Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients.

BACKGROUND: Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). METHOD: A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. RESULTS: Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. CONCLUSIONS: Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients.

Squire's Quest! Dietary outcome evaluation of a multimedia game.

BACKGROUND: Fruit, juice, and vegetable (FJV) consumption among children is low. Innovative programs are needed to enable children to increase FJV intake. Psychoeducational multimedia permits the delivery of interventions as designed and capitalizes on known behavior change principles. DESIGN: Elementary school was the unit of recruitment, assignment, and analysis. Twenty-six elementary schools were pair matched on size and percentage of free or reduced-price lunch, and randomly assigned to treatment or control groups. Data were collected just before and just after the program. SETTING/PARTICIPANTS: All fourth-grade students in participating elementary schools were invited to participate. Data were collected on 1578 students. MAIN OUTCOME Servings of fruit, 100% juice, and vegetables consumed. INTERVENTION: Squire's Quest! is a ten-session, psychoeducational, multimedia game delivered over 5 weeks, with each session lasting about 25 minutes. Based on social cognitive theory, educational activities attempted to increase preferences for FJV through multiple exposures and associating fun with their consumption, increase asking behaviors for FJV at home and while eating out, and increase skills in FJV preparation through making virtual recipes. MEASURES: Four days of dietary intake were assessed before and after the intervention. Assessment was made by the Food Intake Recording Software System (FIRSSt), which conducts a multiple pass, 24-hour dietary intake interview directly with the children. RESULTS: Children participating in Squire's Quest! increased their FJV consumption by 1.0 servings more than the children not receiving the program. CONCLUSIONS: Psychoeducational multimedia games have the potential to substantially change dietary behavior. More research is warranted.

Communicating with patients in cancer care; what areas do nurses find most challenging?

BACKGROUND: Patient communication is a cornerstone of comprehensive oncology nursing care. Oncology nurses, however, do not appear to receive much advanced training in communication skills and many nurses do not feel adequately trained in this area. METHOD: We designed a 33-item questionnaire to assess nurses' perceived level of difficulty and skill in a variety of common clinical situations where patient communication was a challenge. Three hundred fifty oncology nurses in a major cancer center completed the questionnaire. RESULTS: Nurses rated areas where they addressed the physical complaints (pain, fatigue, appetite and weight loss) as least challenging and areas in which they were most prepared. Several items ranked as most difficult and where nurses felt they had the least skills had to do with issues related to death and dying, especially requests for euthanasia and patient loss. Advanced practice nurses rated their perceived communications skills more highly in several different areas. CONCLUSION: The communication challenges faced by oncology nurses require skills that go beyond simple supportive techniques like empathy and listening. Teaching advanced communications skills geared to specific problems identified by nurses may be useful.

5 a day Achievement Badge for African-American Boy Scouts: pilot outcome results.

BACKGROUND: Boy Scouts are an important channel to complement school-based programs to enable boys to eat more fruit, 100% juice, and vegetables (FJV) for chronic disease prevention. The "5 a Day Achievement Badge" program was presented on a pilot study basis to African-American Boy Scout troops in Houston. METHODS: Troops were the unit of recruitment and random assignment to treatment and control groups. The badge program was presented in Fall 1997 by trained dietitians and included activities to increase availability and accessibility of fruit and vegetables at scouts' homes, increase preferences for vegetables, and train in the preparation of FaSST (fast, simple, safe, and tasty) recipes. Weekly comic books demonstrated and reinforced what scouts were expected to do at home. A weekly newsletter with recipes was sent to parents. The program was revised and presented to the control group in Winter 1998. Two 24-h recalls were the primary assessment tools. Telephone interviews were conducted with parents. RESULTS: The intervention resulted in a 0.8 FJV serving difference (post values of treatment versus control groups with pre value covaried). CONCLUSIONS: The changes obtained suggest that the intervention was effective in promoting dietary change.