Provider Counseling about health behaviors among cancer survivors in the United States
ABSTRACT To examine provider discussion or counseling of US cancer survivors about diet, exercise, and tobacco use.
We used 2000 National Health Interview Survey data to examine whether US cancer survivors reported that, within 1 year, a provider (1) discussed diet, (2) recommended they begin or continue exercise, or (3) asked about smoking. We included survivors more than 1 year beyond diagnosis (n = 1,600) and adults without cancer (AWCs; n = 24,636) who saw/talked to a provider within 1 year. We used generalized linear contrasts in bivariable analyses and logistic regression to calculate predicted marginals adjusted for age, sex, comorbidity, usual source of care, and number of provider visits in the prior year.
Few survivors reported discussions or recommendations for all three health behaviors (10% of survivors v 9% of AWCs; P = .57). Although report was more likely than among AWCs, few survivors reported diet discussions (30% of survivors v 23% of AWCs; P < .0001) or exercise recommendations (26% of survivors v 23% of AWCs; P < .005), and a minority were asked about smoking (42% of survivors v 41% of AWCs; P = .41). After adjustment, survivors were less likely to report exercise recommendations than were AWCs (22% v 24%, respectively; P = .02). Colorectal cancer survivors were less likely than were AWCs of similar age range to report exercise recommendations (16% v 27%, respectively; P < .003) or smoking discussions (31% v 41%, respectively; P < .05). Cervical cancer survivors were more likely than AWCs of similar age range to discuss smoking (58% v 43%, respectively; P < .001).
Findings from this nationally representative sample suggest that many providers may miss opportunities to counsel survivors about healthy behaviors, perhaps particularly colorectal cancer survivors.
- SourceAvailable from: Sarah Arvey
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- "In this study, knowledge about how to reduce cancer risk was significantly associated with five out of six positive health behaviors. Recent surveys have found that 65% of survivors endorse unmet information needs related to health promotion (Kent et al., 2012) and rarely report receiving recommendations about health behaviors from their clinical providers (Sabatino et al., 2007), suggesting room for improvement in survivor education about how to reduce cancer risk. Increased delivery of comprehensive survivorship care plans, which are recommended to include guidelines for healthy lifestyle and for cancer screenings (Hewitt et al., 2005; Rechis, Beckjord, Arvey, Reynolds, & Goldrick, 2012), are intended to address some of these gaps in survivor knowledge and increase patient selfefficacy to make the positive health changes most essential to their long term well-being. "
ABSTRACT: Abstract Positive health-promoting behaviors, including both lifestyle factors (e.g., physical activity) and appropriate health service utilization (e.g., screening for secondary cancers), can minimize the health risks and challenges facing cancer survivors. The goal of this paper is to examine factors associated with positive health behaviors in 2615 post-treatment cancer survivors who completed the 2010 LIVESTRONG survey. Multivariate logistic regression was used model odds of reporting each of six positive health behaviors "as a result of your experience with cancer": three 'healthy lifestyle' behaviors and three 'health care utilization' behaviors. In fully-adjusted models, factors associated with greater likelihood of engaging in positive lifestyle behaviors (e.g., physical activity, changing diet) included sociodemographic factors, greater knowledge about how to reduce cancer risk; and reporting more psychological benefits due to cancer (ps < .01). Factors associated with greater likelihood of attending medical appointments and obtaining recommended cancer screenings included older age, better patient-provider communication, greater knowledge about how to reduce cancer risk, and more psychological benefits of cancer (ps <.01). Results suggest that knowledge about how to prevent cancer and benefit-finding after cancer are related to positive health behaviors broadly, whereas better patient-provider communication is associated with positive cancer screening and health care utilization but not healthy lifestyle behaviors. Clinical interventions targeting these modifiable factors could maximize positive health behavior changes among cancer survivors, affecting risk for cancer recurrence as well as overall health and well-being.Journal of Psychosocial Oncology 08/2014; 32(6). DOI:10.1080/07347332.2014.955243 · 1.04 Impact Factor
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ABSTRACT: Physical activity may play an important role in the rehabilitation of cancer survivors during and after treatment. Current research suggests that numerous beneficial outcomes are experienced in cancer survivors undergoing exercise interventions during or after cancer treatment. Exercise not only plays a role in managing side effects but also improves functional capacity and quality of life. The purpose of this article is to provide an overview of the oncology literature supporting the use of exercise as an effective intervention for improving cancer-related fatigue, other side effects, functional capacity, and quality of life among cancer survivors.Current Sports Medicine Reports 01/2009; 8(6):325-30. DOI:10.1249/JSR.0b013e3181c22324 · 1.60 Impact Factor