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Elizabeth G Eakin - One of the best experts on this subject based on the ideXlab platform.
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moderators of health behavior initiation and maintenance in a randomized Telephone Counseling trial
Preventive Medicine, 2014Co-Authors: Sheleigh Lawler, Marina M Reeves, Elisabeth A H Winkler, Ana D Goode, Brianna S Fjeldsoe, Elizabeth G EakinAbstract:Abstract Objective This study compares moderators of initiation and maintenance of health behavior changes. Methods Data come from a cluster-randomized, 12-month Telephone Counseling intervention for physical activity and diet, targeting type 2 diabetes or hypertension patients (n = 434, Australia,2005–2007). Demographic and health-related characteristics, theoretical constructs, and baseline behavioral outcomes were considered as moderators. Mixed models, adjusting for baseline values, assessed moderation of intervention effects for trial outcomes (physical activity, intakes of fat, saturated fat, fiber, fruit, vegetables) at end-of-intervention (12 months/initiation) and maintenance follow-up (18 months), and compared moderation between these periods. Results Social support for physical activity and baseline physical activity were significant (p Conclusions This exploratory study showed that moderation of physical activity and diet effects sometimes differed between initiation and maintenance. To identify unique moderators for initiation and/or maintenance of behavior changes, future studies need to report on and statistically test for such differences.
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Multiple Health Behavior Changes and Co-variation in a Telephone Counseling Trial
Annals of Behavioral Medicine, 2010Co-Authors: Sheleigh P. Lawler, Marina M Reeves, Nicholas Graves, Elizabeth Winkler, Neville Owen, Elizabeth G EakinAbstract:Background Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Purpose Within a 12-month, Telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. Methods A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive Telephone Counseling or usual care. Results Those receiving Telephone Counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. Conclusions For patients with chronic conditions, Telephone Counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.
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multiple health behavior changes and co variation in a Telephone Counseling trial
Annals of Behavioral Medicine, 2010Co-Authors: Sheleigh Lawler, Marina M Reeves, Nicholas Graves, Elizabeth Winkler, Neville Owen, Elizabeth G EakinAbstract:Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Within a 12-month, Telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive Telephone Counseling or usual care. Those receiving Telephone Counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. For patients with chronic conditions, Telephone Counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.
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Telephone Counseling for physical activity and diet in primary care patients
American Journal of Preventive Medicine, 2009Co-Authors: Elizabeth G Eakin, Marina M Reeves, Shaleigh P Lawler, Nicholas Graves, Brian Oldenburg, Chris Del Mar, Ken Wilke, Elizabeth Winkler, Adrian G BarnettAbstract:Background The delivery of effective interventions to assist patients to improve their physical activity and dietary behaviors is a challenge in the busy primary care setting. Design Cluster RCT with practices randomized to Telephone Counseling intervention or usual care. Data collection took place from February 2005 to November 2007, with analysis from December 2007 to April 2008. Setting/participants Four-hundred thirty-four adult patients with type 2 diabetes or hypertension (mean age=58.2 [SD=11.8]; 61% female; mean BMI=31.1 [SD=6.8]) from a disadvantaged community were recruited from ten primary care practices. Intervention Twelve-month Telephone Counseling intervention. Main outcome measures Physical activity and dietary intake were assessed by self-report at baseline, 4, and 12 months. Results At 12 months, patients in both groups increased moderate-to-vigorous physical activity by a mean of 78 minutes per week (SE=10). Significant intervention effects (Telephone Counseling minus usual care) were observed for: calories from total fat (decrease of 1.17%; p Conclusions The study targeted a challenging primary care patient sample and, using a Telephone-delivered intervention, demonstrated modest improvements in diet and in physical activity. Results suggest that Telephone Counseling is a feasible means of delivering lifestyle intervention to primary care patients with chronic conditions—patients whose need for ongoing support for lifestyle change is often beyond the capacity of primary healthcare practitioners. Trial registration Australian Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, www.anzctr.org.au/default.aspx , ACTRN012607000195459.
Suzanne M Miller - One of the best experts on this subject based on the ideXlab platform.
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tailored Telephone Counseling to improve adherence to follow up regimens after an abnormal pap smear among minority underserved women
Patient Education and Counseling, 2013Co-Authors: Suzanne M Miller, Siukuen Azor Hui, Kuangyi Wen, John Scarpato, Fang Zhu, Joanne S Buzaglo, Enrique HernandezAbstract:Objective The present study explored the impact of a tailored Telephone Counseling intervention on increasing follow-up adherence after an abnormal Pap smear result among low-income, minority women, which may reduce cervical cancer disparity.
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enhancing adherence following abnormal pap smears among low income minority women a preventive Telephone Counseling strategy
Journal of the National Cancer Institute, 1997Co-Authors: Suzanne M Miller, Caryn Lerman, Enrique Hernandez, K K Siejak, C M Schroeder, C W HelmAbstract:were the 47 patients who had received Telephone confirmation (49 [61%] of 80 women versus 17 [36.2%] of 47; OR = 2.70; 95% CI = 1.15-6.51). The 6-month adherence rates for patients in the Telephone confirmation group and the standard care group (n = 30) were low and did not differ significantly (17 [36.2%] of 47 women versus nine [30.0%] of 30; OR = 1.08; 95% CI = 0.40-2.89). Forgetting medical appointments (OR = 0.31; 95% CI = 0.19-0.51) and having scheduling conflicts (OR = 0.45; 95% CI = 0.28-0.72) were also associated with lower rates of adherence. Conclusion: The use of Telephone Counseling appears to be an effective strategy for enhancing initial and long-term adherence to a follow-up cervical diagnostic procedure in a traditionally underserved population. Patients who respond to a positive Pap test result with a particular profile of psychologic barriers may require more intensive and targeted Counseling interventions. [J Natl Cancer Inst 1997;89:703-8]
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Telephone Counseling improves adherence to colposcopy among lower income minority women
Journal of Clinical Oncology, 1992Co-Authors: Caryn Lerman, Parviz Hanjani, Craig Caputo, Suzanne M Miller, E Delmoor, Susan Nolte, Paul F EngstromAbstract:PURPOSEA randomized trial was conducted to evaluate the impact of a Telephone Counseling intervention to improve patient adherence to colposcopic examination for suspected cervical intraepithelial neoplasia (CIN).METHODSSubjects were lower-income, minority women who missed a scheduled initial appointment for colposcopy at an urban medical clinic. Patients were randomly assigned to either a control condition (n = 42) or a Telephone Counseling condition (n = 48). The 15-minute, structured Telephone Counseling intervention protocol addressed educational, psychosocial, and practical barriers to colposcopy adherence.RESULTSThe most common patient-reported barriers to colposcopy adherence included a lack of understanding of the purpose of colposcopy (50%), worry about or fear of cancer (25%), and forgetting (23%). Telephone Counseling was found to be highly effective in addressing these barriers and improving adherence to diagnostic follow-up and treatment. Of patients in the control condition, 43% complied wit...
Alfred C Marcus - One of the best experts on this subject based on the ideXlab platform.
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can Telephone Counseling post treatment improve psychosocial outcomes among early stage breast cancer survivors
Psycho-oncology, 2010Co-Authors: Alfred C Marcus, Lari Wenzel, David Cella, Susan Powell Emsbo, Kathleen Garrett, Marianne J Brady, Diane L Fairclough, Meredith Patewillig, Denise Barnes, Brenda C KluhsmanAbstract:Objective To determine whether a Telephone Counseling program can improve psychosocial outcomes among breast cancer patients post-treatment.
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randomized controlled trial of a psychosocial Telephone Counseling intervention in brca1 and brca2 mutation carriers
Cancer Epidemiology Biomarkers & Prevention, 2010Co-Authors: Kristi D Graves, Beth N. Peshkin, Lari Wenzel, Marc Schwartz, George Luta, Paul Wileyto, Steven Narod, Alfred C Marcus, David Cella, Susan Powell EmsboAbstract:Background: Responses following BRCA1/2 genetic testing are relevant for the comprehension of risk status and may play a role in risk management decision making. The objective of this study was to evaluate a psychosocial Telephone Counseling (PTC) intervention delivered to BRCA1/2 mutation carriers following standard genetic Counseling (SGC). We examined the effect of the intervention on distress and the concerns related to genetic testing. Methods: This prospective randomized clinical trial included 90 BRCA1/2 mutation carriers. We measured anxiety, depression, and genetic testing distress outcomes at intervention baseline and 6 and 12 months following disclosure. We evaluated the effects of SGC versus SGC plus PTC on psychological outcomes using intention-to-treat analyses through generalized estimating equations. Results: At 6 months, PTC reduced depressive symptoms ( Z = −2.25, P = 0.02) and genetic testing distress ( Z = 2.18, P = 0.02) compared with SGC. Furthermore, women in the intervention condition reported less clinically significant anxiety at 6 months (χ21 = 4.11, P = 0.04) than women who received SGC. We found no differences in outcomes between the intervention groups at the 12-month follow-up. Conclusions: As an adjunct to SGC, PTC delivered following disclosure of positive BRCA1/2 test results seems to offer modest short-term benefits for distress and anxiety. These results build upon a growing literature of psychosocial interventions for BRCA1/2 carriers and, given the potential impact of affect on risk management decision making, suggest that some carriers may derive benefits from adjuncts to traditional genetic Counseling. Cancer Epidemiol Biomarkers Prev; 19(3); 648–54
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predictors of participation in psychosocial Telephone Counseling following genetic testing for brca1 and brca2 mutations
Cancer Epidemiology Biomarkers & Prevention, 2004Co-Authors: Chanita Hughes Halbert, Beth N. Peshkin, Lari Wenzel, Steven Narod, Alfred C Marcus, Caryn Lerman, Camille Corio, Tiffani A Demarco, Scarlett L BellamyAbstract:Although adjunctive educational and psychosocial programs are now being developed for BRCA1 and BRCA2 (BRCA1/2) mutation carriers, limited information is available about whether mutation carriers will want to receive such programs or about the characteristics of individuals who participate. The goals of the present study were to describe rates of completing a psychosocial Telephone Counseling (PTC) intervention that was offered to female BRCA1/2 mutation carriers and to identify sociodemographic and psychological factors associated with decisions to complete the intervention. Subjects were 66 BRCA1/2 mutation carriers who were randomized to receive a PTC intervention following receipt of genetic test results. Sociodemographic and psychological factors were evaluated before notification of assignment to the PTC intervention. Completion of the intervention was determined from study records. Overall, 75.8% of subjects completed the PTC intervention. Compared to unaffected subjects, those affected with breast and/or ovarian cancer were 76% less likely to complete the intervention [odds ratio (OR) = 0.24, 95% confidence interval (CI) = 0.06, 0.98, P = 0.05]. In addition, subjects with higher levels of cancer-specific distress [OR = 4.74, 95% CI = 1.02, 22.03, P = 0.05] and those with greater perceptions of social support [OR = 5.81, 95% CI = 1.29, 26.16, P = 0.02] were also most likely to complete the intervention. The results of this study suggest that while most BRCA1/2 mutation carriers are likely to complete an adjunctive psycho-educational program, personal history of cancer, cancer-specific distress, and perceptions of social support are likely to influence participation.
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Telephone Counseling of breast cancer patients after treatment a description of a randomized clinical trial
Psycho-oncology, 1998Co-Authors: Alfred C Marcus, Lari Wenzel, David Cella, Kathleen Garrett, Marianne J Brady, Brenda C Kluhsman, Lori A Crane, Maureen W Mcclatchey, Meredith PatewilligAbstract:The Telephone Counseling Trial for Breast Cancer Survivors is a randomized, controlled study designed to test the impact of a Telephone-based Counseling intervention on quality of life of early-stage breast cancer patients who have completed adjuvant treatment. A psychoeducational Counseling model is utilized to promote adaptive coping to re-entry stressors and survivorship issues. Adaptation is fostered through the exploration of thematic materials, application of active coping strategies, encouragement of a personal expression of the breast cancer experience and the provision of psychological support. Patients are being recruited in collaboration with two NCI-designated clinical cooperative oncology groups: the Eastern Cooperative Oncology Group (ECOG) and the Southwest Cooperative Oncology Group (SWOG). The recruitment goal is 400 breast cancer survivors with Stage 1, Stage 2 and Stage 3 disease (with no greater than 10 positive lymph nodes involved). Patients are being enrolled by data managers on-site during their last treatment visit. The intervention is being delivered by the Cancer Information and Counseling Line (CICL) of the AMC Cancer Research Center. It includes 16 Telephone outcalls which are delivered over a 12-month period. Primary outcome measures are quality of life, mood, social support, self-efficacy, and sexual functioning, assessed at baseline, 3, 6, 12 and 18 months follow-up. This article provides a description of the intervention protocol and study design. It is argued that this study could provide a model for developing and testing other psychosocial interventions within clinical cooperative groups nationwide.
Enrique Hernandez - One of the best experts on this subject based on the ideXlab platform.
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tailored Telephone Counseling to improve adherence to follow up regimens after an abnormal pap smear among minority underserved women
Patient Education and Counseling, 2013Co-Authors: Suzanne M Miller, Siukuen Azor Hui, Kuangyi Wen, John Scarpato, Fang Zhu, Joanne S Buzaglo, Enrique HernandezAbstract:Objective The present study explored the impact of a tailored Telephone Counseling intervention on increasing follow-up adherence after an abnormal Pap smear result among low-income, minority women, which may reduce cervical cancer disparity.
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enhancing adherence following abnormal pap smears among low income minority women a preventive Telephone Counseling strategy
Journal of the National Cancer Institute, 1997Co-Authors: Suzanne M Miller, Caryn Lerman, Enrique Hernandez, K K Siejak, C M Schroeder, C W HelmAbstract:were the 47 patients who had received Telephone confirmation (49 [61%] of 80 women versus 17 [36.2%] of 47; OR = 2.70; 95% CI = 1.15-6.51). The 6-month adherence rates for patients in the Telephone confirmation group and the standard care group (n = 30) were low and did not differ significantly (17 [36.2%] of 47 women versus nine [30.0%] of 30; OR = 1.08; 95% CI = 0.40-2.89). Forgetting medical appointments (OR = 0.31; 95% CI = 0.19-0.51) and having scheduling conflicts (OR = 0.45; 95% CI = 0.28-0.72) were also associated with lower rates of adherence. Conclusion: The use of Telephone Counseling appears to be an effective strategy for enhancing initial and long-term adherence to a follow-up cervical diagnostic procedure in a traditionally underserved population. Patients who respond to a positive Pap test result with a particular profile of psychologic barriers may require more intensive and targeted Counseling interventions. [J Natl Cancer Inst 1997;89:703-8]
Lari Wenzel - One of the best experts on this subject based on the ideXlab platform.
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psychosocial Telephone Counseling for survivors of cervical cancer results of a randomized biobehavioral trial
Obstetrical & Gynecological Survey, 2015Co-Authors: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A Tucker, Bradley J Monk, Edward L NelsonAbstract:Purpose Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial Telephone Counseling (PTC) intervention on QOL domains and associations with biomarkers. Patients and Methods We conducted a randomized clinical trial in survivors of cervical cancer, who were 9 and less than 30 months from diagnosis (n 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. Results Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P .05); significant differences in gynecologic and cancer-specific concerns (P .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels. Conclusion This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship. J Clin Oncol 33:1171-1179. © 2015 by American Society of Clinical Oncology
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can Telephone Counseling post treatment improve psychosocial outcomes among early stage breast cancer survivors
Psycho-oncology, 2010Co-Authors: Alfred C Marcus, Lari Wenzel, David Cella, Susan Powell Emsbo, Kathleen Garrett, Marianne J Brady, Diane L Fairclough, Meredith Patewillig, Denise Barnes, Brenda C KluhsmanAbstract:Objective To determine whether a Telephone Counseling program can improve psychosocial outcomes among breast cancer patients post-treatment.
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randomized controlled trial of a psychosocial Telephone Counseling intervention in brca1 and brca2 mutation carriers
Cancer Epidemiology Biomarkers & Prevention, 2010Co-Authors: Kristi D Graves, Beth N. Peshkin, Lari Wenzel, Marc Schwartz, George Luta, Paul Wileyto, Steven Narod, Alfred C Marcus, David Cella, Susan Powell EmsboAbstract:Background: Responses following BRCA1/2 genetic testing are relevant for the comprehension of risk status and may play a role in risk management decision making. The objective of this study was to evaluate a psychosocial Telephone Counseling (PTC) intervention delivered to BRCA1/2 mutation carriers following standard genetic Counseling (SGC). We examined the effect of the intervention on distress and the concerns related to genetic testing. Methods: This prospective randomized clinical trial included 90 BRCA1/2 mutation carriers. We measured anxiety, depression, and genetic testing distress outcomes at intervention baseline and 6 and 12 months following disclosure. We evaluated the effects of SGC versus SGC plus PTC on psychological outcomes using intention-to-treat analyses through generalized estimating equations. Results: At 6 months, PTC reduced depressive symptoms ( Z = −2.25, P = 0.02) and genetic testing distress ( Z = 2.18, P = 0.02) compared with SGC. Furthermore, women in the intervention condition reported less clinically significant anxiety at 6 months (χ21 = 4.11, P = 0.04) than women who received SGC. We found no differences in outcomes between the intervention groups at the 12-month follow-up. Conclusions: As an adjunct to SGC, PTC delivered following disclosure of positive BRCA1/2 test results seems to offer modest short-term benefits for distress and anxiety. These results build upon a growing literature of psychosocial interventions for BRCA1/2 carriers and, given the potential impact of affect on risk management decision making, suggest that some carriers may derive benefits from adjuncts to traditional genetic Counseling. Cancer Epidemiol Biomarkers Prev; 19(3); 648–54
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predictors of participation in psychosocial Telephone Counseling following genetic testing for brca1 and brca2 mutations
Cancer Epidemiology Biomarkers & Prevention, 2004Co-Authors: Chanita Hughes Halbert, Beth N. Peshkin, Lari Wenzel, Steven Narod, Alfred C Marcus, Caryn Lerman, Camille Corio, Tiffani A Demarco, Scarlett L BellamyAbstract:Although adjunctive educational and psychosocial programs are now being developed for BRCA1 and BRCA2 (BRCA1/2) mutation carriers, limited information is available about whether mutation carriers will want to receive such programs or about the characteristics of individuals who participate. The goals of the present study were to describe rates of completing a psychosocial Telephone Counseling (PTC) intervention that was offered to female BRCA1/2 mutation carriers and to identify sociodemographic and psychological factors associated with decisions to complete the intervention. Subjects were 66 BRCA1/2 mutation carriers who were randomized to receive a PTC intervention following receipt of genetic test results. Sociodemographic and psychological factors were evaluated before notification of assignment to the PTC intervention. Completion of the intervention was determined from study records. Overall, 75.8% of subjects completed the PTC intervention. Compared to unaffected subjects, those affected with breast and/or ovarian cancer were 76% less likely to complete the intervention [odds ratio (OR) = 0.24, 95% confidence interval (CI) = 0.06, 0.98, P = 0.05]. In addition, subjects with higher levels of cancer-specific distress [OR = 4.74, 95% CI = 1.02, 22.03, P = 0.05] and those with greater perceptions of social support [OR = 5.81, 95% CI = 1.29, 26.16, P = 0.02] were also most likely to complete the intervention. The results of this study suggest that while most BRCA1/2 mutation carriers are likely to complete an adjunctive psycho-educational program, personal history of cancer, cancer-specific distress, and perceptions of social support are likely to influence participation.
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Telephone Counseling of breast cancer patients after treatment a description of a randomized clinical trial
Psycho-oncology, 1998Co-Authors: Alfred C Marcus, Lari Wenzel, David Cella, Kathleen Garrett, Marianne J Brady, Brenda C Kluhsman, Lori A Crane, Maureen W Mcclatchey, Meredith PatewilligAbstract:The Telephone Counseling Trial for Breast Cancer Survivors is a randomized, controlled study designed to test the impact of a Telephone-based Counseling intervention on quality of life of early-stage breast cancer patients who have completed adjuvant treatment. A psychoeducational Counseling model is utilized to promote adaptive coping to re-entry stressors and survivorship issues. Adaptation is fostered through the exploration of thematic materials, application of active coping strategies, encouragement of a personal expression of the breast cancer experience and the provision of psychological support. Patients are being recruited in collaboration with two NCI-designated clinical cooperative oncology groups: the Eastern Cooperative Oncology Group (ECOG) and the Southwest Cooperative Oncology Group (SWOG). The recruitment goal is 400 breast cancer survivors with Stage 1, Stage 2 and Stage 3 disease (with no greater than 10 positive lymph nodes involved). Patients are being enrolled by data managers on-site during their last treatment visit. The intervention is being delivered by the Cancer Information and Counseling Line (CICL) of the AMC Cancer Research Center. It includes 16 Telephone outcalls which are delivered over a 12-month period. Primary outcome measures are quality of life, mood, social support, self-efficacy, and sexual functioning, assessed at baseline, 3, 6, 12 and 18 months follow-up. This article provides a description of the intervention protocol and study design. It is argued that this study could provide a model for developing and testing other psychosocial interventions within clinical cooperative groups nationwide.
