参与式培训预防工人工伤和肌肉骨骼系统疾病效果的随机对照研究

目的 研究参与式培训对预防工人工伤和肌肉骨骼系统疾病(MSD)的效果。 方法 随机选取30家企业1 825名工人,其中918名干预组工人接受参与式培训,907名对照组工人接受授课式培训,比较两组培训前1年、培训后1年男女工人工伤发生率和MSD发生率的变化,从而评估培训效果。 结果 培训后1年随访率为59.1%。干预组培训后的工伤发生率(5.0%)低于培训前的发生率(8.9%),两者差异有统计学意义(P<0.01);培训后,干预组男性工人工伤发生率从11.3%降至5.5%,差异有统计学意义(P<0.01)。女性工人工伤发生率在培训前后差异无统计学意义(P>0.05)。培训1年后,干预组和对照组男女工人MSD发生率差异均无统计学意义(P>0.05)。 结论 参与式培训比授课式培训能更有效地降低男性工人工伤发生率,但两种培训方式均不能有效降低MSD和女性工人工伤的发生率。     

Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial

Purpose

The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders (WUEMSDs) among computer workers.

Methods

Four hundred computer workers answered a questionnaire on work-related upper extremity musculoskeletal symptoms (WUEMSS). Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospective, randomized controlled 6-month intervention. Body posture and workstation layouts were assessed by the Ergonomic Questionnaire. We used the Visual Analogue Scale to assess the intensity of WUEMSS. The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities. Health-related quality of life was assessed with the Short Form-36. After baseline assessment, those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions, an ergonomic training brochure, and workplace visits with workstation adjustments. Follow-up assessment was conducted after 6 months.

Results

In the intervention group, body posture (p < 0.001) and workstation layout (p = 0.002) improved over 6 months; furthermore, intensity (p < 0.001), duration (p < 0.001), and frequency (p = 0.009) of WUEMSS decreased significantly in the intervention group compared with the control group. Additionally, the functional status (p = 0.001), and physical (p < 0.001), and mental (p = 0.035) health-related quality of life improved significantly compared with the controls. There was no improvement of work day loss due to WUEMSS (p > 0.05).

Conclusions

Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs.     

Observations of Group Care Worker-Child Interaction in Residential Youth Care: Pedagogical Interventions and Child Behavior

Background

The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children.

Objective

The aim of the current study was to observe the pedagogical interventions of group care workers within residential youth care and their associations with child behaviors.

Methods

Group care worker interventions and child behaviors were videotaped during structured observations. Participants included 95 children (64 % boys, M _age = 9.19) and 53 group care workers (74 % female, M _age = 33.79 years). A coding system was developed to code pedagogical interventions and child behaviors.

Results

It showed that group care workers mainly used positive pedagogical interventions (warmth/support and positive control) and seldom used negative pedagogical interventions (permissiveness and negative control). Frustration and anger of children was associated with positive controlling interventions and permissiveness of group care workers. The hypothesis that child anxiety and nervousness is associated with warm and supportive interventions could not be confirmed.

Conclusions

Pedagogical interventions should be part of education, training, and supervision of group care workers.     

Health effects and acceptance of a physical activity program for older long-term unemployed workers

Purpose

Long-term unemployment has negative effects on both mental and physical health. In combination with an inactive lifestyle, it often leads to functional or constitutional limitations that make reemployment in the labor market difficult especially for older adults. The presented pilot study examined a 3-month-long interventional program for improving health of older, long-term unemployed persons with regard to its effectiveness and acceptance by the target group.

Methods

The low-threshold intervention was offered by a job training center that supports reemployment and was divided into lectures for enhancing the individual health competence and a supervised physical training part in a fitness center. One hundred and nineteen long-term unemployed workers (53.7 ± 3 years) took part in a prospective investigation with 3 data collection points: before intervention (T1), after intervention (T2, n = 94), and 6 month after intervention (T3, n = 59). The spectrum of methods included the assessment of nutritional status, cardiovascular risk factors, physical fitness, chronic backache, and depression.

Results

As a result of the intervention, the physical fitness improved significantly (maximal oxygen uptake: p < 0.002). Cardiovascular risk factors like systolic and diastolic blood pressure (p < 0.016; p < 0.001) and percentage body fat (p < 0.017) decreased significantly. There were also remarkable effects in the reduction in depression (p < 0.028). Chronic backache was lowered in more than 50% of the cases.

Conclusion

The health promotion program reached people who have a desire to improve both physical and mental health. To assume responsibility for their own health may be a first step in regaining self-confidence and lowering the work placement barriers.     

Prevalence and associated factors of depressive symptoms among Chinese male correctional officers

Objectives

Chinese correctional officers (COs) consist of frontline COs in direct contact with the prisoners and non-frontline COs (including administrative staff and professionals). Male COs compose the majority of Chinese COs, especially for frontline COs. Although they are quite susceptible to depressive symptoms due to highly risky and stressful working environment, few studies focus on this issue. This study aimed to evaluate the prevalence of depressive symptoms and to explore its associated factors among Chinese male frontline and non-frontline COs.

Methods

This cross-sectional study was performed during the period of March/April 2011. The study population comprised of 1,900 male COs in four male prisons in a province of northeast China. A questionnaire including the Center for Epidemiological Studies Depression Scale, demographic factors, work conditions, effort–reward imbalance questionnaire was distributed to these COs. A total of 1,494 effective respondents became our subjects (981 frontline COs and 513 non-frontline COs). Frontline and non-frontline COs were analyzed separately.

Results

Approximately 61.4 % of Chinese male COs had depressive symptoms (63.5 % in frontline COs and 57.3 % in non-frontline COs). Multivariate logistic analyses showed that effort–reward ratio, overcommitment, chronic disease, and threat perception were associated with depressive symptoms in frontline and non-frontline COs, whereas weekly work time had an effect only in frontline COs.

Conclusions

Chinese male COs, especially frontline COs, might have high-level prevalence of depressive symptoms. Moreover, this study had identified important risk factors that might be important in planning strategies for prevention and intervention of depressive symptoms for Chinese male COs.     

Sick leave due to back pain in a cohort of young workers

Purpose

Evidence on risk factors for sick leave from prospective studies in work settings is limited. Furthermore, most available studies focused on workers with substantial low back disorders. These studies consistently report that physical work factors constitute a hindrance to work. However, it remains unclear whether the same risk factors are relevant in workers with less severe conditions or in early phases of the development of back pain. Therefore, this article aims to study risk factors for the occurrence of sick leave due to low back pain (LBP) among young workers with no or a modest history of back pain.

Methods

Participants were 716 young healthcare or distribution workers with no or minimal antecedents of LBP in the year before inclusion. We investigated the role of potential physical, psychosocial and individual risk factors at baseline on the occurrence of sick leave due to LBP 1 year later. To this purpose, we used Cox regression with a constant risk period.

Results

Six per cent (95 % CI 4.1–7.6) of the workers reported sick leave 1 year later; they accounted for 12 % of the sick-leave days independent of cause. A non-stimulating psychosocial work environment turned out to be the strongest risk factor for sick leave due to LBP (RR 6.08; 95 % CI 1.42–26.07). Physical factors were not predictive.

Conclusions

In the early phases of back pain and in less severe conditions, the main benefit of interventions lies in targeting the organisation and design of jobs to create a challenging professional environment.     

Exploring subgroup effects by socioeconomic position of three effective school-based dietary interventions: the European TEENAGE project

Objectives

The aim of this study was to explore subgroup effects by high and low socioeconomic position (SEP) of three previously conducted, effective European interventions.

Methods

Reanalyses stratified by SEP were conducted by the research groups of each study. All studies were school-based: two multi-component interventions targeting intake of fat or fruit and vegetables (FV), and a free breakfast initiative.

Results

Computer-tailored advice affected fat intake among low, but not high SEP girls after 1 year. A multi-component intervention affected the total FV intake in both SEP groups, vegetable intake in low SEP and fruit intake in high SEP across three countries after 1 year, whereas free fruit affected total FV and fruit intake equally in both SEP groups in one country after 2 years. Providing a free healthy breakfast increased consumption of healthy food items only in the low SEP group.

Conclusions

Reanalysing intervention studies by SEP is a quick and easy way to explore patterns in effects by SEP across interventions. Providing healthy food might be a promising strategy for decreasing social inequalities.     

Assessment of a prevention program for work-related stress among urban police officers

Objective

To determine the efficacy of a primary prevention program designed to improve psychobiological responses to stress among urban police officers.

Methods

A random sample of 37 police cadets received complementary training in psychological and technical techniques to reduce anxiety and enhance performance when facing a series of police critical incidents. Training was done by Special Forces officers, trained by the authors in imaging. A random sample of 38 cadets, receiving training as usual, was followed in parallel. Assessment of somatic and psychological health, and stress biomarkers, was done at baseline, immediately following training, and after 18 months as regular police officers. Comparison was done using two-way repeated analysis of variance (ANOVA) and logistic regression.

Results

The intervention group improved their general health and problem-based coping as compared to the control group. They also demonstrated lower levels of stomach problems, sleep difficulties, and exhaustion. Training was associated with an OR of 4.1 (95% CI, 1.3–13.7; p < 0.05) for improved GHQ scores during the study as compared to no changes or worsening score.

Conclusions

This first primary prevention study of high-risk professions demonstrates the validity and functional utility of the intervention. Beneficial effects lasted at least during the first 2 years on the police force. It is suggested that preventive imagery training in first responders might contribute to enhanced resiliency.     

Evaluation of an intervention using a self-regulatory counselling aid: pre- and post- intervention results of the OPTIMAHL 60plus study

Objectives

The study covers development and evaluation of an innovative counselling aid in an intervention study. The main purpose of the study was to establish whether improvements in nutrition and physical activity behaviour according to standard recommendations can be demonstrated.

Methods

OPTIMAHL 60plus is a quasi-experimental study in which participants were assigned in clusters to an intervention or control group. The study was conducted in low socio-economic-status districts in Bremen, Germany. 423 elderly participated at baseline and 369 after 3 months intervention. Face-to-face interviews (24-h recall and frequency questionnaire) were conducted at T0 and T1. χ ²-tests, sign-test and logistic regression were used for statistical analyses.

Results

No significant differences could be shown when comparing the intervention versus control group at T1. Significant changes from T0 to T1 in the intervention group were identified for daily fruit and vegetable (χ ²-test, p = 0.04), and for weekly fish consumption (χ ²-test, p = 0.04). However, similar results could also be shown for the control group.

Conclusions

A practical counselling aid for elderly was developed and evaluated. Changes in the health behaviour of elderly were identified, but effects could not be clearly traced to the intervention.     

Training Teachers to Build Resilience in Children in the Aftermath of War: A Cluster Randomized Trial

Background

There is growing interest in school-based interventions for building resilience in children facing trauma and adversity. Recent studies focus on teacher training as an effective way to enhance resilience in their students, and emphasize the need for additional evidence-based practice.

Objective

The aim of this study was to evaluate the effectiveness of a short-term resilience-building teacher intervention on reducing post-traumatic distress in students in the context of exposure to recurrent rocket attacks in Israel.

Methods

A quasi-experimental, cluster randomized design employing intervention and wait-list control groups was implemented with students from grades four-six (N = 563) in four schools in Acre in the aftermath of the Second Lebanon War. We assessed the students’ trauma exposure, posttraumatic symptoms and anxiety before and after the intervention or the wait-list condition.

Results

There was a significantly (p < 0.001) greater decrease of posttraumatic symptoms and anxiety levels among the students whose teachers participated in the intervention group as compared to students whose teachers were in the wait-list control group. A multiple regression model showed that this greater decrease in posttraumatic symptoms and anxiety levels was statistically significant after controlling for demographic variables, trauma exposure and past trauma history.

Conclusion

The results of this study show that the training of teachers alone in building resilience can effectively lower post-traumatic distress and anxiety in their students. The empowerment of teachers and by building upon their expertise and experience are crucial for creating sustainability in school-based interventions.     

A randomised controlled trial of a school-based intervention to prevent tobacco use among children and adolescents in Italy

Aim

A randomised field trial was conducted to evaluate a school-based programme to prevent tobacco use in children and adolescents.

Subject and methods

The trial included 534 children and 308 adolescents who were randomly selected to receive or not to receive the prevention programme. The prevention programme included: (a) health facts and the effect of smoking, (b) analysis of the mechanisms underlying intiation of smoking and (c) refusal skills training to deal with the social pressures to smoke. A questionnaire was administered before the intervention programme and 2 years later.

Results

The prevalence rates of smoking in both groups of children and adolescents were increased at the end of the study. Anyway, the difference of smoking prevalence between the intervention and control groups was statistically significant only for the children’s group (from 18.3 to 18.8% for the intervention group and from 17.8 to 26.9% in the control group) (p?=?0.035). As regards reasons that induced the start of smoking, there was a significant increase of the issue “because smokers are fools” (p?=?0.004 for children; p?<?0.001 for adolescents) and “because smokers are irresponsible” (p?≤?0.001 for both children and adolescents) in the experimental groups.

Conclusion

The results suggest that a school-based intervention programme addressing tobacco use among children and adolescents, based on the development of cognitive and behavioural aspects, can be effective. After 1 year of intervention, smoking prevalence was significantly lower in children belonging to the intervention group than in children not randomised to intervention. Targeting young children before they begin to smoke can be a successful way of prevention.     

The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers

Objectives

To investigate the effect of a change in second-hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced.

Methods

HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3–12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine-specific badge and expressed as inhaled cigarette equivalents per day (CE/d).

Results

PWV and HRV parameters significantly changed in a dose-dependent manner in the intervention group as compared to the control group. A one CE/d decrease was associated with a 2.3 % (95 % CI 0.2–4.4; p = 0.031) higher root mean square of successive differences (RMSSD), a 5.7 % (95 % CI 0.9–10.2; p = 0.02) higher high-frequency component and a 0.72 % (95 % CI 0.40–1.05; p < 0.001) lower PWV.

Conclusions

PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk.     

The impact of common mental disorders on work ability in mentally and physically demanding construction work

Purpose

To gain insight into (1) the prevalence and incidence of common mental disorders (CMD) and low work ability among bricklayers and construction supervisors; (2) the impact of CMD on current work ability and work ability 1 year later and (3) the added value of job-specific questions about work ability for detecting signs of low work ability.

Methods

We randomly selected 750 bricklayers and 750 supervisors. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire 1 year later. Work ability was measured with the first three questions of the Work Ability Index and job-specific questions. Self-reported CMD were measured with instruments designed to detect a high need for recovery after work, distress and depression. We used univariate logistic regression to analyse the presence or absence of CMD as independent variable.

Results

The prevalence and incidence of CMD among 199 bricklayers and 224 supervisors was 22 %/10 % and 32 %/15 %, respectively. The prevalence of low general work ability was comparable for both occupations (5 %). CMD were associated with low current work ability and low work ability at follow-up (ORs 4.3–22.4), but not with a reduction in work ability 1 year later. Questions on job-specific work ability resulted in more indications of low work ability among both occupations than did questions on general work ability.

Conclusions

Regardless of occupation, workers who report CMD at baseline have a high likelihood of current low work ability and low work ability 1 year later.     

The effect of Tai Chi on health-related quality of life in people with elevated blood glucose or diabetes: a randomized controlled trial

Purpose

The aim was to assess the effects of a Tai Chi–based program on health-related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control.

Method

41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical-care control group (N = 21). The Tai Chi group involved 3 × 1.5 h supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention.

Results

There were significant improvements in favor of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95 % CI = 1.35–9.57, P < 0.05), role physical (mean difference = 18.60, 95 % CI = 2.16–35.05, P < 0.05), bodily pain (mean difference = 9.88, 95 % CI = 2.06–17.69, P < 0.05) and vitality (mean difference = 9.96, 95 % CI = 0.77–19.15, P < 0.05).

Conclusions

The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.     

Anxiety and Response to Reading Intervention among First Grade Students

Background

For school-aged children with reading difficulties, an emerging and important area of investigation concerns determining predictors of intervention response. Previous studies have focused exclusively on cognitive and broadly defined behavioral variables. What has been missing, however, are studies examining anxiety, which is among the most commonly experienced difficulty for youth.

Objective

The present study examined anxiety among children classified as typically achieving or showing inadequate/adequate response following an intervention for reading problems.

Methods

Participants were 153 ethnically-diverse children (84 male, 69 female) evaluated in the winter and spring of their first-grade academic year. Children completed several standardized measures of reading achievement involving decoding and fluency along with a multidimensional anxiety rating scale.

Results

Repeated measures ANOVA revealed significant main effects for time and scale and significant interactions for time × scale and group × scale. Logistic regression examined whether anxiety predicted response to intervention (Y/N) at the end of the school-year.

Conclusions

Results showed overall decreases in anxiety over time, with the exception of the harm avoidance area which increased and also interacted with group (children with decoding/fluency difficulties reported less harm avoidance than typically achieving children). The harm avoidance area was most pertinent across analyses highlighting the potential importance of targeting this area; however, none of the anxiety scales predicted response group at the end of the intervention. Ongoing research is needed in this area in order to identify characteristics of inadequate responders to reading intervention programs and/or inform interventions that incorporate these socioemotional factors.     

Adherence to Mediterranean diet and close dietetic supervision increase total dietary antioxidant intake and plasma antioxidant capacity in subjects with abdominal obesity

Purpose

To determine the effect of Mediterranean-type diet and close dietetic supervision on dietary antioxidant intake and plasma total antioxidant capacity (TAC) in patients with abdominal obesity.

Methods

Ninety subjects with abdominal obesity, 46 in intervention group, 44 in control group, participated in a 2-month, randomized, parallel dietary intervention. All participants were counseled on Greek Mediterranean diet. The intervention group was under close dietetic supervision, followed a specific relevant daily and weekly food plan consuming antioxidant-rich foods and food products. Total dietary antioxidant intake was calculated from the volunteers’ food diaries, and plasma TAC using plasma ORAC assay and plasma ferric-reducing antioxidant power (FRAP) assay, both at baseline and at 2 months.

Results

Following the 2-month period, total dietary antioxidant intake was increased in the intervention group compared to the control group (P = 0.000). In addition, increased intake of total fat, due to higher consumption of monounsaturated fatty acids, as well as increased intakes of dietary fiber, vitamin C and alcohol was also observed in the intervention group compared to the control group (P < 0.05). Plasma TAC was increased in the intervention group compared to the control group (P = 0.039) using the ORAC assay, while there was a trend toward a TAC increase (P = 0.077) using the FRAP assay.

Conclusion

Adherence to a Mediterranean-type diet, with emphasis on an increase in foods rich in antioxidants and close dietetic supervision, can increase total dietary antioxidant intake and plasma TAC in patients with abdominal obesity.     

Wissenschaftliche Begleitung, formative Evaluation und partizipative Forschung

Background

In Germany, a line of concomitant research evolved that combines elements of participatory research with evaluation needs of a program. Yet, methodological differences remain and influence the academic-community partnership.

Methods

Through a mixed methods approach, the case was reconstructed based on a documentary analysis, participatory observation and a survey with participants at baseline and follow-up, 21 month later.

Results

The case with the most difficult context factors profited least from the intervention. Analyses from the three perspectives lead to divergent interpretations of the causes. Most likely the amendable results were significantly influenced by power imbalances in the academic-community partnership.

Conclusion

More critical attention needs to be paid to the partnership’s dynamics. A stronger particatory perspective as well as critical self-reflection and peer intervision are recommended to foster an open dialogue of the partnership.     

Prevalence of respiratory symptoms and disorders among rice mill workers in India

Objectives

Lung function tests have become an integral part of assessment of pulmonary disease. Diseases of the respiratory system induced by occupational dusts are influenced by the duration of exposure. The aim of the study is to investigate the impairment of lung function and prevalence of respiratory symptoms among the rice mill workers.

Methods

A total of 120 rice mill workers from three districts of Karnataka were included in this study. Fifty urban dwellers from the same socio-economic level were selected as controls. The study included clinical examination, assessment of respiratory symptoms, pulmonary function test, measurement of peak expiratory flow rate, absolute eosinophil count, ESR estimation, total IgE estimation and radiographic test.

Results

The present study has shown that the rice mill workers complained of several types of respiratory disorders like phlegm (40.8 %), dyspnea (44.2 %), chest tightness (26.7 %), cough (21.7 %), and nose irritation (27.5 %). Rice mill workers exposed to dust presented significantly (p < 0.05) lower levels of FVC (3.44 ± 0.11), FEV₁ (2.73 ± 0.15) and PEFR (304.95 ± 28.79) than the controls. The rice mill workers are having significantly higher absolute eosinophil counts, total IgE and ESR than control groups. The hematological findings suggest that the harmful effects may be linked to both non-specific irritation and allergic responses to rice husk dust among rice mill workers.

Conclusion

Dust exposure in the working environment affects the lung function values and increased the respiratory symptoms among the rice mill workers.     

Antioxidant status of elite athletes remains impaired 2 weeks after a simulated altitude training camp

Background

It has been shown that the antioxidant status was altered by the “live high-train low” (LHTL) method, however, no information is available regarding the antioxidant restoration during the recovery period.

Aim of the study

We tested the hypothesis that the antioxidant status is impaired by 18 days LHTL in elite athletes and remained altered after 14 days of recovery.

Methods

Eleven elite cross-country skiers from the French Skiing Federation were submitted to 18-day endurance training. Six (hypoxic group; HG) trained at 1,200 m and lived in hypoxia (simulated altitude of 2,500 m–3,000 m–3,500 m) and 5 (control group; CG) trained and lived at 1,200 m. Plasma levels of advanced oxidation protein products (AOPP), malondialdehydes (MDA), ferric reducing antioxidant power (FRAP), trolox equivalent antioxidant capacity (TEAC) lipid-soluble antioxidants (α-tocopherol, β-carotene and lycopene) were measured at rest, before (PRE), the first day after (POST1) and again 2 weeks (POST14) after the training. Intakes of vitamins A and E were evaluated from the dietary recording.

Results

In POST1, FRAP and TEAC decreased in both groups, however, the TEAC decrease persisted in POST14 for HG only. Lycopene and β-carotene decreased in POST1 for HG and remained lower in POST14. Finally, AOPP increased only for HG in POST1. The general decline of antioxidant status for both groups might result from insufficient intakes in vitamins A and E.

Conclusion

This is the first study to show that the antioxidant status did not return to baseline 2 weeks after 18 days of LHTL training.     

Health behavior change among breast cancer patients

Objectives

Changes in health behavior among women with breast cancer with respect to food intake, exercise and smoking habits are considered. We aimed to analyze (1) significant modifications of these behaviors about a year after breast cancer surgery and (2) the impact of social, medical and behavioral patient characteristics on these changes.

Methods

Data were derived from a longitudinal study of 229 women (age < 70) in Germany with a first manifestation of breast cancer. Food intake, physical activity and smoking were assessed by means of personal interviews immediately after surgery (T0) and 14 months later (T1).

Results

The intake of fruits and vegetables and physical exercise increased significantly over the observation period. Socio-demographic and medical parameters were largely irrelevant for behavioral changes while smoking status turned out as most important for changes in daily fruit consumption.

Conclusions

The results demonstrate that breast cancer patients change their lifestyle habits in a significant way even without intervention. Patients who smoke are in particular need of professional support to implement health-promoting behavior, and intervention should especially focus on this group.