UMB/DFHCC Comprehensive Cancer Partnership Program

Summary

Principal Investigator: Karen Emmons
Abstract: DESCRIPTION Overweight and obesity disproportionately affect racial and ethnic minority and lower income populations, particularly women. An accumulating body of scientific evidence indicates that obesity, sedentary lifestyles, and unhealthy dietary patterns may significantly increase the risk of several major cancer types. Unfortunately however, the efficacy of weight management programs in diverse sociodemographic groups has been mixed. Accumulating scientific evidence demonstrates that electronic health promotion strategies (e-health) may be effective in assisting individuals to make dietary and PA change. While the literature on e-health technologies has blossomed in recent years, comparatively little empirical attention has been directed to the feasibility of utilizing such technologies to promote healthy weight-control behaviors among sociodemographically-diverse women. E-health tools however, can be adapted to meet the specific literacy, cultural, and logistical needs of these populations. What remains unclear however is the extent to which interpersonal assistance (e.g. coaching) is necessary to realize the maximum amount of ehealth system utilization in the target population. This study is a three-year investigation designed to demonstrate the feasibility of designing and implementing an interactive electronic diet and PA monitoring and feedback system (eSolutions) to be implemented in an urban community recreation center. Study procedures will occur in two phases. In Phase 1, we propose to conduct formative research, design the eSolutions system in an iterative software development process, and conduct usability testing of the system among the target population. In Phase 2, we propose to test the feasibility of implementing the tool among approximately 60 overweight adult women in an urban YMCA branch. Participants will be randomly assigned to one of two experimental conditions: 1) self-paced use of the eSolutions system, or;2) a combined program consisting of eSolutions plus a 12-week coached intervention (eSolutions-Plus). We will examine short term outcomes at the end of this 12 week initial phase. Following the initial phase, participants in both conditions will be asked to utilize the eSolutions for an additional 12-week self-paced maintenance phase. During the maintenance phase, half of the participants in both conditions will be randomly assigned to receive monthly telephone calls to remind them to utilize eSolutions and troubleshoot any system difficulties. Assessments (including self-report survey, anthropometric measurements, and the retrieval of eSolutions system data) will be conducted at baseline, 12-, and 24-weeks post-baseline. Primary outcomes will include measures of sustained eSolutions system utilization. Secondary outcomes will include improvement in dietary practices, PA and weight-loss. This study will demonstrate the feasibility of the eSolutions system and will further provide estimates of effect size that will be used to plan a future randomized controlled trial to test this intervention among YMCAs in Massachusetts. This pilot study also provides a basis for demonstrating additional evidence of successful collaboration between the DF/HCC and UMB and will facilitate our ongoing partnership with the network of Massachusetts YMCAs. A. SPECIFIC AIMS This study responds to an urgent need to develop, test, and implement cancer prevention interventions for physical activity (PA) promotion and weight management, particularly among ethnically diverse and low-income populations.', 2 We hypothesize that electronic health promotion (e-health) strategies may be effectively implemented in weight management interventions conducted among underserved populations. However, an outstanding question concerns whether the provision of interpersonal support is necessary for members of low income and ethnically diverse populations to realize the full benefits of e-health weight management systems. This issue may impact not only program efficacy, but also the potential for sustainability. Thus, the primary aim of the proposed study is to determine the feasibility of developing and implementing an interactive electronic diet and PA monitoring and feedback system (eSolutions) to promote improvements in diet, PA, and weight loss among a lower income, ethnically-diverse population attending an urban community recreation center. Our specific aims are: 1. To develop eSolutions, an interactive electronic diet and PA monitoring and feedback system for sociodemographically-diverse, low literacy audiences. 1.1. To evaluate the usability of eSolutions among members of the target population. 2. To determine whether there are differential levels of sustained system utilization between two experimental groups: 1) those using eSolutions in a self-paced fashion, compared to 2) those receiving a combined program consisting of eSolutions plus a 12-week coached weight loss intervention (eSolutions-Plus). 2.1. To determine whether monthly telephone support calls (after week 12 of the protocol) promote longer-term eSolutions system utilization. 3. To estimate the extent to which participants receiving e Solutions-Plus have greater shorter and longer-term improvements in diet, PA, and weight loss compared to those receiving eSolutions alone. 3.1 To estimate whether the greatest longer-term improvements (at 96 weeks) in diet, PA, and weight loss/maintenance are found among eSolutions-Plus participants receiving monthly telephone support calls (after week 12 of the protocol).
Funding Period: 2009-09-30 - 2011-09-29
more information: NIH RePORT

Top Publications

  1. pmc Communication in end-stage cancer: review of the literature and future research
    ELIZABETH D TRICE
    Center for Psycho Oncology and Palliative Care Research, Dana Farber Cancer Institute, Boston, Massachusetts 02114, USA
    J Health Commun 14:95-108. 2009
  2. pmc Racial differences in predictors of intensive end-of-life care in patients with advanced cancer
    Elizabeth Trice Loggers
    Department of MedicalOncology, Center for Psycho Oncology and Palliative Care Research, Dana Farber Cancer Institute Boston, MA 02114, USA
    J Clin Oncol 27:5559-64. 2009
  3. pmc Anxiety disorders in advanced cancer patients: correlates and predictors of end-of-life outcomes
    Ryan Spencer
    Department of Obstetrics, Gynecology, and Reproductive Medicine, Brigham and Women s Hospital, Boston, Massachusetts
    Cancer 116:1810-9. 2010
  4. ncbi Training community health workers about cancer clinical trials
    Lidia Schapira
    Massachusetts General Hospital, Boston, MA 02214, USA
    J Immigr Minor Health 13:891-8. 2011
  5. ncbi Health beliefs, attitudes and service utilization among Haitians
    Jennifer D Allen
    Center for Community Based Research, Dana Farber Cancer Institute, Boston, MA 02215, USA
    J Health Care Poor Underserved 24:106-19. 2013
  6. ncbi Time availability and preference for e-health communication channels for nutrition and physical activity
    Lisa M Quintiliani
    Boston University, Boston, MA 02118, USA
    J Cancer Educ 28:408-11. 2013
  7. pmc Predictors of intensive end-of-life and hospice care in Latino and white advanced cancer patients
    Elizabeth T Loggers
    1 Group Health Research Institute, Group Health Co operative, Seattle, Washington
    J Palliat Med 16:1249-54. 2013
  8. pmc A pilot test of a church-based intervention to promote multiple cancer-screening behaviors among Latinas
    Jennifer D Allen
    Dana Farber Cancer Institute, Boston, MA, USA
    J Cancer Educ 29:136-43. 2014

Detail Information

Publications8

  1. pmc Communication in end-stage cancer: review of the literature and future research
    ELIZABETH D TRICE
    Center for Psycho Oncology and Palliative Care Research, Dana Farber Cancer Institute, Boston, Massachusetts 02114, USA
    J Health Commun 14:95-108. 2009
    ..We review the pertinent literature and discuss areas for future research...
  2. pmc Racial differences in predictors of intensive end-of-life care in patients with advanced cancer
    Elizabeth Trice Loggers
    Department of MedicalOncology, Center for Psycho Oncology and Palliative Care Research, Dana Farber Cancer Institute Boston, MA 02114, USA
    J Clin Oncol 27:5559-64. 2009
    ..Black patients are more likely than white patients to receive life-prolonging care near death. This study examined predictors of intensive end-of-life (EOL) care for black and white advanced cancer patients...
  3. pmc Anxiety disorders in advanced cancer patients: correlates and predictors of end-of-life outcomes
    Ryan Spencer
    Department of Obstetrics, Gynecology, and Reproductive Medicine, Brigham and Women s Hospital, Boston, Massachusetts
    Cancer 116:1810-9. 2010
    ..The authors explored associations between anxiety disorders and advanced cancer patients' physical performance status, physician-patient relationships, end-of-life (EOL) treatment preferences and outcomes, and quality of death...
  4. ncbi Training community health workers about cancer clinical trials
    Lidia Schapira
    Massachusetts General Hospital, Boston, MA 02214, USA
    J Immigr Minor Health 13:891-8. 2011
    ..Further research is needed to identify the impact of this training on accrual to cancer clinical trials...
  5. ncbi Health beliefs, attitudes and service utilization among Haitians
    Jennifer D Allen
    Center for Community Based Research, Dana Farber Cancer Institute, Boston, MA 02215, USA
    J Health Care Poor Underserved 24:106-19. 2013
    ..Leveraging positive cultural traditions and existing communication networks could increase the impact of Haitian health initiatives...
  6. ncbi Time availability and preference for e-health communication channels for nutrition and physical activity
    Lisa M Quintiliani
    Boston University, Boston, MA 02118, USA
    J Cancer Educ 28:408-11. 2013
    ..05). Our study suggests that time availability may be another important factor to consider when planning cancer prevention programs...
  7. pmc Predictors of intensive end-of-life and hospice care in Latino and white advanced cancer patients
    Elizabeth T Loggers
    1 Group Health Research Institute, Group Health Co operative, Seattle, Washington
    J Palliat Med 16:1249-54. 2013
    ..The role of end-of-life (EOL) care preferences and conversations in receipt of care near death for Latinos is unclear...
  8. pmc A pilot test of a church-based intervention to promote multiple cancer-screening behaviors among Latinas
    Jennifer D Allen
    Dana Farber Cancer Institute, Boston, MA, USA
    J Cancer Educ 29:136-43. 2014
    ..Fourteen percent also reported receiving help from the PN in finding a primary care provider. This study supports the feasibility and acceptability of churches as a setting to promote cancer screening among Latinas...