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Objectives: This study investigated the beliefs about cancer treatment, outcomes, and screening among adults aged 50–74 in Newfoundland and Labrador and whether these beliefs or sociodemographic factors were associated with differences in colorectal cancer (CRC) screening behaviours. Methods: This analysis uses data collected from an online survey of adults on cancer awareness and prevention in NL. Chi-square tests were used to assess differences in distributions of beliefs based on CRC screening behaviour. Logistic regression was used to identify sociodemographic factors independently associated with CRC screening behaviour. Results: A total of 724 participants were included in the analysis, 57.4% of which had ever had CRC screening. Most held positive beliefs about cancer outcomes and treatment. Only beliefs about screening affected CRC screening behaviour. People who never had CRC screening were more likely to believe their worries about what might be found would prevent them from screening (χ2 = 9.380, p = 0.009); screening is only necessary if they have symptoms (χ2 = 15.680, p < 0.001); and screening has a high risk of leading to unnecessary surgery (χ2 = 6.824, p = 0.032). Regression identified that men had higher likelihood of having had CRC screening than women in our study (OR = 1.689, 95%CI = 1.135–2.515), as did all age groups compared to ages 50–54. No associations were found with the other sociodemographic factors studied. Conclusion: Beliefs about cancer screening appear to play some role in CRC screening behaviour, but the absolute effect was small. The relatively few sociodemographic associations with screening behaviour suggest that NL's CRC screening program is equitably reaching people from different socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Background: Our objective was to examine cancer risk factor awareness and beliefs about cancer treatment, outcomes, and screening, and how these are mediated by sociodemographic variables, among Newfoundland and Labrador residents.Methods: Participants aged 35 to 74 were recruited through Facebook advertising, and a self-administered online questionnaire was used to collect data. Descriptive statistics, Spearman rank correlations, and multivariate logistic regression analyses were performed.Results: Of the 1048 participants who responded and met the inclusion criteria for this study, 1019 were selected for this analysis. Risk factor recognition was generally good, though several risk factors had poor awareness: being over 70 years old (53.4% respondents aware), having a low-fiber diet (65.0%), and drinking more than 1 unit of alcohol per day (62.8%). Our results showed that the participants' awareness of risk factors was significantly associated with higher income level (rs = 0.237, P <  0.001), higher education (rs = 0.231, P <  0.001), living in rural regions (rs = 0.163, P <  0.001), and having a regular healthcare provider (rs = 0.081, P = 0.010). Logistic regression showed that among NL residents in our sample, those with higher income, post-secondary education, those in very good or excellent health, and those with a history of cancer all had higher odds of having more positive beliefs about cancer treatment and outcomes. Those with a history of cancer, and those with very good or excellent health, also had higher odds of having more positive beliefs about cancer screening. Finally, compared to Caucasian/white participants, those who were non-Caucasian/white had lower odds of having more positive beliefs about cancer screening.Conclusion: Among adults in NL, there was poor awareness that low-fiber diets, alcohol, and age are risk factors for cancer. Lower income and education, rural residence, and not having a health care provider were associated with lower risk factor awareness. We also found a few associations between sociodemographic factors and beliefs about cancer treatment and outcomes or screening. We stress that while addressing awareness is necessary, so too is improving social circumstances of disadvantaged groups who lack the resources necessary to adopt healthy behaviours. [ABSTRACT FROM AUTHOR]

Background: While a dietary pattern is often believed to be stable in a population, there is limited research assessing its stability over time. The objective of this study is to explore and compare major dietary patterns derived for the Canadian subpopulation residing in Newfoundland and Labrador (NL), through two time-separated studies using an identical method. Methods: In this study, we derived and compared the major dietary patterns derived from two independent studies in the NL adult population. The first study was based on the healthy controls from a large population-based case-control study (CCS) in 2005. The second was from a food-frequency questionnaire validation project (FFQVP) conducted in 2012. In both studies, participants were recruited in the same manner and dietary information was collected by an identical self-administered food-frequency questionnaire (FFQ). Exploratory common factor analysis was conducted to identify major dietary patterns. A comparison was conducted between the two study populations. Results: Four major dietary patterns were identified: Meat, Vegetables/fruits, Fish, and Grains explaining 22 %, 20 %, 12 % and 9 % variance respectively, with a total variance of 63 %. Three major dietary patterns were derived for the controls of the CCS: Meat, Plant-based diet, and Fish explaining 24 %, 20 %, and 10 % variance respectively, with a total variance of 54 %. As the Plant-based diet pattern derived for the CCS was a combination of the Vegetables/ fruits and Grains patterns derived for the FFQVP, no considerable difference in dietary patterns was found between the two studies. Conclusion: A comparison between two time-separated studies suggests that dietary patterns of the NL adult population have remained reasonably stable over almost a decade. [ABSTRACT FROM AUTHOR]

Background: The Food- Frequency Questionnaire (FFQ) is a dietary assessment tool frequently used in large-scale nutritional epidemiology studies. The goal of the present study is to validate a self-administered version of the Hawaii FFQ modified for use in the general adult population of Newfoundland and Labrador (NL). Methods: Over a one year period, 195 randomly selected adults completed four 24-hour dietary recalls (24-HDRs) by telephone and one subsequent self-administered FFQ. Estimates of energy and nutrients derived from the 24-HDRs and FFQs were compared (protein, carbohydrate, fibre, fat, vitamin A, carotene, vitamin D, and calcium). Data were analyzed using the Pearson's correlation coefficients, cross-classification method, and Bland-Altman plots. Results: The mean nutrient intake values of the 24-HDRs were lower than those of the FFQs, except for protein in men. Sex and energy-adjusted de-attenuated Pearson correlation coefficients for each nutrient varied from 0.13 to 0.61. Except for protein in men, all correlations were statistically significant with p < 0.05. Cross-classification analysis revealed that on average, 74% women and 78% men were classified in the same or adjacent quartile of nutrient intake when comparing data from the FFQ and 24-HDRs. Bland-Altman plots showed no serious systematic bias between the administration of the two instruments over the range of mean intakes. Conclusion: This 169-item FFQ developed specifically for the adult NL population had moderate relative validity and therefore can be used in studies to assess food consumption in the general adult population of NL. This tool can be used to classify individual energy and nutrient intakes into quartiles, which is useful in examining relationships between diet and chronic disease. [ABSTRACT FROM AUTHOR]

Objective: Although a large body of epidemiological research suggests that red meat intake increases the risk of colorectal cancer, little is known regarding how such an association varies across populations and types of red meat. The objective of this study was to assess whether an association exists between the intakes of total red meat and pickled red meat and the risk of colorectal cancer in study subjects residing in Newfoundland and Labrador.Methods: This case-control study of 1,204 residents of Newfoundland and Labrador was part of a larger study on colorectal cancer. Personal history food frequency questionnaires were used to collect retrospective data from 518 individuals diagnosed with colorectal cancer and 686 controls. Intakes were ranked and divided into tertiles. Logistic regression was used to examine the possible association between meat intakes and colorectal cancer diagnosis while controlling for possible confounding factors.Results: A positive, but non-statistically significant, association between total red meat intake and CRC was observed in this study. Pickled red meat consumption was found to be significantly associated with an increased risk of CRC (men, OR = 2.07, 95% CI 1.37-3.15; women, OR = 2.51, 95% CI 1.45-4.32), the odds ratios increasing with each tertile of consumption, suggesting a dose-response effect.Conclusion: Intake of pickled red meat appears to increase the risk of colorectal cancer in Newfoundland and Labrador. [ABSTRACT FROM AUTHOR]

To investigate the health burden of diabetes and determine its impact on health-related quality of life (HRQOL) in a population with a high prevalence of chronic conditions. A representative sample of the Canadian province of Newfoundland and Labrador (NL) was used to estimate prevalence of diabetes and mean health utility index (HUI), a utility-based measure of HRQOL. Diabetes-deleted life expectancy (LE) and health-adjusted life expectancy (HALE) were derived to measure HRQOL. Diabetic individuals comprised 6.8% of the sample and accounted for 14% of total deaths from 2001 to 2005. Life Expectancy at age 15 was 61.3 years for men and 66.7 years for women, of which 53.0 and 57.0 years, respectively, were spent with perfect health (86.4 and 85.5%). Eliminating diabetes would extend both the overall LE and HALE for men by 1.3 and 1.4 years, and women by 2.0 and 1.7 years, respectively. People with diabetes had a significantly lower HRQOL than people without diabetes (mean HUI: 0.78 vs. 0.88, P < 0.01). The burden of illness from diabetes in NL is considerable. Using cause-eliminated LE and HALE provides a robust approach for assessing HRQOL that may have important implications for diabetes surveillance, prevention, and management strategies. [ABSTRACT FROM AUTHOR]

Background: Facebook has shown promise as an economical means of recruiting participants for health research. However, few studies have evaluated this recruitment method in Canada, fewer still targeting older adults, and, to our knowledge, none specifically in Newfoundland and Labrador (NL).Objective: This study aimed to assess Facebook advertising as an economical means of recruiting a representative sample of adults aged 35 to 74 years in NL for a cross-sectional health survey.Methods: Facebook advertising was used to recruit for a Web-based survey on cancer awareness and prevention during April and May 2018; during recruitment, additional advertisements were targeted to increase representation of demographics that we identified as being underrepresented in our sample. Sociodemographic and health characteristics of the study sample were compared with distributions of the underlying population to determine representativeness. Cramer V indicates the magnitude of the difference between the sample and population distributions, interpreted as small (Cramer V=0.10), medium (0.30), and large (0.50). Sample characteristics were considered representative if there was no statistically significant difference in distributions (chi-square P>.01) or if the difference was small (V≤0.10), and practically representative if 0.10Results: Facebook advertising is feasible and economical to conduct survey research, reaching 34,012 people, of which 2067 clicked on the ad, for a final sample size of 1048 people at Can $2.18 per recruit versus the quoted Can $23,316.05 for 400 recruits (Can $35.52 per recruit) via RDD. The sample was representative of rural and urban geography (P=.02; V=0.073), practically representative of age (P=.003; V=0.145) and income (P<.001; V=0.188), and over-representative of women (P<.001; V=0.507) and higher levels of education (P<.001; V=0.488). The sample was representative of the proportion of people with a regular health care provider (P=.94; V=0.025), diabetes prevalence (P=.002; V=0.096), and having had a colonoscopy or sigmoidoscopy (P=.27; V=0.034), and it was practically representative of smoking status (P<.001; V=0.14), and body mass index (P<.001; V=0.135). The sample was not representative of arthritis prevalence (P<.001; V=0.573), perceived health (P<.001; V=0.384), or time since last seasonal flu shot (P<.001; V=0.449).Conclusions: Facebook advertising offers an easy, rapid, and economical means to recruit a partially representative (representative or practically representative of 8 of the 13 characteristics studied) sample of middle-aged and older adults for health survey research. As Facebook uses a nonrandom targeting algorithm, caution is warranted in its applications for certain types of research. [ABSTRACT FROM AUTHOR]