The Cooking for a Lifetime of Cancer Prevention (C4L program) is a direct education intervention designed to increase participant's intention to: 1) implement nutrition and physical behaviors for cancer prevention (achieve and maintain a healthy weight, consume fruits and vegetables, limit red meat, avoid processed meat, choose whole grains, and limit alcohol, and meet US physical activity guidelines), and 2) be screened for breast, cervical, and/or colorectal cancer as age and sex appropriate. In addition, participants will be able to: 3) select and prepare healthy foods for an overall healthy lifestyle and for cancer prevention, and 4) eligible participants will be able to connect with referral to free and reduced cost cancer screening services through the Breast and Cervical Cancer Control Program (BCCP) or other cancer resources in their community. The one-time, three-hour workshop includes educational presentations that address SNAP-Ed outcomes, including encouraging healthy eating, increasing physical activity and reducing sedentary time, and improving food resource management.
Intervention Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time
SNAP-Ed Strategies: Direct Education
C4L targets adults and older adults in community-based settings (Extension offices, churches, food pantries, senior centers). The intervention was originally designed to reach low-income and uninsured women that would be eligible for screening services offered through the Georgia Breast and Cervical Cancer Control Program. Program evaluation data suggest C4L likely reaches a SNAP-Ed eligible audience through proxy measures. As an example, sample data from the last two years indicate approximately 37% of participants have Medicare and/or Medicaid, 28% have no health insurance, and 40% have a high school education or GED or less.
Settings: Community-wide, Faith-based centers, Food pantries, Healthcare, Worksites
Age/Population Group: Adults, Older Adults
Race: All
Ethnicity: All
C4L includes two educational presentations: 1) lifestyle guidelines for cancer prevention and 2) screening guidelines for breast, cervical and colorectal cancer, handouts and activities, and recipe demonstration and tasting. These intervention components increase awareness of the link between lifestyle behaviors and cancer prevention and provide participants with the knowledge and skills to implement recommended lifestyle behaviors. All of these components are critical to the intervention, but the recipe demonstration has been modified at times to address the setting (i.e., educators created and shared a video of themselves conducting a recipe demo or created PowerPoint slides illustrating the recipe steps.
C4L includes two PowerPoint presentations, seven handouts, a cookbook, and program evaluation materials.
University of Georgia Extension Family and Consumer Science Agents reached more than 1,175 people in 46 Georgia counties (1,098 people) and 3 rural Texas counties (77 people) with the C4L program in the 2017-2018 programming year. Completed evaluation data (n = 967) indicates participants were 90% female, primarily middle-aged (approximately 51 years, range 11 - 96 years old), 22% Hispanic and 40% Black/African American, and 20% reported having no insurance.
Participants reported that they were significantly (p <.001) more likely to do all of the behaviors discussed, including exercise at least 30 minutes 5 days a week, achieve a healthy weight, eat more fruits and vegetables and less red and processed meat, and limit alcohol consumption following the program.
The program is also motivating participants to get their recommended cancer screenings. Following the program, 67% of participants said they were "definitely going to" get a colonoscopy, and an additional 17% said they "may do it." More than 87% of participants reported that the program was very or extremely helpful in helping them think about changing some of their habits to reduce cancer risk. Common themes from participant feedback included that the program was informative, helped them think about their own risk for cancer, and helped them learn how to cook healthier. A mixed methods evaluation of Cooking for a Lifetime of Cancer Prevention can be found here.
Evidence Base: Research-tested
Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.
| Readiness and Capacity - Short Term (ST) | Changes - Medium Term (MT) | Effectiveness and Maintenance - Long Term (LT) | Population Results (R) | |
| Individual | ST1, ST3 | |||
| Environmental Settings | ||||
| Sectors of Influence |
- ST1i: After the program, 51.8% reported increased intention to choose whole grains at least half of the time.
- ST1g: After the program, 55.8% reported increased intention to make half of their plate fruits and vegetables.
- ST1h: After the program, 55.8% reported increased intention to make half of their plate fruits and vegetables.
- ST1k: After the program, 63.6% reported increased intention to limit red meat to 18 ounces or less per week.
- ST3a: After the program, 53% reported increased intention to exercise 30 minutes per day 5 days per week.
C4L provides the following evaluation materials:
- Retrospective questionnaire assessing intent to change targeted behaviors (in English and in Spanish)
- Educator interview questions assessing program implementation and fidelity
Website: https://www.fcs.uga.edu/extension/health-prevent-and-control-disease-curricula-for-sale
Contact Person(s):
Dr. Alison C Berg
Associate Professor and Extension Specialist, University of Georgia
Phone: 706-542-8860
Email: alisoncberg@uga.edu
Beth Kindamo, MS, RDN, LD
Assistant Nutrition Educator and Program Coordinator, UGA Extension Nutritional Sciences
Phone: 706-542-8860
Email: bethkindamo@uga.edu
*Updated as of August 29, 2023