A randomized trial of tailoring and motivational interviewing to promote fruit and vegetable consumption for cancer prevention and control.
BACKGROUND
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.


OBJECTIVE
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.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Campbell
Marci Kramish
MK
Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA. marci_campbell@unc.edu
Carr
Carol
C
Devellis
Brenda
B
Switzer
Boyd
B
Biddle
Andrea
A
Amamoo
M Ahinee
MA
Walsh
Joan
J
Zhou
Bingqing
B
Sandler
Robert
R
D000368:Aged; D000704:Analysis of Variance; D001521:Behavior Therapy; D002338:Carotenoids / Q000097:blood; D015179:Colorectal Neoplasms / Q000178:diet therapy / Q000517:prevention & control*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006266:Health Education / Q000191:economics / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity / Q000502:physiology; D010353:Patient Education as Topic; D012044:Regression Analysis; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D017741:Survivors; D014675:Vegetables
D002338:Carotenoids