PERCEPTION, ATTITUDES, AND BELIEFS TOWARDS SOY AMONG HEALTHY ASIAN WOMEN PARTICIPATING IN A SOY INTERVENTION TRIAL

Introduction: The soy-breast cancer risk relationship has remained controversial due to limited and inconsistent research findings. This is exacerbated by difficulties in recruiting and retaining participants in dietary intervention trials. Perception is known to influence recruitment and retention. Yet, little is known about the public’s perception towards soy, most especially within the Asian population. Here, we describe the perception, attitudes and beliefs towards soy in a cohort of healthy, Asian post-menopausal women and how this influences participation in a soy intervention trial. Materials and Method: A close -ended survey on perception, attitudes and beliefs on soy was administered at baseline to 131 women enrolled into The Malaysian Soy and Mammographic Density (MiSo) Study. Fisher’s test was used to measure differences in perception between retained (“active”) participants and discontinued/lost to follow up (“withdrawn”) participants. Motivators and barriers to regular soy consumption were deductively mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) Model and the Theoretical Domains Framework (TDF). Results: Out of 131 enrolled women, 86 (65.5%) are active and 45 (34.4%) are withdrawn. Our cohort mostly consists of Chinese women (77.9%) ranging between the ages of 45 – 65. A total of 114 (87.0%) women are post-menopausal and 17 (13.0%) are peri-menopausal. 
Most women enter the study with a positive perception towards soy. However, compared to active participants, withdrawn participants were less likely to have heard anything about soy, though this was not significant. Using the COM-B Model, we noted that one’s social environment plays an underlying large role in consuming soy regularly. Additionally, active participants were more motivated by their social environment, while withdrawn participants had more personal motivations,  though this was not statistically significant. Conversely, the main barrier to regular soy consumption was in the knowledge domain, such as GMO soybeans and high sugar content in soy milk. Discussion/Conclusion: Post-menopausal Asian women generally have a positive perception of soy, which appears to be driven by their social environment. This study suggests that improving the quality of information about the benefits and risks of consuming soy may encourage more Asian women to incorporate regular soy intake into their diet. Furthermore, it underscores the importance of using a theorybased approach in the design of dietary intervention studies to improve participant recruitment and retention.