Development and refinement of the Cardiovascular Health Equity through Food (CHEF) intervention for childhood cancer survivors.

PURPOSE

The aim of this study was to develop and refine Cardiovascular Health Equity through Food (CHEF), an intervention to address food insecurity (FI) in early childhood cancer survivors (CCS).

METHODS

Single-center mixed-methods pilot study of a novel "food is medicine" intervention evaluating acceptability, satisfaction, and opportunities for refinement. CHEF participants were provided: (1) meal-kit delivery for 3 household meals/week for 3 months and (2) application assistance for federal nutrition benefits. Eligible participants were CCS < 1 year from cancer therapy completion, with self-reported FI or household income < 200% federal poverty level. Acceptability was defined as > 75% consent to participation, < 25% attrition, and > 75% program-component utilization. Surveys were completed at baseline and end-intervention, and semi-structured interviews were completed at months 1, 2, and 4.

RESULTS

Ten families (100%) consented to participation, with 0% attrition. Ninety-seven percent of meal kits were successfully received and > 90% cooked. Four families utilized study-team assistance in navigating benefits participation. One hundred percent of families would participate again, and 80% would recommend to others. Qualitative feedback supported CHEF's timing following treatment and positive impact on family cooking engagement. Broader non-English language accessibility, formalized benefits counseling, and extended duration were identified as refinement opportunities.

CONCLUSION

CHEF was highly acceptable among CCS in early survivorship. The next steps include proof-of-concept evaluation of the refined intervention's impact on cardiovascular-relevant outcomes among CCS with FI.

IMPLICATIONS FOR CANCER SURVIVORS

Interventions directly addressing food insecurity, a known cardiovascular risk factor, have the potential to support well-being and address health disparities among childhood cancer survivors.