Colorectal cancer (CRC) is the second leading cause of cancer death; over 150,000 adults are diagnosed with CRC in the United States each year. Adenomatous polyps are a highly prevalent and treatable precursor to CRC. Consistent evidence suggests physical activity, smoking, and diets that are low in fruits/vegetables and high in red meat increase risk for polyps and CRC. Thus decreasing lifestyle risk factors could especially benefit polyp patients. Having polyps diagnosed may be a teachable moment when at-risk individuals may be particularly motivated to change their risk behaviors. The US Preventive Health Services Task Force suggests that those ages 50 and older seek CRC screening, which offers the opportunity to link interventions to this potentially important teachable moment in a large at-risk group. The proposed two-site randomized trial will evaluate a state-of-the-art comprehensive multiple risk factor intervention for polyp patients using a case management model. Polyp patients (N=1425) who agree to participate will be surveyed at baseline (following colon polyp removal) and randomly assigned to either: (1) comprehensive multiple risk factor intervention, including provider recommendations for behavior change, a goal setting session with a health educator, tailored self-help materials, telephone counseling, and personal progress reports; or (2) usual care. Primary outcomes to be assessed include changes in: (1) fruit, vegetable, and red meat consumption; (2) physical activity level; (3) multiple risk factor profile; and (4) smoking cessation (among smokers only). Follow-up assessments will occur at 6 and 12 months after polyp removal, and self-reported changes in diet and smoking will be biochemically validated. A theory-based intervention protocol (based on """"""""social ecological"""""""" Model), computer-assisted counseling, and tailored progress reports will maximize standardization of implementation across the two study sites. The intervention is suited to the managed care environment, thus increasing its potential generalize ability and disseminability. A process tracking system will enable a detailed cost-effectiveness evaluation.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA074000-02
Application #
2895910
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
Meissner, Helen I
Project Start
1998-09-30
Project End
2002-07-31
Budget Start
1999-09-24
Budget End
2000-07-31
Support Year
2
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Dana-Farber Cancer Institute
Department
Type
DUNS #
149617367
City
Boston
State
MA
Country
United States
Zip Code
02215
Adams, Rebecca N; Mosher, Catherine E; Blair, Cindy K et al. (2015) Cancer survivors' uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer 121:77-83
Ottenbacher, Allison; Sloane, Richard; Snyder, Denise C et al. (2013) Cancer-specific concerns and physical activity among recently diagnosed breast and prostate cancer survivors. Integr Cancer Ther 12:206-12
Mosher, Catherine E; Lipkus, Isaac; Sloane, Richard et al. (2013) Long-term outcomes of the FRESH START trial: exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity. Psychooncology 22:876-85
Ottenbacher, Allison J; Day, R Sue; Taylor, Wendell C et al. (2012) Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer 20:2483-9
Wilkinson, Anna V; Barrera, Stephanie L; McBride, Colleen M et al. (2012) Extant health behaviors and uptake of standardized vs tailored health messages among cancer survivors enrolled in the FRESH START trial: a comparison of fighting-spirits vs fatalists. Psychooncology 21:108-13
Ottenbacher, Allison J; Day, R Sue; Taylor, Wendell C et al. (2011) Exercise among breast and prostate cancer survivors--what are their barriers? J Cancer Surviv 5:413-9
Christy, Shannon M; Mosher, Catherine E; Sloane, Richard et al. (2011) Long-term dietary outcomes of the FRESH START intervention for breast and prostate cancer survivors. J Am Diet Assoc 111:1844-51
Sloane, Richard; Snyder, Denise Clutter; Demark-Wahnefried, Wendy et al. (2009) Comparing the 7-day physical activity recall with a triaxial accelerometer for measuring time in exercise. Med Sci Sports Exerc 41:1334-40
Mosher, Catherine E; Fuemmeler, Bernard F; Sloane, Richard et al. (2008) Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors'dietary outcomes. Psychooncology 17:1014-23
Snyder, Denise Clutter; Sloane, Richard; Lobach, David et al. (2008) Differences in baseline characteristics and outcomes at 1- and 2-year follow-up of cancer survivors accrued via self-referral versus cancer registry in the FRESH START Diet and exercise trial. Cancer Epidemiol Biomarkers Prev 17:1288-94

Showing the most recent 10 out of 31 publications