Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors' dietary outcomes.
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.
Mosher
Catherine E
CE
Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY 10022, USA. mosherc@mskcc.org
Fuemmeler
Bernard F
BF
Sloane
Richard
R
Kraus
William E
WE
Lobach
David F
DF
Snyder
Denise Clutter
DC
Demark-Wahnefried
Wendy
W
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*