Marilyn Stern1, Jennifer Bleck1, Linda J Ewing2, Esther Davila3, Courtney Lynn4, Gregory Hale5, Suzanne Mazzeo6,7. 1. Department of Child and Family Studies, University of South Florida, Tampa, Florida. 2. Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 3. Department of Psychology, University of South Florida, Tampa, Florida. 4. Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida. 5. All Children's Hospital/Johns Hopkins Medical Center, St. Petersburg, Florida. 6. Department of Psychology, Virginia Commonwealth University, Richmond, Virginia. 7. Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia.
Abstract
BACKGROUND:Obesity rates in pediatric cancer survivors (PCS) are alarmingly high. Although healthy lifestyle changes may prevent future health complications, promoting healthy behaviors in PCS is challenging, and few interventions have successfully addressed this issue. PROCEDURE: This randomized control trial evaluated the feasibility and preliminary effectiveness of a parent-focused six-session intervention, NOURISH-T (Nourishing Our Understanding of Role Modeling to Improve Support and Health for Healthy Transitions), compared with enhanced usual care (EUC) on the outcomes of caregiver and PCS anthropometric measurements, eating behaviors, and physical activity. Behavioral and self-report assessments of caregivers and PCS in both conditions were conducted at baseline, postintervention, and at a 4-month follow-up. RESULTS: In comparison to no change among EUC caregivers, NOURISH-T caregivers showed small yet significant decreases from baseline through follow-up on BMI, waist-hip ratio, and total daily caloric intake. However, there was no change with regard to daily fat and sugar intake. NOURISH-T caregivers also showed positive changes in their child feeding behaviors, including decreases in pressuring their child to eat and restricting their child's eating and increased eating together as a family. Similarly, decreases in BMI percentile, waist-hip ratio, and sugary beverage consumption were found for NOURISH-T PCS from baseline to postintervention. NOURISH-T PCS also significantly increased their daily steps, whereas EUC PCS decreased their daily steps. CONCLUSIONS: Results suggest that an intervention targeting parents is feasible and demonstrates preliminary effectiveness. NOURISH-T showed a longer term effect on caregivers, and, although shorter term effect, a positive impact on the PCS themselves. Implications for ways to improve NOURISH-T as an intervention for increasing healthy behaviors of PCS are discussed.
RCT Entities:
BACKGROUND:Obesity rates in pediatric cancer survivors (PCS) are alarmingly high. Although healthy lifestyle changes may prevent future health complications, promoting healthy behaviors in PCS is challenging, and few interventions have successfully addressed this issue. PROCEDURE: This randomized control trial evaluated the feasibility and preliminary effectiveness of a parent-focused six-session intervention, NOURISH-T (Nourishing Our Understanding of Role Modeling to Improve Support and Health for Healthy Transitions), compared with enhanced usual care (EUC) on the outcomes of caregiver and PCS anthropometric measurements, eating behaviors, and physical activity. Behavioral and self-report assessments of caregivers and PCS in both conditions were conducted at baseline, postintervention, and at a 4-month follow-up. RESULTS: In comparison to no change among EUC caregivers, NOURISH-T caregivers showed small yet significant decreases from baseline through follow-up on BMI, waist-hip ratio, and total daily caloric intake. However, there was no change with regard to daily fat and sugar intake. NOURISH-T caregivers also showed positive changes in their child feeding behaviors, including decreases in pressuring their child to eat and restricting their child's eating and increased eating together as a family. Similarly, decreases in BMI percentile, waist-hip ratio, and sugary beverage consumption were found for NOURISH-T PCS from baseline to postintervention. NOURISH-T PCS also significantly increased their daily steps, whereas EUC PCS decreased their daily steps. CONCLUSIONS: Results suggest that an intervention targeting parents is feasible and demonstrates preliminary effectiveness. NOURISH-T showed a longer term effect on caregivers, and, although shorter term effect, a positive impact on the PCS themselves. Implications for ways to improve NOURISH-T as an intervention for increasing healthy behaviors of PCS are discussed.
Authors: Marilyn Stern; Elena Krivoy; Rebecca H Foster; Matthew Bitsko; Amos Toren; Myriam Ben-Arush Journal: Pediatr Blood Cancer Date: 2010-10 Impact factor: 3.167
Authors: Suzanne E Mazzeo; Nichole R Kelly; Marilyn Stern; Rachel W Gow; Kasey Serdar; Ronald K Evans; Resa M Jones; Cynthia M Bulik Journal: Contemp Clin Trials Date: 2012-01-18 Impact factor: 2.226
Authors: Daniel M Green; Cheryl L Cox; Liang Zhu; Kevin R Krull; Deo Kumar Srivastava; Marilyn Stovall; Vikki G Nolan; Kirsten K Ness; Sarah S Donaldson; Kevin C Oeffinger; Lillian R Meacham; Charles A Sklar; Gregory T Armstrong; Leslie L Robison Journal: J Clin Oncol Date: 2011-12-19 Impact factor: 44.544
Authors: Melissa M Hudson; Ann C Mertens; Yutaka Yasui; Wendy Hobbie; Hegang Chen; James G Gurney; Mark Yeazel; Christopher J Recklitis; Neyssa Marina; Leslie R Robison; Kevin C Oeffinger Journal: JAMA Date: 2003-09-24 Impact factor: 157.335
Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Flora Tzelepis; Rebecca J Wyse; Kate M Bartlem; Rachel Sutherland; Erica L James; Courtney Barnes; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2019-11-07
Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Rebecca J Wyse; Tara Clinton-McHarg; Flora Tzelepis; Erica L James; Kate M Bartlem; Nicole K Nathan; Rachel Sutherland; Emma Robson; Sze Lin Yoong; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2018-05-17
Authors: Ankie Tan Cheung; William Ho Cheung Li; Laurie Long Kwan Ho; Ka Yan Ho; Godfrey Chi Fung Chan; Joyce Oi Kwan Chung Journal: J Cancer Surviv Date: 2021-01-03 Impact factor: 4.442