A Home-Based Nutrition and Physical Activity Intervention for Grandparents Raising Grandchildren: A Pilot Study

Five African American grandparents raising their grandchildren participated in a home-based nutrition and physical activity intervention. The primary goals were to increase grandparents' knowledge and skills in selecting and preparing healthy foods and to increase the grandparents' and grandchildren's physical activity levels. Results revealed that grandparents' concerns regarding their chronic diseases and desire to prevent health problems in their grandchildren served as motivators. Following the intervention, grandparents scored higher on nutrition and physical activity knowledge and their self-efficacy improved, although most health status indicators remained unchanged. Self-reported changes included walking more, reading food labels, and switching to a healthier type of fat.     

mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women

Introduction Physical inactivity is prevalent in pregnant women, and innovative strategies to promote physical activity are strongly needed. The purpose of the study was to test a 12-week mobile health (mHealth) physical activity intervention for feasibility and potential efficacy. Methods Participants were recruited between December 2012 and February 2014 using diverse recruitment methods. Thirty pregnant women between 10 and 20 weeks of gestation were randomized to an intervention (mobile phone app plus Fitbit) or a control (Fitbit) group. Both conditions targeted gradual increases in physical activity. The mHealth intervention included daily messages and a mobile phone activity diary with automated feedback and self-monitoring systems. Results On monthly average, 4 women were screened for initial eligibility by telephone and 2.5 were randomized. Intervention participants had a 1096 ± 1898 step increase in daily steps compared to an increase of 259 ± 1604 steps in control participants at 12 weeks. The change between groups in weekly mean steps per day during the 12-week study period was not statistically significant (p = 0.38). The intervention group reported lower perceived barrier to being active, lack of energy, than the control group at 12-week visit (p = 0.02). The rates of responding to daily messages and using the daily diary through the mobile app declined during the 12 week study period. Discussion It was difficult to recruit and randomize inactive women who wanted to increase physical activity during pregnancy. Pregnant women who were motivated to increase physical activity might find using mobile technologies in assessing and promoting PA acceptable. Possible reasons for the non-significant treatment effect of the mHealth intervention on physical activity are discussed. Public awareness of safety and benefits of physical activity during pregnancy should be promoted. Clinicaltrials.Gov Identifier NCT01461707.     

A Pilot Study of Self-Reported Physical Activity and Eating Habits in Turkish Cancer Patients Under Chemotherapy

As in all individuals, improving the quality of life, balanced nutrition and physical activity habits must be acquired in cancer patients. The purpose of this study was to determine eating habits and physical activity of cancer patients receiving chemotherapy. Sixty-six patients were completed the questionnaire included sociodemographic data, type of cancer, anthropometric measurements (size and body weight), dietary and physical activity habits. Body mass index for each patient was calculated. Data were analyzed using Statistical Package for Social Science software. Patients were ranged from underweight to obese according to their body mass index: 6.1% of patients were classified as underweight. Almost half (48.5%, n = 32) reported to be regularly physical active, and 46.9% (n = 15) thereof reported 30 min brisk walking. More vegetables consumption was the most popular answer with 62.1% (n = 41), whereas vegetables/fruit or vegetables/legume consumption was 22.7% (n = 15). Gender differences in food choice and preferring the taste of food were not seen as statistically significant. In this article, patients with different types of cancer reported their eating habits and physical activity. Disease-related and worse prognostic factors were found. An institutional program should be offered to cancer patients for consulting about nutrition and physical activity.     

Dietary Patterns in Puerto Rican and Mexican-American Breast Cancer Survivors: A Pilot Study

Breast cancer is the leading cause of cancer death among Hispanic women. Certain dietary factors have been associated with the risk of breast cancer recurrence, but data in Hispanic survivors is scarce. Objective: to examine dietary patterns and diet quality in two groups of Hispanic breast cancer survivors. Methods: 23 Mexican-American (MA) and 22 Puerto Rican (PR) female breast cancer survivors completed a culturally adapted validated food frequency questionnaire. Intake was standardized per 1000 kcal and compared to US Dietary Guidelines and the DASH-style diet adherence score was calculated. Results: Overweight/obese was 70 % in MA and 91 % in PR. PR consumed diets rich in fruit/100 % fruit juices and beans, while MA diets were high in vegetables, beans, and total grains. Both groups consumed high amounts of starchy vegetables, refined grains, animal protein and calories from solid fats and added sugars but low intakes of whole grains, dairy products and nuts and seeds. DASH scores were relatively low. Conclusion: MA and PR female breast cancer survivors have different dietary patterns but both groups had relatively low diet quality. These groups could benefit from culturally tailored interventions to improve diet quality, which could potentially reduce cancer recurrence. ClinicalTrials.gov Identifier NCT01504789.     

First Steps for Mommy and Me: A Pilot Intervention to Improve Nutrition and Physical Activity Behaviors of Postpartum Mothers and Their Infants

To assess the feasibility of a pediatric primary care based intervention to promote healthful behaviors among 0–6 month old infants and their mothers. We enrolled two intervention practices (60 mother-infant pairs) and one usual care control practice (24 pairs) in a non-randomized controlled trial. We completed visits and interviews with 80 (95%) pairs at birth and 6 months. The intervention included (1) brief focused negotiation by pediatricians, (2) motivational counseling by a health educator, and (3) group parenting workshops. We evaluated the intervention effects on infant feeding, sleep duration, TV viewing, and mothers’ responsiveness to satiety cues. Maternal behavioral targets included postpartum diet, physical activity, TV and sleep. At 6 months, fewer intervention than control infants had been introduced to solid foods (57% vs. 82%; P = 0.04), and intervention infants viewed less TV (mean 1.2 vs. 1.5 h/d; P = 0.07). Compared to control infants, intervention infants had larger increases in their nocturnal sleep duration from baseline to follow up (mean increase 1.9 vs. 1.3 h/d; P = 0.05); larger reductions in settling time (mean reduction −0.70 vs. −0.10 h/d; P = 0.02); and larger reductions in hours/day of nighttime wakefulness (mean reduction −2.9 vs. −1.5 h/d; P = 0.08). There were no differences in breastfeeding, response to satiety cues, or maternal health behaviors. A program of brief focused negotiation by pediatricians, individual coaching by health educators using motivational interviewing, and group parenting workshops tended to improve infant feeding, sleep and media exposure, but had less impact on mothers’ own health-related behaviors.     

The Influence of Neighborhood Crime on Increases in Physical Activity during a Pilot Physical Activity Intervention in Children

The purpose of this study was to examine whether neighborhood crime moderated the response (increases in steps) to a pilot intervention to increase physical activity in children. Twenty-seven insufficiently active children aged 6–10 years (mean age?=?8.7 years; 56 % female; 59 % African American) were randomly assigned to an intensive intervention group (IIG) or minimal intervention group (MIG). Change in average daily number of steps from baseline was regressed against an index of neighborhood crime in a multilevel repeated-measures model that included a propensity score to reduce confounding. Safer neighborhoods were associated with higher increases in steps during the pilot intervention (interaction p?=?0.008). Children in the IIG living in low-crime neighborhoods significantly increased their physical activity (5275?±?1040 steps/day) while those living in high-crime neighborhoods did not (1118?±?1007) (p for difference?=?0.046). In the IIG, the increase in daily steps was highly correlated with neighborhood crime (r?=?0.58, p?=?0.04). These findings suggest the need for physical activity interventions to account for participants’ environments in their design and/or delivery. To promote healthy behaviors in less-supportive environments, future studies should seek to understand how environments modify intervention response and to identify mediators of the relationship between environment and intervention.     

Sensory-Based Nutrition Pilot Intervention for Women

Negative effects of restrained eating (ie, concerns about dieting and weight control) have been observed in eating behaviors. Such findings underscore the need to develop more positive approaches to promote healthy eating behaviors. The objectives of this pilot randomized controlled trial were to investigate and determine whether sensory-based intervention influenced eating-related attitudes and behaviors among restrained women, as well as reliance on physical signals for hunger and satiety. Between January and September 2011, data were collected using validated questionnaires (Restraint Scale, Three-Factor Eating Questionnaire, Mindful Eating Questionnaire, and Intuitive Eating Scale) at baseline (T=1), the end of the intervention period (T=2), and 12 weeks post intervention (T=3). At T=1, women (n=50) from Quebec City, Canada, were randomly assigned to an intervention group (sensory-based intervention) or a waiting list control group. Statistical analyses were conducted using mixed models, including the group, time, and group-by-time interaction. Women from the intervention group showed a significant decrease in Three-Factor Eating Questionnaire−Disinhibition and a significant increase in Mindful Eating Questionnaire−Disinhibition at T=2 vs T=3 (P=0.02 and P=0.02, respectively) and at T=3 vs T=1 (P=0.003 and P=0.002, respectively). Women from the intervention group also showed a significant increase in Intuitive Eating Scale−Unconditional Permission to Eat at T=2 vs T=1 (P<0.0001) and at T=3 vs T=1 (P<0.0001). These preliminary data suggest that sensory-based intervention can be a promising approach to improve eating-related attitudes and behaviors among restrained women, without exacerbating other behaviors such as restrained eating.     

Application of the Updated WCRF/AICR Cancer Prevention Score as an Outcome for Cancer Survivors Participating in a Tailored and Intensive Dietary and Physical Activity Intervention

The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has defined evidence-based guidelines for cancer prevention. These recommendations have been operationalized into a quantitative index for individual assessment. Survivors of cancer are increasingly desiring guidance for diet and lifestyle, and in the absence of research in survivors, are often instructed to follow cancer prevention and public health guidelines. In this study, we examine the utility of the quantitative updated WCRF/AICR scoring criteria to assess change among cancer survivors with overweight/obesity (OW/OB) following an intensive behavioral intervention. We applied the WCRF/AICR scoring criteria (range 0–7) to examine changes over the duration of the study by paired t-tests. Two cancer survivor cohorts with OW/OB (n = 91) completed a six-month phase II clinical trial designed to improve dietary and physical activity patterns. At enrollment and post-intervention, participants completed assessments including anthropometrics, food frequency questionnaires, and objective evaluation of physical activity. Participants improved adherence to all scored recommendations, with a significant increase in mean score from enrollment (3.22 ± 1.06) to post-intervention (4.28 ± 1.04) (p < 0.001). Mean BMI and waist circumference improved (both p < 0.001). The greatest improvements were noted for fruit and non-starchy vegetable intakes (+39%, p < 0.001); the greatest decreases were observed for processed meat consumption (−70%, p < 0.001). The updated WCRF/AICR Score can be applied to cancer survivor intervention studies and provides a tool to compare trials in regard to the baseline status of populations enrolled and the success of the intervention. Future interventions incorporating standardized assessments will help guide effective strategies to improve the health and quality of life for cancer survivors.     

Pilot Study to Enhance Start-up of a Multicenter Nutrition Intervention Trial

Multicenter trials are important for answering questions that require large numbers of subjects. Such trials require standardized implementation of behavioral change programs across diverse populations, regions, and staff. Researchers involved with the Trial of Nonpharmacologic Interventions in the Elderly conducted a 17-week pilot study of their most complex intervention (combined weight and sodium reduction) before actual start-up of the main study. This allowed staff to rehearse implementing the program and to identify and address intervention and standardization issues. Registered dietitians in 4 US communities recruited 28 participants for the pilot study, using eligibility criteria similar to those for the main trial. Participant evaluations reflected high satisfaction with the program materials and overall approach. Minor protocol changes suggested by results of the pilot study were made easily in time for start-up of the main study. Reductions in weight and sodium intake were less than targeted but were sufficient to suggest that the intervention would be effective under optimal conditions. This partial achievement of goals in the pilot study underscored the need to allow for a learning curve, for without it standardization and outcomes of the main study would be compromised. J Am Diet Assoc. 1998;98:322–325.     

A Review of Web-Based Nutrition Information in Spanish for Cancer Patients and Survivors

Nutrition education resources are of interest for cancer patients and survivors throughout the cancer continuum. We examined the web-based nutrition information in Spanish for cancer patients and survivors provided by national cancer organizations (NCOs). The Guide to Internet Resources for Cancer and the membership list of the Union for International Cancer Control were searched to identify the NCOs. The International Patients Decisions Aid Standards (IPDAS) was used to describe the quality of the available information. We identified 20 NCOs that provided nutrition information aimed at a general audience on their websites. Web-based resources of nine NCOs were selected for presentation in this review. Website scores ranged between 20 and 24 in the IPDAS scale (maximum score = 31). The selected NCOs offered reliable and safe information. Healthy eating information for cancer patients and management of side-effects was provided by all websites. Information was more limited for cancer survivors. We recommend that NCOs increase the possibilities for personalized recommendations and interaction with the content by including instrumental tools on their websites.     

Using Single-System Analyses to Assess the Effectiveness of an Exercise Intervention on Quality of Life for Hispanic Breast Cancer Survivors: A Pilot Study

ABSTRACT

Stress is associated with many health maladies, including cancers. Exercise is an effective stress-management tool and is important for physical health. The number of Hispanic women who engage in enough exercise is low. Thus, promoting exercise for this population is of critical importance. Individual effectiveness of behavioral interventions can often be lost in group analyses. Therefore, we employed both group analyses and single-system methodology to test the effectiveness of an exercise program for 25 Hispanic breast cancer survivors. Measures of physical fitness, quality of life, self-reported stress, and salivary cortisol were taken repeatedly before, during, and after the intervention. The intervention improved physical fitness, reduced perceived stress, and decreased cortisol levels as evidenced by both group and single-system analyses.     

Nutrition and Physical Activity Strategies for Cancer Prevention in Current National Comprehensive Cancer Control Program Plans

Obesity, diet and physical inactivity are risk factors for some cancers. Grantees of the National Comprehensive Cancer Control Program (NCCCP) in US states, tribes, and territories develop plans to coordinate funding and activities for cancer prevention and control. Including information and goals related to nutrition and physical activity (NPA) is a key opportunity for primary cancer prevention, but it is currently unclear to what extent NCCCP plans address these issues. We reviewed 69 NCCCP plans and searched for terms related to NPA. Plans were coded as (1) knowledge of NPA and cancer link; (2) goals to improve NPA behaviors; and (3) strategies to increase healthy NPA activities, environments, or systems changes. NPA content was consistently included in all cancer plans examined across all years. Only 4 (6 %) outlined only the relationship between NPA and cancer without goals or strategies. Fifty-nine plans (89 %) contained goals or strategies related to NPA, with 53 (82 %) including both. However, numbers of goals, strategies, and detail provided varied widely. All programs recognized the importance of NPA in cancer prevention. Most plans included NPA goals and strategies. Increasing the presence of NPA strategies that can be modified or adapted appropriately locally could help with more widespread implementation and measurement of NPA interventions.     

Increasing Physical Activity in Preschool: A Pilot Study to Evaluate Animal Trackers

ObjectiveThis report describes a pilot study to evaluate Animal Trackers (AT), a preschool program designed to (1) increase structured physical activity (PA) during the preschool day; (2) increase practice of gross motor skills; (3) provide teachers with an easy-to-use PA program regardless of teacher experience; and (4) implement a teacher walking intervention.DesignPilot observational study in volunteer preschools.SettingNine preschools in New Mexico.ParticipantsTwo-hundred seventy 3- to 5-year-old children and 32 teachers.InterventionDaily 10-minute classroom activities for children.Main Outcome MeasureImplementation and duration of AT activities, teacher preparation time, and added weekly time spent in structured PA.AnalysisProcess evaluation to track program implementation, and pre-post measures to assess outcomes.ResultsAT activities were implemented 4.1 times per week (11.4 minutes/activity), with 7 minutes teacher preparation time. Overall, AT added 47 minutes of structured PA per week for children.Conclusions and ImplicationsThe AT program increased structured PA time in preschools. Teachers felt that AT was developmentally appropriate; that children enjoyed the activities; and that the children's motor skills improved. Results of the pilot study are encouraging, since research suggests that even small increases in PA could help prevent obesity.     

A Pilot Examination of a Mosque-Based Physical Activity Intervention for South Asian Muslim Women in Ontario,Canada

Low levels of physical activity have been reported in South Asian Muslim women. Mosques could be beneficial in providing physical activity opportunities for Muslim women. This study examined the feasibility, acceptability and effectiveness of a mosque-based physical activity program for South Asian Muslim women in Canada. Sixty-two South Asian Muslim women participated in a 24-week mosque-based exercise intervention. Feasibility, acceptability and effectiveness of the program was evaluated by pre-post survey questions from the Duke Activity Status Index (DASI) and International Physical Activity Questionnaire among 28 women who consented to the research data collection. Nineteen women were assessed pre-and post-intervention. The women demonstrated increase in median scores of self-efficacy (90 pre vs. 100 post; p = 0.004) and the importance of engaging in regular physical activity (90 pre vs. 100 post; p = 0.01). Fewer participants were classified as inactive at the end of the intervention (42 % pre vs. 10 % post; p = 0.006). There was a mean increase in DASI scores (39.2 pre vs. 44.6 post; p = 0.06) reflecting an improvement in peak aerobic capacity and functional quality of life. Culturally relevant structured networks such as mosques are important assets when designing healthy lifestyle interventions for South Asian Muslim women.