Abstract A050: Oncology Registered Dietitians’ knowledge, attitudes and practices related to food insecurity among cancer patients: A qualitative study
Authors: Burton-Obanla Amirah A , Sloane Stephanie , Koester Brenda , Gundersen Craig , Fiese Barbara H , Arthur Anna E 
Published: September 2020

Abstract
Introduction: Food insecurity (FI) has been associated with negative health outcomes, including poor quality of life (QOL) and chronic diseases such as cardiovascular disease and diabetes. However, the association between FI and cancer is largely unknown. No comprehensive practice guidelines or consensus criteria currently exist regarding screening for and addressing FI in oncology clinics. Registered Dietitian Nutritionists (RDNs) are on the front lines of nutritional care provided to patients across the cancer continuum, but it is unknown if and how oncology RDNs address FI with their patients. The purpose of this study was to assess oncology RDNs’ knowledge, attitudes and practices related to FI among cancer patients. Methods: One-on-one, semi-structured interviews were conducted with 41 oncology RDNs working at various types of cancer centers across the U.S. and recruited through the Oncology Nutrition Dietetics Practice Group of the Academy of Nutrition and Dietetics. Interviews were conducted by telephone using Microsoft Lync and recorded using the audio software program, Audacity®. Interviews lasted an average of 60 minutes and were conducted by a research specialist trained according to the Ecocultural Family Interview protocol. The interviews were coded by research specialists using a semantic approach to thematic analysis. Data were analyzed using Dedoose. Results: Findings revealed that oncology RDNs are generally aware of the term “food insecurity” and can accurately define it. RDNs believe that FI is a problem for many of their patients and that cancer patients are more likely to be negatively affected by FI compared to healthy adults. RDNs identified potential adverse consequences of FI for cancer outcomes such as poor nutritional status, QOL and tolerance to treatment. Few RDNs reported that they regularly ask their patients about their ability to afford necessary food. Further, the vast majority of RDNs had not heard of or used a validated assessment tool to identify food insecure cancer patients. Conclusions: Most oncology RDNs are knowledgeable about FI and are concerned about the potential negative impact on cancer outcomes. However, most do not use a validated assessment tool to identify cancer patients who may be food insecure. These findings can inform observational or intervention work focused on screening for and addressing FI in oncology settings.
Citation Format: Amirah A Burton-Obanla, Stephanie Sloane, Brenda Koester, Craig Gundersen, Barbara H Fiese, Anna E Arthur. Oncology Registered Dietitians’ knowledge, attitudes and practices related to food insecurity among cancer patients: A qualitative study [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 A050.