Nutrition Health Literacy of Cancer Patients and Their Support Networks.

Study Overview
=================
Brief Summary
-----------------
An exploration of the impact of nutrition literacy on ability of cancer patients and their support networks to get, understand and use nutrition information during cancer treatment.

Detailed Description
-----------------
The study is composed of two component projects: Project A: Validation of a NLit tool for UK population. NLit tool is a measurement tool developed at Kansas University to measure nutrition health literacy. It assesses the following functional literacy skills: numeracy & literacy and the following nutrition knowledge fields: macronutrients, food labels, portion sizes, food groups and consumer skills. This project has two phases: Phase A: Nominal consensus groups x 2 - consumer adaptation and tool review for UK use and pilot testing of electronic tool. Phase B: Testing adapted tool in a group of cancer patients for statistical validation. Project B: Planned survey of people with cancer and their families to explore experiences of access to nutrition information This survey is a combination of validated and unvalidated questions built on models of nutrition health literacy. With validated fields being used to evaluate and understand responses to unvalidated questions. It explores access to nutrition information, self-efficacy, confidence, health care infrastructure and support with nutrition information, population demographics, food security, sources of nutrition information, perceived practical skills and knowledge base.

Official Title
-----------------
Implications of Nutrition Health Literacy on Accessibility and Engagement With Nutrition Information in Cancer Patients and Their Support Networks

Conditions
-----------------
Cancer, Oncologic Disorders, Haematological Malignancy, Nutrition Aspect of Cancer

Intervention / Treatment
-----------------
* Other: Nominal consensus group
* Other: Observational cohort (validity and reliability testing)


Participation Criteria
=================
Eligibility Criteria
-----------------
NLit-UK development Inclusion Criteria: Members of the public (carers, health service users, lay persons) Cancer patients with confirmed diagnosis Friends or family members supporting a patient with a confirmed diagnosis of cancer > 18 yrs old Received cancer treatment at Nottingham University Hospitals between Jan 15 and March 20 Exclusion Criteria: Paediatrics < 18yrs at the time of diagnosis and treatment Unconfirmed diagnosis of cancer Patients on watch and wait

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Nominal consensus group|NLit-UK linguistic and cultural adaptation (NLit-UK) 2 x nominal consensus groups evidence review and topic expert engagement|
|Other: Observational cohort (validity and reliability testing)|Nutrition Literacy Measurement Tool validation (NLit-UK). Target sample 366 on treatment cancer patients confirmatory binary analysis for validity and reliability.|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nutrition health literacy - UK | Measured by UK modified NLit developed during study cultural and linguistic modification of (Gibbs et al., 2018 - original validation) - 64 item questionnaire Scoring interpretation from study: NLit-UK (63item) and NLit-UK short (42-item) NLit-UK (63-item): Scoring interpretation is ≤44 correct is likelihood of poor nutrition literacy; 45-57 is possibility of poor nutrition literacy; and scores ≥58 is likelihood of good nutrition literacy NLit-UK short (42-item): Scoring interpretation is ≤28 correct is likelihood of poor nutrition literacy; 29-37 is possibility of poor nutrition literacy; and scores ≥39 is likelihood of good nutrition literacy | Jun 19 - Mar 2020 | 
| NVS-UK health literacy | Validated tool - 6 part question (Rowlands et al, 2013) Scoring interpretation: low health literacy (≤1), intermediate health literacy (2-3), adequate health literacy (≥4). | Jun 19 - Mar 2020 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prior Knowledge | Did you receive any nutrition advice as part of your care for any of these conditions? (Yes or No). | Jun 19 - Mar 2020 | 
| Educational status (modified HINTS4 Cyc1) | What is the highest grade or level of schooling you completed? GCSE D or less/ GCSE C or above/ Unsure | Jun 19 - Mar 2020 | 
| Economic status (modified HINTS 2) | At the end of the month, how much money are you able to put aside? (Nothing, £100 or less, £101-250, £251-500, £501-1000, more than £1000, do not want to say). | Jun 19 - Mar 2020 | 
| How important did you consider nutrition was in helping you through your treatment? | Response sets: Didn't know enough to consider / Not important ; Moderately Important; Very or extremely important | Jun 19 - Mar 2020 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Nutrition, Health, Literacy, Education, Information, Knowledge