Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Psychooncology. 2018 Sep;27(9):2220-2228. doi: 10.1002/pon.4799. Epub 2018 Jul 25.
To examine psychosocial mediators of the effect of a culturally tailored dietary intervention on dietary change among Hispanic/Latina breast cancer survivors.
Hispanic/Latina breast cancer survivors (n = 70) were randomized to receive either a 12-week theory-based and culturally tailored dietary change program (intervention group, n = 34), or standard-of-care printed recommendations (control group, n = 36) (ClinicalTrials.gov NCT01414062). Fruit/vegetable intake (F/V), % calories from fat, and hypothesized psychosocial mediators were assessed at baseline, 6 and 12 months. Analysis of covariance assessed intervention effects on psychosocial mediators at 6 and 12 months. Mediation analysis using the bootstrap method evaluated the indirect intervention effects on dietary intake at 6 and 12 months through changes in psychosocial mediators at 6 and 12 months.
Compared with controls, at 6 and 12 months, the intervention group reported greater improvements in stages of change (P < .001, P < .001, respectively), self-efficacy (P = .009, P = .002, respectively), snack preference for F/snack preference for F/V (P = .045, P = .002, respectively); at 12 months, the intervention group reported a decrease in chance-oriented external locus of control (P = .02). At 6 months, mediation analysis showed that the intervention effect was associated with an increase of 1.0 (95% CI, -0.1-2.4) serving/day of F/V, compared with the control group, although no indirect effect through the hypothesized psychosocial mediators was observed. At 12 months, the intervention was associated with an increase in 0.5 serving/day F/V through improved taste/snack preference for F/V at 6 and 12 months (95% CIs, 0.1-1.3, 0.0-1.4, respectively).
Future programs can target improving taste/snack preference for F/V to promote dietary change in Hispanic/Latina breast cancer survivors.
探讨一种文化适应的饮食干预对西班牙裔/拉丁裔乳腺癌幸存者饮食变化的影响的心理社会中介因素。
将 70 名西班牙裔/拉丁裔乳腺癌幸存者随机分为接受 12 周基于理论和文化适应的饮食改变计划（干预组，n=34）或标准护理印刷建议（对照组，n=36）（ClinicalTrials.gov NCT01414062）。在基线、6 个月和 12 个月时评估水果/蔬菜摄入量（F/V）、脂肪卡路里百分比和假设的心理社会中介因素。协方差分析评估了 6 个月和 12 个月时干预对心理社会中介因素的影响。使用自举法进行中介分析，评估了 6 个月和 12 个月时心理社会中介因素变化对饮食摄入的间接干预效应。
与对照组相比，干预组在 6 个月和 12 个月时报告了更大的变化阶段（P<0.001，P<0.001），自我效能（P=0.009，P=0.002），零食偏好 F/零食偏好 F/V（P=0.045，P=0.002）；在 12 个月时，干预组报告了机会导向的外部控制源减少（P=0.02）。在 6 个月时，中介分析显示，与对照组相比，干预效应与 F/V 增加 1.0 份/天（95%CI，-0.1-2.4）有关，尽管没有通过假设的心理社会中介因素观察到间接效应。在 12 个月时，干预与 F/V 的 0.5 份/天的增加有关，这是通过 6 个月和 12 个月时对 F/V 的口味/零食偏好的改善（95%CI，0.1-1.3，0.0-1.4）。
未来的项目可以针对改善对 F/V 的口味/零食偏好，以促进西班牙裔/拉丁裔乳腺癌幸存者的饮食改变。
