Designing effective health promotion initiatives for the growing population of more than 11 million U.S. cancer survivors is now of critical importance. The full potential of the significant gains made thus far in cancer prevention and control will only be fulfilled when survivors are provided with the necessary tools to maximize health and quality of life throughout their entire life course. While much is known about the role of behavior in cancer incidence, our understanding of the effects of behavior on key health outcomes for survivors is not nearly as well understood. Changes in diet are one promising, but as yet not fully explored avenue for health promotion among cancer survivors. To fully understand whether dietary modification can meaningfully improve survivor health, we must develop intervention protocols that build upon detailed understanding of survivors'current eating practices and how cancer shapes an individual's self concept and readiness for behavior change. The data produced from the proposed research will provide insight into the social, personal and clinical contexts within which future dietary interventions for long term cancer survivors would be situated. We propose an innovative mixed-methods approach to examining diet among cancer survivors who are no longer undergoing active treatment. Our research methods integrate the holistic context of survivors'ongoing life course and evolving models of clinical care. The research will occur in two sequential and complementary phases. Phase 1 will consist of key informant interviews with 30 health care providers who care for cancer survivors, and phase 2 will integrate detailed qualitative interview data around cancer treatment and history and survivorship identity with current dietary data from a sample of 60 long term survivors of non Hodgkin lymphoma, breast and prostate cancer. The ultimate objective of this exploratory study is to generate hypotheses pertaining to effective and sustainable dietary interventions that reflect both individuals'relationship with their cancer status and the changing model of survivorship care.
Long term survivorship is an increasingly critical area of cancer control research. The proposed study will provide both a provider perspective on the role of nutrition in survivorship care and insights into survivors'readiness to maximize health promotion through dietary behaviors, as well as barriers to important changes. The detailed data that will result from the proposed work will provide preliminary data to facilitate the formulation of behavior change interventions around diet.