Information Needs of Women At Risk of Breast Cancer

Utilizing RE-AIM to examine the translational potential of Project MOVE, a novel intervention for increasing physical activity levels in breast cancer survivors

Translating effective research into community practice is critical for improving breast cancer (BC) survivor health. The purpose of this study is to utilize the RE-AIM framework to evaluate the translational potential of Project MOVE, an innovative intervention focused on increasing physical activity (PA) in BC survivors. A mixed-methods design, including a self-report questionnaire, accelerometry, focus groups, and interviews, was used to inform each RE-AIM dimension. Reach was evaluated by the representativeness of participants. Effectiveness was reflected by change in PA levels and perceptions of satisfaction and acceptability. Adoption was examined using participants' perceived barriers/facilitators to program uptake. Implementation was examined by participants' perceived barriers/facilitators to implementing the program. Maintenance was assessed by participant retention. Assessments occurred at baseline and 6-months. Mixed analysis of variance and content analysis were used to analyze the data. A total of 87 participants participated in Project MOVE and were demographically comparable to similar studies (Reach). Participants indicated high levels of program satisfaction (88%) and previously inactive survivors' significantly increased PA levels from baseline to 6-month follow-up (Effectiveness). Participants reported that a program focused on PA rather than disease helped them overcome barriers to PA (Adoption) and having leaders with BC and exercise expertise was essential to accommodate population specific barriers (Implementation). At 6-months, participant retention was 83% (Maintenance). Project MOVE is an acceptable, practical, and effective program for engaging BC survivors in PA and has the potential to be highly transferable to other populations and regions.

A scoping review of consumer needs for cancer information

OBJECTIVE

This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers.

METHODS

This study used the COSI model to search for articles published from 2007 to 2017.

RESULTS

In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention.

CONCLUSION

This study revealed an increase in the number of research articles identifying cancer patients' information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed.

PRACTICE IMPLICATIONS

There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers' cancer information needs should be developed.

An Evidence-based Approach to Developing the Collaborative, Client-Centred Nutrition Education (3CNE) Framework and Practice Points

PURPOSE

The purpose of this, the third phase of a 3-phase research project, was to develop guidelines for client-centred nutrition education (NE).

METHODS

A 3-phase study was conducted using a progressive development design, where each phase informed the subsequent phase. Phase 1 was a national online survey of dietitians' perceptions of consumers' NE needs and preferences; results informed the Phase 2 national online survey of consumers about their NE needs and preferences. Phase 3 involved national 2-part teleconference consultations with dietitians to discuss implications of the Phase 2 findings for NE practice. This paper is the report of Phase 3.

RESULTS

Discussion group participants were 22 dietitians from around Canada who had been in practice for an average of 14.5 years. Discussions resulted in the development of the Collaborative Client-Centred Nutrition Education (3CNE) conceptual framework and related Practice Points that explicate the complexity of NE practice.

CONCLUSION

The 3CNE framework and Practice Points provide a means to inform precepting students and interns, and for use in planning for the professional development of practicing dietitians on providing client-centred NE.

Toward Evidence-based, Client-centred Nutrition Education Guidelines: Dietitian and Consumer Survey Results

Purpose: Dietitian and consumer perspectives on nutrition education needs and preferences were explored, as these relate to health status.

Methods: Phases 1 and 2 of a three-phase, mixed-methods study are reported. Phase 1 was a national online survey of dietitians, which was designed to inform the development of a consumer survey (Phase 2). Consumers responded to an online survey about their demographics, medical conditions, and nutrition education needs (what they wanted to learn) and preferences (how they wanted to learn). Phase 3 involved teleconferenced discussion groups with dietitians across Canada to develop guidelines for nutrition education.

Results: Dietitian respondents (n=441) perceived that consumer health status was important in predicting needs and preferences for nutrition education; emotional support was considered most important for consumers with life-altering medical conditions. Consumers (n=680) expressed interest in an array of nutrition education approaches; cooking tips, recipes, and supplement advice were the most popular. Respondents with and without medical conditions had similar nutrition education needs and preferences.

Conclusions: Because of the complexity of nutrition education and consumers’ preference for a spectrum of approaches and delivery methods, evidence-based nutrition education guidelines are important to inform dietetics training for the provision of client-centred nutrition education.

Knowledge of antioxidants and breast cancer risk among women attending breast cancer risk assessment clinics

This qualitative study used semistructured interviews to examine the accuracy of knowledge concerning antioxidants and health among a convenience sample of 79 women attending a breast cancer risk assessment clinic. Despite a high level of familiarity (98%) with the word antioxidant, few participants could name more than one of these compounds and most relied on print media (41.6%) and radio/TV (22.2%) for antioxidant information. Thematic content analysis revealed participants' beliefs that antioxidants were strongly linked to reduced breast cancer risk and improved health. They described antioxidant functions that take place before (e.g., "Prevention . . . a best defense mechanism" and "To boost strength and good health") or after (e.g., "Fights diseases, free radicals, and cancer," "Acts as a cleanser or purifier," and "Undoes the harm that I am consciously or unconsciously doing to my body") a health threat. Participants' understandings of the links between antioxidant intake and breast cancer risk did not accurately reflect the scientific evidence. This large priority population group needs tailored, evidence-based nutrition communications to address inaccurate understandings about antioxidant intake and breast cancer risk.

Cancer patients' informational needs on health promotion and related factors: a multi-institutional, cross-sectional study in Korea

BACKGROUND

As the survival rates of cancer patients increase, health promotion for cancer survivors becomes a more important issue. This study examines whether the informational needs on health promotion by cancer patients is being met and evaluates other factors associated with those informational needs.

METHODS

Questionnaires were collected from a total of 2,661 cancer patients at ten cancer centers in Korea from July to August 2008. The questionnaire was designed to elicit informational needs related to healthy behaviors, nutrition, and complementary and alternative medicine (CAM). Multiple logistic regression models were developed to identify factors affecting the informational needs of cancer survivors regarding health promotion.

RESULTS

In our study sample, we found that 64.83%, 66.38%, and 47.40% of patients have unmet informational needs regarding healthy behaviors, nutrition, and CAM, respectively. The desire for information about health promotion appears to be related to socio-demographic factors, clinical factors, behavioral factors, and quality of life. Younger patients with higher levels of education, shorter time since diagnosis, greater stress levels, previous experience using CAM, and problems identified on EQ5D expressed greater needs for health-related information. Cancer recurrence and smoking status were also associated with greater informational needs about nutrition and CAM.

CONCLUSIONS

A significant proportion of cancer patients have unmet informational needs on health promotion. We identified several factors that influence the desire for more health-related information. A tailored approach to providing informational resources to patient groups with unmet informational needs is recommended to enhance the quality of life of cancer patients.