Assessing NCI-CCC Websites for Programs to Support Healthy Lifestyles and Associated Social Drivers of Health: A Content Analysis.

BACKGROUND: Adhering to healthy lifestyle recommendations is vital for cancer prevention and survival but may be constrained by patients' social drivers of health (SDOH). Because the internet is a primary source of cancer-related health information, we assessed all clinical National Cancer Institute-designated Comprehensive Cancer Centers' (NCI-CCCs) websites for content and programmatic supports related to lifestyle and SDOH. PATIENTS AND METHODS: Qualitative content analysis of all 58 clinical NCI-CCC websites used a codebook of 28 content areas within 7 domains based on the Public Health Action Model for Cancer Survivorship, American Cancer Society (ACS) Diet and Physical Activity Guideline, and ACS Health Equity Framework. Frequencies and proportions were reported. RESULTS: Information on Individual Lifestyle Factors was identified on most websites, including alcohol use (n=52; 90%), healthy weight (n=53; 91%), physical activity (n=53; 91%), healthy eating pattern (n=54; 93%), and tobacco use (n=57; 98%). Organizational Services for alcohol use (n=6; 10%), weight management (n=20; 34%), tobacco use (n=44; 76%), and rehab medicine (n=55; 95%) were inconsistent. Information on the Impact of SDOHs was mentioned the least, with the impact of food insecurity (n=29; 50%) being the lowest. Health Equity Supports were offered for food insecurity (n=24; 41%), transportation (n=44; 76%), equitable access to care (n=45; 78%), and financial insecurity (n=51; 88%). CONCLUSIONS: Despite evidence supporting the role of lifestyle in cancer prevention and survival, NCI-CCC websites across the United States vary in how they promote services to help patients meet healthy lifestyle recommendations and address SDOH-related barriers. NCI-CCCs should invest in additional programming and continually update websites to reflect existing programs that support healthy lifestyles and address patients' SDOH. Additional resources and health systems implementation research are needed to comprehensively offer programs for alcohol cessation, weight management, and food security.

Duke Scholars

Author Nia Schwann Mitchell Medicine, General Internal Medicine