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Browsing by Author "Sloane, Richard"
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Item Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors(Wiley, 2009) Mosher, Catherine E.; Sloane, Richard; Morey, Miriam C.; Snyder, Denise Clutter; Cohen, Harvey J.; Miller, Paige E.; Demark-Wahnefried, WendyBACKGROUND: Older cancer survivors are at increased risk for secondary cancers, cardiovascular disease, obesity, and functional decline and, thus, may benefit from health-related interventions. However, to the authors' knowledge, little is known regarding the health behaviors of older cancer survivors and the associations of those behaviors with quality-of-life outcomes, especially during the long-term post-treatment period. METHODS: In total, 753 older (aged ≥65 years) long-term survivors (≥5 years postdiagnosis) of breast, prostate, and colorectal cancer completed 2 baseline telephone interviews to assess their eligibility for a diet and exercise intervention trial. The interviews assessed exercise, diet, weight status, and quality of life. RESULTS: Older cancer survivors reported a median of 10 minutes of moderate-to-vigorous exercise per week, and only 7% had Healthy Eating Index scores >80 (indicative of healthful eating habits relative to national guidelines). Despite their suboptimal health behaviors, survivors reported mental and physical quality of life that exceeded age-related norms. Greater exercise and better diet quality were associated with better physical quality-of-life outcomes (eg, better vitality and physical functioning; P < .05), whereas greater body mass index was associated with reduced physical quality of life (P < .001). CONCLUSIONS: The current results indicated a high prevalence of suboptimal health behaviors among older, long-term survivors of breast, prostate, and colorectal cancer who were interested in lifestyle modification. In addition, the findings pointed to the potential negative impact of obesity and the positive impact of physical activity and a healthy diet on physical quality of life in this population. Cancer 2009.Item Cancer Survivors' Health Worries and Associations with Lifestyle Practices(SAGE, 2008-11-01) Mosher, Catherine E.; Lipkus, Isaac M.; Sloane, Richard; Kraus, William E.; Snyder, Denise Clutter; Peterson, Bercedis; Jones, Lee W.; Demark-Wahnefried, WendyThis study examined among recently diagnosed breast and prostate cancer survivors (N = 678) associations between worry about a future diagnosis of heart disease or cancer and hypothetical and actual adherence to exercise and dietary guidelines. Greater worry about future illness was reported under the hypothetical scenario of nonadherence to guidelines relative to the scenario of adherence. Worry about potential heart disease was associated with actual adherence to guidelines, whereas worry about a potential cancer diagnosis was not. Findings suggest that the motivational properties of worry should be considered when developing interventions to reduce heart disease risk among cancer survivors.Item Cancer survivors' uptake and adherence in diet and exercise intervention trials: an integrative data analysis(Wiley, 2015-01-01) Adams, Rebecca N.; Mosher, Catherine E.; Blair, Cindy K.; Snyder, Denise C.; Sloane, Richard; Demark-Wahnefried, Wendy; Department of Psychology, School of ScienceBACKGROUND: The health benefits of diet and exercise interventions for cancer survivors are well documented. However, little is known regarding demographic and medical predictors of survivors' willingness to participate in diet and exercise intervention trials, study enrollment, intervention adherence, and study completion. To assist in interpreting the generalizability of trial findings and to improve the design of future trials, this study examined predictors of these process measures. METHODS: An integrative data analysis was performed on data from 3 of the largest home-based diet and exercise intervention trials for cancer survivors (n = 23,841). Demographic and medical factors (ie, sex, race, age, time since diagnosis, and cancer type) were examined as predictors of willingness to participate, study enrollment, intervention adherence, and study completion in the pooled sample. A 99% confidence interval was used to determine statistical significance. RESULTS: Across trials, 11.1% of contacted survivors were willing to participate, and 5.7% were eligible and enrolled. Among enrollees, 53.4% demonstrated ≥75% adherence to the intervention, and 91.1% completed the study. Race (Caucasian vs others), age, time since diagnosis, and cancer type predicted survivors' willingness to participate (P < .01). All examined predictors were associated with the likelihood of study enrollment (P < .01). No significant predictors of intervention adherence or study completion were found among study enrollees (P ≥ .01). CONCLUSIONS: Cancer survivors' demographic and medical characteristics predicted their interest and participation in diet and exercise intervention trials. These findings have implications for the generalizability of results and can help to guide procedures used in future trials to enhance patient representation.Item 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, WendyObjective: 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.Item 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, WendyBackground 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.Item 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, WendyBackground: 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.