Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
Ann Behav Med. 2009 Oct;38(2):71-85. doi: 10.1007/s12160-009-9140-5.
Healthful dietary patterns, including eating fruits and vegetables (F&V) and avoiding obesity, may decrease the risk of cancer and other chronic diseases. In addition to promoting health for the general population, a cancer diagnosis may provide a "teachable moment," facilitating the adoption of more healthful eating habits and leading to lower risk of chronic disease and better overall health.
This study was designed to test the effectiveness of two health communication interventions in increasing F&V consumption and physical activity in a sample of older adults (average age of 66 years), including both colorectal cancer (CRC) survivors and noncolorectal cancer-affected (N-CRC) individuals.
CRC survivors and N-CRC individuals were recruited from a population-based case-control study and randomly assigned to four conditions using a 2 x 2 design. We tested two different methods of communicating and promoting health behavior change alone or in combination: tailored print communication (TPC) and brief telephone-based motivational interviewing (TMI).
A significant increase in F&V consumption was found for the combined intervention group in the entire sample (p < 0.05). When stratified by cancer survivor status, the effect was concentrated in the N-CRC subset (p < 0.01) versus CRC survivors. The combined intervention was also found to be most cost-effective for the N-CRC group, with TPC more cost-effective than TMI. For physical activity, none of the interventions produced statistically significant improvements.
This study indicates that combining tailoring and motivational interviewing may be an effective and cost-effective method for promoting dietary behavior change among older healthy adults. More research is needed to identify the optimal dose and timing for intervention strategies to promote dietary and physical activity change among both CRC survivors and the general population.
健康的饮食模式，包括食用水果和蔬菜（F&V）和避免肥胖，可能降低癌症和其他慢性疾病的风险。除了促进普通人群的健康外，癌症诊断可能提供一个“教育时刻”，促进更健康的饮食习惯的采用，并降低慢性疾病的风险，提高整体健康水平。
本研究旨在测试两种健康传播干预措施在增加老年人（平均年龄 66 岁）中 F&V 消费和体力活动的有效性，包括结直肠癌（CRC）幸存者和非结直肠癌（N-CRC）个体。
CRC 幸存者和 N-CRC 个体从一项基于人群的病例对照研究中招募，并使用 2 x 2 设计随机分配到四个条件。我们测试了两种单独的沟通和促进健康行为改变的方法：定制印刷通讯（TPC）和简短的电话式动机访谈（TMI）。
在整个样本中，发现联合干预组的 F&V 消费显著增加（p < 0.05）。按癌症幸存者状态分层时，该效果集中在 N-CRC 亚组（p < 0.01）而非 CRC 幸存者中。联合干预在 N-CRC 组中也被发现最具成本效益，TPC 比 TMI 更具成本效益。对于体力活动，没有任何干预措施产生统计学上显著的改善。
本研究表明，结合定制和动机访谈可能是促进老年健康成年人饮食行为改变的有效且具有成本效益的方法。需要进一步研究以确定干预策略促进 CRC 幸存者和普通人群饮食和体力活动改变的最佳剂量和时间。
