Cancer prevention among working class, multiethnic adults: Results of the healthy directions-health centers study

Objectives. 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.