Dataset Information

A randomized feasibility trial of brief telephone counseling to increase fruit and vegetable intakes.

ABSTRACT:

Objective

This study examined the feasibility of eliciting dietary changes in subjects recruited from a diverse primary care setting in Michigan using a written, one-page plan, either alone or with telephone counseling.

Methods

A total of 96 subjects were enrolled from 9/28/06 to 5/7/07 (49% minorities). Subjects were randomized into three groups. Group 1 received written materials. Group 2 received written materials plus a one-page form that asked them to make a specific daily plan for substituting one less nutritious food with two servings of fruits and vegetables. Group 3 received the written materials, the one-page form and telephone counseling from a dietitian.

Results

Subject retention was 76% for the 12-week study. Subjects in Groups 1, 2 and 3 changed their mean intakes of fruit and vegetables by 0.4, -0.7 and 1.4 servings/day, respectively. Participants in Group 3 lost an average of 0.73 kg, increased their perception of the importance of eating fruits and vegetables, and 63% increased their serum levels of carotenoids by 20% or more.

Conclusion

Recruitment through a primary care clinic was effective. Formulation of a written plan combined with telephone counseling appears to be promising for improving fruit and vegetable intakes and warrants more definitive study.

SUBMITTER: Djuric Z

PROVIDER: S-EPMC2904076 | biostudies-literature | 2010 May-Jun

REPOSITORIES: biostudies-literature

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Publications

A randomized feasibility trial of brief telephone counseling to increase fruit and vegetable intakes.

Djuric Zora Z Ellsworth Jennifer S JS Ren Jianwei J Sen Ananda A Ruffin Mack T MT

Preventive medicine 20100311 5-6

<h4>Objective</h4>This study examined the feasibility of eliciting dietary changes in subjects recruited from a diverse primary care setting in Michigan using a written, one-page plan, either alone or with telephone counseling.<h4>Methods</h4>A total of 96 subjects were enrolled from 9/28/06 to 5/7/07 (49% minorities). Subjects were randomized into three groups. Group 1 received written materials. Group 2 received written materials plus a one-page form that asked them to make a specific daily pl ...[more]

PMID: 20226809

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Project description:BackgroundLaboratory studies indicate that chemicals in fruits and vegetables have anti-carcinogenic and anti-inflammatory activities that can lower breast cancer risk. However, epidemiologic studies of the association between fruit and vegetable intake and breast cancer risk have produced mixed results. Measurement error, confounding, and an emphasis on diet in later adulthood may contribute to weak associations. This paper describes a randomized controlled diet intervention trial in breastfeeding women to examine the effect of high fruit and vegetable intake on breast cancer risk factors, including weight, DNA methylation and inflammatory markers.MethodsEligible breastfeeding women who reside within a 35-mile radius of Amherst, MA are enrolled at five to six weeks postpartum and randomly assigned to a Fruit and Vegetable Intervention Arm (target n = 200) or to a USDA MyPlate Control Arm (target n = 200). The Fruit and Vegetable Intervention group receives weekly telephone or video-based counseling to encourage intake of at least eight to ten daily servings of fruits and vegetables and a weekly delivery of a supplemental box of fruits and vegetables for 20 weeks, and less intensive counseling for up to one year. Breastmilk and infant fecal specimens are collected at baseline, 10 and 20 weeks. Anthropometric measurements are obtained at these timepoints and at the 1-year follow-up. The primary outcomes are change in DNA methylation in breast epithelial cells and change in inflammatory markers in breastmilk from randomization to 20 weeks; and change in weight, waist circumference, and fruit and vegetable intake for the period from randomization to 20 weeks and 1 year.DiscussionThis 1-year randomized diet intervention trial in breastfeeding women will assess whether intake of at least eight to ten daily servings of fruits and vegetables per day improves biomarkers of breast cancer risk directly in the breast (i.e., DNA methylation and inflammatory markers) and helps women maintain a healthy weight.Trial registrationClinicalTrials.gov Identifier: NCT04374747. Registered May 5, 2020. https://www.Clinicaltrialsgov/ct2/show/NCT04374747 .

Project description:PurposeThe ongoing integration of cancer genomic testing into routine clinical care has led to increased demand for cancer genetic services. To meet this demand, there is an urgent need to enhance the accessibility and reach of such services, while ensuring comparable care delivery outcomes. This randomized trial compared 1-year outcomes for telephone genetic counseling with in-person counseling among women at risk of hereditary breast and/or ovarian cancer living in geographically diverse areas.Patients and methodsUsing population-based sampling, women at increased risk of hereditary breast and/or ovarian cancer were randomly assigned to in-person (n = 495) or telephone genetic counseling (n = 493). One-sided 97.5% CIs were used to estimate the noninferiority effects of telephone counseling on 1-year psychosocial, decision-making, and quality-of-life outcomes. Differences in test-uptake proportions for determining equivalency of a 10% prespecified margin were evaluated by 95% CIs.ResultsAt the 1-year follow-up, telephone counseling was noninferior to in-person counseling for all psychosocial and informed decision-making outcomes: anxiety (difference [d], 0.08; upper bound 97.5% CI, 0.45), cancer-specific distress (d, 0.66; upper bound 97.5% CI, 2.28), perceived personal control (d, -0.01; lower bound 97.5% CI, -0.06), and decisional conflict (d, -0.12; upper bound 97.5% CI, 2.03). Test uptake was lower for telephone counseling (27.9%) than in-person counseling (37.3%), with the difference of 9.4% (95% CI, 2.2% to 16.8%). Uptake was appreciably higher for rural compared with urban dwellers in both counseling arms.ConclusionAlthough telephone counseling led to lower testing uptake, our findings suggest that telephone counseling can be effectively used to increase reach and access without long-term adverse psychosocial consequences. Further work is needed to determine long-term adherence to risk management guidelines and effective strategies to boost utilization of primary and secondary preventive strategies.

Project description:BACKGROUND:As adults age, their physical activity decreases and sedentary behavior increases, leading to increased risk of negative health outcomes. Wearable electronic activity monitors have shown promise for delivering effective behavior change techniques. However, little is known about the feasibility and acceptability of non-Fitbit wearables (Fitbit, Inc, San Francisco, California) combined with telephone counseling among adults aged more than 55 years. OBJECTIVE:The purpose of our study was to determine the feasibility, acceptability, and effect on physical activity of an intervention combining a wearable physical activity monitor, tablet device, and telephone counseling among adults aged 55-79 years. METHODS:Adults (N=40, aged 55-79 years, body mass index=25-35, <60 min of activity per week) were randomized to receive a 12-week intervention or to a wait list control. Intervention participants received a Jawbone Up24 monitor, a tablet with the Jawbone Up app installed, and brief weekly telephone counseling. Participants set daily and weekly step goals and used the monitor's idle alert to notify them when they were sedentary for more than 1 h. Interventionists provided brief counseling once per week by telephone. Feasibility was measured using observation and study records, and acceptability was measured by self-report using validated items. Physical activity and sedentary time were measured using ActivPAL monitors following standard protocols. Body composition was measured using dual-energy x-ray absorptiometry scans, and fitness was measured using a 6-min walk test. RESULTS:Participants were 61.48 years old (SD 5.60), 85% (34/40) female, 65% (26/40) white. Average activity monitor wear time was 81.85 (SD 3.73) of 90 days. Of the 20 Up24 monitors, 5 were reported broken and 1 lost. No related adverse events were reported. Acceptability items were rated at least 4 on a scale of 1-5. Effect sizes for most outcomes were small, including stepping time per day (d=0.35), steps per day (d=0.26), sitting time per day (d=0.21), body fat (d=0.17), and weight (d=0.33). CONCLUSIONS:The intervention was feasible and acceptable in this population. Effect sizes were similar to the sizes found using other wearable electronic activity monitors, indicating that when combined with telephone counseling, wearable activity monitors are a potentially effective tool for increasing physical activity and decreasing sedentary behavior. TRIAL REGISTRATION:Clinicaltrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348 (Archived by WebCite at http://www.webcitation.org/6odlIolqy).

Dataset Information

A randomized feasibility trial of brief telephone counseling to increase fruit and vegetable intakes.

Objective

Methods

Results

Conclusion

Publications

A randomized feasibility trial of brief telephone counseling to increase fruit and vegetable intakes.

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