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Buller DB, Sussman AL, Thomson CA, Kepka D, Taren D, Henry KL, Warner EL, Walkosz BJ, Woodall WG, Nuss K, Blair CK, Guest DD, Borrayo EA, Gordon JS, Hatcher J, Wetter DW, Kinsey A, Jones CF, Yung AK, Christini K, Berteletti J, Torres JA, Barraza Perez EY, Small A. #4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial. JMIR Res Protoc 2024; 13:e50392. [PMID: 38386396 PMCID: PMC10921336 DOI: 10.2196/50392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. OBJECTIVE This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. METHODS We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. RESULTS The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. CONCLUSIONS Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. TRIAL REGISTRATION ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50392.
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Affiliation(s)
| | - Andrew L Sussman
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Deanna Kepka
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Taren
- Section of Nutrition, University of Colorado Denver, Aurora, CO, United States
| | - Kimberly L Henry
- Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, CO, United States
| | - Echo L Warner
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | | | - Kayla Nuss
- Klein Buendel, Golden, CO, United States
| | - Cindy K Blair
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Evelinn A Borrayo
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | | | - David W Wetter
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Christopher F Jones
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Angela K Yung
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kaila Christini
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - John A Torres
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
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Werts SJ, Lavelle SA, Crane TE, Thomson CA. Recruitment and Retention Strategies Used in Dietary Randomized Controlled Interventions with Cancer Survivors: A Systematic Review. Cancers (Basel) 2023; 15:4366. [PMID: 37686640 PMCID: PMC10486591 DOI: 10.3390/cancers15174366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The purpose of this review was to systematically evaluate the quality of reporting of recruitment and retention methods in diet-related intervention trials among cancer survivors. METHODS A systematic search of five databases in Spring 2023 identified dietary intervention randomized controlled trials with a minimum of 50 cancer survivors, an intervention of at least eight weeks, and at least six months of study duration. Outcomes investigated include methodologic description and reporting of recruitment and retention rates. RESULTS Seventeen trials met inclusion criteria. Recruitment methods included cancer registry and clinician referral, hospital records, flyers, and media campaigns, and were reported in 88.2% of studies. Eleven of 17 studies (64.7%) met a priori recruitment goals. Eleven studies identified an a priori retention goal and seven met the goal. Retention goals were met more often for studies of less than one year (71.4%) versus greater than one year (50%), and for studies with remote or hybrid delivery (66.7%) versus only in-person delivery (50%). CONCLUSIONS Recruitment goals and methods are frequently reported; reporting of retention methods and goals is limited. Efforts are needed to improve reporting of retention methods and rates to inform best practices and enhance the rigor of future dietary intervention trials.
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Affiliation(s)
- Samantha J. Werts
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, USA
| | - Sarah A. Lavelle
- College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ 85721, USA;
| | - Tracy E. Crane
- Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA
| | - Cynthia A. Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, USA
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Grischott T, Senn O, Frei A, Rosemann T, Neuner-Jehle S. Comparison of Motivational Short Interventions to Improve Smokers' Health Behavior (The COSMOS Study): A Pragmatic Cluster-Randomized Two-Arm Trial in General Practice. Nicotine Tob Res 2023; 25:102-110. [PMID: 35759949 DOI: 10.1093/ntr/ntac159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Helping smokers to quit is an important task of general practitioners (GPs). However, achieving tobacco abstinence is difficult, and smokers who fail may still want to improve their health in other ways. Therefore, Swiss GPs developed a multithematic coaching concept that encourages health behavior changes beyond smoking cessation alone. AIMS AND METHODS To compare the effectiveness of such coaching with state-of-the-art smoking cessation counseling, we conducted a pragmatic cluster-randomized two-arm trial with 56 GPs in German-speaking Switzerland and 149 of their cigarette smoking patients. GPs were instructed in either multithematic health coaching or smoking cessation counseling. After 12 months, we compared their patients' improvements in cigarette consumption, body weight, physical inactivity, alcohol consumption, stress, unhealthy diet, and a health behavior of their own choice, using hierarchical logistic regression models and Fisher's exact and t tests. RESULTS Over 95% of all participants achieved clinically relevant improvements in at least one health behavior, with no difference between study arms (health coaching vs. smoking cessation counseling: aOR = 1.21, 95% CI = [0.03-50.76]; and aOR = 1.78, 95% CI = [0.51-6.25] after non-responder imputation). Rates of clinically relevant improvements in the individual health behaviors did not differ between study arms either (they were most frequent in physical activity, achieved by 3 out of 4 patients), nor did the extent of the improvements. CONCLUSIONS Multithematic health coaching and state-of-the art smoking cessation counseling were found to be comparable interventions, both in terms of smoking cessation success and, quite unexpectedly, their effects on other health behaviors. IMPLICATIONS The findings of our study suggest that in general practice, multithematic health coaching is an effective smoking cessation intervention, and conversely, monothematic smoking cessation counseling also achieves the beneficial effects of a multithematic health behavior intervention. This opens up the possibility for GPs to support their smoking patients in improving their health behavior in additional and more flexible ways.
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Affiliation(s)
- Thomas Grischott
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stefan Neuner-Jehle
- Institute of Primary Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Heredia-Ciuró A, Martín-Núñez J, López-López JA, López-López L, Granados-Santiago M, Calvache-Mateo A, Valenza MC. Effectiveness of healthy lifestyle-based interventions in lung cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2022; 31:71. [PMID: 36542189 DOI: 10.1007/s00520-022-07542-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To assess the effectiveness of healthy lifestyle-based interventions in lung cancer survivors. METHODS We performed a literature search using PubMed, Web of Science, and Science Direct (last search March 2022). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. A systematic review and meta-analysis of randomized controlled trials were performed. We included controlled trials testing the effect of healthy lifestyle-based interventions in lung cancer survivors versus a control intervention where lung cancer patients had no treatment, were receiving the usual care, or had not an active role in the intervention. The data were pooled and a meta-analysis was completed for quality of life, psychological distress, and cancer-related symptoms. RESULTS We selected 14 studies, which included 1519 patients with lung cancer. The treatment status of these patients was heterogeneous. Healthy lifestyle programs were applied isolated or in combination with usual care in most of the studies. The components of the healthy lifestyle programs were also heterogeneous. Results showed significant differences in favor of healthy lifestyle-based interventions in comparison to the control group for quality of life (p = 0.01), psychological distress (p = 0.05), and cancer-related symptoms (p = 0.03). CONCLUSIONS The findings indicated a beneficial effect of healthy lifestyle-based interventions for improving quality of life, psychological distress, and cancer-related symptoms in lung cancer patients. However, this review could not show any conclusion about the better treatment moment to apply healthy lifestyle-based interventions. REVIEW REGISTRATION PROSPERO Identifier: CRD42021292152. REVIEW REGISTRATION DATE 19/12/2021.
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Affiliation(s)
- Alejandro Heredia-Ciuró
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Javier Martín-Núñez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | | | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - María Granados-Santiago
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Andrés Calvache-Mateo
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain.
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Pekmezi D, Fontaine K, Rogers LQ, Pisu M, Martin MY, Schoenberger-Godwin YM, Oster RA, Kenzik K, Ivankova NV, Demark-Wahnefried W. Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) cancer survivor health: program project protocols for remote lifestyle intervention and assessment in 3 inter-related randomized controlled trials among survivors of obesity-related cancers. BMC Cancer 2022; 22:471. [PMID: 35488238 PMCID: PMC9051494 DOI: 10.1186/s12885-022-09519-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Scalable, multiple behavior change interventions are needed to address poor diet, inactivity, and excess adiposity among the rising number of cancer survivors. Efficacy-tested diet (RENEW) and exercise (BEAT Cancer) programs were adapted for web delivery among middle-aged and older cancer survivors for the AMPLIFI study, a National Cancer Institute-funded, multi-site, program project. METHODS Throughout the continental U.S., survivors of several obesity-related cancers are being recruited for three interconnected randomized controlled trials (RCTs). Projects 1 and 2 test 6-month diet or exercise interventions versus a wait-list control condition. Upon completion of the 6-month study period, the intervention participants receive the next behavior change sequence (i.e., diet receives exercise, exercise receives diet) and the wait-list control arm initiates a 12-month combined diet and exercise intervention. Project 3 tests the efficacy of the sequential versus simultaneous interventions. Assessments occur at baseline and semi-annually for up to 2-years and include: body mass index, health behaviors (diet quality, accelerometry-assessed physical activity/sleep), waist circumference, D3 creatine-assessed muscle mass, physical performance, potential mediators/moderators of treatment efficacy, biomarkers of inflammation and metabolic regulation, health care utilization, cost, and overall health. Four shared resources support AMPLIFI RCTs: 1) Administrative; 2) Adaptation, Dissemination and Implementation; 3) Recruitment and Retention; and 4) Assessment and Analysis. DISCUSSION Representing a new generation of RCTs, AMPLIFI will exclusively use remote technologies to recruit, intervene and assess the efficacy of the newly-adapted, web-based diet and exercise interventions and determine whether sequential or combined delivery works best for at-risk (older, rural, racial minority) cancer survivors. TRIAL REGISTRATION ClinicalTrials.gov , NCT04000880 . Registered 27 June 2019.
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Affiliation(s)
- Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA.
| | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
| | - Laura Q Rogers
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Maria Pisu
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Michelle Y Martin
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yu-Mei Schoenberger-Godwin
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Robert A Oster
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | - Kelly Kenzik
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Medicine, UAB, Birmingham, AL, USA
| | | | - Wendy Demark-Wahnefried
- O'Neal Comprehensive Cancer Center, UAB, Birmingham, AL, USA
- Department of Nutrition Sciences, UAB, Birmingham, AL, USA
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Impact of Rotating Shifts on Lifestyle Patterns and Perceived Stress among Nurses: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095235. [PMID: 35564629 PMCID: PMC9101667 DOI: 10.3390/ijerph19095235] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/05/2023]
Abstract
Although rotating shifts have a negative health impact, their association with hospital nurses’ health risks remains controversial due to incomplete adjustment in lifestyle patterns and heterogeneity of work schedules. However, whether work schedule characteristics are associated with lifestyle patterns and perceived stress remains undetermined. We assessed the correlations of work schedule characteristics, lifestyle patterns, and perceived stress among hospital nurses. This cross-sectional study included 340 nurses from two hospitals. Final data from 329 nurses regarding work schedule characteristics, lifestyle patterns (physical activity, dietary behavior, and sleep pattern), and perceived stress were analyzed via linear regression models. Fixed-day-shift nurses had reduced perceived stress (β = 0.15, p = 0.007) compared with rotating-shift nurses. Additionally, among rotating-shift nurses, fixed-evening- and fixed-night-shift nurses had longer sleep duration (β = 0.27, p < 0.001; β = 0.25, p < 0.001) compared to non-fixed-rotating-shift nurses. Longer rotating-shift work was associated with healthier dietary behaviors (β = 0.15, p = 0.008), better sleep quality (β = −0.17, p = 0.003), lower perceived stress (β = −0.24, p < 0.001), and shorter sleep duration (β = −0.17, p = 0.003). Hospital nurses’ work schedule characteristics were associated with lifestyle patterns, dietary behavior, sleep pattern, and perceived stress. Fixed-shifts were beneficial for lifestyle and lower perceived stress. Longer rotating shifts could help nurses adjust their lifestyles accordingly.
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Handley NR, Wen KY, Gomaa S, Brassil K, Shimada A, Leiby B, Jackson L, McMorris M, Calvaresi A, Dicker AP. A Pilot Feasibility Study of Digital Health Coaching for Men With Prostate Cancer. JCO Oncol Pract 2022; 18:e1132-e1140. [PMID: 35394806 DOI: 10.1200/op.21.00712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Prostate cancer is the most common cancer among men in the United States. The majority of prostate cancer treatment occurs in the ambulatory setting, and patients and their caregivers take on significant responsibility for monitoring and managing treatment and disease-related toxicity. Digital health coaching has shown promise as a tool to positively influence outcomes. We completed a single-arm pilot study to assess the feasibility of digital health coaching in men with prostate cancer. METHODS Men with a history of prostate cancer requiring treatment in the past 2 years were eligible for inclusion. Participants engaged in a 12-week health coaching program, consisting of a combination of at least one telephone call and up to four digital nudges (defined as content delivered via text, e-mail, or app on the basis of the participant's preference) per week. Prostate cancer-specific content addressed one of the following topics each week: fatigue, pain management, healthy eating, exercise, managing incontinence, sexual health, managing stress and anxiety, financial toxicity, goal setting during treatment, managing side effects, communicating with the health care team, and medication adherence. Services were provided at no cost to the participant. RESULTS A hundred patients were consented for the study, and 88 enrolled. The feasibility threshold of 60% was met with 63 of the 88 enrolled individuals completing the 3-month program (proportion = 71.6%; 90% CI, 62.6 to 79.4; P = .016). CONCLUSION Digital health coaching for men with prostate cancer is feasible. These findings support further evaluation of digital health coaching for men with prostate cancer in larger randomized controlled trials.
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Affiliation(s)
- Nathan R Handley
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA.,Center for Connected Care, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Kuang-Yi Wen
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Sameh Gomaa
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Ayako Shimada
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Benjamin Leiby
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | | | | | - Anne Calvaresi
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
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Association between Fruit and Vegetable Intake and Physical Activity among Breast Cancer Survivors: A Longitudinal Study. Curr Oncol 2021; 28:5025-5034. [PMID: 34940061 PMCID: PMC8699935 DOI: 10.3390/curroncol28060422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
This study examines the association between rates of change in daily fruit and vegetable intake and in weekly levels of moderate-to-vigorous intensity physical activity (MVPA) over a 15-month period in women following primary treatment completion for breast cancer. Breast cancer survivors (N = 199) self-reported fruit and vegetable intake and wore an accelerometer for 7 consecutive days to measure levels of MVPA on five occasions every 3 months. Multivariate latent growth modeling revealed that the rate of change in fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Baseline (Mean = 3.46 months post-treatment) levels of MVPA were not associated with the rate of change of daily fruit and vegetable intake; likewise, baseline fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Behavioral interventions promoting fruit and vegetable intake should not be assumed to yield concomitant effects in promoting MVPA or vice versa.
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Meyer-Schwickerath C, Morawietz C, Baumann FT, Huber G, Wiskemann J. Efficacy of face-to-face behavior change counseling interventions on physical activity behavior in cancer survivors - a systematic review and meta-analysis. Disabil Rehabil 2021; 44:5386-5401. [PMID: 34261403 DOI: 10.1080/09638288.2021.1938247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This systematic review and meta-analysis of randomized controlled trials determines the efficacy of face-to-face behavior change counseling (BCC) interventions on physical activity (PA) behavior in adult cancer survivors at least pre-and immediately post-intervention compared to usual care. Additionally, this review aims to answer the question which behavior change techniques (BCTs) are most effective. MATERIALS AND METHODS A structured search of the databases Medline, OTseeker, PEDro, the Cochrane Library, and article reference lists was conducted. All trials were critically appraised for methodological quality using the PEDro scale. The BCC interventions were coded using the BCT Taxonomy (v1). Random effect meta-analysis explored between group differences in PA behavior post intervention. Standardized mean differences (SMD) describe effect sizes. RESULTS Fourteen studies were included, 12 effect sizes within 11 trials were pooled in meta-analysis. The SMD between groups favored the intervention group with a small effect (SMD 0.22; 95% CI 0.11, 0.33; p < 0.0001). The BCTs "graded tasks", "self-monitoring of behavior", "action planning" and "habit reversal" were more frequently coded in more efficacious interventions. CONCLUSION BCC interventions are effective in increasing PA behavior in cancer survivors. Further research is needed providing details of fidelity assessment and structuring the intervention description by using a BCT taxonomy. Health care professionals should consider our results while awaiting further trial evaluation.Implications for RehabilitationFace-to-face behavior change counseling interventions can significantly increase physical activity behavior in cancer survivors.Although small differences are evident, included trials presented with a broad variety of study components, and characteristics, which limits the interpretation of effective components.The behavior change techniques "Graded tasks", "Action planning", "Habit reversal", and "Credible Source" were used in the trials with a positive effect, but not in the ineffective ones.
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Affiliation(s)
- Corinna Meyer-Schwickerath
- Institute of Sports and Sports Sciences, University of Heidelberg, Heidelberg, Germany.,Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Morawietz
- Institute of Sports and Sports Sciences, University of Duisburg-Essen, Essen, Germany
| | - Freerk T Baumann
- Department of Internal Medicine, Center for Integrated Oncology Cologne Bonn, University Hospital of Cologne, Cologne, Germany
| | - Gerhard Huber
- Institute of Sports and Sports Sciences, University of Heidelberg, Heidelberg, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
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Peixoto NMDSM, Peixoto TADSM, Pinto CAS, Santos CSVDB. Nursing intervention focusing on health promotion behaviors in adult cancer patients: a scoping review. Rev Esc Enferm USP 2021; 55:e03673. [PMID: 33886904 DOI: 10.1590/s1980-220x2019039403673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/29/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This review aims to map and provide an overview of literature concerning nursing strategies and intervention programs that promote healthy behaviors in cancer patients. METHOD A scoping review was conducted using the methodological framework developed by Joanna Briggs Institute and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. Twelve databases were searched (2012-2019). Retrieved data included descriptive analyses exploring studies' methodological characteristics and results. RESULTS From 1589 studies, 12 were included. Most studies included patients on survivorship period (n=10) and selected intervention strategies focusing patient's knowledge and awareness (n=8). Educational sessions were supported by behavioral change reinforcements and motivational incentives. Only two of the considered studies analysed intervention cost effectiveness, but none disclosed intervention-related costs. CONCLUSION Nursing interventions are effective in promoting health behaviors when include health education and encouragement towards change. Survivorship is the perfect time for health promotion. Nurses can be considered health promoters, by encouraging health education and enhance survivor's motivation.
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Gamification for Family Engagement in Lifestyle Interventions: A Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:831-844. [PMID: 33786746 DOI: 10.1007/s11121-021-01214-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 10/21/2022]
Abstract
The majority of chronic conditions that plague the USA are modifiable by lifestyle change. Lifestyle interventions that incorporate family members for social support and that use game design elements to engage family members have the potential to improve upon traditional interventions, which have largely been unsustainable. Determining the populations where family member support in a lifestyle intervention are present and the extent of gamification of lifestyle intervention components that engage these family members is an important and underexplored area of work. A systematic review of lifestyle interventions involving family members were reviewed for game design elements using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Game design elements related to engaged learning and motivational affordances from previous literature were included. Sixty-one studies met inclusion criteria. These studies reported on 50 independent interventions that were reviewed. Thirty-one of these interventions addressed lifestyle in those with a chronic condition, and 19 addressed lifestyle in those at high risk for chronic conditions. The majority of the lifestyle interventions included at least one game design element, yet overall there were limited elements utilized together. Compared with successful gamified programs that have greatly impacted a population's health behaviors, there were relatively a limited number of elements reported, particularly those that support social relatedness, such as meaningful storylines. Meaningfulness of the game design elements chosen and their arrangement was not apparent. Technology was under-utilized as a potential modality for intervention component delivery. Developing products to train researchers to properly apply game design elements to intervention components, as well as test their effectiveness, are areas for future research.
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Han MK, Anderson R, Viennois E, Merlin D. Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015. PLoS One 2020; 15:e0232157. [PMID: 32324818 PMCID: PMC7179926 DOI: 10.1371/journal.pone.0232157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/09/2020] [Indexed: 12/20/2022] Open
Abstract
Various diets and food components have been implicated as one of the environmental factors associated with inflammatory bowel disease (IBD). Patients are often recommended nutritional guidelines to manage disease symptoms. However, the current food consumption pattern of US adults with IBD that are nationally representative is unclear. A secondary analysis of National Health Interview Survey 2015 was performed to characterize the estimated US adults with IBD and their food intake and consumption frequency using bivariate and multivariate logistic regression. Fries were consumed by a greater number of people with IBD. IBD population drank less 100% fruit juice and ate more cheese and cookies than non-IBD population. Intake of fries (OR 1.60, 95% CI 1.14-2.25) and sports and energy drinks (OR 1.46, 95% CI 1.07-1.97) and more frequent drinking of regular soda were significantly associated with the likelihood of having been told one have IBD, while popcorn (OR 0.73, 95% CI 0.548-0.971) and milk (OR 0.70, 95% CI 0.497-0.998) were associated with smaller odds, adjusting for covariates. Foods typically labeled as junk food were positively associated with IBD. Nonetheless, of the assessed 26 foods, we found eating patterns between IBD and non-IBD population to be mostly analogous. It is unclear whether the results reflect potential change in food intake in IBD population long before the survey interview. Understanding the role of food intake in IBD risk/prevalence would benefit from identifying other environmental factors (i.e. food desert), food processing (i.e. frying), and potential bioactive food components that can induce intestinal inflammation that can increase the individual's susceptibility to IBD.
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Affiliation(s)
- Moon K. Han
- Institute for Biomedical Sciences, Center for Diagnostics and Therapeutics, Center for Inflammation, Immunity and Infection, Digestive Disease Research Group, Georgia State University, Atlanta, Georgia, United States of America
| | - Raeda Anderson
- Department of Research and Engagement, Georgia State University, Atlanta, Georgia, United States of America
| | - Emilie Viennois
- Institute for Biomedical Sciences, Center for Diagnostics and Therapeutics, Center for Inflammation, Immunity and Infection, Digestive Disease Research Group, Georgia State University, Atlanta, Georgia, United States of America
| | - Didier Merlin
- Institute for Biomedical Sciences, Center for Diagnostics and Therapeutics, Center for Inflammation, Immunity and Infection, Digestive Disease Research Group, Georgia State University, Atlanta, Georgia, United States of America
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia, United States of America
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Cox-Martin E, Cox MG, Basen-Engquist K, Bradley C, Blalock JA. Changing multiple health behaviors in cancer survivors: smoking and exercise. PSYCHOL HEALTH MED 2019; 25:331-343. [PMID: 31630537 DOI: 10.1080/13548506.2019.1679849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Research regarding cross-behavioral relationships between the cognitive mechanisms motivating health behavior change is lacking for cancer survivors. This study investigated these relationships to inform the development of multiple health behavior change (MHBC) interventions for this at-risk population. Eligible participants included cancer survivors attending an intake appointment for smoking cessation services. This cross-sectional survey study assessed participants' self-efficacy and motivation (stage of change) for smoking cessation and exercise, as well as self-reported health behaviors. Analyses evaluated cross-behavioral associations between cognitive mechanisms and their relationships with smoking and exercise behaviors. Seventy-six participants completed the survey questionnaire. The correlation between self-efficacy scores for smoking cessation and exercise was statistically significant (r = .45, 95% CI [.09, .67]), as were correlations between self-efficacy and reported levels of exercise ((r = .44, 95% CI [.20, .65]) strenuous); ((r = .36, 95% CI [.12, .59]) moderate), exercise self-efficacy and smoking behavior (r = -.27, 95% CI [-.46, -.05]), and smoking self-efficacy and smoking behavior (r = -0.41, 95% CI [-.61, -.18]). For cancer survivors, associations between exercise self-efficacy and smoking cessation self-efficacy may offer an opportunity to leverage MHBC; specifically, this positive association may facilitate exercise intervention in survivors seeking smoking cessation services..
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Affiliation(s)
- Emily Cox-Martin
- Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew G Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cathy Bradley
- Department of Health Systems, Management, and Policy, and University of Colorado Cancer Center, University of Colorado School of Public Health, Aurora, CO, USA
| | - Janice A Blalock
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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14
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Wu LM, Chen CM, Hsu HT, Liu Y, Su HL. Tailored education enhances healthy behaviour self-efficacy in childhood cancer survivors: A randomised controlled study with a 4-month follow-up. Eur J Cancer Care (Engl) 2019; 28:e13063. [PMID: 31020742 DOI: 10.1111/ecc.13063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/30/2019] [Accepted: 03/25/2019] [Indexed: 12/18/2022]
Abstract
This study was to evaluate the acceptability and effectiveness of a tailored education on healthy behaviour self-efficacy (HBSE) and health promotion lifestyle (HPL) for childhood cancer survivors. A two-group, randomised study with repeated measures was conducted in Taiwan. Participants were randomly assigned to receive six 45-60 min individual education and follow-up telephone counselling sessions (n = 34) or standard of care only (n = 35). Each participant was assessed with HBSE and HPL questionnaires and was evaluated at three time points (at baseline, and then 1 and 4 months after intervention). The attrition rate was 7.2%. HBSE and HPL scores increased across the three time points in the experimental group (all p < 0.05), except for the HBSE exercise subscale (p = 0.85). HBSE scores were significantly higher for the experimental group than for the control group after 4 months of intervention (F = 5.32, p = 0.02, η2 = 0.25). No significant improvements in HBSE were observed over time in the control group. The intervention was acceptable and effective in promoting HBSE in childhood cancer survivors. Further empirical work is needed to reveal the effects of the intervention over a longer period of time and to improve patient engagement in exercise.
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Affiliation(s)
- Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Mi Chen
- Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Hsin-Tien Hsu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi Liu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Lan Su
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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15
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Cooley ME, Blonquist TM, Hong F, Nayak MM, Crouter SE, Hayman LL, Jaklitsch MT, Emmons KM, Bueno R. The effect of a lifestyle risk reduction intervention on lifestyle adherence and health-related quality of life in nonsmall cell lung cancer survivors: Feasibility study outcomes. Psychooncology 2019; 28:920-923. [PMID: 30673155 DOI: 10.1002/pon.5002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/30/2018] [Accepted: 01/03/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Mary E Cooley
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Traci M Blonquist
- Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Fangxin Hong
- Division of Biostatistics, Department of Data Sciences (Dana-Farber Cancer Institute) and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Manan M Nayak
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Scott E Crouter
- College of Education, Health and Human Sciences, University of Tennesee, Knoxville, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, University of Massachusetts-, Boston, Tennessee, USA
| | - Michael T Jaklitsch
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Karen M Emmons
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Somayaji D, Blok AC, Hayman LL, Colson Y, Jaklisch M, Cooley ME. Enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction intervention: a qualitative study. Support Care Cancer 2019; 27:1299-1308. [PMID: 30643990 DOI: 10.1007/s00520-018-4631-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 12/27/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction interventions have improved HR-QOL in other cancer survivors. The purpose of this study was to explore lung cancer survivor perspectives on making behavioral changes in the context of a lifestyle risk reduction intervention. METHODS Twenty-two lung cancer survivors participated in interviews after completing the Healthy Directions (HD) intervention. Interviews were audiotaped, transcribed, and analyzed using inductive content analysis. Demographic and clinical characteristics were gathered through a survey and analyzed using descriptive statistics. RESULTS Five main themes were identified: (1) the diagnosis was a motivator for behavior change, (2) participants had to deal with disease consequences, (3) the coach provided guidance, (4) strategies for change were initiated, and (5) social support sustained behavioral changes. Other important subthemes were the coach helped interpret symptoms, which supported self-efficacy and goal setting, and survivors employed self-monitoring behaviors. Several participants found the recommended goals for physical activity were difficult and were discouraged if unable to attain the goal. Findings underscore the need for individualized prescriptions of physical activity, especially for sedentary survivors. CONCLUSIONS Lung cancer survivors described the benefits of coaching to enhance their engagement in behavioral change. Additional research is needed to validate the benefit of the HD intervention to improve HR-QOL among this vulnerable and understudied group of cancer survivors.
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Affiliation(s)
- Darryl Somayaji
- University at Buffalo, 3435 Main Street, 201C, Buffalo, NY, 14214, USA.
| | - Amanda C Blok
- Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Hospital, United States Department of Veterans Affairs, 200 Springs Road, Building 70 (152), Bedford, MA, 01730, USA.,Graduate School of Nursing and Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA, 02125-3393, USA
| | - Yolanda Colson
- Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Michael Jaklisch
- Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Mary E Cooley
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-512, Boston, MA, 02215, USA
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17
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The relationship between indoor tanning and body mass index, physical activity, or dietary practices: a systematic review. J Behav Med 2018; 42:188-203. [DOI: 10.1007/s10865-018-9991-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 11/08/2018] [Indexed: 01/13/2023]
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18
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Ninot G, Debourdeau P, Blanc-Legier F, De Crozals F, De Rauglaudre G, Khouri S, Kirscher S, Mineur L, Piollet I, Sant I, Schillinger P, Serin D. Pour des soins de support de l’après cancer. Bull Cancer 2018; 105:763-770. [DOI: 10.1016/j.bulcan.2018.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 01/03/2023]
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19
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Glenn BA, Crespi CM, Rodriguez HP, Nonzee NJ, Phillips SM, Sheinfeld Gorin SN, Johnson SB, Fernandez ME, Estabrooks P, Kessler R, Roby DH, Heurtin-Roberts S, Rohweder CL, Ory MG, Krist AH. Behavioral and mental health risk factor profiles among diverse primary care patients. Prev Med 2018; 111:21-27. [PMID: 29277413 PMCID: PMC5930037 DOI: 10.1016/j.ypmed.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/02/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
Behavioral and mental health risk factors are prevalent among primary care patients and contribute substantially to premature morbidity and mortality and increased health care utilization and costs. Although prior studies have found most adults screen positive for multiple risk factors, limited research has attempted to identify factors that most commonly co-occur, which may guide future interventions. The purpose of this study was to identify subgroups of primary care patients with co-occurring risk factors and to examine sociodemographic characteristics associated with these subgroups. We assessed 12 behavioral health risk factors in a sample of adults (n=1628) receiving care from nine primary care practices across six U.S. states in 2013. Using latent class analysis, we identified four distinct patient subgroups: a 'Mental Health Risk' class (prevalence=14%; low physical activity, high stress, depressive symptoms, anxiety, and sleepiness), a 'Substance Use Risk' class (29%; highest tobacco, drug, alcohol use), a 'Dietary Risk' class (29%; high BMI, poor diet), and a 'Lower Risk' class (27%). Compared to the Lower Risk class, patients in the Mental Health Risk class were younger and less likely to be Latino/Hispanic, married, college educated, or employed. Patients in the Substance Use class tended to be younger, male, African American, unmarried, and less educated. African Americans were over 7 times more likely to be in the Dietary Risk versus Lower Risk class (OR 7.7, 95% CI 4.0-14.8). Given the heavy burden of behavioral health issues in primary care, efficiently addressing co-occurring risk factors in this setting is critical.
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Affiliation(s)
- Beth A Glenn
- Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA.
| | - Catherine M Crespi
- Center for Cancer Prevention and Control Research, Department of Biostatistics, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA
| | - Hector P Rodriguez
- Division of Health Policy and Management, University of California, Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720, USA
| | - Narissa J Nonzee
- Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA
| | - Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Chicago, IL 60611, USA
| | - Sherri N Sheinfeld Gorin
- New York Physicians against Cancer (NYPAC), Herbert Irving Comprehensive Cancer Center, New York, NY 10032, USA; Division of Cancer Control and Population Sciences (Leidos Biomedical Research, Inc.), National Cancer Institute, 6130 Executive Plaza, Bethesda, MD 20892, USA
| | - Sallie Beth Johnson
- Department of Health Sciences Administration, Jefferson College of Health Sciences at Carilion Clinic, 101 Elm Avenue, Roanoke, VA 24016, USA; Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA
| | - Maria E Fernandez
- University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Paul Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Rodger Kessler
- Doctor of Behavorial Health Program, College of Health Solutions, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, USA
| | - Dylan H Roby
- Department of Health Services Administration, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
| | - Suzanne Heurtin-Roberts
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Boulevard, Rockville, MD 20852, USA
| | - Catherine L Rohweder
- UNC Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, NC 27599, USA
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M Health Sciences Center, College Station, TX 77843, USA
| | - Alex H Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, PO Box 980251, Richmond, VA 23298, USA
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20
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Amireault S, Fong AJ, Sabiston CM. Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors. Am J Lifestyle Med 2018; 12:184-199. [PMID: 30202391 PMCID: PMC6124968 DOI: 10.1177/1559827616661490] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/17/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.
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Affiliation(s)
- Steve Amireault
- Steve Amireault, PhD, Department of Health and Kinesiology, Purdue University, 800 West Stadium Avenue, Lambert Fieldhouse, Office 311A, West Lafayette, IN 47907; e-mail:
| | - Angela J. Fong
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
| | - Catherine M. Sabiston
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
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Basen-Engquist K, Alfano CM, Maitin-Shepard M, Thomson CA, Schmitz KH, Pinto BM, Stein K, Zucker DS, Syrjala KL, Fallon E, Doyle C, Demark-Wahnefried W. Agenda for Translating Physical Activity, Nutrition, and Weight Management Interventions for Cancer Survivors into Clinical and Community Practice. Obesity (Silver Spring) 2017; 25 Suppl 2:S9-S22. [PMID: 29086526 PMCID: PMC5683412 DOI: 10.1002/oby.22031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/23/2017] [Indexed: 12/11/2022]
Abstract
Evidence supporting physical activity, diet, and weight management for cancer survivors has grown, leading to the development of guidelines and interventions. The next step is to identify necessary practice and policy changes and to develop a research agenda to inform how interventions can be delivered to survivors most effectively and efficiently in health care settings and by community-based organizations. Here, an agenda is proposed for research, practice, and policy that incorporates recommendations for a range of programming options, a patient-centered, tailored screening and referral approach, and training needs for survivorship care providers and providers of exercise, nutrition, and weight management services. Research needs to focus on sustainability, dissemination, and implementation. Needed policy changes are presented, as well as opportunities to leverage current health care policies.
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Affiliation(s)
- Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | | | - Cynthia A Thomson
- Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona, USA
| | - Kathryn H Schmitz
- Department of Public Health Science, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Bernardine M Pinto
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - Kevin Stein
- Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | | | - Karen L Syrjala
- Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Colleen Doyle
- American Cancer Society, Inc., Atlanta, Georgia, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA
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22
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Blok AC, Blonquist TM, Nayak MM, Somayaji D, Crouter SE, Hayman LL, Colson YL, Bueno R, Emmons KM, Cooley ME. Feasibility and acceptability of "healthy directions" a lifestyle intervention for adults with lung cancer. Psychooncology 2017; 27:250-257. [PMID: 28426922 DOI: 10.1002/pon.4443] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 03/02/2017] [Accepted: 04/14/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aims of this feasibility study of an adapted lifestyle intervention for adults with lung cancer were to (1) determine rates of enrollment, attrition, and completion of 5 nurse-patient contacts; (2) examine demographic characteristics of those more likely to enroll into the program; (3) determine acceptability of the intervention; and (4) identify patient preferences for the format of supplemental educational intervention materials. METHODS This study used a single-arm, pretest and posttest design. Feasibility was defined as ≥20% enrollment and a completion rate of 70% for 5 nurse-patient contact sessions. Acceptability was defined as 80% of patients recommending the program to others. Data was collected through electronic data bases and phone interviews. Descriptive statistics, Fisher's exact test and Wilcoxon rank sum test were used for analyses. RESULTS Of 147 eligible patients, 42 (28.6%) enrolled and of these, 32 (76.2%) started the intervention and 27 (N = 27/32; 84.4%; 95% CI, 67.2%-94.7%) completed the intervention. Patients who were younger were more likely to enroll in the study (P = .04) whereas there were no significant differences by gender (P = .35). Twenty-three of the 24 (95.8%) participants' contacted posttest recommended the intervention for others. Nearly equal numbers of participants chose the website (n = 16, 50%) vs print (n = 14, 44%). CONCLUSION The intervention was feasible and acceptable in patients with lung cancer. Recruitment rates were higher and completion rates were similar as compared to previous home-based lifestyle interventions for patients with other types of cancer. Strategies to enhance recruitment of older adults are important for future research.
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Affiliation(s)
- Amanda C Blok
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | | | | | - Laura L Hayman
- University of Massachusetts Medical School, Worcester, MA, USA.,University of Massachusetts Boston, Boston, MA, USA
| | | | | | - Karen M Emmons
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mary E Cooley
- Dana-Farber Cancer Institute, Boston, MA, USA.,University of Massachusetts Boston, Boston, MA, USA
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Does Psychoeducation Added to Oncology Rehabilitation Improve Physical Activity and Other Health Outcomes? A Systematic Review. REHABILITATION ONCOLOGY 2017. [DOI: 10.1097/01.reo.0000000000000045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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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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25
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Spees CK, Hill EB, Grainger EM, Buell JL, White SE, Kleinhenz MD, Clinton SK. Feasibility, Preliminary Efficacy, and Lessons Learned From a Garden-Based Lifestyle Intervention for Cancer Survivors. Cancer Control 2016; 23:302-10. [PMID: 27556671 PMCID: PMC5097863 DOI: 10.1177/107327481602300314] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cancer survivors remain at increased risk for secondary malignancies, comorbidities, and all-cause mortality. Lifestyle behaviors, such as diet and physical activity, are strongly linked to a decreased risk of chronic disease and improved health outcomes, yet a paucity of research has been conducted in this vulnerable population. METHODS Adult cancer survivors were recruited to participate in Growing Hope, an experimental single-group study designed to assess the feasibility and efficacy of a theory-driven and evidence-based intervention. For 4 months, 22 participants received group and individual education and had access to harvesting fresh produce at an urban garden. Data on program satisfaction, compliance, diet, and physical activity were collected via surveys; anthropometrics, blood values, and skin carotenoids were objectively measured. RESULTS The intervention resulted in significant improvements in consumption of fruits and vegetables (P = .003), decreased consumption of red and processed meats (P = .030) and sugar-sweetened beverages (P = .020). Levels of skin carotenoids, fasting blood glucose, and non-high density lipoprotein cholesterol were also significantly improved (P = .011, P = .043, and P = .05, respectively). CONCLUSIONS The results of this study support the feasibility and efficacy of a multifaceted, garden-based intervention for cancer survivors. In addition, these preliminary results demonstrate a positive impact aligning with the current lifestyle recommendations for cancer survivorship. Larger randomized controlled trials are warranted to define impact on sustained health outcomes.
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Affiliation(s)
- Colleen K Spees
- Medical Dietetics and Health Sciences, OSU College of Medicine, Columbus, OH 43210, USA.
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Kanera IM, Bolman CAW, Willems RA, Mesters I, Lechner L. Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) intervention for cancer survivors: a randomized controlled trial. J Cancer Surviv 2016; 10:883-97. [PMID: 26984534 PMCID: PMC5018034 DOI: 10.1007/s11764-016-0535-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/03/2016] [Indexed: 11/26/2022]
Abstract
Purpose The web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) responds to the needs of cancer survivors and oncology care providers to improve the counseling related to self-management of lifestyle and psychosocial challenges. In present study, overall intervention effects and the effects of using specific components were evaluated on vegetable, fruit, whole grain bread, and fish consumption, physical activity (PA), and smoking behavior. Methods Cancer survivors from 21 Dutch hospitals were recruited for a randomized controlled trial (N = 432). Intervention effects after 6 months were evaluated using multilevel linear regression analysis (complete cases and intention-to-treat). By conducting moderation analyses, additional effects of following the behavior-related modules were explored. The false discovery rate correction was applied to account for multiple testing. Results After 6 months, 409 participants completed follow-up (dropout = 11.5 %). Indications were found that access to the intervention may result in increases of moderate PA and vegetable intake. The moderate PA increase was meaningful: 74.74 min p/w higher increase in the intervention condition. Effect sizes of moderate PA (d = .25) and vegetable (d = .37) consumption were comparable to prior effective interventions. Visiting behavior-related modules affected moderate PA, fruit, and fish consumption. However, after correction for multiple testing, significances expired. No significant intervention effect was found on smoking behavior due to low numbers of smokers. Implications for Cancer Survivors Although the effectiveness was only shown only to a limited extend, this study provided several indications that this theory-based, comprehensive, and personalized eHealth intervention provides valuable content to complement usual cancer aftercare.
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Affiliation(s)
- Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Optimizing Patient Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
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Xiang X. Chronic Disease Diagnosis as a Teachable Moment for Health Behavior Changes Among Middle-Aged and Older Adults. J Aging Health 2015; 28:995-1015. [PMID: 26634998 DOI: 10.1177/0898264315614573] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine the impact of a new chronic disease diagnosis on substance use (i.e., smoking and drinking), utilization of preventive medical procedures, and physical activity among middle-aged and older adults. METHOD Individual-level data came from 1996 to 2010 waves of the U.S. Health and Retirement Study. Disease diagnosis was ascertained from self-reports of physician-diagnosed diseases. A case-control difference-in-differences approach estimated in logistic regression was applied to test study hypotheses. RESULTS After a diagnosis of chronic disease, participants decreased substance use and increased utilization of preventive medical procedures. Physical activity declined after a diagnosis of lung disease, cancer, and stroke. DISCUSSION Chronic disease diagnosis may be an important teachable moment that can motivate individuals to adopt multiple risk-reducing health behaviors. Future research needs to elucidate the mechanisms through which disease diagnosis affects behaviors and test the modifying effect of time since diagnosis on intervention effectiveness.
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