title: Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors' dietary outcomes.
abstract: OBJECTIVE
  This study examined change in self-efficacy as a mediator of the effects of a mailed print intervention on the dietary and exercise practices of newly diagnosed breast and prostate cancer survivors.
  
  
  METHODS
  A total of 543 breast and prostate cancer patients were recruited from 39 states and two provinces within North America. Participants were randomly assigned to receive a 10-month program of tailored mailed print materials that aimed to increase fruit and vegetable consumption, reduce fat intake, and/or increase exercise or a 10-month program of publically available materials on diet and exercise. Telephone surveys conducted at baseline and 1 year assessed dietary practices, physical activity, and self-efficacy for engaging in these health behaviors.
  
  
  RESULTS
  Results indicated that changes in self-efficacy for fat restriction and eating more fruits and vegetables were significant mediators of the intervention's effects on dietary outcomes at 1-year follow-up. The intervention did not significantly affect self-efficacy for exercise; however, a significant, positive relationship was found between self-efficacy for exercise and exercise duration at follow-up.
  
  
  CONCLUSIONS
  Findings are largely consistent with Social Cognitive Theory and support the use of strategies to increase self-efficacy in health promotion interventions for cancer survivors.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY 10022, USA. mosherc@mskcc.org
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Mosher
authors.forename: Bernard F
authors.initials: BF
authors.lastname: Fuemmeler
authors.forename: Richard
authors.initials: R
authors.lastname: Sloane
authors.forename: William E
authors.initials: WE
authors.lastname: Kraus
authors.forename: David F
authors.initials: DF
authors.lastname: Lobach
authors.forename: Denise Clutter
authors.initials: DC
authors.lastname: Snyder
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology*; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*