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Improving lifestyle behaviors after breast cancer treatment among African American women with and without diabetes: role of health care professionals
Jarvandi S, Perez M, Margenthaler J, Colditz GA, Kreuter MW, Jeffe DB
Annals of Behavioral Medicine 2021 Jan;55(1):1-13
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Little is known about the effect of health professionals' advice on promoting healthy lifestyle behaviors (diet and exercise) among breast cancer patients. PURPOSE: To identify predictors of receiving lifestyle advice from health professionals and its impact on healthy lifestyle behaviors. METHODS: We used data from a randomized controlled trial of an interactive, cancer-communication video program using African American breast cancer survivor stories for newly diagnosed African American breast cancer patients (stages 0 to III). Participants completed five interviews over 2 years. This intervention did not significantly affect changes in quality-of-life outcomes. In secondary analysis, we examined differences in baseline variables between women with and without diabetes. Logistic regression models identified independent predictors of receiving advice from "a doctor or other health professional" to improve diet and exercise and of self-reported change in diet and exercise habits at 2 year follow-up. RESULTS: Of 193 patients included (85% of 228 enrolled), 53 (28%) had diabetes. At 2 year follow-up, a greater proportion of women with (versus without) diabetes reported receiving advice by a doctor/health professional to improve their diet (73% versus 57%, p = 0.04,). Predictors of receiving dietary advice were obesity, diabetes, and breast-conserving surgery (each p < 0.05). Women receiving dietary advice were 2.75 times more likely to report improving their diet (95% confidence interval 1.17 to 6.46) at follow-up, but receiving physical activity advice was not significantly associated with patients reporting an increase in exercise. CONCLUSIONS: Although receiving dietary advice predicted dietary improvements, receiving exercise advice did not lead to an increase in physical activity. CLINICAL TRIAL REGISTRATION: Trial number NCT00929084.

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