Skip to main content
Top
Published in: Journal of Cancer Education 3/2016

01-09-2016

Measuring Nutrition Literacy in Breast Cancer Patients: Development of a Novel Instrument

Authors: Heather D. Gibbs, Edward F. Ellerbeck, Christie Befort, Byron Gajewski, Amy R. Kennett, Qing Yu, Danielle Christifano, Debra K. Sullivan

Published in: Journal of Cancer Education | Issue 3/2016

Login to get access

Abstract

No nutrition literacy instruments have been tested in breast cancer survivors, yet nutrition is a critical lifestyle factor for optimizing weight and improving quality of life in breast cancer survival. Our objectives were to adapt our Nutrition Literacy Assessment Instrument for breast cancer populations and to pilot test its validity and reliability. We modified the instrument based on review by content experts in cancer and nutrition and cognitive interviews with 18 cancer survivors. The modified instrument (Nutrition Literacy Assessment Instrument for Breast Cancer, NLit-BCa) was pilot-tested with 17 high-risk women and 55 breast cancer survivors. We conducted the NLit-BCa on two separate occasions 4 weeks apart and assessed reliability by confirmatory factor analysis. Construct validity was evaluated by comparing results of the NLit-BCa to a Healthy Eating Index score derived from two separate 24-h dietary recalls. Content validity of the NLit-BCa was acceptable (0.93). Entire reliability for three instrument domains was substantial (>0.80), while remaining domains demonstrated fair or moderate reliability. Significant relationships were found between five of the six domains of nutrition literacy and diet quality (P < 0.05). The NLit-BCa is content valid and demonstrates promising reliability and construct validity related to diet quality, through a larger sample size, and removal of non-discriminating items is needed to confirm these findings. Thus, the NLit-BCa demonstrates potential for comprehensively measuring nutrition literacy in breast cancer populations.
Appendix
Available only for authorised users
Literature
2.
go back to reference Pruitt JD, Bensimhon D, Kraus WE (2006) Nutrition as a contributor and treatment option for overweight and obesity. Am Heart J 151(3):628CrossRefPubMed Pruitt JD, Bensimhon D, Kraus WE (2006) Nutrition as a contributor and treatment option for overweight and obesity. Am Heart J 151(3):628CrossRefPubMed
3.
go back to reference WCRF (2009) Policy and action for cancer prevention. Food, nutrition, and physical activity: a global perspective. American Institute for Cancer Research, Washington DC WCRF (2009) Policy and action for cancer prevention. Food, nutrition, and physical activity: a global perspective. American Institute for Cancer Research, Washington DC
4.
go back to reference Silk KJ, Sherry J, Winn B, Keesecker N, Horodynski MA, Sayir A (2008) Increasing nutrition literacy: testing the effectiveness of print, web site, and game modalities. J Nutr Educ Behav 40(1):3–10CrossRefPubMed Silk KJ, Sherry J, Winn B, Keesecker N, Horodynski MA, Sayir A (2008) Increasing nutrition literacy: testing the effectiveness of print, web site, and game modalities. J Nutr Educ Behav 40(1):3–10CrossRefPubMed
5.
go back to reference Gibbs H, Chapman-Novakofski K (2012) Exploring nutrition literacy: attention to assessment and the skills clients need. Health 4(3):120–124CrossRef Gibbs H, Chapman-Novakofski K (2012) Exploring nutrition literacy: attention to assessment and the skills clients need. Health 4(3):120–124CrossRef
7.
go back to reference Kushi LH, Byers T, Doyle C et al (2006) American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 56(5):254–281CrossRefPubMed Kushi LH, Byers T, Doyle C et al (2006) American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 56(5):254–281CrossRefPubMed
8.
go back to reference Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23(7):1370–1378CrossRefPubMed Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23(7):1370–1378CrossRefPubMed
9.
go back to reference Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society's SCS-II. J Clin Oncol 26(13):2198–2204CrossRefPubMed Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society's SCS-II. J Clin Oncol 26(13):2198–2204CrossRefPubMed
10.
go back to reference Thomson CA (2012) Diet and breast cancer understanding risks and benefits. Nutr Clin Pract 27(5):636–650CrossRefPubMed Thomson CA (2012) Diet and breast cancer understanding risks and benefits. Nutr Clin Pract 27(5):636–650CrossRefPubMed
11.
go back to reference Maley M, Warren BS, Devine CM (2013) A second chance: meanings of body weight, diet, and physical activity to women who have experienced cancer. J Nutr Educ Behav Maley M, Warren BS, Devine CM (2013) A second chance: meanings of body weight, diet, and physical activity to women who have experienced cancer. J Nutr Educ Behav
12.
go back to reference Heidemann C, Schulze MB, Franco OH, van Dam RM, Mantzoros CS, Hu FB (2008) Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women. Circulation 118(3):230–237CrossRefPubMedPubMedCentral Heidemann C, Schulze MB, Franco OH, van Dam RM, Mantzoros CS, Hu FB (2008) Dietary patterns and risk of mortality from cardiovascular disease, cancer, and all causes in a prospective cohort of women. Circulation 118(3):230–237CrossRefPubMedPubMedCentral
13.
go back to reference Polit DF, Beck CT (2006) The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health 29(5):489–497CrossRefPubMed Polit DF, Beck CT (2006) The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health 29(5):489–497CrossRefPubMed
14.
go back to reference Befort CA, Klemp JR, Fabian C et al (2014) Protocol and recruitment results from a randomized controlled trial comparing group phone-based versus newsletter interventions for weight loss maintenance among rural breast cancer survivors. Contemp Clin Trials 37(2):261–271CrossRefPubMedPubMedCentral Befort CA, Klemp JR, Fabian C et al (2014) Protocol and recruitment results from a randomized controlled trial comparing group phone-based versus newsletter interventions for weight loss maintenance among rural breast cancer survivors. Contemp Clin Trials 37(2):261–271CrossRefPubMedPubMedCentral
15.
go back to reference Moshfegh AJ, Rhodes DG, Baer DJ et al (2008) The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr 88(2):324–332PubMed Moshfegh AJ, Rhodes DG, Baer DJ et al (2008) The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr 88(2):324–332PubMed
16.
go back to reference Miller PE, Mitchell DC, Harala PL, Pettit JM, Smiciklas-Wright H, Hartman TJ (2011) Development and evaluation of a method for calculating the Healthy Eating Index-2005 using the Nutrition Data System for Research. Public Health Nutr 14(02):306–313CrossRefPubMed Miller PE, Mitchell DC, Harala PL, Pettit JM, Smiciklas-Wright H, Hartman TJ (2011) Development and evaluation of a method for calculating the Healthy Eating Index-2005 using the Nutrition Data System for Research. Public Health Nutr 14(02):306–313CrossRefPubMed
18.
go back to reference Lt H, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J 6(1):1–55CrossRef Lt H, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J 6(1):1–55CrossRef
19.
go back to reference Shrout PE (1998) Measurement reliability and agreement in psychiatry. Stat Methods Med Res 7(3):301–317CrossRefPubMed Shrout PE (1998) Measurement reliability and agreement in psychiatry. Stat Methods Med Res 7(3):301–317CrossRefPubMed
20.
go back to reference Bennett IM, Chen J, Soroui JS, White S (2009) The contribution of health literacy to disparities in self-rated health status and preventive health behaviors in older adults. Ann Fam Med 7(3):204–211CrossRefPubMedPubMedCentral Bennett IM, Chen J, Soroui JS, White S (2009) The contribution of health literacy to disparities in self-rated health status and preventive health behaviors in older adults. Ann Fam Med 7(3):204–211CrossRefPubMedPubMedCentral
21.
go back to reference Wolf MS, Knight SJ, Lyons EA et al (2006) Literacy, race, and PSA level among low-income men newly diagnosed with prostate cancer. Urology 68(1):89–93CrossRefPubMed Wolf MS, Knight SJ, Lyons EA et al (2006) Literacy, race, and PSA level among low-income men newly diagnosed with prostate cancer. Urology 68(1):89–93CrossRefPubMed
22.
go back to reference Parker RM, Baker DW, Williams MV, Nurss JR (1995) The test of functional health literacy in adults. J Gen Intern Med 10(10):537–541CrossRefPubMed Parker RM, Baker DW, Williams MV, Nurss JR (1995) The test of functional health literacy in adults. J Gen Intern Med 10(10):537–541CrossRefPubMed
23.
go back to reference (2002) The Diabetes Prevention Program (DPP) description of lifestyle intervention. Diabetes Care 25(12):2165–2171 (2002) The Diabetes Prevention Program (DPP) description of lifestyle intervention. Diabetes Care 25(12):2165–2171
24.
go back to reference Guenther PM, Kirkpatrick SI, Reedy J et al (2014) The healthy eating index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr 113.183079 Guenther PM, Kirkpatrick SI, Reedy J et al (2014) The healthy eating index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr 113.183079
25.
go back to reference Morris NS, Field TS, Wagner JL et al (2013) The association between health literacy and cancer-related attitudes, behaviors, and knowledge. J Health Commun 18(1):223–241CrossRefPubMedPubMedCentral Morris NS, Field TS, Wagner JL et al (2013) The association between health literacy and cancer-related attitudes, behaviors, and knowledge. J Health Commun 18(1):223–241CrossRefPubMedPubMedCentral
Metadata
Title
Measuring Nutrition Literacy in Breast Cancer Patients: Development of a Novel Instrument
Authors
Heather D. Gibbs
Edward F. Ellerbeck
Christie Befort
Byron Gajewski
Amy R. Kennett
Qing Yu
Danielle Christifano
Debra K. Sullivan
Publication date
01-09-2016
Publisher
Springer US
Published in
Journal of Cancer Education / Issue 3/2016
Print ISSN: 0885-8195
Electronic ISSN: 1543-0154
DOI
https://doi.org/10.1007/s13187-015-0851-y

Other articles of this Issue 3/2016

Journal of Cancer Education 3/2016 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine