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J Racial Ethn Health Disparities. 2019 Oct;6(5):1021-1029. doi: 10.1007/s40615-019-00603-x. Epub 2019 Jun 5.

Examining Colorectal Cancer Risk Awareness and Food Shelf Use Among Health Center Patients.

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Public Health Administration and Policy, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.



To employ the Colorectal Cancer Risk Awareness for Public Health Prevention (CRC-PHP) survey to examine how food shelf use and other covariates predict awareness of colorectal cancer (CRC) risk factors among patients of a Federally Qualified Health Center in Minneapolis, Minnesota. Secondary aims included describing the demographic and chronic-disease characteristics of the patient population and assessing their general knowledge of additional CRC risk factors and intent to make healthy food selections in the near future.


Measures included CRC risk awareness, food shelf use, chronic-disease status, and intent to select healthy food options. Regression models and chi-square tests of independence were employed to examine differences among food shelf users and non-users.


Among the 103 patients surveyed, 29% reported using a food shelf in the last 12 months. Forty-seven percent of food shelf users and 38% of non-users reported having at least 1 diet-related condition (e.g., type 2 diabetes mellitus). Food shelf users scored 1.2 points higher than non-users, on average, on the CRC risk-factor awareness scale. They also answered more survey questions correctly regarding fruit and vegetable intake and its effect on CRC risk (p = 0.035). Most participants reported being likely to purchase health-promoting foods in the future. In addition, participants reported being likely to select foods that were labeled as protective against CRC.


Behavioral interventions exist that are focused on preventing and managing type II diabetes among food shelf users. Building off such interventions and incorporating behavioral economics components (such as nudges and product labels) has the potential to reduce food shelf customers' heightened risk and management of CRC.


Colon cancer; Colorectal cancer; Community health centers; Diabetes mellitus; Food insecurity; Minority health

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