Grant: Operating Grant: CCS/CIHR Action Grants

Diets account for $1.4 billion direct/indirect costs of cancers of the mouth, larynx, upper respiratory, esophagus, liver, pancreas, colon, rectum, kidney, breast, ovary and uterus.Newfoundland and Labrador (NL) has the highest age-standardized incidence rate of colorectal cancer (CRC) in Canada; 1/3 of CRC cases are due to diet. NL ranks lowest in Canada on markers of healthy eating.Action is needed to prevent cancer by targeting determinants of diet, such as food access in rural communities. Focusing on diet and its determinants (i.e. food store), this project uses community-engaged processes to reduce diet-related cancer risk in NL by improving food retail environments. Specifically, we aim to (a) describe and monitor systems of multilevel factors impacting diet-related cancer risk in NL communities, focusing on food stores, and (b) co-develop, test and evaluate the feasibility and impact of food store interventions on store- (food access) and individual-level (diet) outcomes. This study includes two community-based interventions supported by Food First NL: (a) community food system exploration and (b) food retailer action. Using multiple data sources (interviews, community meetings, food retailer audits, and individual surveys), stories of change and the impacts of interventions on diet-related cancer risk will be explored through community case study analyses. Our analyses will focus on the outcomes of the intervention in the context of which it takes place. Improving diets requires multi-component interventions reaching individuals and communities. This multidisciplinary, innovative and systems-level study aims to equitably improve food environments, diets and cancer risk and will provide a deep understanding of complex, contextualized interventions. By co-learning with Food First NL and rural communities in NL, we capitalize on strengths in NL to address gaps in community primary prevention of diet-related cancer.