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Caleça T, Ribeiro P, Vitorino M, Menezes M, Sampaio-Alves M, Mendes AD, Vicente R, Negreiros I, Faria A, Costa DA. Breast Cancer Survivors and Healthy Women: Could Gut Microbiota Make a Difference?-"BiotaCancerSurvivors": A Case-Control Study. Cancers (Basel) 2023; 15:cancers15030594. [PMID: 36765550 PMCID: PMC9913170 DOI: 10.3390/cancers15030594] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/09/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
In this first analysis, samples from 23 BC survivors (group 1) and 291 healthy female controls (group 2) were characterised through the V3 and V4 regions that encode the "16S rRNA" gene of each bacteria. The samples were sequenced by next-generation sequencing (NGS), and the taxonomy was identified by resorting to Kraken2 and improved with Bracken, using a curated database called 'GutHealth_DB'. The α and β-diversity analyses were used to determine the richness and evenness of the gut microbiota. A non-parametric Mann-Whitney U test was applied to assess differential abundance between both groups. The Firmicutes/Bacteroidetes (F/B) ratio was calculated using a Kruskal-Wallis chi-squared test. The α-diversity was significantly higher in group 1 (p = 0.28 × 10-12 for the Chao index and p = 1.64 × 10-12 for the ACE index). The Shannon index, a marker of richness and evenness, was not statistically different between the two groups (p = 0.72). The microbiota composition was different between the two groups: a null hypothesis was rejected for PERMANOVA (p = 9.99 × 10-5) and Anosim (p = 0.04) and was not rejected for β-dispersion (p = 0.158), using Unifrac weighted distance. The relative abundance of 14 phyla, 29 classes, 25 orders, 64 families, 116 genera, and 74 species differed significantly between both groups. The F/B ratio was significantly lower in group 1 than in group 2, p < 0.001. Our study allowed us to observe significant taxonomic disparities in the two groups by testing the differences between BC survivors and healthy controls. Additional studies are needed to clarify the involved mechanisms and explore the relationship between microbiota and BC survivorship.
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Affiliation(s)
- Telma Caleça
- Medical Oncology Department, Hospital Professor Doutor Fernando Fonseca, 2720-276 Amadora, Portugal
- Correspondence: (T.C.); (D.A.C.)
| | - Pedro Ribeiro
- Laboratory Medicine Centre Germano de Sousa, 1600-513 Lisbon, Portugal
| | - Marina Vitorino
- Medical Oncology Department, Hospital Professor Doutor Fernando Fonseca, 2720-276 Amadora, Portugal
| | - Maria Menezes
- Medical Oncology Department, Hospital do Espírito Santo de Évora, 7000-811 Évora, Portugal
| | - Mafalda Sampaio-Alves
- PTSurg–Portuguese Surgical Research Collaborative, 1600 Lisbon, Portugal
- Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal
| | - Ana Duarte Mendes
- Medical Oncology Department, Hospital Professor Doutor Fernando Fonseca, 2720-276 Amadora, Portugal
| | - Rodrigo Vicente
- Medical Oncology Department, Hospital Professor Doutor Fernando Fonseca, 2720-276 Amadora, Portugal
| | - Ida Negreiros
- Hospital CUF, Breast Cancer Unit, 1998-018 Lisbon, Portugal
| | - Ana Faria
- Faculdade de Ciências Médicas, NOVA Medical School, 1169-056 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Faculdade de Ciências Médicas, NOVA Medical School, 1150-082 Lisbon, Portugal
- CINTESIS-Center for Health Technology Services Research, Faculdade de Ciências Médicas, NOVA Medical School, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Diogo Alpuim Costa
- Hospital CUF, Breast Cancer Unit, 1998-018 Lisbon, Portugal
- Faculdade de Ciências Médicas, NOVA Medical School, 1169-056 Lisbon, Portugal
- Medical Oncology Department, Hospital de Cascais Dr. José de Almeida, 2755-009 Cascais, Portugal
- Correspondence: (T.C.); (D.A.C.)
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Ajmera P, Miraj M, Kalra S, Goyal RK, Chorsiya V, Shaik RA, Alzhrani M, Alanazi A, Alqahtani M, Miraj SA, Pawaria S, Mehta V. Impact of telehealth interventions on physiological and psychological outcomes in breast cancer survivors: A meta-analysis of randomised controlled trials. Front Oncol 2023; 12:1017343. [PMID: 36686741 PMCID: PMC9850160 DOI: 10.3389/fonc.2022.1017343] [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] [Received: 08/11/2022] [Accepted: 11/15/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction The use of telehealth interventions has been evaluated in different perspectives in women and also supported with various clinical trials, but its overall efficacy is still ascertained. The objective of the present review is to identify, appraise and analyze randomized controlled trials on breast cancer survivors who have participated in technology-based intervention programs incorporating a wide range of physical and psychological outcome measures. Material and methods We conducted electronic search of the literature during last twenty years i.e., from 2001 till August 10, 2021 through four databases. Standardized mean difference with 95% confidence interval was used. Results A total of 56 records were included in the qualitative and 28 in quantitative analysis. Pooled results show that telehealth interventions were associated with improved quality of life (SMD 0.48, 95% CI 0.03 to 0.92, p=0.04), reduced depression (SMD -1.27, 95% CI =-2.43 to -0.10 p=0.03), low distress and less perceived stress (SMD -0.40, 95% CI =-0.68 to -0.12, p=0.005). However, no significant differences were observed on weight change (SMD -0.27, 95% CI =-2.39 to 1.86, p=0.81) and anxiety scores (SMD -0.09, 95% CI =-0.20 to 0.02, p=0.10) between the two groups. Improvement in health care competence and fitness among participants was also reported. Conclusion Study concludes that telehealth care is a quick, convenient and assuring approach to breast cancer care in women that can reduce treatment burden and subsequent disturbance to the lives of breast cancer survivors.
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Affiliation(s)
- Puneeta Ajmera
- Department of Public Health, School of Allied Health Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Mohammad Miraj
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia,*Correspondence: Mohammad Miraj,
| | - Sheetal Kalra
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Ramesh K. Goyal
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Varsha Chorsiya
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Msaad Alzhrani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia
| | - Ahmad Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, AlMajmaah, Saudi Arabia
| | - Mazen Alqahtani
- College of Applied Medical Sciences, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia
| | - Shaima Ali Miraj
- Department of Public Health, College of Health Science, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Sonia Pawaria
- Faculty of Physiotherapy, SGT University, Gurugram, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
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Zetner D, Kamby C, Gülen S, Christophersen C, Paulsen CB, Piga E, Hoffmeyer B, Mahmood F, Rosenberg J. Quality-of-life outcomes following topical melatonin application against acute radiation dermatitis in patients with early breast cancer: A double-blind, randomized, placebo-controlled trial. J Pineal Res 2023; 74:e12840. [PMID: 36385713 PMCID: PMC10078485 DOI: 10.1111/jpi.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/27/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
The aim of this double-blind, placebo-controlled, randomized study was to investigate whether topical melatonin administered during radiation therapy could increase the quality of life in patients with primary breast cancer. Patients were followed from the first radiation fraction until 3 weeks after the last. The patients applied 1 g of cream to the irradiated area of the skin twice daily, consisting of either 25 mg/g melatonin and 150 mg/g dimethyl sulfoxide, or a placebo cream. Outcomes were the European Organisation for Research and Treatment of Cancer's quality-of-life questionnaires for breast cancer (QLQ-C30 and QLQ-BR23) on the last day of radiation therapy. As a secondary outcome, we evaluated the breast symptom (BS) scores over the entire duration of the trial in a repeated measures linear model. We included 65 patients and had 17 drop-outs, thus totaling 26 and 22 patients in the melatonin and placebo groups, respectively. BS scores on the last day of radiation did not differ between groups (p = .333). However, the linear model analyzing BS for the entire duration showed that melatonin significantly decreased the symptoms (p = .001). There was no difference in the BS score on the last day of radiation, however, we found that the patients in the melatonin group had significantly lower BS scores over the entire duration of the trial.
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Affiliation(s)
- Dennis Zetner
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| | - Claus Kamby
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| | - Sengül Gülen
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | | | - Cecilie B Paulsen
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Emily Piga
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Bodil Hoffmeyer
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Faisal Mahmood
- Department of Oncology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Jacob Rosenberg
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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Von Ah D, Crouch AD, Monahan PO, Stump TE, Unverzagt FW, Storey S, Cohee AA, Cella D, Champion VL. Association of cognitive impairment and breast cancer survivorship on quality of life in younger breast cancer survivors. J Cancer Surviv 2021; 16:812-822. [PMID: 34173970 PMCID: PMC9300496 DOI: 10.1007/s11764-021-01075-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/12/2021] [Indexed: 01/22/2023]
Abstract
Purpose Younger breast cancer survivors (BCS) often report cognitive impairment and poor quality of life (QoL), which could be interrelated. The purpose of this study was to examine the association of cognitive impairment and breast cancer status (BCS versus healthy control (HC)), with QoL, which included psychological (depressive symptoms, well-being, perceived stress, and personal growth) and physical well-being (physical functioning and fatigue). Methods Four hundred ninety-eight BCS (≤45 years at diagnosis) who were 3 to 8 years post-chemotherapy treatment and 394 HC completed subjective questionnaires and a one-time neuropsychological assessment, including tests of attention, memory, processing speed, and verbal fluency. For each test, cognitive impairment was defined as scoring 1.5 and 2.0 standard deviations below the mean of the HC group. Separate linear regression models for each outcome were ran controlling for known covariates. Results BCS reported significantly more memory problems than HC (p < 0.0001), with up to 23% having significant impairment. Cognitive performance did not differ significantly between BCS and HCs. BCS vs. HCs had greater depression and fatigue, yet more personal growth. Objective and subjective cognitive impairment were significantly related to greater depressive symptoms and perceived stress and lower well-being and physical functioning; whereas, objective impairment was related to less personal growth and subjective impairment was related to greater fatigue. Conclusions Younger BCS report significant cognitive impairment years after treatment which may relate to greater decrements in QoL. Implications to Cancer Survivors Assessment and interventions to address cognitive concerns may also influence QoL outcomes in younger BCS. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01075-x.
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Affiliation(s)
- Diane Von Ah
- Indiana University School of Nursing, 600 Barnhill Drive, NU 120, Indianapolis, IN 46202 USA
| | - Adele D. Crouch
- Indiana University School of Nursing, 600 Barnhill Drive, NU 120, Indianapolis, IN 46202 USA
| | - Patrick O. Monahan
- Department of Biostatistics, Indiana University School of Medicine, HS3000, Indianapolis, IN 46202 USA
| | - Timothy E. Stump
- Department of Biostatistics, Indiana University School of Medicine, HS3000, Indianapolis, IN 46202 USA
| | - Frederick W. Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th Street, Suite 2800, Indianapolis, IN 46202 USA
| | - Susan Storey
- Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th Street, Suite 2800, Indianapolis, IN 46202 USA
| | - Andrea A. Cohee
- Indiana University School of Nursing, 600 Barnhill Drive, NU 120, Indianapolis, IN 46202 USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave – 21st Floor, Chicago, IL 60611 USA
- Institute for Public Health and Medicine-Center for Patent Centered Outcomes, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave – 21st Floor, Chicago, IL 60611 USA
| | - Victoria L. Champion
- IU Simon Cancer Center, Indiana University School of Nursing, 600 Barnhill Drive, NU 318, Indianapolis, IN 46202 USA
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Chan RJ, Teleni L, McDonald S, Kelly J, Mahony J, Ernst K, Patford K, Townsend J, Singh M, Yates P. Breast cancer nursing interventions and clinical effectiveness: a systematic review. BMJ Support Palliat Care 2020; 10:276-286. [PMID: 32499405 DOI: 10.1136/bmjspcare-2019-002120] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/06/2020] [Accepted: 05/06/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the effects of nurse-led interventions on the health-related quality of life, symptom burden and self-management/behavioural outcomes in women with breast cancer. METHODS Cochrane Controlled Register of Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Embase databases were searched (January 1999 to May 2019) to identify randomised controlled trials (RCTs) and controlled before-and-after studies of interventions delivered by nurses with oncology experience for women with breast cancer. Risk of bias was evaluated using the revised Cochrane risk-of-bias tool for randomised trials. Intervention effects were synthesised by cancer trajectory using The Omaha System Intervention Classification Scheme. RESULTS Thirty-one RCTs (4651 participants) were included. All studies were at risk of bias mainly due to inherent limitations such as lack of blinding and self-report data. Most studies (71%; n=22) reported at least one superior intervention effect. There were no differences in all outcomes between those who receive nurse-led surveillance care versus those who received physical led or usual discharge care. Compared with control interventions, there were superior teaching, guidance and counselling (63%) and case management (100%) intervention effects on symptom burden during treatment and survivorship. Effects of these interventions on health-related quality of life and symptom self-management/behavioural outcomes were inconsistent. DISCUSSION There is consistent evidence from RCTs that nurse-led surveillance interventions are as safe and effective as physician-led care and strong evidence that nurse-led teaching, guidance and counselling and case management interventions are effective for symptom management. Future studies should ensure the incorporation of health-related quality of life and self-management/behavioural outcomes and consider well-designed attentional placebo controls to blind participants for self-report outcomes. PROTOCOL REGISTRATION The International Prospective Register of Systematic Reviews (PROSPERO): CRD42020134914).
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Affiliation(s)
- Raymond Javan Chan
- Division of Cancer Services, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Queensland, Australia .,School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Laisa Teleni
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Suzanne McDonald
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jaimon Kelly
- School of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Jane Mahony
- McGrath Foundation, North Sydney, New South Wales, Australia
| | - Kerryn Ernst
- McGrath Foundation, North Sydney, New South Wales, Australia
| | - Kerry Patford
- McGrath Foundation, North Sydney, New South Wales, Australia
| | - James Townsend
- McGrath Foundation, North Sydney, New South Wales, Australia
| | - Manisha Singh
- McGrath Foundation, North Sydney, New South Wales, Australia
| | - Patsy Yates
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
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Nasiriani K, Motevasselian M, Farnia F, Shiryazdi SM, Khodayarian M. The Effect of Telephone Counseling and Education on Breast Cancer Screening in Family Caregivers of Breast Cancer Patients. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2017; 5:306-316. [PMID: 29043277 PMCID: PMC5635551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Breast cancer is the most common form of malignancy among females. Family history is a key risk factor for breast cancer. Breast cancer screening practices are vital in patients with family history of breast cancer. Telephone counseling and education may be appropriate for improved breast cancer screening. This study was done to determine family caregiver patients' knowledge of risk factors for breast cancer and practice of breast cancer screening and also to assess the effect of telephone counseling and education on mammography screening. METHODS This study was a community-based trial. The participants of the study were 90 caregivers who were randomly divided into an experimental group, telephone counseling and education, and a control group. The intervention group received counseling and education phone calls. A three-section questionnaire was responded and filled out through telephone interviews with the participants. The collected data were analyzed with SPSS18, using descriptive and inferential statistics. RESULTS The results showed that 88.9% of the participants did not know when to do breast self-exam (BSE). Mammography was performed by the participants before and after the telephone counseling in intervention group (P<0.00), which were 13.3% and 77.8% respectively). Moreover, the major cause of failure to participate in mammography was lack of enough knowledge in 73.3% of the participants. CONCLUSION This study concluded that knowledge and practice on breast cancer screening in family caregiver of breast cancer patients was low. Telephone counseling and educating may provide a suitable technique for earlier detection of breast cancer in family caregivers of breast cancer patients and it can influence the decision making regarding mammography screening among 40-year-old or older women. Trial Registration Number: 2017052316870N3.
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Affiliation(s)
- Khadijeh Nasiriani
- Research Center for Nursing and Midwifery Care, Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran;
| | - Monireh Motevasselian
- Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran;
| | - Farahnaz Farnia
- Research Center for Nursing and Midwifery Care, Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran;
| | - Seyed Mostafa Shiryazdi
- Department of General Surgery, School of Medicine, Shahid Sadooghi University of Medical Sciences and Health Services, Yazd, Iran
| | - Mahsa Khodayarian
- Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran;
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Okuyama S, Jones W, Ricklefs C, Tran ZV. Psychosocial telephone interventions for patients with cancer and survivors: a systematic review. Psychooncology 2014; 24:857-70. [PMID: 25328103 DOI: 10.1002/pon.3704] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/28/2014] [Accepted: 09/16/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Over one third of patients with cancer experience elevated psychosocial distress. As screening for distress becomes more common, the number of patients referred for psychosocial care will increase. Psychosocial telephone interventions are recommended as a convenient and exportable alternative to in-person interventions addressing psychosocial distress. This study reviews the efficacy of randomized controlled trials (RCTs) of psychosocial telephone interventions for patients with cancer. METHODS We conducted a systematic review of peer-reviewed RCTs evaluating telephone interventions in adult patients with cancer across the survivorship continuum. RESULTS Through a database search, 480 articles were identified. After manual review, 13 were included, with 7 additional studies identified by back citation, totaling 20 studies. Participants were largely Caucasian, highly educated, with mean age ranging from 49 to 75 years. Most participants were patients with breast cancer (n = 13 studies). Sample sizes were generally small, with most patients recruited from large medical centers. Only one screened for psychosocial need. Interventions varied greatly in length and intensity. Eight studies reported significant effects post-intervention in the hypothesized direction on at least one psychosocial outcome measure. Of these eight studies, four included more than one follow-up assessment; of these, only one reported significant effects at last follow-up. No clear commonalities were found among studies reporting significant effects. CONCLUSIONS Methodological concerns and lack of consistency in adherence to CONSORT reporting guidelines were identified. This body of research would benefit from well-designed, theory-based RCTs adequately powered to provide more definitive evidence for intervention efficacy. This will probably require multi-institutional collaborations, guided by intervention and research methodology best practices.
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Affiliation(s)
- Sonia Okuyama
- University of Colorado Cancer Center, Cancer Prevention and Control, Aurora, CO, USA
| | - Whitney Jones
- Colorado School of Public Health, Department of Community and Behavioral Health, Aurora, CO, USA
| | - Christine Ricklefs
- University of Colorado Cancer Center, Cancer Prevention and Control, Aurora, CO, USA
| | - Zung Vu Tran
- Colorado School of Public Health, Department of Biostatistics and Informatics, Aurora, CO, USA
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