Abstract B143: Associations between the food environment and food insecurity on fruit and vegetable intake among urban-dwelling Latina breast cancer survivors participating in the Mi Vida Saludable trial
Authors: Kadro Zachary O. , Rillamas-Sun Eileen , Langley Blake , Koch Pam , Contento Isobel , Gaffney Ann Ogden , Meisner Allison , Greenlee Heather 
Published: September 2024

Abstract
Socioeconomic disparities prevalent in Hispanic populations may cause inequities in cancer outcomes and risk factors. We explored the association of access to healthy foods (AHF) and food insecurity (FI) with changes in fruit and vegetable (FV) intake in Latina breast cancer (BC) survivors living in New York City who participated in the Mi Vida Saludable trial. Mi Vida Saludable was a 2x2 factorial trial (n=167) that tested the effects of an in-person and/or eHealth intervention on FV intake and physical activity (PA). Main study results showed only the in-person intervention had modest increases in FV intake. Eligibility criteria included being female, self-identifying as Latina/Hispanic, ³18 years old, history of stage 0-III BC, &gt;3 months post-treatment, &lt;5 daily serving of FV and/or &lt;150 minutes/week of moderate-vigorous PA. FV intake was assessed via 3 24-hour diet recalls at baseline and 12 months. AHF was from a modified validated Access to Healthy Food scale. FI was assessed via questions about eating less or going hungry due to lack of money. Generalized estimating equations examined whether baseline AHF and FI were associated with change in daily FV intake, adjusting for baseline age, marital status, education, and study arm. Three-way interaction terms (AHF or FI with time and study arm) were included to test if associations of AHF and FI with change in FV intake varied by intervention arms. FV intake was log-transformed due to a non-normal distribution; percent changes from baseline were described. AHF was measured in 86 women with 58% and 42% reporting low-medium and high access, respectively. Women with high AHF were more likely to be older (59 vs. 53 years, p=.002) and scored lower on a 5-point acculturation scale (higher score suggests higher acculturation, 1.8 vs. 2.1, p=.01). FI, measured in 157 participant, was prevalent in 23% of women. Women with FI were more likely to be single (44% vs. 16%, p=.003), renting (100% vs. 86%, p=.02), and have higher mean BMI (31 vs. 29 kg/m2, p=.02). 3-way interactions were not statistically significant, though analyses were likely underpowered. In the control group, the adjusted daily FV intake decreased by 79% (p=.01) from baseline to 12 months for women with low-medium AHF and by 49% (p=.10) for those with high AHF; similarly, daily FV intake decreased by 64% (p=.01) for women with FI and by 58% (p=.01) for women without FI. Most Latina BC survivors in New York City who participated in a 12-month diet and PA intervention trial had low-medium AHF at baseline; nearly 1/4 had FI. Associations of AHF or FI with changes in FV intake did not vary significantly by study arm, although sample sizes across strata were small. In the control arm, women with low-medium AHF and FI had larger decreases in FV intake after 12 months. Future dietary intervention studies in Latina BC survivors, and other underserved or under-resourced populations, should account for AHF and FI in the study design, and develop strategies to connect people to healthy food resources.
Citation Format: Zachary O. Kadro, Eileen Rillamas-Sun, Blake Langley, Pam Koch, Isobel Contento, Ann Ogden Gaffney, Allison Meisner, Heather Greenlee. Associations between the food environment and food insecurity on fruit and vegetable intake among urban-dwelling Latina breast cancer survivors participating in the Mi Vida Saludable trial [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B143.