title: Capitalizing on the "teachable moment" to promote healthy dietary changes among cancer survivors: the perspectives of health care providers.
abstract: OBJECTIVE
  Although cancer is often thought of as a teachable moment, many cancer survivors do not adhere to behavioral recommendations that might improve their health. This study explored health care providers' perspectives on the importance and feasibility of addressing behavior change, specifically healthy diet, with cancer survivors.
  
  
  METHODS
  In-depth interviews were conducted with 33 health care providers who care for posttreatment survivors of breast cancer, prostate cancer, and non-Hodgkin's lymphoma. Interviews were analyzed thematically.
  
  
  RESULTS
  Health care providers emphasized the strength of evidence linking diet/obesity to recurrence in their assessment of the importance of promoting dietary change among their survivor patients. Cancer specialists (e.g., oncologists, surgeons) generally brought up dietary change with patients if they considered the evidence to be strong. In contrast, primary care providers viewed health promotion as important for all patients and reported treating cancer survivor patients the same as others when it came to making dietary recommendations. There was a lack of consensus among providers on the best timing to bring up behavior change. Providers described specific subgroups of patients who they saw as more motivated to make behavior changes and patient barriers to making dietary changes.
  
  
  CONCLUSIONS
  Health care providers can play an important role in promoting healthy diet among cancer survivors. As the evidence base around diet and cancer recurrence/prognosis grows, it is important that this information is communicated to providers. Strategies such as incorporating behavior change messages into survivor care plans may help standardize recommendations to survivors.
authors.affiliation: Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway St., Baltimore, MD, 21205, USA, kcoa1@jhu.edu.
authors.forename: Kisha I
authors.initials: KI
authors.lastname: Coa
authors.forename: Katherine Clegg
authors.initials: KC
authors.lastname: Smith
authors.forename: Ann C
authors.initials: AC
authors.lastname: Klassen
authors.forename: Laura E
authors.initials: LE
authors.lastname: Caulfield
authors.forename: Kathy
authors.initials: K
authors.lastname: Helzlsouer
authors.forename: Kim
authors.initials: K
authors.lastname: Peairs
authors.forename: Lillie
authors.initials: L
authors.lastname: Shockney
mesh_terms: D001521:Behavior Therapy / Q000379:methods; D001943:Breast Neoplasms / Q000534:rehabilitation*; D005247:Feeding Behavior; D005260:Female; D006282:Health Personnel; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008228:Lymphoma, Non-Hodgkin / Q000534:rehabilitation*; D008297:Male; D009042:Motivation; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000523:psychology; D010465:Perception; D011471:Prostatic Neoplasms / Q000178:diet therapy*; D040242:Risk Reduction Behavior; D017741:Survivors / Q000523:psychology*