Leveraging the close bonds between patients and their oncology providers, we propose to assess the efficacy of an innovative intervention strategy to integrate nutrition into standard oncology care using the 5As model (Ask, Advise, Assess, Assist, and Arrange), an evidence-based behavioral counseling framework with proven application in other areas of clinical practice. The oncology care provider will ask the patient to complete a nutrition assessment at outpatient visits (Ask), and advise the patient to follow evidence-based nutrition recommendations using a Nutrition Prescription (Advise). The provider will further refer the patient to a nutritionist to assess the patient’s individual nutritional needs (Assess). The provider will distribute the Nutrition Toolkit to the patient, and the nutritionist will assist the patient to set up personalized nutritional goals (Assist). The provider will refer the patient to receive home delivery of medically tailored meals and to a nutritionist for nutritional counseling (Arrange).

The Nutrition Prescription aims to enhance providers’ role in communicating basic nutrition advice to patients with lung cancer. It contains seven recommendations, adapted from the newly released Cancer Prevention Recommendations by WCRF/AICR with strong evidence-base. Providers can advise patients to follow evidence-based nutrition recommendations using a Nutrition Prescription. Cancer patients undergoing treatment often experience treatment-related side effects that could impact nutrition. Oncology providers will refer patients to nutritionists who will assess patients’ individual nutritional needs during each treatment phase and assist patients in establishing personalized nutritional goals as part of the Nutrition Prescription.