title: Determinants of adherence to nutrition-related cancer prevention guidelines among African American breast cancer survivors.
abstract: BACKGROUND
  Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors.
  
  
  METHODS
  AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were used to examine the relationship between adherence to nutrition-related cancer prevention guidelines and potential predictors of adherence.
  
  
  RESULTS
  Majority of the survivors met the guideline for red and processed meat (n=191, 83.4%), but did not meet the guideline for fruits and vegetables (n=189, 80.4%). For survivors with annual household incomes < $25,000, the odds of meeting or partially meeting the guideline for fruits and vegetables was 75.4% less than for participants with incomes > $50,000 (OR= 0.25, 95% CI: 0.08, 0.80). Poor physical functioning (OR= 38.48, 95% CI: 2.26, 656.58), sleep disturbances (OR= 60.84, 95% CI: 1.61, 2296.02), and income > $50,000 (OR= 51.02, 95% CI: 1.13, 2311.70) were associated with meeting the guideline for red and processed meat.
  
  
  CONCLUSIONS
  Many AA breast cancer survivors are not meeting the nutrition-related cancer prevention guidelines. For this population, more interventions that enhance access to and consumption of healthy diets are needed.
authors.affiliation: Master of Science in Psychology, Augusta University, Augusta, GA.
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Ramirez
authors.affiliation: Institute of Public & Preventive Health, Augusta University, Augusta, GA.
authors.forename: Yunmi
authors.initials: Y
authors.lastname: Chung
authors.affiliation: Institute of Public & Preventive Health, Augusta University, Augusta, GA; Dental College of Georgia, Augusta University, Augusta, GA.
authors.forename: Yoo
authors.initials: Y
authors.lastname: Wonsuk
authors.affiliation: Institute of Public & Preventive Health, Augusta University, Augusta, GA.
authors.forename: Brittney
authors.initials: B
authors.lastname: Fontenot
authors.affiliation: Institute of Public & Preventive Health, Augusta University, Augusta, GA.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Ansa
authors.affiliation: SISTAH Talk Breast Cancer Support Group, Miami, FL.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Whitehead
authors.affiliation: Institute of Public & Preventive Health, Augusta University, Augusta, GA; Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA.
authors.forename: Selina A
authors.initials: SA
authors.lastname: Smith
keywords: African Americans; adherence; breast cancer survivors; health- related quality of life; nutrition guidelines