title: Long-term dietary outcomes of the FRESH START intervention for breast and prostate cancer survivors.
abstract: BACKGROUND
  Cancer survivors are at increased risk for secondary cancers and other diseases. Healthy dietary practices may improve cancer survivors' health and well-being.
  
  
  OBJECTIVE
  The durability of the effects of the FRESH START intervention, a program of sequentially tailored mailed materials, and standardized mailed materials (for controls) on cancer survivors' dietary outcomes was assessed over a 2-year period. Greater dietary gains were expected for FRESH START participants relative to controls.
  
  
  METHODS
  Participants were randomized to receive tailored vs standardized 10-month mailed print interventions promoting diet and exercise behaviors. Data were collected at baseline and 1- and 2-year follow-ups.
  
  
  METHODS
  Breast and prostate cancer survivors (n=543) were recruited from 39 states and two provinces within North America. A total of 489 participants completed the 2-year follow-up assessment (10% attrition).
  
  
  METHODS
  Participants were randomly assigned to either a 10-month program of tailored mailed print materials promoting fruit and vegetable consumption, reduced total and saturated fat intake, and/or increased exercise or to a 10-month program of publicly available mailed materials on diet and exercise.
  
  
  METHODS
  Telephone surveys (supported with blood biomarkers) assessed dietary habits at baseline and 1- and 2-year follow-ups.
  
  
  METHODS
  Paired-samples t tests were conducted to examine the durability of the intervention's effects on dietary outcomes within each study arm. Arm differences in follow-up outcomes were then tested with the general linear model, controlling for the baseline value of the outcomes.
  
  
  RESULTS
  Both arms reported decreased saturated fat intake, increased servings of fruits and vegetables, and better overall diet quality at year 2 relative to baseline. However, FRESH START participants reported better overall diet quality and lower total and saturated fat intake compared to controls at the 2-year follow-up.
  
  
  CONCLUSIONS
  Results suggest that mailed material interventions, especially those that are tailored, can produce long-term dietary improvement among cancer survivors.
authors: Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA. shanchri@iupui.edu
authors: Shannon M
authors: SM
authors: Christy
authors: Catherine E
authors: CE
authors: Mosher
authors: Richard
authors: R
authors: Sloane
authors: Denise C
authors: DC
authors: Snyder
authors: David F
authors: DF
authors: Lobach
authors: Wendy
authors: W
authors: Demark-Wahnefried
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000517:prevention & control*; D004032:Diet / Q000592:standards*; D004041:Dietary Fats / Q000008:administration & dosage; D015444:Exercise / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D011471:Prostatic Neoplasms / Q000401:mortality / Q000517:prevention & control*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D014675:Vegetables
chemical_list: D004041:Dietary Fats