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Brenne SS, Ness-Jensen E, Laugsand EA. External validation of the colorectal cancer risk score LiFeCRC using food frequency questions in the HUNT study. Int J Colorectal Dis 2024; 39:57. [PMID: 38662227 PMCID: PMC11045582 DOI: 10.1007/s00384-024-04629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To mitigate the increasing colorectal cancer (CRC) incidence globally and prevent CRC at the individual level, individual lifestyle information needs to be easily translated into CRC risk assessment. Several CRC risk prediction models exist and their clinical usefulness depends on their ease of use. Our objectives were to assess and externally validate the LiFeCRC score in our independent, unselected population and to investigate the use of simpler food frequency measurements in the score. METHODS Incidental colon and rectal cancer cases were compared to the general population among 78,580 individuals participating in a longitudinal health study in Norway (HUNT). Vegetable, dairy product, processed meat and sugar/confectionary consumption was scored based on food frequency. The LiFeCRC risk score was calculated for each individual. RESULTS Over a median of 10 years following participation in HUNT, colon cancer was diagnosed in 1355 patients and rectal cancer was diagnosed in 473 patients. The LiFeCRC score using food frequencies demonstrated good discrimination in CRC overall (AUC 0.77) and in sex-specific models (AUC men 0.76 and women 0.77) in this population also including individuals ≥ 70 years and patients with diabetes. It performed somewhat better in colon (AUC 0.80) than in rectal cancer (AUC 0.72) and worked best for female colon cancer (AUC 0.81). CONCLUSION Readily available clinical variables and food frequency questions in a modified LiFeCRC score can identify patients at risk of CRC and may improve primary prevention by motivating to lifestyle change or participation in the CRC screening programme.
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Affiliation(s)
- Siv S Brenne
- Department of Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Forskningsveien 2, N-7600, Levanger, Norway.
| | - Eivind Ness-Jensen
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Forskningsveien 2, N-7600, Levanger, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Eivor A Laugsand
- Department of Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Forskningsveien 2, N-7600, Levanger, Norway
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Symvoulakis EK, Stachteas P, Smyrnakis E, Volkos P, Mantadaki AE, Karelis A, Petraki C, Nioti K, Mastronikolis S, Antoniou AM, Linardakis M. Multiple Behavioral Risk Factors As Assets for Chronic Disease Prevention: Observations From Urban Primary Care Settings in Crete, Greece. Cureus 2024; 16:e56711. [PMID: 38646332 PMCID: PMC11032647 DOI: 10.7759/cureus.56711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
AIM This study aimed to assess the health profile of patient-attendees visiting primary healthcare (PHC) practice settings in the midst of the COVID-19 pandemic and to explore the relationships between multiple behavioral risk factors (MBRFs) and consultation-driven health information. Multiple behavioral risk factors involve a variety of unhealthy behaviors that are associated with an increased prevalence of non-communicable diseases (NCDs). SUBJECTS AND METHODS The study design was based on a dataset analysis, afterward exploring the feasibility and diagnostic capacity of respiratory morbidity aspects from a study previously conducted. The study dataset contained information regarding socio-demographic characteristics, health habits, clinical information, and reported comorbidities from 183 primary care patient-attendees. A categorical regression analysis was performed, using as a numeric variable the multiple MBRFs (clustering of 0 to four factors) in order to examine relationships with the basic and clinical characteristics of the patient-attendees. RESULTS Based on this secondary analysis, it was found that the prevalence of MBRFs is quite common among patient-attendees visiting urban PHC facilities. The prevalence of current smoking, sleep deprivation, increased body weight, and medium/high perceived stress levels were 33.9%, 52.5%, 83.1%, and 35.0%, respectively. An increased occurrence of MBRFs might be significantly predicted by the lower age of patient-attendees (b = -0.221, p = 0.05), by the absence of gray hair at an early age (b = -0.144, p = 0.042), by the physical discomfort during activities (b = 0.191, p = 0.017), or by the lower oxygen saturation (b = -0.184, p = 0.004). Diabetes mellitus (25.1%) was the most prevalent condition, followed by bronchial asthma (18.6%) and depression (15.8%). CONCLUSIONS Lower age, absence of premature hair whitening, physical discomfort during activities, and lower oxygen saturation are linked with an increased occurrence of MBRFs, leading to a neglected way of living. Those factors could be used to alert researchers, policymakers, and PHC professionals to act accordingly in order to prevent or early diagnose NCDs.
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Affiliation(s)
- Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Panagiotis Stachteas
- Laboratory of Primary Health Care, General Practice and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Panagiotis Volkos
- Fourth Local Health Team, Academic Unit of Heraklion, Heraklion, GRC
| | - Aikaterini E Mantadaki
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Andreas Karelis
- Department of Family Medicine, Private Primary Care Facilities, Heraklion, GRC
| | - Chrysi Petraki
- Department of Family Medicine, Private Primary Care Facilities, Heraklion, GRC
| | - Kadiani Nioti
- Department of Family Medicine, Private Primary Care Facilities, Heraklion, GRC
| | | | - Aikaterini M Antoniou
- Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Manolis Linardakis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
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Shah V, Geller G, Xu D, Taylor L, Griffin S, Usher-Smith JA. Evaluating the potential impact of lifestyle-based behavior change interventions delivered at the time of colorectal cancer screening. Cancer Causes Control 2024; 35:561-574. [PMID: 37925646 PMCID: PMC10838843 DOI: 10.1007/s10552-023-01773-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/01/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE To analyze interventions implemented at the time of colorectal cancer (CRC) screening, or among individuals who have previously undergone investigation for CRC, focused on reducing CRC risk through promotion of lifestyle behavior change. Additionally, this review evaluated to what extent such interventions apply behavior change techniques (BCTs) to achieve their objectives. METHODS Five databases were systematically searched to identify randomized control trials seeking to reduce CRC risk through behavior change. Outcomes were changes in health-related lifestyle behaviors associated with CRC risk, including changes in dietary habits, body mass index, smoking behaviors, alcohol consumption, and physical activity. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random effects models. BCT's were coded from a published taxonomy of 93 techniques. RESULTS Ten RCT's met the inclusion criteria. Greater increase in fruit/vegetable consumption in the intervention group were observed with respect to the control (SMD 0.13, 95% CI 0.08 to 0.18; p < 0.001). Across fiber, alcohol, fat, red meat, and multivitamin consumption, and smoking behaviors, similar positive outcomes were observed (SMD 0.09-0.57 for all, p < 0.01). However, among physical activity and body mass index, no difference between the intervention groups compared with controls were observed. A median of 7.5 BCTs were applied across included interventions. CONCLUSION While magnitude of the observed effect sizes varied, they correspond to potentially important changes in lifestyle behaviors when considered on a population scale. Future interventions should identify avenues to maximize long-term engagement to promote sustained lifestyle behavior change.
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Affiliation(s)
- Veeraj Shah
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - Greta Geller
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Diane Xu
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Lily Taylor
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
| | - Simon Griffin
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
| | - Juliet A Usher-Smith
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
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Riggi E, Baccini M, Camussi E, Gallo F, Anatrone C, Pezzana A, Senore C, Giordano L, Segnan N. Promoting healthy lifestyle habits among participants in cancer screening programs: Results of the randomized controlled Sti.Vi study. J Public Health Res 2022; 11:22799036221106542. [PMID: 35928498 PMCID: PMC9343860 DOI: 10.1177/22799036221106542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Unhealthy diets, physical inactivity, alcohol and tobacco consumption are among the leading risk factors for non-communicable diseases. It is estimated that around 40% of cancers could be prevented by adopting healthy lifestyles. Design and methods: The Stili di Vita (Sti.Vi) study was a randomized study for assessing the impact of healthy lifestyle interventions on anthropometric measures, metabolic parameters, and health outcomes among participants of cancer screening programs in Turin (Italy). Eligible women aged 50–54 years, invited to biennial mammography screening, and 58-years-old men and women, invited to a once-only sigmoidoscopy for colorectal cancer (CRC) screening were randomly allocated to Diet group (DG), Physical Activity group (PAG), Physical Activity plus Diet group (PADG), or control group (CG). Physical and eating habits, metabolic and anthropometric measurements, repeatedly collected, were the study outcomes. The active intervention, offered to participants assigned to the DG, PAG, and PADG arms, consisted of a basic module and an advanced module. The effect of the interventions was estimated through logistic regression or a difference in differences approach. A multiple imputation procedure was implemented to deal with missing values and q-values have been calculated in the presence of multiple hypothesis testing. Results: Out of the 8442 screened attendees, 1270 signed informed consent, while 1125 participants accomplished the baseline visit. Participants were equally distributed across the four treatments as following: 273 (24.3%) in DG, 288 (25.6%) in the PAG, 283 (25.1%) in PADG, and 281 (25%) in the CG. Participants assigned to DG or PADG increased their consumption of whole grains (OR = 1.77, 95% CI: 1.20–2.60 and OR = 1.55, 95% CI: 1.06–2.27, respectively) and legumes (OR = 1.77, 95% CI: 1.12–2.79 and OR = 2.24, 95% CI: 1.41–3.57, respectively), with respect to CG. The participants randomized to DG reduced processed meat and increased fruit consumption (OR = 2.57, 95% CI: 1.76–3.76 and OR = 2.38, 95% CI: 1.12–5.06, respectively). The effects were more evident in the CRC screening subgroup. No relevant difference was observed between PAG and CG. No impact was observed on physical activity habits. Conclusions: Our findings suggest that active interventions can increase awareness and induce diet changes. However, participation rate and compliance to the courses was quite low, innovative strategies to enhance participants’ retention are needed, with the ultimate goal of increasing awareness and inducing positive lifestyle changes.
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Affiliation(s)
- Emilia Riggi
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Elisa Camussi
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Federica Gallo
- Epidemiology Unit, Staff Health Direction, Local Health Authority 1 of Cuneo, Cuneo, Italy
| | - Caterina Anatrone
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Andrea Pezzana
- Dietetics and Clinical Nutrition Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Carlo Senore
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Livia Giordano
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Nereo Segnan
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
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Ronto R, Saberi G, Leila Robbers GM, Godrich S, Lawrence M, Somerset S, Fanzo J, Chau JY. Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000209. [PMID: 36962370 PMCID: PMC10021177 DOI: 10.1371/journal.pgph.0000209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/23/2022] [Indexed: 11/18/2022]
Abstract
Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review literature on effectiveness of those interventions aiming to promote protein-rich foods from lower ecological footprint sources. Five electronic databases (Medline, Web of Science, Scopus, Embase and Global Health) were searched for articles published up to January 2021. Quantitative studies were eligible for inclusion if they reported on actual or intended consumption of protein-rich animal-derived and/or plant-based foods; purchase, or selection of meat/plant-based diet in real or virtual environments. We assessed 140 full-text articles for eligibility of which 51 were included in this review. The results were narratively synthesised. Included studies were categorised into individual level behaviour change interventions (n = 33) which included education, counselling and self-monitoring, and micro-environmental/structural behaviour change interventions (n = 18) which included menu manipulation, choice architecture and multicomponent approaches. Half of individual level interventions (52%) aimed to reduce red/processed meat intake among people with current/past chronic conditions which reduced meat intake in the short term. The majority of micro-environmental studies focused on increasing plant-based diet in dining facilities, leading to positive dietary changes. These findings point to a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.
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Affiliation(s)
- Rimante Ronto
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | - Golsa Saberi
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | | | - Stephanie Godrich
- School of Medicine and Health Sciences, Edith Cowan University, Perth, Australia
| | - Mark Lawrence
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Shawn Somerset
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Jessica Fanzo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Josephine Y. Chau
- Department of Health Sciences, Macquarie University, Sydney, Australia
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6
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Kwasny T, Dobernig K, Riefler P. Towards reduced meat consumption: A systematic literature review of intervention effectiveness, 2001-2019. Appetite 2021; 168:105739. [PMID: 34648912 DOI: 10.1016/j.appet.2021.105739] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 07/16/2021] [Accepted: 10/06/2021] [Indexed: 01/28/2023]
Abstract
A reduction of meat consumption and shift to plant-based diets, especially in industrialized countries, is acknowledged as crucial for reaching climate targets, addressing public health problems, and protecting animal welfare. While scholarly research distilled drivers of meat consumption and barriers to its reduction, insights into the effectiveness of measures to initiate such a profound change in consumer behaviour are relatively scarce. This paper presents a systematic literature review on consumption-side interventions in the context of meat consumption across scholarly disciplines. Our analysis confirms that existing research predominantly assessed interventions addressing personal factors of behavioural change such as knowledge and emotions. Whether these interventions are effective depends on whether information (i) is provided on health, animal welfare or environmental effects, (ii) is emotionally or cognitively framed, and (iii) is aligned with consumers' information needs. Moreover, linking meat to living animals or to the humanness of animals activates negative emotions and, thus, reduces meat consumption. Further, increasing the visibility and variety of vegetarian dishes in food environments decreases meat-eating. Also, educational courses on how to shop and cook vegetarian food are effective in reducing meat consumption. There is less evidence on the effectiveness of interventions addressing socio-cultural factors such as social norms. Regarding future research directions, existing research mainly investigated the influence of interventions on attitudes and behavioural intentions. Hence, there is still a need for studies to assess more long-term effects of intervention measures on actual meat consumption and their potential to initiate fundamental changes in dietary habits.
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Affiliation(s)
- Tatjana Kwasny
- University of Applied Sciences Wiener Neustadt, Institute of Marketing & Sales, Schloegelgasse 22-26, 2700, Wiener Neustadt, Austria; University of Natural Resources and Life Sciences, Institute of Marketing & Innovation, Feistmantelstrasse 4, 1180, Vienna, Austria.
| | - Karin Dobernig
- University of Applied Sciences Wiener Neustadt, Institute for Sustainability, Zeiselgraben 4, 3250, Wieselburg, Austria; WU Vienna University of Economics and Business, Institute for Ecological Economics, Welthandelsplatz 1/D5/Level 3, 1020, Vienna, Austria.
| | - Petra Riefler
- University of Natural Resources and Life Sciences, Institute of Marketing & Innovation, Feistmantelstrasse 4, 1180, Vienna, Austria.
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Unanue-Arza S, Solís-Ibinagagoitia M, Díaz-Seoane M, Mosquera-Metcalfe I, Idigoras I, Bilbao I, Portillo I. Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review. Eur J Public Health 2021; 31:346-355. [PMID: 33313657 PMCID: PMC8071594 DOI: 10.1093/eurpub/ckaa203] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Colorectal cancer (CRC) screening programmes require high levels of participation in order to reduce mortality. To improve participation rates, it is necessary to identify the health risk factors and social inequalities associated with non-participation. Methods A systematic review was conducted between June and September of 2019 in six databases: CINHAL, Medline, Scopus, Social Sciences Citation Index, Embase and PsycINFO. Studies assessing the relationship between health risk factors, participation in preventive activities and participation in CRC screening were included. Methodological assessment was carried out according to the Quality Assessment Tools of the National Heart, Lung and Blood Institute. Results A total of nine studies that analyze participation in both organized and opportunistic screening programmes using any type of screening method were finally selected. Data were mainly self-reported although in two studies medical records were also studied. We identified several variables: gender, body mass index, consultation with a doctor or a specialist, educational level, employment, health insurance, residence, ethnicity, age, marital status, income, other preventive activities, obesity, physical activity, smoking, family history of CRC and general health status. Conclusion The scarcity of studies linking risk factors, social inequalities and participation in preventive activities for participation in screening in the same study makes it difficult to reach definitive patterns related to non-participation in CRC screening programmes. Nevertheless, being under 60, obese, smoker and sedentary have shown an association with non-participation as well as not visiting a doctor.
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Affiliation(s)
- Saloa Unanue-Arza
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Bizkaia, Spain
- Correspondence: Saloa Unanue-Arza., Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Barrio Sarriena s/n 48940 Leioa, Bizkaia, Spain, Tel: +34 946 01 5610, e-mail:
| | | | - Marta Díaz-Seoane
- Department of Preventive Medicine and Public Health, University Clinical Hospital of Valladolid, Valladolid, Spain
| | | | - Isabel Idigoras
- BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
- Basque Country Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Isabel Bilbao
- BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
- Basque Country Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Isabel Portillo
- BioCruces-Bizkaia Health Research Institute, Barakaldo, Spain
- Basque Country Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, Bilbao, Spain
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Yuwaki K, Kuchiba A, Otsuki A, Odawara M, Okuhara T, Ishikawa H, Inoue M, Tsugane S, Shimazu T. Effectiveness of a Cancer Risk Prediction Tool on Lifestyle Habits: A Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2021; 30:1063-1071. [PMID: 33771848 DOI: 10.1158/1055-9965.epi-20-1499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/29/2021] [Accepted: 03/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Risk prediction models offer a promising approach to lifestyle modification. We evaluated the effect of personalized advice based on cancer risk prediction in improving five lifestyle habits (smoking, alcohol consumption, salt intake, physical activity, and body mass index) compared with standard advice without risk prediction among a Japanese general population with at least one unhealthy lifestyle habit. METHODS In a parallel-design, single-blind, randomized controlled trial between February 2018 and July 2019, 5984 participants aged 40-64 years with unhealthy lifestyle habits were recruited from persons covered under a life insurance policy. They were randomly assigned to an intervention or control group and received personalized or standard advice, respectively. They were also sent an invitation to participate in a lifestyle modification program aimed at improving lifestyle. Primary outcome was an improvement in lifestyle, defined as an increase in healthy lifestyle habits within 6 months. RESULTS The proportion of participants who improved their lifestyle within 6 months in the intervention group did not significantly differ from that in the control group (18.4% vs. 17.7%; P = 0.488). Among participants with low health literacy and two or fewer of five healthy habits, the proportion of participants subscribing to the lifestyle modification program was higher in the intervention group than in the control group. CONCLUSIONS Compared with standardized advice, personalized advice based on cancer risk prediction had no effect on improving lifestyle. IMPACT Provision of predicted cancer risk information did not induce change in unhealthy lifestyle.
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Affiliation(s)
- Keiichi Yuwaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan.,Underwriting and Medical Department, The Dai-ichi Life Insurance Company, Limited, Koto-ku, Tokyo, Japan
| | - Aya Kuchiba
- Division of Biostatistical Research, Center for Public Health Sciences/Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Aki Otsuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Miyuki Odawara
- Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hirono Ishikawa
- Teikyo University Graduate School of Public Health, Itabashi-ku, Tokyo, Japan
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan.
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9
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Galekop MMJ, Uyl-de Groot CA, Ken Redekop W. A Systematic Review of Cost-Effectiveness Studies of Interventions With a Personalized Nutrition Component in Adults. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:325-335. [PMID: 33641765 DOI: 10.1016/j.jval.2020.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Important links between dietary patterns and diseases have been widely applied to establish nutrition interventions. However, knowledge about between-person heterogeneity regarding the benefits of nutrition intervention can be used to personalize the intervention and thereby improve health outcomes and efficiency. We performed a systematic review of cost-effectiveness analyses (CEAs) of interventions with a personalized nutrition (PN) component to assess their methodology and findings. METHODS A systematic search (March 2019) was performed in 5 databases: EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar. CEAs involving interventions in adults with a PN component were included; CEAs focusing on clinical nutrition or undernutrition were excluded. The CHEERS checklist was used to assess the quality of CEAs. RESULTS We identified 49 eligible studies among 1792 unique records. Substantial variation in methodology was found. Most studies (91%) focused only on psychological concepts of PN such as behavior and preferences. Thirty-four CEAs were trial-based, 13 were modeling studies, and 4 studies were both trial- and model-based. Thirty-two studies used quality-adjusted life year as an outcome measure. Different time horizons, comparators, and modeling assumptions were applied, leading to differences in costs/quality-adjusted life years. Twenty-eight CEAs (49%) concluded that the intervention was cost-effective, and 75% of the incremental cost-utility ratios were cost-effective given a willingness-to-pay threshold of $50 000 per quality-adjusted life year. CONCLUSIONS Interventions with PN components are often evaluated using various types of models. However, most PN interventions have been considered cost-effective. More studies should examine the cost-effectiveness of PN interventions that combine psychological and biological concepts of personalization.
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Affiliation(s)
- Milanne M J Galekop
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Carin A Uyl-de Groot
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - W Ken Redekop
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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10
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Aleksandrova K, Reichmann R, Kaaks R, Jenab M, Bueno-de-Mesquita HB, Dahm CC, Eriksen AK, Tjønneland A, Artaud F, Boutron-Ruault MC, Severi G, Hüsing A, Trichopoulou A, Karakatsani A, Peppa E, Panico S, Masala G, Grioni S, Sacerdote C, Tumino R, Elias SG, May AM, Borch KB, Sandanger TM, Skeie G, Sánchez MJ, Huerta JM, Sala N, Gurrea AB, Quirós JR, Amiano P, Berntsson J, Drake I, van Guelpen B, Harlid S, Key T, Weiderpass E, Aglago EK, Cross AJ, Tsilidis KK, Riboli E, Gunter MJ. Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score. BMC Med 2021; 19:1. [PMID: 33390155 PMCID: PMC7780676 DOI: 10.1186/s12916-020-01826-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/23/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. METHODS The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992-2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. RESULTS The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell's C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264-0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084-0.575)). CONCLUSIONS LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level.
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Affiliation(s)
- Krasimira Aleksandrova
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
| | - Robin Reichmann
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mazda Jenab
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | | | | | - Fanny Artaud
- CESP, Faculté de Medicine, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | | | - Gianluca Severi
- CESP, Faculté de Medicine, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Dipartimento di Statistica, Informatica e Applicazioni "G. Parenti" (DISIA), University of Florence, Florence, Italy
| | - Anika Hüsing
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | | | - Salvatore Panico
- EPIC Centre of Naples, Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II, Naples, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | - Sjoerd G Elias
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kristin B Borch
- Department of Community Medicine, Health Faculty, UiT-the Arctic university of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Health Faculty, UiT-the Arctic university of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, Health Faculty, UiT-the Arctic university of Norway, Tromsø, Norway
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universidad de Granada, Granada, Spain
| | - José María Huerta
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Núria Sala
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Translational Research Laboratory, Catalan Institute of Oncology (ICO), Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Aurelio Barricarte Gurrea
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Ministry of Health of the Basque Government, Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Jonna Berntsson
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Isabel Drake
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Bethany van Guelpen
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elom K Aglago
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Marc J Gunter
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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11
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Minian N, Corrin T, Lingam M, deRuiter WK, Rodak T, Taylor VH, Manson H, Dragonetti R, Zawertailo L, Melamed OC, Hahn M, Selby P. Identifying contexts and mechanisms in multiple behavior change interventions affecting smoking cessation success: a rapid realist review. BMC Public Health 2020; 20:918. [PMID: 32532233 PMCID: PMC7291527 DOI: 10.1186/s12889-020-08973-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome. Methods This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis. Results Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts. Conclusion In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment). Trial registration PROSPERO registration number: CRD42017064430
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Affiliation(s)
- Nadia Minian
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Tricia Corrin
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Mathangee Lingam
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Wayne K deRuiter
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, 1403 - 29 Street NW, Calgary, Alberta, T2N 2T9, Canada
| | - Heather Manson
- Public Health Ontario, 480 University Avenue, Toronto, Ontario, M5G 1V2, Canada
| | - Rosa Dragonetti
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Laurie Zawertailo
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Osnat C Melamed
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Margaret Hahn
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada. .,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. .,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
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12
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Mezerji NMG, Moghimbeigi A, Eghbalian M, Kopaei MR. Investigating the effect of herbal antioxidants on the process of colon cancer treatment: A systematic review. COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1735682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
| | - Abbas Moghimbeigi
- Department of Epidemiology and Biostatistics, School of Public Health, Alborz University of Medical Sciences Karaj Iran
| | - Mostafa Eghbalian
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences Hamadan Iran
| | - Mahmoud Rafieian Kopaei
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences Shahrekord Iran
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13
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Mills K, Griffin SJ, Sutton S, Usher-Smith JA. Development and usability testing of a very brief intervention for personalised cancer risk assessment to promote behaviour change in primary care using normalisation process theory. Prim Health Care Res Dev 2020; 21:e1. [PMID: 31934843 PMCID: PMC7005588 DOI: 10.1017/s146342361900080x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/13/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cancer is the second leading cause of death worldwide. Lifestyle choices play an important role in the aetiology of cancer with up to 4 in 10 cases potentially preventable. Interventions delivered by healthcare professionals (HCPs) that incorporate risk information have the potential to promote behaviour change. Our aim was to develop a very brief intervention incorporating cancer risk, which could be implemented within primary care. METHODS Guided by normalisation process theory (NPT), we developed a prototype intervention using literature reviews, consultation with patient and public representatives and pilot work with patients and HCPs. We conducted focus groups and interviews with 65 HCPs involved in delivering prevention activities. Findings were used to refine the intervention before 22 HCPs completed an online usability test and provided further feedback via a questionnaire incorporating a modified version of the NoMAD checklist. RESULTS The intervention included a website where individuals could provide information on lifestyle risk factors view their estimated 10-year risk of developing one or more of the five most common preventable cancers and access lifestyle advice incorporating behaviour change techniques. Changes incorporated from feedback from the focus groups and interviews included signposting to local services and websites, simplified wording and labelling of risk information. In the usability testing, all participants felt it would be easy to collect the risk information. Ninety-one percent felt the intervention would enable discussion about cancer risk and believed it had potential to be easily integrated into National Health Service (NHS) Health Checks. However, only 36% agreed it could be delivered within 5 min. CONCLUSIONS With the use of NPT, we developed a very brief intervention that is acceptable to HCPs in primary care and could be potentially integrated into NHS Health Checks. However, further work is needed to assess its feasibility and potential effectiveness.
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Affiliation(s)
- Katie Mills
- Research Associate, The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J. Griffin
- Professor of General Practice, The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Stephen Sutton
- Professor of Behavioural Science, The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Juliet A. Usher-Smith
- Clinical Senior Research Associate, The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
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14
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Mujcic A, Blankers M, Bommelé J, Boon B, Berman AH, Verdonck‐de Leeuw IM, van Laar M, Engels R. The effectiveness of distance‐based interventions for smoking cessation and alcohol moderation among cancer survivors: A meta‐analysis. Psychooncology 2020; 29:49-60. [PMID: 31663182 PMCID: PMC8246955 DOI: 10.1002/pon.5261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate current evidence for the effectiveness of distance-based interventions to support smoking cessation (SC) or alcohol moderation (AM) among cancer survivors. Secondary, differences in effectiveness are explored regarding multibehaviour interventions versus single-behaviour interventions targeting SC or AM only. METHODS A systematic search of PubMed, PsycINFO, Web of Science, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was conducted. Intervention studies with and without control groups and randomized controlled trials were included. Random effects meta-analyses were conducted for the main outcomes: SC and AM rates at the follow-up closest to 6 months. Using subgroup analyses and meta-regression, effectiveness of single-behaviour versus multibehaviour interventions was evaluated. RESULTS A total of 17 studies with 3796 participants; nine studies on SC only, eight studies on multibehaviour interventions including an SC or AM module, and no studies on AM only were included. All studies had at least some concerns regarding bias. Distance-based SC interventions led to higher cessation rates than control conditions (10 studies, odds ratio [OR] = 1.56; 95% CI, 1.13-2.15, P = .007). Single-behaviour SC interventions reduced smoking rates compared with baseline (risk difference [RD] = 0.29; 95% CI, 0.19-0.39, P < .0001), but multibehaviour interventions did not (RD = 0.13; 95% CI, -0.05 to 0.31, P = 0.15). There was insufficient evidence that distance-based multibehaviour interventions reduced alcohol use compared with controls (three studies, standardized mean difference [SMD] = 0.12; 95% CI, -0.08 to 0.31, P = .24). CONCLUSIONS Distance-based SC interventions are effective in supporting SC among cancer survivors. Single-behaviour SC interventions appear more effective than multibehaviour interventions. No evidence was found for the effectiveness of distance-based AM interventions for cancer survivors.
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Affiliation(s)
- Ajla Mujcic
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
| | - Matthijs Blankers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Department of Research, Arkin Mental Health CareAmsterdamThe Netherlands
- Amsterdam UMC, Location AMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Bommelé
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Brigitte Boon
- Academy Het Dorp Department Scientific Research, Siza Arnhem, The NetherlandsArnhemThe Netherlands
- Department Scientific ResearchSizaArnhemThe Netherlands
| | - Anne H. Berman
- Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska InstituteStockholmSweden
- Stockholm Center for Dependency DisordersStockholm Health Care Services, Stockholm RegionStockholmSweden
- Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center AmsterdamAmsterdamThe Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam Public HealthAmsterdamThe Netherlands
| | - Margriet van Laar
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Rutger Engels
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
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The Role of Self-Determination in Changing Physical Activity Behavior in People Diagnosed With Bowel Polyps: A Pilot Randomized Controlled Trial. J Aging Phys Act 2020; 28:42-52. [PMID: 31188705 DOI: 10.1123/japa.2018-0279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 04/17/2019] [Accepted: 05/09/2019] [Indexed: 11/18/2022]
Abstract
This nonblinded randomized controlled trial investigated the efficacy of a physical activity (PA) intervention underpinned by self-determination theory. Participants (N = 31, mean age 69 years [SD = 4.9]) diagnosed with bowel polyps were randomized to an active lifestyle program (ALP; n = 17) or standard care (n = 14). ALP received supervised exercise and counseling for 6 months. Both groups were followed up at 12 months. Outcomes were change in PA and behavioral regulation. Data were analyzed with intention to treat. At 6 months, differences were observed for behavioral regulation in favor of ALP (p < .05). PA differences were significant for leisure, walking, and vigorous in favor of ALP (p < .05). The self-determination theory can be an effective strategy for promoting PA behavior change in this population, but a larger trial is needed to further explore the utility of the self-determination theory in this context.
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16
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Hand GA. A Scoping Review of Positive Lifestyle and Wellness Interventions to Inform the Development of a Comprehensive Health Promotion Program: "HealthPro." A Commentary to Schuette and Colleagues (2018). Am J Lifestyle Med 2019; 13:351-353. [PMID: 31285715 PMCID: PMC6600615 DOI: 10.1177/1559827619840637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Knudsen MD, Hjartåker A, Robb KA, de Lange T, Hoff G, Berstad P. Improving Cancer Preventive Behaviors: A Randomized Trial of Tailored Lifestyle Feedback in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev 2018; 27:1442-1449. [PMID: 30389802 DOI: 10.1158/1055-9965.epi-18-0268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/06/2018] [Accepted: 09/05/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cancer screening provides an opportunity to increase awareness of cancer-preventive lifestyle behaviors such as nonsmoking, physical activity, low alcohol consumption, and a healthy diet. We tested the effect of standardized, individually tailored written feedback (TF), and a standard leaflet (SL) on 1-year lifestyle behaviors in a colorectal cancer screening setting. METHODS A total of 3,642 men and women aged 50-74 years invited to sigmoidoscopy screening were randomly assigned to: (i) TF; (ii) SL for cancer-preventive lifestyle behaviors; or (iii) control. Participants were mailed two self-reported lifestyle questionnaires (LSQ) 1 year apart. The TF intervention was based on the prescreening LSQ answers. We analyzed differences [with 95% confidence intervals (CI)] by comparing prescreening to 1-year follow-up of single cancer-preventive factors and the number of cancer-preventive lifestyle behaviors (range 0-4) between the groups by multivariable logistic regression and analysis of covariance (ANCOVA). RESULTS A total of 1,054 screening participants without neoplastic findings (29% of those invited to screening) were included in this study. Participants in the TF group increased their number of cancer-preventive lifestyle behaviors significantly compared with those in the control group by 0.11 (95% CI, 0.02 to 0.19). Overweight/obese individuals in the TF group had a -0.84 kg (95% CI, -1.47 to -0.22) larger reduction in body weight compared with the control group. CONCLUSIONS TF at sigmoidoscopy screening led to small improvements in cancer-preventive behaviors. IMPACT Colorectal cancer screening is a suitable setting for increasing awareness of cancer-preventive behavior.
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Affiliation(s)
- Markus Dines Knudsen
- Department of Bowel Cancer Screening, Cancer Registry of Norway, Norway.
- Department of Research and Development, Telemark Hospital, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anette Hjartåker
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kathryn A Robb
- Institute of Health and Wellbeing, University of Glasgow, Scotland, United Kingdom
| | - Thomas de Lange
- Department of Bowel Cancer Screening, Cancer Registry of Norway, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Geir Hoff
- Department of Bowel Cancer Screening, Cancer Registry of Norway, Norway
- Department of Research and Development, Telemark Hospital, Norway
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Paula Berstad
- Department of Bowel Cancer Screening, Cancer Registry of Norway, Norway
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Bianchi F, Dorsel C, Garnett E, Aveyard P, Jebb SA. Interventions targeting conscious determinants of human behaviour to reduce the demand for meat: a systematic review with qualitative comparative analysis. Int J Behav Nutr Phys Act 2018; 15:102. [PMID: 30340498 PMCID: PMC6194670 DOI: 10.1186/s12966-018-0729-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/28/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Reducing meat consumption can help prevent non-communicable diseases and protect the environment. Interventions targeting conscious determinants of human behaviour are generally acceptable approaches to promote dietary change, but little is known about their effectiveness to reduce the demand for meat. OBJECTIVE To evaluate the effectiveness of interventions targeting conscious determinants of human behaviour to reduce the demand for meat. METHODS We searched six electronic databases on the 31st of August 2017 with a predefined algorithm, screened publicly accessible resources, contacted authors, and conducted forward and backward reference searches. Eligible studies employed experimental designs to evaluate interventions targeting conscious determinants of human behaviour to reduce the consumption, purchase, or selection of meat in comparison to a control condition, a baseline period, or relative to other eligible interventions. We synthesised results narratively and conducted an exploratory crisp-set Qualitative Comparative Analysis to identify combinations of intervention characteristics associated with significant reductions in the demand for meat. RESULTS We included 24 papers reporting on 59 interventions and 25,477 observations. Self-monitoring interventions and individual lifestyle counselling led to, or were associated with reduced meat consumption. Providing information about the health or environmental consequences of eating meat was associated with reduced intentions to consume and select meat in virtual environments, but there was no evidence to suggest this approach influenced actual behaviour. Education about the animal welfare consequences of eating meat was associated with reduced intentions to consume meat, while interventions implicitly highlighting animal suffering were not. Education on multiple consequences of eating meat led to mixed results. Tailored education was not found to reduce actual or intended meat consumption, though few studies assessed this approach. CONCLUSION Some interventions targeting conscious determinants of human behaviour have the potential to reduce the demand for meat. In particular, self-monitoring interventions and individual lifestyle counselling can help to reduce meat consumption. There was evidence of effectiveness of some educational messages in reducing intended consumption and selection of meat in virtual environments. PROTOCOL REGISTRATION CRD42017076720 .
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Affiliation(s)
- Filippo Bianchi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Radcliffe Primary Care Building, Woodstock Rd, Oxford, OX2 6GG UK
| | - Claudia Dorsel
- Department of Psychology, Heinrich Heine University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Emma Garnett
- Department of Zoology, University of Cambridge, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Radcliffe Primary Care Building, Woodstock Rd, Oxford, OX2 6GG UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Radcliffe Primary Care Building, Woodstock Rd, Oxford, OX2 6GG UK
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Minian N, deRuiter WK, Lingam M, Corrin T, Dragonetti R, Manson H, Taylor VH, Zawertailo L, Ebnahmady A, Melamed OC, Rodak T, Hahn M, Selby P. The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol. Syst Rev 2018; 7:38. [PMID: 29490688 PMCID: PMC5831832 DOI: 10.1186/s13643-018-0702-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 02/16/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. METHODS An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. DISCUSSION This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017064430.
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Affiliation(s)
- Nadia Minian
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Wayne K. deRuiter
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Mathangee Lingam
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Tricia Corrin
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Rosa Dragonetti
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Heather Manson
- Public Health Ontario, 480 University Avenue, Toronto, Ontario Canada
| | - Valerie H. Taylor
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
- Women’s College Hospital, 76 Grenville Street, Toronto, Ontario Canada
| | - Laurie Zawertailo
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
- Pharmacology & Toxicology, University of Toronto, 1 King’s College Circle, Toronto, Ontario Canada
| | - Arezoo Ebnahmady
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Osnat C. Melamed
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
| | - Margaret Hahn
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
- Psychiatry, University of Toronto, 250 College Street 8th Floor, Toronto, Ontario Canada
- Institute of Medical Sciences, 1 King’s College Circle, Toronto, Ontario Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario Canada
- Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, Ontario Canada
- Psychiatry, University of Toronto, 250 College Street 8th Floor, Toronto, Ontario Canada
- Dalla Lana School of Medicine, University of Toronto, 155 College St, Toronto, Ontario Canada
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Giacobbi P, Long D, Nolan R, Shawley S, Johnson K, Misra R. Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial. J Behav Med 2018; 41:87-98. [PMID: 28766183 PMCID: PMC7147977 DOI: 10.1007/s10865-017-9876-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 07/17/2017] [Indexed: 01/10/2023]
Abstract
The purpose of this randomized wait-list controlled trial was to test the feasibility and preliminary efficacy of a guided imagery based multi-behavior intervention intended to address psychological stress, food cravings, and physical activity. Personalized guided imagery scripts were created and participants were instructed to practice guided imagery every day for 35 consecutive days. Of 48 women who enrolled, we report comparisons between 16 randomized to treatment with 19 who were wait-listed (overall Mage = 45.50; Mbodymassindex = 31.43). Study completers reported 89% compliance with practicing guided imagery during the intervention. A significant time-by-group interaction was observed with reductions in food cravings and increases in physical activity compared with wait-list controls. Telephone-based multi-behavior interventions that utilize guided imagery to address food cravings and exercise behavior appear to be acceptable for overweight and obese women. Future phone-based guided imagery research testing this skill to address multiple health behaviors is justified.
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Affiliation(s)
- Peter Giacobbi
- Department of Sport Sciences, Joint Appointment, Social and Behavioral Sciences, West Virginia University, Health and Education Building, 208, 375 Birch Street, P. O. Box 6116, Morgantown, WV, 26506-6116, USA.
| | - Dustin Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Ryals Public Health Building, Room 327, Birmingham, AL, 35294-0022, USA
| | - Richard Nolan
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Samantha Shawley
- School of Public Health, West Virginia Univesity, Morgantown, WV, USA
| | - Kelsey Johnson
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Ranjita Misra
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, 3301 HSC South, Morgantown, WV, 26505, USA
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Boniol M, Dragomir M, Autier P, Boyle P. Physical activity and change in fasting glucose and HbA1c: a quantitative meta-analysis of randomized trials. Acta Diabetol 2017; 54:983-991. [PMID: 28840356 DOI: 10.1007/s00592-017-1037-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/02/2017] [Indexed: 11/26/2022]
Abstract
AIMS A systematic review was conducted of randomized trials which evaluated the impact of physical activity on the change in fasting glucose and HbA1c. METHODS A literature search was conducted in PubMed until December 2015. Studies reporting glucose or HbA1c at baseline and at the end of study were included, and the change and its variance were estimated from studies with complete data. Mixed-effect random models were used to estimate the change of fasting glucose (mg/dl) and HbA1c (%) per additional minutes of physical activity per week. RESULTS A total of 125 studies were included in the meta-analysis. Based on 105 studies, an increase of 100 min in physical activity per week was associated with an average change of -2.75 mg/dl of fasting glucose (95% CI -3.96; -1.55), although there was a high degree of heterogeneity (83.5%). When restricting the analysis on type 2 diabetes and prediabetes subjects (56 studies), the average change in fasting glucose was -4.71 mg/dl (95% CI -7.42; -2.01). For HbA1c, among 76 studies included, an increase of 100 min in physical activity per week was associated with an average change of -0.14% of HbA1c (95% CI -0.18; -0.09) with heterogeneity (73%). A large degree of publication bias was identified (Egger test p < 0.001). When restricting the analysis on type 2 diabetes and prediabetes subjects (60 studies), the average change in HbA1c was -0.16% (95% CI -0.21; -0.11). CONCLUSIONS This analysis demonstrates that moderate increases in physical activity are associated with significant reductions in both fasting glucose and HbA1c.
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Affiliation(s)
- Mathieu Boniol
- Strathclyde Institute of Global Public Health at iPRI, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130, Ecully Ouest Lyon, France
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France
| | - Miruna Dragomir
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France.
| | - Philippe Autier
- Strathclyde Institute of Global Public Health at iPRI, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130, Ecully Ouest Lyon, France
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France
| | - Peter Boyle
- Strathclyde Institute of Global Public Health at iPRI, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130, Ecully Ouest Lyon, France
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France
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Amato K, Park E, Nigg CR. Prioritizing multiple health behavior change research topics: expert opinions in behavior change science. Transl Behav Med 2017; 6:220-7. [PMID: 27356992 DOI: 10.1007/s13142-015-0381-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Multiple health behavior change (MHBC) approaches are understudied. The purpose of this study is to provide strategic MHBC research direction. This cross-sectional study contacted participants through the Society of Behavioral Medicine email listservs and rated the importance of 24 MHBC research topics (1 = not at all important, 5 = extremely important) separately for general and underserved populations. Participants (n = 76) were 79 % female; 76 % White, 10 % Asian, 8 % African American, 5 % Hispanic, and 1 % Native Hawaiian/Pacific Islander. Top MHBC research priorities were predictors of behavior change and the sustainability, long-term effects, and dissemination/translation of interventions for both populations. Recruitment and retention of participants (t(68) = 2.17, p = 0.000), multi-behavioral indices (t(68) = 3.54, p = 0.001), and measurement burden (t(67) = 5.04, p = 0.001) were important for the underserved. Results identified the same top research priorities across populations. For the underserved, research should emphasize recruitment, retention, and measurement burden.
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Affiliation(s)
- Katie Amato
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, 96822, USA
| | - Eunhee Park
- College of Medicine, Seoul National University, Seoul, South Korea
| | - Claudio R Nigg
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, 96822, USA.
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Greaney ML, Puleo E, Sprunck-Harrild K, Haines J, Houghton SC, Emmons KM. Social Support for Changing Multiple Behaviors: Factors Associated With Seeking Support and the Impact of Offered Support. HEALTH EDUCATION & BEHAVIOR 2017; 45:198-206. [DOI: 10.1177/1090198117712333] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction. Social support is important for behavior change, and it may be particularly important for the complexities of changing multiple risk behaviors (MRB). Research is needed to determine if participants in an MRB intervention can be encouraged to activate their social network to aid their change efforts. Methods. Healthy Directions 2, a cluster-randomized controlled trial of an intervention conducted in two urban health centers, targeted five behaviors (physical activity, fruit and vegetable intake, red meat consumption, multivitamin use, and smoking). The self-guided intervention emphasized changing MRB simultaneously, focused on self-monitoring and action planning, and encouraged participants to seek support from social network members. An MRB score was calculated for each participant, with one point being assigned for each behavioral recommendation that was not met. Analyses were conducted to identify demographic and social contextual factors (e.g., interpersonal, neighborhood, and organizational resources) associated with seeking support and to determine if type and frequency of offered support were associated with changes in MRB score. Results. Half (49.6%) of participants identified a support person. Interpersonal resources were the only contextual factor that predicted engagement of a support person. Compared to individuals who did not seek support, those who identified one support person had 61% greater reduction in MRB score, and participants identifying multiple support persons had 100% greater reduction. Conclusion. Engagement of one’s social network leads to significantly greater change across multiple risk behaviors. Future research should explore strategies to address support need for individuals with limited interpersonal resources.
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Affiliation(s)
| | | | | | - Jess Haines
- University of Guelph, Guelph, Ontario, Canada
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Diet, Alcohol Use, and Colorectal Cancer Screening among Black Church-goers. HEALTH BEHAVIOR AND POLICY REVIEW 2017; 4:118-128. [PMID: 28798944 DOI: 10.14485/hbpr.4.2.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Interventions for colorectal cancer (CRC) prevention among black adults are needed. Connections between CRC screening non-adherence and other health risk behaviors may inform intervention development. METHODS Associations between red meat (RM) and fruit and vegetable (FV) consumption, at-risk alcohol use, and CRC ever-screening were examined using adjusted logistic regressions among 520 church-going black adults in Houston, Texas, aged >50. RESULTS In the final adjusted model, being younger, uninsured, eating more RM and engaging in at-risk alcohol use were associated with lower likelihood of CRC ever-screening. CONCLUSIONS Church-based interventions to increase CRC screening among black adults might capitalize on associations with RM consumption and alcohol use behaviors as part of a broader wellness promotion initiative.
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Correa-Fernández V, Díaz-Toro EC, Reitzel LR, Guo L, Chen M, Li Y, Calo WA, Shih YCT, Wetter DW. Combined treatment for at-risk drinking and smoking cessation among Puerto Ricans: A randomized clinical trial. Addict Behav 2017; 65:185-192. [PMID: 27825036 PMCID: PMC5358923 DOI: 10.1016/j.addbeh.2016.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/29/2016] [Accepted: 10/20/2016] [Indexed: 11/19/2022]
Abstract
Tobacco and alcohol use are linked behaviors that individually and synergistically increase the risk for negative health consequences. This study was a two-group, randomized clinical trial evaluating the efficacy of a behavioral intervention, "Motivation And Problem Solving Plus" (MAPS+), designed to concurrently address smoking cessation and the reduction of at-risk drinking. Targeted interventions may promote coaction, the likelihood that changing one behavior (smoking) increases the probability of changing another behavior (alcohol use). Puerto Ricans (N=202) who were smokers and at-risk drinkers were randomized to standard MAPS treatment focused exclusively on smoking cessation (S-MAPS), or MAPS+, focused on cessation and at-risk drinking reduction. Drinking outcomes included: number of at-risk drinking behaviors, heavy drinking, binge drinking, and drinking and driving. MAPS+ did not have a significant main effect on reducing at-risk drinking relative to S-MAPS. Among individuals who quit smoking, MAPS+ reduced the number of drinking behaviors, the likelihood of meeting criteria for heavy drinking relative to S-MAPS, and appeared promising for reducing binge drinking. MAPS+ did not improve drinking outcomes among individuals who were unsuccessful at quitting smoking. MAPS+ showed promise in reducing at-risk drinking among Puerto Rican smokers who successfully quit smoking, consistent with treatment enhanced coaction. Integrating an alcohol intervention into cessation treatment did not reduce engagement in treatment, or hinder cessation outcomes, and positively impacted at-risk drinking among individuals who quit smoking. Findings of coaction between smoking and drinking speak to the promise of multiple health behavior change interventions for substance use treatment and chronic disease prevention.
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Affiliation(s)
- Virmarie Correa-Fernández
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, United States.
| | - Elba C Díaz-Toro
- Division of Cancer Control and Population Sciences, University of Puerto Rico, Comprehensive Cancer Center, PMB 371, PO Box 70344, San Juan, PR 00936-8344, Puerto Rico.
| | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, United States.
| | - Lin Guo
- Department of Psychology, Rice University, 6500 Main St, Bioscience Research Collaborative, Houston, TX 77030, United States.
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Unit 1411, P.O. Box 301402, Houston, TX 77230, United States.
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Unit 1411, P.O. Box 301402, Houston, TX 77230, United States.
| | - William A Calo
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1102-F McGavran-Greenberg Bldg, CB 7411, Chapel Hill, NC 27599-7411, United States.
| | - Ya-Chen Tina Shih
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Unit 1444, P.O. Box 301402, Houston, TX 77230, United States.
| | - David W Wetter
- Department of Population Health Sciences and The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84108, United States.
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Beeken RJ, Croker H, Heinrich M, Smith L, Williams K, Hackshaw A, Hines J, Machesney M, Krishnaswamy M, Cavanagh S, Roylance R, Hill A, Pritchard-Jones K, Wardle J, Fisher A. Study protocol for a randomised controlled trial of brief, habit-based, lifestyle advice for cancer survivors: exploring behavioural outcomes for the Advancing Survivorship Cancer Outcomes Trial (ASCOT). BMJ Open 2016; 6:e011646. [PMID: 27881518 PMCID: PMC5178807 DOI: 10.1136/bmjopen-2016-011646] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 08/11/2016] [Accepted: 10/17/2016] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Positive health behaviours such as regular physical activity and a healthy diet have significant effects on cancer outcomes. There is a need for simple but effective behaviour change interventions with the potential to be implemented within the cancer care pathway. Habit-based advice encourages repetition of a behaviour in a consistent context so that the behaviour becomes increasingly automatic in response to a specific contextual cue. This approach therefore encourages long-term behaviour change and can be delivered through printed materials. 'Healthy Habits for Life' is a brief intervention based on habit theory, and incorporating printed materials plus a personally tailored discussion, that has been designed specifically for patients with a diagnosis of cancer. The aim of this trial was to test the effect of 'Healthy Habits for Life' on a composite health behaviour risk index (CHBRI) over 3 months in patients with a diagnosis of breast, colorectal or prostate cancer. METHOD AND ANALYSIS A 2-arm, individually randomised controlled trial in patients with breast, colorectal and prostate cancer. Patients will be recruited over 18 months from 7 National Health Service Trusts in London and Essex. Following baseline assessments and allocation to intervention or usual care, patients are followed up at 3 and 6 months. The primary outcome will be change in CHBRI at 3 months. Maintenance of any changes over 6 months, and changes in individual health behaviours (including dietary intake, physical activity, alcohol consumption and smoking status) will also be explored. ETHICS AND DISSEMINATION Ethical approval was obtained through the National Research Ethics Service Committee South Central-Oxford B via the Integrated Research Application System (reference number 14/SC/1369). Results of this study will be disseminated through peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER 17421871.
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Affiliation(s)
- Rebecca J Beeken
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Helen Croker
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Maggie Heinrich
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Lee Smith
- Department of Life Sciences, The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Kate Williams
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Allan Hackshaw
- The Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK
| | - John Hines
- Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | | | | | | | | | | | | | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Abigail Fisher
- Department of Epidemiology & Public Health, University College London, London, UK
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Future directions of multiple behavior change research. J Behav Med 2016; 40:194-202. [DOI: 10.1007/s10865-016-9809-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/20/2016] [Indexed: 11/25/2022]
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Usher-Smith JA, Walter FM, Emery JD, Win AK, Griffin SJ. Risk Prediction Models for Colorectal Cancer: A Systematic Review. Cancer Prev Res (Phila) 2015; 9:13-26. [PMID: 26464100 DOI: 10.1158/1940-6207.capr-15-0274] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/15/2015] [Indexed: 12/12/2022]
Abstract
Colorectal cancer is the second leading cause of cancer-related death in Europe and the United States. Survival is strongly related to stage at diagnosis and population-based screening reduces colorectal cancer incidence and mortality. Stratifying the population by risk offers the potential to improve the efficiency of screening. In this systematic review we searched Medline, EMBASE, and the Cochrane Library for primary research studies reporting or validating models to predict future risk of primary colorectal cancer for asymptomatic individuals. A total of 12,808 papers were identified from the literature search and nine through citation searching. Fifty-two risk models were included. Where reported (n = 37), half the models had acceptable-to-good discrimination (the area under the receiver operating characteristic curve, AUROC >0.7) in the derivation sample. Calibration was less commonly assessed (n = 21), but overall acceptable. In external validation studies, 10 models showed acceptable discrimination (AUROC 0.71-0.78). These include two with only three variables (age, gender, and BMI; age, gender, and family history of colorectal cancer). A small number of prediction models developed from case-control studies of genetic biomarkers also show some promise but require further external validation using population-based samples. Further research should focus on the feasibility and impact of incorporating such models into stratified screening programmes.
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Affiliation(s)
- Juliet A Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
| | - Fiona M Walter
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Department of General Practice, Melbourne Medical School Faculty of Medicine, Dentistry & Health Sciences The University of Melbourne, Carlton, Victoria, Australia
| | - Jon D Emery
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Department of General Practice, Melbourne Medical School Faculty of Medicine, Dentistry & Health Sciences The University of Melbourne, Carlton, Victoria, Australia
| | - Aung K Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 4, The University of Melbourne, Victoria, Australia
| | - Simon J Griffin
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Katz ML, Reiter PL, Young GS, Pennell ML, Tatum CM, Paskett ED. Adherence to Multiple Cancer Screening Tests among Women Living in Appalachia Ohio. Cancer Epidemiol Biomarkers Prev 2015; 24:1489-94. [PMID: 26282630 DOI: 10.1158/1055-9965.epi-15-0369] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/28/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is a lack of information about the correlates of completing all three cancer screening tests among women living in Appalachia. METHODS Cross-sectional telephone interviews were conducted (April-September 2013) among women (n = 637) ages 51 to 75 years from 12 Appalachia Ohio counties. Outcomes of within screening guidelines were verified by medical records. Multivariable logistic regression models identified correlates of being within guidelines for all three cancer screening tests. RESULTS Screening rates included mammography (32.1%), Pap test (36.1%), and a colorectal cancer test (30.1%). Only 8.6% of women were within guidelines for all tests. Having had a check-up in the past 2 years and having received a screening recommendation were significantly related to being within guidelines for all three tests (P < 0.01). Participants with higher annual household incomes [$60,000+; OR, 3.53; 95% confidence interval (CI), 1.49-8.33] and conditions requiring regular medical visits (OR, 3.16; 95% CI, 1.29-7.74) were more likely to be within guidelines for all three screening tests. CONCLUSION Less than 10% of women had completed screening within guidelines for all three screening tests. Regular contact with the health care system and higher incomes were significant predictors of being within guidelines. IMPACT Within guidelines rates for the three recommended cancer screening tests are low among women in Appalachia Ohio. This finding illustrates the need for innovative interventions to improve rates of multiple cancer screening tests.
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Affiliation(s)
- Mira L Katz
- College of Public Health, The Ohio State University, Columbus, Ohio. Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. College of Medicine, The Ohio State University, Columbus, Ohio.
| | - Paul L Reiter
- College of Public Health, The Ohio State University, Columbus, Ohio. Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. College of Medicine, The Ohio State University, Columbus, Ohio
| | - Gregory S Young
- Center for Biostatistics, The Ohio State University, Columbus, Ohio
| | - Michael L Pennell
- College of Public Health, The Ohio State University, Columbus, Ohio. Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Cathy M Tatum
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Electra D Paskett
- College of Public Health, The Ohio State University, Columbus, Ohio. Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. College of Medicine, The Ohio State University, Columbus, Ohio
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McCahon D, Daley AJ, Jones J, Haslop R, Shajpal A, Taylor A, Wilson S, Dowswell G. Enhancing adherence in trials promoting change in diet and physical activity in individuals with a diagnosis of colorectal adenoma; a systematic review of behavioural intervention approaches. BMC Cancer 2015; 15:505. [PMID: 26148790 PMCID: PMC4494153 DOI: 10.1186/s12885-015-1502-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 06/19/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Little is known about colorectal adenoma patients' ability to adhere to behavioural interventions promoting a change in diet and physical activity. This review aimed to examine health behaviour intervention programmes promoting change in diet and/or physical activity in adenoma patients and characterise interventions to which this patient group are most likely to adhere. METHODS Searches of eight databases were restricted to English language publications 2000-2014. Reference lists of relevant articles were also reviewed. All randomised controlled trials (RCTs) of diet and physical activity interventions in colorectal adenoma patients were included. Eligibility and quality were assessed and data were extracted by two reviewers. Data extraction comprised type, intensity, provider, mode and location of delivery of the intervention and data to enable calculation of four adherence outcomes. Data were subject to narrative analysis. RESULTS Five RCTs with a total of 1932 participants met the inclusion criteria. Adherence to the goals of the intervention ranged from 18 to 86 % for diet and 13 to 47 % for physical activity. Diet interventions achieving ≥ 50 % adherence to the goals of the intervention were clinic based, grounded in cognitive theory, delivered one to one and encouraged social support. CONCLUSIONS The findings of this review indicate that behavioural interventions can encourage colorectal adenoma patients to improve their diet. This review was not however able to clearly characterise effective interventions promoting increased physical activity in this patient group. Further research is required to establish effective interventions to promote adherence to physical activity in this population.
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Affiliation(s)
- Deborah McCahon
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Amanda J Daley
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Janet Jones
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Richard Haslop
- Critical Care and Perioperative Medical Research Group, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
| | - Arjun Shajpal
- School of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Aliki Taylor
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sue Wilson
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - George Dowswell
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Gates P, Albertella L. The effectiveness of telephone counselling in the treatment of illicit drug and alcohol use concerns. J Telemed Telecare 2015; 22:67-85. [PMID: 26026185 DOI: 10.1177/1357633x15587406] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 03/20/2015] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Technology-assisted substance use interventions such as 'high-tech' internet-based treatments are thought to be effective; however, the relatively 'low-tech' use of telephone counselling does not yet have an established evidence base. This paper reviews the literature including articles with information on the use of telephone counselling for the treatment of illicit drug or alcohol use. METHODS A systematic literature search using a set of telephone counselling and substance-related terms was conducted across four electronic databases. English studies prior to June 2014 that involved the use of telephone counselling with the treatment of illicit drug or alcohol use as a primary or secondary outcome were included. Review papers, opinion pieces, letters or editorials, case studies, published abstracts, and posters were excluded. In all, 94 publications were included in the review. RESULTS AND DISCUSSION The literature was supportive of telephone counselling for the treatment of alcohol use in the short term; however, literature regarding illicit drug use was particularly scarce. The generalisability of findings was limited by evident methodological issues in the included studies.
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Affiliation(s)
- Peter Gates
- National Cannabis Prevention and Information Centre, Randwick NSW, Australia
| | - Lucy Albertella
- National Cannabis Prevention and Information Centre, Randwick NSW, Australia
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Concurrent occurrence of multiple positive lifestyle behaviors and depression among adults in the United States. J Affect Disord 2014; 165:126-30. [PMID: 24882189 DOI: 10.1016/j.jad.2014.04.073] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 04/26/2014] [Accepted: 04/26/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND To our knowledge, no studies have examined the dose-response association between concurrent occurrence of multiple positive health behaviors and depression. As a result, the purpose of this study was to examine the dose-response association between concurrent occurrence of lifestyle behaviors (i.e., diet, physical activity, and smoking) on depression symptoms among a national sample of U.S. adults (20-85 yr). METHODS Using data from the 2005-2006 NHANES (n=2574), diet was assessed from the healthy eating index variable; physical activity was assessed via accelerometry; smoking was assessed from cotinine levels; and depression was assessed from the Patient Health Questionnaire 9 (PHQ-9). RESULTS Each lifestyle behavior was independently associated with depression in the expected direction, and there was also evidence of a dose-response relationship. Compared to those having 0 positive lifestyle factors, those with 1, 2, and 3 positive lifestyle factors, respectively, were 15% (p=0.38), 67% (p=0.001), and 82% (p=0.01) less likely to be classifed as having moderate or greater depression symptoms (PHQ-9 ≥10). LIMITATIONS The main limitation of this study was the cross-sectional design. CONCLUSION there is a dose-response relationship between concurrent occurrence of positive lifestyle behaviors and depression symptoms.
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Julian-Reynier C, Resseguier N, Bouhnik AD, Eisinger F, Lasset C, Fourme E, Noguès C. Cigarette smoking in women after BRCA1/2 genetic test disclosure: a 5-year follow-up study of the GENEPSO PS cohort. Genet Med 2014; 17:117-24. [DOI: 10.1038/gim.2014.82] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/04/2014] [Indexed: 11/09/2022] Open
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Emmons KM, Puleo E, Greaney ML, Gillman MW, Bennett GG, Haines J, Sprunck-Harrild K, Viswanath K. A randomized comparative effectiveness study of Healthy Directions 2--a multiple risk behavior intervention for primary care. Prev Med 2014; 64:96-102. [PMID: 24642140 PMCID: PMC4204110 DOI: 10.1016/j.ypmed.2014.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 03/04/2014] [Accepted: 03/10/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of the Healthy Directions 2 (HD2) intervention in the primary care setting. METHODS HD2 was a cluster randomized trial (conducted 3/09-11/11). The primary sampling unit was provider (n=33), with secondary sampling of patients within provider (n=2440). Study arms included: 1) usual care (UC); 2) HD2--a patient self-guided intervention targeting 5 risk behaviors; and 3) HD2 plus 2 brief telephone coaching calls (HD2+CC). The outcome measure was the proportion of participants with a lower multiple risk behavior (MRB) score by follow-up. RESULTS At baseline, only 4% of the participants met all behavioral recommendations. Both HD2 and HD2+CC led to improvements in MRB score, relative to UC, with no differences between the two HD2 conditions. Twenty-eight percent of the UC participants had improved MRB scores at 6 months, vs. 39% and 43% in HD2 and HD2+CC, respectively (ps≤.001); results were similar at 18 months (p≤.05). The incremental cost of one risk factor reduction in MRB score was $310 for HD2 and $450 for HD2+CC. CONCLUSIONS Self-guided and coached intervention conditions had equivalent levels of effect in reducing multiple chronic disease risk factors, were relatively low cost, and thus are potentially useful for routine implementation in similar health settings.
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Affiliation(s)
- Karen M Emmons
- Kaiser Foundation Research Institute, 1800 Harrison Avenue, Oakland, CA 94612, USA.
| | - Elaine Puleo
- University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Matthew W Gillman
- Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Gary G Bennett
- Duke University, Department of Psychology and Neuroscience, Box 90086, 417 Chapel Drive, Durham NC 27708-0086
| | - Jess Haines
- University of Guelph, Guelph, Ontario, Canada
| | | | - K Viswanath
- Dana-Farber Cancer Institute, Boston, MA, USA
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Handelsman Y, Leroith D, Bloomgarden ZT, Dagogo-Jack S, Einhorn D, Garber AJ, Grunberger G, Harrell RM, Gagel RF, Lebovitz HE, McGill JB, Hennekens CH. Diabetes and cancer--an AACE/ACE consensus statement. Endocr Pract 2014; 19:675-93. [PMID: 23978590 DOI: 10.4158/ep13248.cs] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Stuart KL, Wyld B, Bastiaans K, Stocks N, Brinkworth G, Mohr P, Noakes M. A telephone-supported cardiovascular lifestyle programme (CLIP) for lipid reduction and weight loss in general practice patients: a randomised controlled pilot trial. Public Health Nutr 2014; 17:640-7. [PMID: 23452940 PMCID: PMC10282359 DOI: 10.1017/s1368980013000220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 10/31/2012] [Accepted: 12/10/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate a primary prevention care model using telephone support delivered through an existing health call centre to general practitioner-referred patients at risk of developing CVD, using objective measures of CVD risk reduction and weight loss. DESIGN Participants were randomised into two groups: (i) those receiving a telephone-supported comprehensive lifestyle intervention programme (CLIP: written structured diet and exercise advice, plus seven telephone sessions with the Heart Foundation Health Information Service); and (ii) those receiving usual care from their general practitioner (control: written general lifestyle advice). Fasting plasma lipids, blood pressure, weight, waist circumference and height were assessed on general practice premises by a practice nurse at Weeks 0 and 12. SETTING Two general practices in Adelaide, South Australia. SUBJECTS Forty-nine men and women aged 48·0 (sd 5·88) years identified by their general practitioner as being at future risk of CVD (BMI = 33·13 (sd 5·39) kg/m2; LDL cholesterol (LDL-C) = 2·66 (sd 0·92) mmol/l). RESULTS CLIP participants demonstrated significantly greater reductions in LDL-C (estimated mean (EM) = 1·98 (se 0·17) mmol/l) and total cholesterol (EM = 3·61 (se 0·21) mmol/l) at Week 12 when compared with the control group (EM = 3·23 (se 0·18) mmol/l and EM = 4·77 (se 0·22) mmol/l, respectively). There were no significant treatment effects for systolic blood pressure (F(1,45) = 0·28, P = 0·60), diastolic blood pressure (F(1,43) = 0·52, P = 0·47), weight (F(1,42) = 3·63, P = 0·063) or waist circumference (F(1,43) = 0·32, P = 0·577). CONCLUSIONS In general practice patients, delivering CLIP through an existing telephone health service is effective in achieving reductions in LDL-C and total cholesterol. While CLIP may have potential for wider implementation to support primary prevention of CVD, longer-term cost-effectiveness data are warranted.
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Affiliation(s)
- Keren Louise Stuart
- Discipline of General Practice, School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, Australia
| | - Belinda Wyld
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia
| | - Kathryn Bastiaans
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia
| | - Nigel Stocks
- Discipline of General Practice, School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, Australia
| | - Grant Brinkworth
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia
| | - Phil Mohr
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia
| | - Manny Noakes
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia
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Prochaska JJ, Fromont SC, Delucchi K, Young-Wolff KC, Benowitz NL, Hall S, Bonas T, Hall SM. Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change. Health Psychol 2014; 33:1518-29. [PMID: 24467257 DOI: 10.1037/a0035164] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Individuals with serious mental illness (SMI) are dying on average 25 years prematurely. The leading causes are chronic preventable diseases. In the context of a tobacco-treatment trial, this exploratory study examined the behavioral risk profiles of adults with SMI to identify broader interventional needs. METHOD Recruited from five acute inpatient psychiatry units, participants were 693 adult smokers (recruitment rate = 76%, 50% male, 45% Caucasian, age M = 39, 49% had income < $10,000) diagnosed with mood disorders (71%), substance-use disorders (63%), posttraumatic stress disorder (39%), psychotic disorders (25%), and attention deficit-hyperactivity disorder (25%). The Staging Health Risk Assessment, the primary measure used in this study, screened for risk status and readiness to change 11 health behaviors, referencing the period prior to acute hospitalization. RESULTS Participants averaged 5.2 (SD = 2.1) risk behaviors, including smoking (100%), high-fat diet (68%), inadequate fruits/vegetables (67%), poor sleep (53%), physical inactivity (52%), and marijuana use (46%). The percent prepared to change ranged from 23% for tobacco and marijuana to 76% for depression management. Latent class analysis differentiated three risk groups: the global higher risk group included patients elevated on all risk behaviors; the global lower risk group was low on all risks; and a mood and metabolic risk group, characterized by inactivity, unhealthy diet, sleep problems, and poor stress and depression management. The global higher risk group (11% of sample) was younger, largely male, and had the greatest number of risk behaviors and mental health diagnoses; had the most severe psychopathologies, addiction-treatment histories, and nicotine dependence; and the lowest confidence for quitting smoking and commitment to abstinence. CONCLUSION Most smokers with SMI engaged in multiple risks. Expanding targets to treat co-occurring risks and personalizing treatment to individuals' multibehavioral profiles may increase intervention relevance, interest, and impact on health.
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Affiliation(s)
- Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University
| | | | - Kevin Delucchi
- Department of Psychiatry, University of California-San Francisco
| | - Kelly C Young-Wolff
- Stanford Prevention Research Center, Department of Medicine, Stanford University
| | - Neal L Benowitz
- Division of Clinical Pharmacology, Departments of Medicine and Bioengineering & Therapeutic Sciences, University of California-San Francisco
| | - Stephen Hall
- Department of Psychiatry, University of California-San Francisco
| | | | - Sharon M Hall
- Department of Psychiatry, University of California-San Francisco
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Evers KE, Quintiliani LM. Advances in multiple health behavior change research. Transl Behav Med 2013; 3:59-61. [PMID: 24073161 DOI: 10.1007/s13142-013-0198-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Kerry E Evers
- Pro-Change Behavior Systems, Inc., 1174 Kingstown Road, Unit 101, South Kingstown, RI 02879 USA
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Fashoyin-Aje L, Sanghavi K, Bjornard K, Bodurtha J. Integrating genetic and genomic information into effective cancer care in diverse populations. Ann Oncol 2013; 24 Suppl 7:vii48-54. [PMID: 24001763 DOI: 10.1093/annonc/mdt264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This paper provides an overview of issues in the integration of genetic (related to hereditary DNA) and genomic (related to genes and their functions) information in cancer care for individuals and families who are part of health care systems worldwide, from low to high resourced. National and regional cancer plans have the potential to integrate genetic and genomic information with a goal of identifying and helping individuals and families with and at risk of cancer. Healthcare professionals and the public have the opportunity to increase their genetic literacy and communication about cancer family history to enhance cancer control, prevention, and tailored therapies.
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Affiliation(s)
- L Fashoyin-Aje
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 600 N. Wolfe St., Baltimore, MD 21287, USA.
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Messina CR, Lane DS, Anderson JC. Perceptions of risk factors for colorectal cancer and colorectal cancer risk-related behaviors among current, ex-, and nonsmokers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:444-453. [PMID: 23749423 DOI: 10.1007/s13187-013-0485-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Smoking significantly increases risk for colorectal cancer (CRC). We examined smokers' and nonsmokers' perceptions of behavioral factors for the increased risk of CRC and evaluated how these related to CRC screening. Self-reported questionnaire data were obtained from a random, average CRC risk sample of women and men (aged 50-75 years) during 2004. Smokers less frequently reported recent CRC screening than nonsmokers (p = 0.03). Smokers not adherent to screening less frequently agreed that smoking and alcohol consumption (both strongly linked to CRC) increased the risk for CRC (p values < 0.05) than nonsmokers. Notably, the number of concurrent CRC risk behaviors reported by smokers not adherent to CRC screening increased with the number of cigarettes smoked per day, identifying heavy smokers who do not screen as a subgroup most in need of intervention. Findings extend current understanding on processes underlying smokers' perceptions of risk for CRC and how these relate to screening utilization, which can guide provider efforts to improve CRC screening among smokers and reduce their CRC risk-related behaviors.
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Affiliation(s)
- Catherine R Messina
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY 11794-8036, USA.
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Bredin SSD. A Novel Telehealth Approach to the Primary and Secondary Prevention of Cardiometabolic Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0337-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Greaney ML, Puleo E, Bennett GG, Haines J, Viswanath K, Gillman MW, Sprunck-Harrild K, Coeling M, Rusinak D, Emmons KM. Factors associated with choice of web or print intervention materials in the healthy directions 2 study. HEALTH EDUCATION & BEHAVIOR 2013; 41:52-62. [PMID: 23720532 DOI: 10.1177/1090198113486803] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many U.S. adults have multiple behavioral risk factors, and effective, scalable interventions are needed to promote population-level health. In the health care setting, interventions are often provided in print, although accessible to nearly everyone, are brief (e.g., pamphlets), are not interactive, and can require some logistics around distribution. Web-based interventions offer more interactivity but may not be accessible to all. Healthy Directions 2 was a primary care-based cluster randomized controlled trial designed to improve five behavioral cancer risk factors among a diverse sample of adults (n = 2,440) in metropolitan Boston. Intervention materials were available via print or the web. Purpose. To (a) describe the Healthy Directions 2 study design and (b) identify baseline factors associated with whether participants opted for print or web-based materials. METHODS Hierarchical regression models corrected for clustering by physician were built to examine factors associated with choice of intervention modality. RESULTS At baseline, just 4.0% of participants met all behavioral recommendations. Nearly equivalent numbers of intervention participants opted for print and web-based materials (44.6% vs. 55.4%). Participants choosing web-based materials were younger, and reported having a better financial status, better perceived health, greater computer comfort, and more frequent Internet use (p < .05) than those opting for print. In addition, Whites were more likely to pick web-based material than Black participants. CONCLUSIONS Interventions addressing multiple behaviors are needed in the primary care setting, but they should be available in web and print formats as nearly equal number of participants chose each option, and there are significant differences in the population groups using each modality.
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Hawkes AL, Chambers SK, Pakenham KI, Patrao TA, Baade PD, Lynch BM, Aitken JF, Meng X, Courneya KS. Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial. J Clin Oncol 2013; 31:2313-21. [PMID: 23690410 DOI: 10.1200/jco.2012.45.5873] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. METHODS In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. RESULTS At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. CONCLUSION The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.
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Affiliation(s)
- Anna L Hawkes
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Queensland, Australia.
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Castro Y, Basen-Engquist K, Fernandez ME, Strong LL, Eakin EG, Resnicow K, Li Y, Wetter DW. Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers. BMC Public Health 2013; 13:237. [PMID: 23506397 PMCID: PMC3610197 DOI: 10.1186/1471-2458-13-237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 03/04/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U.S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities. METHODS/DESIGN The proposed study will evaluate the efficacy of an evidence-based and theoretically-driven Motivation And Problem Solving (MAPS) intervention, adapted and culturally-tailored for reducing cancer risk related to smoking, poor diet, and physical inactivity among high-risk Mexican-origin smokers who are overweight/obese (n = 400). Participants will be randomly assigned to one of two groups: Health Education (HE) or MAPS (HE + up to 18 MAPS counseling calls over 18 months). Primary outcomes are smoking status, servings of fruits and vegetables, and both self-reported and objectively measured physical activity. Outcome assessments will occur at baseline, 6 months, 12 months, and 18 months. DISCUSSION The current study will contribute to a very limited evidence base on multiple risk factor intervention studies on Mexican-origin individuals and has the potential to inform both future research and practice related to reducing cancer risk disparities. An effective program targeting multiple cancer risk behaviors modeled after chronic care programs has the potential to make a large public health impact because of the dearth of evidence-based interventions for Latinos and the extended period of support that is provided in such a program. TRIAL REGISTRATION National Institutes of Health Clinical Trials Registry # NCT01504919.
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Affiliation(s)
- Yessenia Castro
- School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maria E Fernandez
- Division of Health Promotion and Behavioral Science, The University of Texas School of Public Health, Houston, TX, USA
| | - Larkin L Strong
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Research - Unit 1440, PO Box 301402, Houston, TX, 77230-1402, USA
| | - Elizabeth G Eakin
- Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, QLD, Australia
| | - Ken Resnicow
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David W Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Research - Unit 1440, PO Box 301402, Houston, TX, 77230-1402, USA
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Anderson AS, Mackison D, Boath C, Steele R. Promoting Changes in Diet and Physical Activity in Breast and Colorectal Cancer Screening Settings: An Unexplored Opportunity for Endorsing Healthy Behaviors. Cancer Prev Res (Phila) 2013; 6:165-72. [DOI: 10.1158/1940-6207.capr-12-0385] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Drake BF, Quintiliani LM, Sapp AL, Li Y, Harley AE, Emmons KM, Sorensen G. Comparing strategies to assess multiple behavior change in behavioral intervention studies. Transl Behav Med 2013; 3:114-121. [PMID: 23504621 DOI: 10.1007/s13142-013-0195-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Alternatives to individual behavior change methods have been proposed, however, little has been done to investigate how these methods compare. PURPOSE To explore four methods that quantify change in multiple risk behaviors targeting four common behaviors. METHODS We utilized data from two cluster-randomized, multiple behavior change trials conducted in two settings: small businesses and health centers. Methods used were: (1) summative; (2) z-score; (3) optimal linear combination; and (4) impact score. RESULTS In the Small Business study, methods 2 and 3 revealed similar outcomes. However, physical activity did not contribute to method 3. In the Health Centers study, similar results were found with each of the methods. Multivitamin intake contributed significantly more to each of the summary measures than other behaviors. CONCLUSIONS Selection of methods to assess multiple behavior change in intervention trials must consider study design, and the targeted population when determining the appropriate method/s to use.
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Affiliation(s)
- Bettina F Drake
- Department of Surgery, Washington University School of Medicine (Drake), St. Louis, MO; Department of General Internal Medicine, Boston University Medical Center (Quintiliani), Boston, MA; Department of Biostatistics, Harvard School of Public Health (Li), Boston, MA; University of Wisconsin, School of Public Health (Harley), Milwaukee, WI; Center for Community-Based Research, Department of Society, Human Development and Health, Harvard School of Public Health (Sapp, Emmons, Sorensen), Boston, MA
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Hawkes AL, Patrao TA, Green A, Aitken JF. CanPrevent: a telephone-delivered intervention to reduce multiple behavioural risk factors for colorectal cancer. BMC Cancer 2012; 12:560. [PMID: 23181756 PMCID: PMC3529678 DOI: 10.1186/1471-2407-12-560] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 11/22/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This pilot study aimed to test the acceptability and short-term effectiveness of a telephone-delivered multiple health behaviour change intervention for relatives of colorectal cancer survivors. METHODS A community-based sample of 22 first-degree relatives of colorectal cancer survivors were recruited via a media release. Data were collected at baseline and at six weeks (post-intervention). Outcome measures included health behaviours (physical activity, television viewing, diet, alcohol, body mass index, waist circumference and smoking), health-related quality of life (Short Form-36) and perceived colorectal cancer risk. Intervention satisfaction levels were also measured. The intervention included six telephone health coaching sessions, a participant handbook and a pedometer. It focused on behavioural risk factors for colorectal cancer [physical activity, diet (red and processed meat consumption, fruit and vegetable intake), alcohol, weight management and smoking], and colorectal cancer risk. RESULTS From baseline to six weeks, improvements were observed for minutes moderate-vigorous physical activity (150.7 minutes), processed meat intake (-1.2 serves/week), vegetable intake (1 serve/day), alcohol intake (-0.4 standard drinks/day), body mass index (-1.4 kg/m2), and waist circumference (-5.1 cm). Improvements were also observed for physical (3.3) and mental (4.4) health-related quality of life. Further, compared with baseline, participants were more likely to meet Australian recommendations post-intervention for: moderate-vigorous physical activity (27.3 vs 59.1%); fruit intake (68.2 vs 81.8%); vegetable intake (4.6 vs 18.2%); alcohol consumption (59.1 vs 72.7%); body mass index (31.8 vs 45.5%) and waist circumference (18.2 vs 27.3%). At six weeks participants were more likely to believe a diagnosis of CRC was related to family history, and there was a decrease in their perceived risk of developing CRC in their lifetime following participation in CanPrevent. The intervention retention rate was 100%, participants reported that it was highly acceptable and they would recommend it to others at risk of colorectal cancer. CONCLUSIONS Positive behaviour change achieved through this intervention approach has the potential to impact on the progression of CRC and other cancers or chronic diseases. A large scale randomised controlled trial is required to confirm the positive results of this acceptability and short-term effectiveness study. TRIAL REGISTRATION ACTRN12612000516886.
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Affiliation(s)
- Anna L Hawkes
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, Queensland, 4004, Australia
| | - Tania A Patrao
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, Queensland, 4004, Australia
| | - Anita Green
- The University of Queensland Health Service, The University of Queensland, Brisbane, Australia
| | - Joanne F Aitken
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, Queensland, 4004, Australia
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48
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MAYS DARREN, PESHKIN BETHN, WALKER LESLIER, ABRAHAM ANISHAA, HAWKINS KIRSTENB, TERCYAK KENNETHP. Patterns and correlates of multiple risk factors for adult-onset cancer among adolescents. J Child Health Care 2012; 16:250-62. [PMID: 22363044 PMCID: PMC3518276 DOI: 10.1177/1367493511430680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors investigated patterns and correlates of multiple cancer risk factors (MCRFs) among adolescents. Baseline data from an intervention efficacy trial were analyzed to examine patterns of co-occurring MCRFs and sociodemographic and theoretical (e.g. prevention self-efficacy) correlates of MCRFs among adolescents (N = 50) aged 13-21 years. The mean total MCRFs was 4.6 (SD = 1.6; range = 0-9). The most common risk factors were intentions to use alcohol (n = 40, 80%), <5 daily servings of fruits/vegetables (n = 40, 80%), and lifetime alcohol use (n = 38, 76%). MCRFs commonly co-occurred, suggesting a clustered risk profile. Higher age (B = 0.19, 95% confidence interval [CI]: 0.01, 0.38) and lower prevention self-efficacy (B = -0.16, 95% CI: -0.30, -0.02) were significantly (p < 0.05) associated with MCRFs. Multiple health behavior change interventions are needed to prevent accumulation of risk factors as youth mature. Self-efficacy may be an important target for prevention interventions.
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Affiliation(s)
- DARREN MAYS
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - BETH N. PESHKIN
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - LESLIE R. WALKER
- Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington, USA
| | - ANISHA A. ABRAHAM
- Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA
| | - KIRSTEN B. HAWKINS
- Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA
| | - KENNETH P. TERCYAK
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
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Koshy P, Mackenzie M, Leslie W, Lean M, Hankey C. Eating the elephant whole or in slices: views of participants in a smoking cessation intervention trial on multiple behaviour changes as sequential or concurrent tasks. BMC Public Health 2012; 12:500. [PMID: 22759785 PMCID: PMC3416689 DOI: 10.1186/1471-2458-12-500] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 07/03/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper explores smoking cessation participants' perceptions of attempting weight management alongside smoking cessation within the context of a health improvement intervention implemented in Glasgow, Scotland. METHODS One hundred and thirty-eight participants were recruited from smoking cessation classes in areas of multiple deprivation in Glasgow and randomised to intervention, receiving dietary advice, or to control groups. The primary outcome of the study was to determine the % change in body weight. Semi-structured interviews were conducted with a purposive sample of 15 intervention and 15 control participants at weeks 6 (during the intervention) and 24 (at the end of the intervention). The current paper, though predominantly qualitative, links perceptions of behaviour modification to % weight change and cessation rates at week 24 thereby enabling a better understanding of the mediators influencing multiple behaviour change. RESULTS Our findings suggest that participants who perceive separate behaviour changes as part of a broader approach to a healthier lifestyle, and hence attempt behaviour changes concurrently, may be at comparative advantage in positively achieving dual outcomes. CONCLUSIONS These findings highlight the need to assess participants' preference for attempting multiple behaviour changes sequentially or simultaneously in addition to assessing their readiness to change. Further testing of this hypothesis is warranted. TRIAL REGISTRATION ISRCTN94961361.
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Affiliation(s)
- Preethi Koshy
- Human Nutrition, School of Medicine, University of Glasgow, Glasgow, G4 0SF, UK.
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50
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Senore C, Giordano L, Bellisario C, Di Stefano F, Segnan N. Population based cancer screening programmes as a teachable moment for primary prevention interventions. A review of the literature. Front Oncol 2012; 2:45. [PMID: 22649789 PMCID: PMC3355877 DOI: 10.3389/fonc.2012.00045] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 04/18/2012] [Indexed: 12/04/2022] Open
Abstract
Background and aim: Unhealthy diet, physical inactivity, and smoking are key risk factors for the major non-communicable diseases such as cancer, cardiovascular diseases, and diabetes. The screening procedure may represent an ideal setting for promoting healthy lifestyles as it represents a time when subjects are probably more inclined to consider a relationship between their own habits and their effects on health. The aim of this study is to review available evidence concerning interventions combining screening and primary prevention interventions, aimed at promoting the adoption of healthy lifestyles. Methods: We searched the MEDLINE and Cochrane library electronic databases for intervention studies of primary prevention interventions implemented in the context of established screening programmes, or of pilot screening projects, where the study design included a comparison group. Results: Comprehensive interventions are acceptable for asymptomatic subjects targeted for cancer screening, can result in improvements and may be cost–effective. A positive impact of these interventions in favoring the adoption of cancer protective dietary behaviors was observed in all studies. Conflicting results were instead reported with respect to physical activity, while no impact could be observed for interventions aimed to favor smoking cessation. Conclusions: The retrieved studies suggest that the screening setting may offer valuable opportunities to provide credible, potentially persuasive life style advice, reaching a wide audience. A multiple risk factor approach may maximize the benefit of behavioral change, as the same health related habits are associated not only with cancers targeted by screening interventions, but also with other cancers, coronary artery disease, and other chronic conditions, while unhealthy behaviors may be mutually reinforcing. In order to cover a maximum number of possibilities, health education programmes should include multiple strategies, integrating and combining models of individual, social, and environmental change.
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Affiliation(s)
- Carlo Senore
- Epidemiologia dei Tumori II, AOU S Giovanni Battista - CPO Piemonte Torino, Italy
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