Browsing by Author "Lobach, David F."

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    Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors' dietary outcomes
    (Wiley, 2008) Mosher, Catherine E.; Fuemmeler, Bernard F.; Sloane, Richard; Kraus, William E.; Lobach, David F.; Snyder, Denise Clutter; Demark-Wahnefried, Wendy
    Objective: This study examined change in self-efficacy as a mediator of the effects of a mailed print intervention on the dietary and exercise practices of newly diagnosed breast and prostate cancer survivors. Method: A total of 543 breast and prostate cancer patients were recruited from 39 states and two provinces within North America. Participants were randomly assigned to receive a 10-month program of tailored mailed print materials that aimed to increase fruit and vegetable consumption, reduce fat intake, and/or increase exercise or a 10-month program of publically available materials on diet and exercise. Telephone surveys conducted at baseline and 1 year assessed dietary practices, physical activity, and self-efficacy for engaging in these health behaviors. Results: Results indicated that changes in self-efficacy for fat restriction and eating more fruits and vegetables were significant mediators of the intervention's effects on dietary outcomes at 1-year follow-up. The intervention did not significantly affect self-efficacy for exercise; however, a significant, positive relationship was found between self-efficacy for exercise and exercise duration at follow-up. Conclusions: Findings are largely consistent with Social Cognitive Theory and support the use of strategies to increase self-efficacy in health promotion interventions for cancer survivors. Copyright © 2008 John Wiley & Sons, Ltd.
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    Long-Term Dietary Outcomes of the FRESH START Intervention for Breast and Prostate Cancer Survivors
    (Elsevier, 2011) Christy, Shannon M.; Mosher, Catherine E.; Sloane, Richard; Snyder, Denise C.; Lobach, David F.; Demark-Wahnefried, Wendy
    Background Cancer survivors are at increased risk for secondary cancers and other diseases. Healthy dietary practices may improve cancer survivors' health and well-being. Objective The durability of the effects of the FRESH START intervention, a program of sequentially tailored mailed materials, and standardized mailed materials (for controls) on cancer survivors' dietary outcomes was assessed over a 2-year period. Greater dietary gains were expected for FRESH START participants relative to controls. Design Participants were randomized to receive tailored vs standardized 10-month mailed print interventions promoting diet and exercise behaviors. Data were collected at baseline and 1- and 2-year follow-ups. Participants/setting Breast and prostate cancer survivors (n=543) were recruited from 39 states and two provinces within North America. A total of 489 participants completed the 2-year follow-up assessment (10% attrition). Intervention Participants were randomly assigned to either a 10-month program of tailored mailed print materials promoting fruit and vegetable consumption, reduced total and saturated fat intake, and/or increased exercise or to a 10-month program of publicly available mailed materials on diet and exercise. Main outcome measures Telephone surveys (supported with blood biomarkers) assessed dietary habits at baseline and 1- and 2-year follow-ups. Statistical analyses performed Paired-samples t tests were conducted to examine the durability of the intervention's effects on dietary outcomes within each study arm. Arm differences in follow-up outcomes were then tested with the general linear model, controlling for the baseline value of the outcomes. Results Both arms reported decreased saturated fat intake, increased servings of fruits and vegetables, and better overall diet quality at year 2 relative to baseline. However, FRESH START participants reported better overall diet quality and lower total and saturated fat intake compared to controls at the 2-year follow-up. Conclusions Results suggest that mailed material interventions, especially those that are tailored, can produce long-term dietary improvement among cancer survivors.
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    Long-term Outcomes of the FRESH START Trial: Exploring the Role of Self-efficacy in Cancer Survivors’ Maintenance of Dietary Practices and Physical Activity
    (Wiley, 2013-04) Mosher, Catherine E.; Lipkus, Isaac; Sloane, Richard; Snyder, Denise C.; Lobach, David F.; Demark-Wahnefried, Wendy
    Background: This study examined whether changes in self-efficacy explain the effects of a mailed print intervention on long-term dietary practices of breast and prostate cancer survivors. The relationship between change in self-efficacy and long-term physical activity (PA) also was examined. Methods: Breast and prostate cancer survivors (N = 543) from 39 US states and two Canadian provinces participated in the FRESH START intervention trial. Participants were randomly assigned to receive a 10-month program of mailed print materials on diet and PA available in the public domain or a 10-month program of tailored materials designed to increase fruit and vegetable (F&V) intake, decrease fat intake, and/or increase PA. Changes in self-efficacy for F&V intake and fat restriction were analyzed as potential mediators of the intervention's effects on diet at 2-year follow-up. Because we previously found that change in self-efficacy for PA did not vary by group assignment, the relationship between change in self-efficacy and PA at 2-year follow-up was examined across study conditions. Results: Results suggest that change in self-efficacy for fat restriction partially explained the intervention's effect on fat intake (mean indirect effect = -0.28), and change in self-efficacy for F&V consumption partially explained the intervention's effect on daily F&V intake (mean indirect effect = .11). Change in self-efficacy for fat restriction partially accounted for the intervention's impact on overall diet quality among men only (mean indirect effect = 0.60). Finally, change in self-efficacy for PA predicted PA at 2-year follow-up. Conclusions: Findings suggest that self-efficacy may influence long-term maintenance of healthy lifestyle practices among cancer survivors.