Nutritional Prevention Of Colorectal Cancer: Attitudes And Practices Of Primary Care Providers

Abstract

Colorectal cancer (CRC) is a leading cause of cancer-related deaths around the world. The identification and description of many modifiable and non-modifiable risk factors to CRC has spurred the development of prevention and early detection protocols and recommendations to help reduce CRC incidence and mortality. Measures to manage CRC include diagnostic screenings and lifestyle changes. As rates of screening increase, prevention counseling rates among primary care providers (PCPs) remain low. Barriers to nutrition prevention reported by PCPs are inconsistent across the literature which has led to confusion about the reason for poor nutrition prevention efforts among PCPs. This practice inquiry (PI) addressed the identified practice gap using the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. In the "Plan" phase (Chapter 2), a systematic review of the research literature determined existing nutrition recommendations for CRCs and barriers to implementation by PCPs. Development of several nutrition recommendations for fiber, vitamin D, alcohol, red and processed meats intakes, and dietary patterns were outlined for PCP use in practice. Barriers to nutrition prevention implementation were identified as time, reimbursement, knowledge, and health literacy. To augment findings from the literature, a provider survey was completed (Chapters 3-4). Barriers identified by the participants (n=47) include lack of time, education materials, nutrition knowledge, low health literacy, and lack of patient interest. These findings indicate that several changes are needed to improve the use of CRC prevention guidelines, including additional education and education materials, changes in office policy and additional research to create and analyze the interventions recommended to improve existing nutrition prevention counseling for CRC.