The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults

Neamțu, Andreea-Adriana; Anton, Alina; Maghiar, Laura; Iftode, Andrada; Căpraru, Anca-Maria; Dumitrescu, Cristina; Kis, Andreea-Mihaela; Popovici, Ramona Amina; Dehelean, Cristina-Adriana; Maghiar, Teodor-Andrei

doi:10.3390/nu18142293

This is an early access version, the complete PDF, HTML, and XML versions will be available soon.

Open AccessArticle

The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults

by

Andreea-Adriana Neamțu

^1,2,3,4,†

,

Alina Anton

^1,2,†

,

Laura Maghiar

^5,6,*

,

Andrada Iftode

^1,2,*,

Anca-Maria Căpraru

^7,8

,

Cristina Dumitrescu

^1,2,

Andreea-Mihaela Kis

⁹

,

Ramona Amina Popovici

⁹

,

Cristina-Adriana Dehelean

^1,2 and

Teodor-Andrei Maghiar

^10,11

¹

Department of Toxicology, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timișoara, Romania

²

Research Centre for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timișoara, Romania

³

Department of Pathology, Clinical County Emergency Hospital of Arad, Andrenyi Karoly Str., No. 2–4, 310037 Arad, Romania

⁴

Department of Pathology, “Pius Brinzeu” Clinical County Emergency Hospital Timișoara, Liviu Rebreanu Boulevard, No. 156, 300723 Timișoara, Romania

⁵

Department of Psycho-Neurosciences and Rehabilitation, Faculty of Medicine and Pharmacy, University of Oradea, Universității Str., No. 1, 410087 Oradea, Romania

⁶

Department of Dermatovenerology, Clinical County Emergency Hospital Bihor, 410169 Oradea, Romania

⁷

Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania

⁸

Department of Pharmacy, Poiana Mare Psychiatry Hospital, Gării Str., No. 40, 207470 Poiana Mare, Romania

⁹

Department of Management and Communication in Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timișoara, Romania

¹⁰

Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, Universității Str., No. 1, 410087 Oradea, Romania

¹¹

Department of Surgery, Pelican Hospital, Corneliu Coposu Str., No. 2, 410450 Oradea, Romania

Show full affiliation list

Hide full affiliation list

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally and can be considered as co-first authors.

Nutrients 2026, 18(14), 2293; https://doi.org/10.3390/nu18142293

Submission received: 26 May 2026 / Revised: 26 June 2026 / Accepted: 11 July 2026 / Published: 13 July 2026

(This article belongs to the Special Issue Dietary Patterns and Colorectal Cancer Risk: Mechanisms, Biomarkers, and Prevention Strategies)

Download

Browse Figure

Versions Notes

Abstract

Background/Objectives: Colorectal cancer (CRC) disproportionately affects Romania, where mortality exceeds the EU average and screening uptake remains low. Diet is among the most modifiable CRC risk factors, yet no validated instrument for assessing nutritional knowledge, attitudes, and practices (KAP) related to CRC prevention exists for the Romanian population. We developed and pilot-tested the EduNutriCRC questionnaire and characterised the corresponding nutritional KAP profile of Romanian adults. Methods: In a cross-sectional pilot study (April–May 2026), a convenience sample of 301 Romanian adults aged 18–74 years completed the 51-item self-administered questionnaire. The instrument was evaluated for internal consistency and dimensional structure (exploratory factor analysis), with non-parametric tests used for group comparisons. Results: The composite knowledge score (C1–C9; maximum 9) was 6.12 ± 2.25 with wide item-level variation. Internal consistency was acceptable, and the Attitudes subscale resolved into two factors (Motivation & Self-Efficacy and Perceived Barriers). Screening engagement was critically low (92.4% never tested; 81.7% unaware of the national programme). Although 64.1% expressed willingness to change their diet, 46.2% reported consuming processed meat at least weekly. Motivation & Self-Efficacy, but not the knowledge score, was inversely correlated with risk-food consumption (ρ = −0.39, p < 0.001). Conclusions: EduNutriCRC demonstrated acceptable psychometric properties at the pilot stage. The study identified prevalent nutritional misconceptions, a marked knowledge–behaviour gap, low screening awareness, and a structural mismatch between information sources used and those trusted. Attitudes and self-efficacy, rather than factual knowledge, were the more proximal correlates of dietary behaviour, supporting the development of self-efficacy-focused, culturally adapted educational interventions for CRC prevention in Romania, with EduNutriCRC serving as a baseline and monitoring instrument.

Keywords: colorectal cancer; nutritional prevention; knowledge–attitudes–practices (KAP); questionnaire; nutrition education; dietary risk factors; cancer prevention; health literacy; pilot validation study

Graphical Abstract

Share and Cite

MDPI and ACS Style

Neamțu, A.-A.; Anton, A.; Maghiar, L.; Iftode, A.; Căpraru, A.-M.; Dumitrescu, C.; Kis, A.-M.; Popovici, R.A.; Dehelean, C.-A.; Maghiar, T.-A. The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults. Nutrients 2026, 18, 2293. https://doi.org/10.3390/nu18142293

AMA Style

Neamțu A-A, Anton A, Maghiar L, Iftode A, Căpraru A-M, Dumitrescu C, Kis A-M, Popovici RA, Dehelean C-A, Maghiar T-A. The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults. Nutrients. 2026; 18(14):2293. https://doi.org/10.3390/nu18142293

Chicago/Turabian Style

Neamțu, Andreea-Adriana, Alina Anton, Laura Maghiar, Andrada Iftode, Anca-Maria Căpraru, Cristina Dumitrescu, Andreea-Mihaela Kis, Ramona Amina Popovici, Cristina-Adriana Dehelean, and Teodor-Andrei Maghiar. 2026. "The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults" Nutrients 18, no. 14: 2293. https://doi.org/10.3390/nu18142293

APA Style

Neamțu, A.-A., Anton, A., Maghiar, L., Iftode, A., Căpraru, A.-M., Dumitrescu, C., Kis, A.-M., Popovici, R. A., Dehelean, C.-A., & Maghiar, T.-A. (2026). The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults. Nutrients, 18(14), 2293. https://doi.org/10.3390/nu18142293

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Menu

The EduNutriCRC Questionnaire: A Pilot Knowledge–Attitudes–Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Further Information

Guidelines

MDPI Initiatives

Follow MDPI