Extant health behaviors and uptake of standardized vs tailored health messages among cancer survivors enrolled in the FRESH START trial: a comparison of fighting-spirits vs fatalists.
OBJECTIVE
Cancer coping styles have been associated with several cancer-related outcomes. We examined whether baseline lifestyle behaviors differed between cancer survivors with fatalistic vs fighting-spirit coping styles, and whether there was differential response to two diet-exercise mailed-print interventions, one standardized and another individually tailored.


METHODS
Baseline differences by coping style are presented for 628 breast and prostate cancer survivors who participated in the FRESH START trial, along with multivariable analyses on rates of uptake by coping style and arm assignment for those completing the 2-year trial.


RESULTS
At baseline, several differences were observed between fighting-spirits and fatalists, with the former significantly more likely to be white, younger, leaner, more-educated and at risk for depression, and less likely to consume 5+fruits and vegetables (F&V)/day (p-values<0.05). Improvements in physical activity were observed, with fighting-spirits exhibiting the greatest gains from baseline to Year-1, regardless of intervention type; but by Year-2, these differences diminished as fatalists gained ground. Moreover, fatalists who received standardized intervention material also charted steady improvements in F&V intake over the study period; by Year-2, 58.1% of fatalists achieved the 5-a-day goal vs 44.6% of fighting-spirits (p-value<0.05).


CONCLUSIONS
Lifestyle behaviors and health message uptake differs by cancer coping style. Although tailored interventions appear most effective and minimize differential uptake, standardized interventions also can improve behaviors, though fighting-spirits may require additional boosters to maintain change.
Division of Epidemiology, Human Genetics and Environmental Science, University of Texas School of Public Health, Austin Regional Campus, Austin, TX, USA. anna.v.wilkinson@uth.tmc.edu
Anna V
AV
Wilkinson
Stephanie L
SL
Barrera
Colleen M
CM
McBride
Denise C
DC
Snyder
Richard
R
Sloane
Karen M
KM
Meneses
Dorothy
D
Pekmezi
William E
WE
Kraus
Wendy
W
Demark-Wahnefried
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology*; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011471:Prostatic Neoplasms / Q000523:psychology*; D011788:Quality of Life; D020377:Self Efficacy; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D014675:Vegetables; D055815:Young Adult