Proof-of-Concept Testing of the Cardiovascular Health Equity Through Food (CHEF) Intervention in Childhood Cancer Survivors

Inclusion Criteria:

• Child with any primary cancer diagnosis (non-relapsed, non-secondary malignancy) whohas received cancer-directed therapy that includes chemotherapy and/or radiationtherapy;

• Child is within one of the following time windows:

1. Among those receiving chemotherapy, any time from start of last planned cycleof chemotherapy until 12 months from completion of chemotherapy;

2. Among those receiving radiation therapy alone or radiation and surgery, anytime from completion of radiation until 12 months post completion;

• Child has 1 or more cardiovascular risk factor (defined as any of: body mass index ≥ 85th percentile; systolic or diastolic blood pressure ≥90th percentile; dyslipidemia [triglycerides ≥150 mg/dL, total cholesterol ≥200 mg/dL, LDL cholesterol ≥130 mg/dL,HDL cholesterol ≤40 mg/dL]; impaired glucose metabolism [fasting glucose ≥100 mg/dL,hemoglobin A1c ≥5.7%]; anthracycline exposure ≥100 mg/m2; or any radiation exposureto chest, brain, thoracic spine, or total body);

• Child is ≤18 years of age at time of enrollment, or over 18 years of age but undermedical guardianship;

• Parent/guardian screened positive for food insecurity.* *Assessed through validated 2-item food insecurity screen.

Exclusion Criteria:

• Patient received only surgery, or watchful waiting/surveillance, for cancer-directed therapy;

• Foreign national family receiving cancer care as an embassy-pay patient.