A self-administered e-health dietary quality (DQ) assessment in patients (pts) at increased hereditary risk of cancer (CA): Feasibility and preliminary findings.

Abstract

e22544 Background: Pts at increased hereditary CA risk frequently express interest in “eating healthier”. Many providers have limited nutrition training and lack user-friendly tools to gauge DQ. Computerized DQ assessment can simplify reporting of eating habits with visual cues and provides immediate feedback, allowing comparison of results to national standards (USDA Healthy Eating Index/HEI). Here, we examine feasibility and preliminary efficacy of eHealth DQ assessment in pts seen by a CA risk assessment service for genetic counseling, testing, and high-risk follow-up. Methods: Pts undergoing cancer risk assessment are invited to complete a 20-min eHealth DQ assessment (VioScreen) with repeat assessment at 3-mo (FU). Sampling is purposeful using select risk criteria (e.g., any PV+, prostate CA risk). VioScreen offers detailed DQ feedback, an HEI score (adult optimal > 80), and a dietary inflammatory index (DII) score. Pts can opt for a registered dietician (RD) consult to review DQ feedback. Demographic/survey measures are collected at baseline/FU. Goal accrual is 210 pts. Primary outcome is feasibility defined by completion of: informed consent >25% by interested pts; baseline VioScreen >75%; all study parts >50% after baseline VioScreen, and favorable acceptability (mean < 3 on 5-pt Likert). Descriptive statistics and chi-square tests are used in data reporting. Results: To date, 171 pts have expressed interest, and 73.1% (125/171) have provided informed consent. Of these, 81.6% (102/125) completed baseline VioScreen, and 55.9% (57/102) completed the study with acceptability means of 1.56-2.42. Those w/complete data (n = 57) have mean age 52.1 yrs, 84% F sex, 88% White race, 86% college degree and 65% income > $100K. > 50% have a PV in a CA risk gene, 66% are overweight/obese, and 32% are current/past smokers. 33% (19/57) consulted with an RD, and 40% reported weight loss (baseline to FU). Mean HEI (n = 57) was 71.2 baseline and 71.8 FU and was significantly lower for overweight/obese pts at both timepoints (p = 0.009 and p = 0.031, respectively). Men had larger gains in HEI (+4.9, p = 0.071), while carriers of non-BRCA1/2 mutations had significantly improved DII scores at FU (p = 0.009). Pts who met w/RD had greater numeric gains in HEI (+2.2) and DII (-0.7) (p = NS) but reported VioScreen results more difficult to understand (p = 0.017) and had less confidence in their DQ at baseline (p = 0.022) and their ability to achieve the VioScreen recommendations (p = 0.060). At FU, pts who met w/RD reported higher motivation to take vitamins/supplements (p = 0.012), while those who lost weight were more confident in their ability to be healthy (p = 0.023) and to control their health (p = 0.016). Conclusions: eHealth DQ assessment is feasible in high-risk patients. Preliminary results identify prevalent modifiable CA risk factors including suboptimal DQ and excess body weight.