Tracy E Crane1,2, Terry A Badger3,4, Patrick O'Connor5, Chris Segrin6, Alexis Alvarez3, Sarah J Freylersythe4, Irlena Penaloza7, Thaddeus W W Pace3,4, Alla Sikorskii8. 1. College of Nursing, University of Arizona, 1305 N. Martin, Room 337, Tucson, AZ, 85721, USA. tecrane@email.arizona.edu. 2. The University of Arizona Cancer Center, Tucson, AZ, USA. tecrane@email.arizona.edu. 3. College of Nursing, University of Arizona, 1305 N. Martin, Room 337, Tucson, AZ, 85721, USA. 4. The University of Arizona Cancer Center, Tucson, AZ, USA. 5. Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. 6. Department of Communication, University of Arizona, Tucson, AZ, USA. 7. Department of Nutrition Science, University of Arizona, Tucson, AZ, USA. 8. Department of Psychiatry, Michigan State University, East Lansing, MI, USA.
Abstract
PURPOSE: Assess feasibility, acceptability, and preliminary efficacy of an integrated symptom management and lifestyle intervention (SMLI) to improve adherence to the American Cancer Society's (ACS) Guidelines on Nutrition and Physical Activity in Latina cancer survivors and their informal caregivers (dyads). METHODS: Forty-five dyads were randomized to a 12-week telephone-delivered intervention or attention control. Intervention effects on nutrition, physical activity, symptom burden, and self-efficacy for symptom management were estimated using Cohen's ds. RESULTS: Mean age was 64 for survivors and 53 for caregivers. Feasibility was demonstrated by the 63% consent rate out of approached dyads. The SMLI was acceptable for 98% of dyads. Among survivors, medium-to-large effect sizes were found for increased servings of total fruits and vegetables (d = 0.55), vegetables (d = 0.72), and decreased sugar intake (d = - 0.51) and medium clinically significant effect sizes for total minutes of physical activity per week (d = 0.42) and grams of fiber intake per day (d = 0.40) for intervention versus attention control. Additionally, medium-to-large intervention effects were found for the reduction of symptom burden (d = 0.74). For caregivers, medium-to-large intervention effects were found for reduced total sugar intake (d = - 0.60) and sugar intake from sugar-sweetened beverages (d = - 0.65); vegetable intake was increased with a medium effect size (d = 0.41). CONCLUSION: SMLI was feasible and acceptable for both dyadic members. A larger, well-powered trial is needed to formally evaluate SMLI effectiveness. IMPLICATIONS FOR CANCER SURVIVORS: Integrating symptom management with lifestyle behavior interventions may increase adherence to the ACS guidelines on nutrition and physical activity to prevent new and recurrent cancers.
PURPOSE: Assess feasibility, acceptability, and preliminary efficacy of an integrated symptom management and lifestyle intervention (SMLI) to improve adherence to the American Cancer Society's (ACS) Guidelines on Nutrition and Physical Activity in Latina cancer survivors and their informal caregivers (dyads). METHODS: Forty-five dyads were randomized to a 12-week telephone-delivered intervention or attention control. Intervention effects on nutrition, physical activity, symptom burden, and self-efficacy for symptom management were estimated using Cohen's ds. RESULTS: Mean age was 64 for survivors and 53 for caregivers. Feasibility was demonstrated by the 63% consent rate out of approached dyads. The SMLI was acceptable for 98% of dyads. Among survivors, medium-to-large effect sizes were found for increased servings of total fruits and vegetables (d = 0.55), vegetables (d = 0.72), and decreased sugar intake (d = - 0.51) and medium clinically significant effect sizes for total minutes of physical activity per week (d = 0.42) and grams of fiber intake per day (d = 0.40) for intervention versus attention control. Additionally, medium-to-large intervention effects were found for the reduction of symptom burden (d = 0.74). For caregivers, medium-to-large intervention effects were found for reduced total sugar intake (d = - 0.60) and sugar intake from sugar-sweetened beverages (d = - 0.65); vegetable intake was increased with a medium effect size (d = 0.41). CONCLUSION: SMLI was feasible and acceptable for both dyadic members. A larger, well-powered trial is needed to formally evaluate SMLI effectiveness. IMPLICATIONS FOR CANCER SURVIVORS: Integrating symptom management with lifestyle behavior interventions may increase adherence to the ACS guidelines on nutrition and physical activity to prevent new and recurrent cancers.
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