Open Access Open Badges Research

Diffusion and dissemination of evidence-based dietary srategies for the prevention of cancer

Donna Ciliska1, Paula Robinson23, Tanya Armour2, Peter Ellis234, Melissa Brouwers23, Mary Gauld25, Fulvia Baldassarre25 and Parminder Raina25*

Author Affiliations

1 School of Nursing, McMaster University, 1200 Main St. W. Hamilton, Ontario, L8N 3Z5, Canada

2 Department of Clinical Epidemiology & Biostatistics (CEB), McMaster University, 1200 Main St. W. Hamilton, Ontario, L8N 3Z5, Canada

3 Cancer Care Ontario Program in Evidence Based Care (CCO PEBC) McMaster University, 50 Main St. E. Hamilton, Ontario, L8N 1E9, Canada

4 Hamilton Regional Cancer Centre, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada

5 McMaster University Evidence-based Practice Center, 50 Main St. E. Hamilton, Ontario, L8N 1E9, Canada

For all author emails, please log on.

Nutrition Journal 2005, 4:13  doi:10.1186/1475-2891-4-13

Published: 8 April 2005



The purpose was to determine what strategies have been evaluated to disseminate cancer control interventions that promote the uptake of adult healthy diet?


A systematic review was conducted. Studies were identified by searching MEDLINE, PREMEDLINE, Cancer LIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists and by contacting technical experts. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions in individuals, healthcare providers, or institutions. Studies of children or adolescents only were excluded.


One hundred one articles were retrieved for full text screening. Nine reports of seven distinct studies were included; four were randomized trials, one was a cohort design and three were descriptive studies. Six studies were rated as methodologically weak, and one was rated as moderate. Studies were not meta-analyzed because of heterogeneity, low methodological quality, and incomplete data reporting. No beneficial dissemination strategies were found except one that looks promising, the use of peer educators in the worksite, which led to a short-term increase in fruit and vegetable intake.

Conclusions and Implications

Overall, the quality of the evidence is not strong and is primarily descriptive rather than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies, and to compare dissemination and diffusion strategies with different messages and different target audiences.