title: The Diet Quality Index-Revised: a tool to promote and evaluate dietary change among older cancer survivors enrolled in a home-based intervention trial.
abstract: OBJECTIVE
  To utilize the Diet Quality Index-Revised (DQI-R) as a framework for delivering and evaluating an intervention to improve overall diet quality among older cancer survivors.
  
  
  METHODS
  As part of a randomized controlled trial to improve lifestyle behaviors among older cancer survivors, we sought a dietary measure that could serve as both an intervention framework and a means to evaluate global dietary quality. The DQI-R measures overall diet quality by summing 10 subscales that relate to national guidelines. At baseline, DQI-R scores were generated from three multi-pass 24-hour dietary recalls. The 6-month intervention delivered tailored feedback on individual DQI-R subscales. Dietary recalls were repeated at 6 and 12 months.
  
  
  METHODS
  Elderly (aged >or=65 years) individuals within 18 months of diagnosis of breast or prostate cancer (n=182) were randomized postbaseline measures to intervention vs attention control arms.
  
  
  RESULTS
  Significant differences in overall diet quality were observed between arms at 6 months, with the intervention arm improving (67.6+/-12.2 to 69.8+/-13.9), and controls declining (67.5+/-12.5 to 64.6+/-14.7) (P=0.003). Significant differences were observed between arms over time in dietary diversity subscale scores: baseline and 6-month follow-up means among intervention and control arms were 4.8+/-1.3 to 4.8+/-1.4, and 4.7+/-1.2 to 4.1+/-1.1, respectively (P=0.001).
  
  
  CONCLUSIONS
  The DQI-R served as an effective guide and evaluation tool for this diet-related randomized controlled trial. Like many interventions, our effect diminished after the intervention was complete. Future research should consider testing interventions that use the DQI-R, or other global diet-related indexes, as guides and evaluation tools over longer study periods, as well as in other populations.
authors.affiliation: School of Nursing, Duke University, Box 3322 Duke University Medical Center, Durham, NC 27710, USA. snyde023@mc.duke.edu
authors.forename: Denise
authors.initials: D
authors.lastname: Clutter Snyder
authors.forename: Richard
authors.initials: R
authors.lastname: Sloane
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Haines
authors.forename: Paige
authors.initials: P
authors.lastname: Miller
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Clipp
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
authors.forename: Carl
authors.initials: C
authors.lastname: Pieper
authors.forename: Harvey
authors.initials: H
authors.lastname: Cohen
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000178:diet therapy / Q000517:prevention & control*; D004032:Diet / Q000592:standards*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D011939:Mental Recall; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018673:Nutrition Policy; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D052756:Nutritional Sciences / Q000193:education*; D010809:Physical Fitness; D011471:Prostatic Neoplasms / Q000178:diet therapy / Q000517:prevention & control*; D011788:Quality of Life; D013689:Telephone; D014481:United States