Improving Cancer Risk Awareness including Obesity as a Risk Factor for Cancer from a Multi-Tiered Community-based Intervention in a Small US Community

Background:  Awareness of obesity as a risk for cancer is low compared to other cancer risks such as tobacco. This study evaluated increases in cancer risk awareness, including obesity as a risk factor for cancer, from a multi-tiered community based intervention. The intervention was developed and implemented to reduce cancer risk from obesity, tobacco, and sunburn in a small community in Texas. Few studies exist in effectiveness of community based intervention on increasing cancer risk awareness.

Methods:  In person surveys (N=1136) were carried out over three periods: baseline (June 2011), post intervention (June 2012), and follow up (January 2013) in two sites (control and intervention). The questionnaire used included questions on participant’s health practices, attitudes, and perceptions of cancer and awareness of cancer risk factors along with sociodemographic variables. Majority of the participants (N=756, 88%) attended the session once, analyzed separately as community group participants from few of the participants (N=107, 12%) who participated in both the baseline and the post intervention data collection session, analyzed separately as paired group participants.

Results:  The intervention was successful in significantly and sustainably changing the participants’ attitude towards unhealthy weight status as a risk for cancer in the intervention community. Overall, the unadjusted intervention effect on cancer risk awareness (including tanning beds, sun-burn, overweight and obesity, chewing tobacco/using snuff, and smoking tobacco as risk factors for cancer) was significant for both the paired and community group participants: 0.392 ± 0.165 (p value=0.020) and 0.282 ± 0.125 (p value=0.024) respectively. The adjusted intervention effect was significant in the paired group participants (0.528 ± 0.189, p value=0.006) only. Sociodemographic factors such as education, income, gender and age had a significant impact on cancer risk awareness score for the community group participants. There was also a sustained significant increase in cancer risk awareness after the intervention.

Conclusion: This research shows the success of a multi-tiered community based intervention to increase cancer knowledge awareness that could easily be replicated in other communities. This adds to evidence that multi-tiered community-based interventions can play a key role to bring sustained cancer risk awareness and could be potentially used to change health behavior and attitude.