METHODS
  Ten community health centers were randomized to intervention or to control. Patients who resided in low-income, multiethnic neighborhoods were eligible; the intervention targeted fruit and vegetable consumption, red meat consumption, multivitamin intake, and physical activity. Outcomes were measured at 8 months.
  
  
  RESULTS
  The intervention led to significant increases in fruit and vegetable consumption and multivitamin intake and reductions in red meat consumption; no change was found in physical activity levels. The intervention effect was not changed when contextual variables that may function as confounders or effect modifiers (e.g., gender, education, race/ethnicity, respondent and parents' country of birth, and poverty status) were included in the analyses.
  
  
  CONCLUSIONS
  The intervention led to significant improvements in health behaviors among a working class, multiethnic population, regardless of race/ ethnicity and socioeconomic status. Interventions that respond to the social context of working class individuals across racial/ethnic categories hold promise for improving cancer-related risk behaviors.
authors.affiliation: Harvard School of Public Health and Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney St, Boston, MA 02115, USA. karen_m_emmons@dfci.harvard.edu
authors.forename: Karen M
authors.initials: KM
authors.lastname: Emmons
authors.forename: Ann M
authors.initials: AM
authors.lastname: Stoddard
authors.forename: Robert
authors.initials: R
authors.lastname: Fletcher
authors.forename: Caitlin
authors.initials: C
authors.lastname: Gutheil
authors.forename: Elizabeth Gonzalez
authors.initials: EG
authors.lastname: Suarez
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lobb
authors.forename: Jane
authors.initials: J
authors.lastname: Weeks
authors.forename: Judy Anne
authors.initials: JA
authors.lastname: Bigby
mesh_terms: D000328:Adult; D000368:Aged; D003151:Community Health Centers; D004032:Diet; D005006:Ethnicity; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D012923:Social Class