Abstract C088: The importance of the social environment in achieving high levels of physical activity and fruit and vegetable intake in an African American cohort
Authors: Heredia Natalia I , Nguyen Nga , McNeill Lorna H 
Published: September 2020

Abstract
Introduction. As compared to all other racial/ethnic groups in the U.S., African Americans experience the highest incidence and/or morality of several cancers, including colorectal, breast, prostate, and endometrial cancer. High levels of physical activity (PA) and fruit and vegetable (FV) intake are known to decrease risk for several of these cancers. However, only a small subset of African Americans successfully perform both of these cancer prevention behaviors. The purpose of this study is to assess which individual, social and neighborhood variables are associated with African American adults successfully performing both PA and FV intake. Methods. This is a cross-sectional analysis of African American adults recruited from Black churches in the greater Houston area. Self-administered questionnaires collected various self-reported variables as well as PA and FV intake. We created a combined 4-category behavioral outcome: high PA/high FV, low PA/ high FV, high PA/low FV, and low PA/low FV. We conducted both standard and stepwise multinomial logistic regression to examine the association between individual, social, neighborhood-level variables and the 4-category outcome. Results. This sample of African American adults (n=1009) had a mean age of 49 years, and was mostly female, and obese. As compared to the low PA/low FV intake group, the high PA/high FV intake had statistically significant lower odds of various individual-level variables (worrying about getting cancer, perceived stress, loneliness, financial strain) and higher odds of various social-level variables (social status, social cohesion, social organizations, and social norms). Interestingly, in stepwise multinomial logistic regression models where we entered all potential predictors into the stepwise selection process, controlling for sex, education, and employment status, the final model showed only variables on the social level remained significant. More specifically, perceiving oneself to have higher social status in the community (OR=1.14, 95%CI 1.01-1.29, p=.031), participating in more social organizations (Adjusted OR=1.60, 95%CI 1.24-2.06, p=.0003), social norms for FV intake (Adjusted OR=2.03, 95%CI 1.26, 3.29, p=.004), and social norms for PA (Adjusted OR=2.80, 95%CI 1.33, 5.89, p=.007) remained significantly associated with higher odds of high PA/high FV intake. Discussion. These findings indicate that social influences may be most critical for high PA and FV intake in African American adults. Interventions focused on various social-level variables may be key to promoting these two cancer prevention behaviors in African American communities.
Citation Format: Natalia I Heredia, Nga Nguyen, Lorna H McNeill. The importance of the social environment in achieving high levels of physical activity and fruit and vegetable intake in an African American cohort [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C088.