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Yeary KHK, Clark N, Saad-Harfouche F, Erwin D, Kuliszewski MG, Li Q, McCann SE, Yu H, Lincourt C, Zoellner J, Tang L. Cruciferous Vegetable Intervention to Prevent Cancer Recurrence in Non-Muscle Invasive Bladder Cancer Survivors: Development using a Systematic Process (Preprint). JMIR Cancer 2021; 8:e32291. [PMID: 35166681 PMCID: PMC8889476 DOI: 10.2196/32291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/30/2021] [Accepted: 01/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Bladder cancer is one of the top 10 most common cancers in the United States. Most bladder cancers (70%-80%) are diagnosed at early stages as non–muscle-invasive bladder cancer (NMIBC), which can be removed surgically. However, 50% to 80% of NMIBC cases recur within 5 years, and 15% to 30% progress with poor survival. Current treatments are limited and expensive. A wealth of preclinical and epidemiological evidence suggests that dietary isothiocyanates in cruciferous vegetables (Cruciferae) could be a novel, noninvasive, and cost-effective strategy to control NMIBC recurrence and progression. Objective The aim of this study is to develop a scalable dietary intervention that increases isothiocyanate exposure through Cruciferae intake in NMIBC survivors. Methods We worked with a community advisory board (N=8) to identify relevant factors, evidence-based behavior change techniques, and behavioral theory constructs used to increase Cruciferae intake in NMIBC survivors; use the PEN-3 Model focused on incorporating cultural factors salient to the group’s shared experiences to review the intervention components (eg, the saliency of behavioral messages); administer the revised intervention to community partners for their feedback; and refine the intervention. Results We developed a multicomponent intervention for NMIBC survivors consisting of a magazine, tracking book, live telephone call script, and interactive voice messages. Entitled POW-R Health: Power to Redefine Your Health, the intervention incorporated findings from our adaptation process to ensure saliency to NMIBC survivors. Conclusions This is the first evidence-based, theoretically grounded dietary intervention developed to reduce bladder cancer recurrence in NMIBC survivors using a systematic process for community adaptation. This study provides a model for others who aim to develop behavioral, community-relevant interventions for cancer prevention and control with the overall goal of wide-scale implementation and dissemination.
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Affiliation(s)
- Karen H Kim Yeary
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Nikia Clark
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Frances Saad-Harfouche
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Deborah Erwin
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Margaret Gates Kuliszewski
- New York State Cancer Registry, New York State Department of Health, Albany, NY, United States
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY, United States
| | - Qiang Li
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- Department of Pharmacology & Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Susan E McCann
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Han Yu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Catherine Lincourt
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Jamie Zoellner
- Department of Public Health Science, University of Virginia, Charlottesville, VA, United States
| | - Li Tang
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Herghelegiu AM, Wenzel KM, Moser A, Prada GI, Nuta CR, Stuck AE. Effects of Health Risk Assessment and Counselling on Fruit and Vegetable Intake in Older People: A Pragmatic Randomised Controlled Trial. J Nutr Health Aging 2020; 24:591-597. [PMID: 32510111 DOI: 10.1007/s12603-020-1373-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Interventions to increase fruit and vegetable intake among community-dwelling older people have shown mixed effects. We investigated whether an intervention based on an initial multidimensional health risk assessment and subsequent physician-lead nutrition counselling has favourable effects on dietary intake among community-dwelling older people. DESIGN Randomised controlled trial comparing the intervention versus usual care. SETTING AND PARTICIPANTS Non-disabled persons aged 65 years or older at an ambulatory geriatric clinic in Bucharest, Romania, allocated to intervention (n=100) and control (n=100) groups. INTERVENTION Participants received a computer-generated health profile report based on answers to a health risk assessment questionnaire, followed by monthly individual counselling sessions with a geriatrician on topics related to health promotion and disease prevention, with a special focus on adequate fruit and vegetable consumption. MEASUREMENTS Fruit and vegetable intake at baseline and at 6-month follow-up. RESULTS At baseline, fruit and vegetable intake was below the recommended five portions per day in most study participants (85% in the intervention group, and 86% among controls, respectively). At six months, intake increased in the intervention group from a median of 3.8 to 4.6 portions per day, and decreased in the control group due to a seasonal effect from a median of 3.8 to 3.1 portions per day. At six months, fruit and vegetable consumption was significantly higher among persons in the intervention group as compared to controls (median difference 1.4 portions per day, 95% confidence interval 1.1-1.7, p<0.001). CONCLUSION Personalised food-based dietary guidance, delivered as part of multidimensional preventive health counselling during geriatric clinic visits, results in relevant improvement of fruit and vegetable intake in community-dwelling older adults.
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Affiliation(s)
- A M Herghelegiu
- Andreas Ernst Stuck, Department of Geriatrics, Inselspital, University Hospital Bern, and University of Bern, Bern, Switzerland,
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Nanri H, Yamada Y, Itoi A, Yamagata E, Watanabe Y, Yoshida T, Miyake M, Date H, Ishikawa-Takata K, Yoshida M, Kikutani T, Kimura M. Frequency of Fruit and Vegetable Consumption and the Oral Health-Related Quality of Life among Japanese Elderly: A Cross-Sectional Study from the Kyoto-Kameoka Study. Nutrients 2017; 9:nu9121362. [PMID: 29244736 PMCID: PMC5748812 DOI: 10.3390/nu9121362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/10/2017] [Accepted: 12/13/2017] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Many previous studies have reported that fruit and vegetable consumption is associated with a reduced risk of various disease, but whether or not their consumption is associated with the oral health-related quality of life (OHRQoL) is unclear. The objective of this study was to examine the association between the frequency of fruit and vegetable consumption and the OHRQoL in elderly subjects by sex. METHODS We analyzed cross-sectional data from a population-based Kyoto-Kameoka Study in 2012 of 3112 men and 3439 women (age ≥ 65 years). The frequencies of fruit and vegetable consumption were assessed using a validated food frequency questionnaire. We evaluated the OHRQoL using the General Oral Health Assessment Index (GOHAI), a self-reported measure designed to assess the oral health problems in old adults. RESULTS After adjusting for age, body mass index, alcohol, smoking, education, socioeconomic status, history of disease, medication use, mobility disability, and total energy intake, a higher frequency of combined fruit and vegetable consumption showed a significant positive association with the GOHAI score in both men and women (p-trend < 0.001 in both sexes). These associations remained significant after adjustment for poor mastication and denture use (p-trend all < 0.05 in both sexes). We observed a significant positive association even when the frequencies of fruit or vegetable consumption were analyzed separately (all p-trend < 0.05 in both sexes). CONCLUSIONS A higher frequency of fruit and/or vegetable consumption independently showed a strong positive association with the OHRQoL in both men and women. Further prospective studies are needed to confirm these findings.
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Affiliation(s)
- Hinako Nanri
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
| | - Yosuke Yamada
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
| | - Aya Itoi
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo 650-0046, Japan.
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyoto 610-0395, Japan.
| | - Yuya Watanabe
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
- Faculty of Health and Sports Science, Doshisha University, Kyoto 610-0394, Japan.
| | - Tsukasa Yoshida
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
- Senior Citizens' Welfare Section, Kameoka City Government, Kyoto 621-8501, Japan.
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
| | - Heiwa Date
- Department of Data Science, Shiga University, Shiga 522-8522, Japan.
| | - Kazuko Ishikawa-Takata
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan.
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima 734-8553, Japan.
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University, Tokyo 184-0011, Japan.
| | - Misaka Kimura
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kyoto 621-8555, Japan.
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
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