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Karen M. Emmons, PhD, Ann M. Stoddard, ScD, Robert Fletcher, MD, MSc, Caitlin Gutheil, MS, Elizabeth Gonzalez Suarez, MA, Rebecca Lobb, MPH, Jane Weeks, MD, MSc and Judy Anne Bigby, MD

Karen M. Emmons is with the Dana-Farber Cancer Institute and the Harvard School of Public Health, Boston, Mass. At the time of the study, Anne M. Stoddard was with the University of Massachusetts, Amherst. Robert Fletcher is with Harvard Medical School, Boston, Mass. Caitlin Gutheil and Elizabeth Gonzalez Suarez are with the Dana-Farber Cancer Institute. Rebecca Lobb is with Harvard Medical School, Division of Ambulatory Care and Prevention. Jane Weeks is with the Dana-Farber Cancer Institute and Harvard Medical School. Judy Ann Bigby is with the Brigham and Women’s Hospital and Harvard Medical School.

Correspondence: Requests for reprints should be sent to Karen M. Emmons, PhD, Harvard School of Public Health and Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney St, Boston, MA 02115 (e-mail: karen_m_emmons{at}dfci.harvard.edu).

Objectives. We analyzed outcomes from a study that examined social-contextual factors in cancer prevention interventions for working class, multiethnic populations.

Methods. Ten community health centers were randomized to intervention or to control. Patients who resided in low-income, multiethnic neighborhoods were eligible; the intervention targeted fruit and vegetable consumption, red meat consumption, multivitamin intake, and physical activity. Outcomes were measured at 8 months.

Results. The intervention led to significant increases in fruit and vegetable consumption and multivitamin intake and reductions in red meat consumption; no change was found in physical activity levels. The intervention effect was not changed when contextual variables that may function as confounders or effect modifiers (e.g., gender, education, race/ethnicity, respondent and parents’ country of birth, and poverty status) were included in the analyses.

Conclusions. The intervention led to significant improvements in health behaviors among a working class, multiethnic population, regardless of race/ ethnicity and socioeconomic status. Interventions that respond to the social context of working class individuals across racial/ethnic categories hold promise for improving cancer-related risk behaviors.

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