Online Program

Capitalizing on the ‘teachable moment' to promote healthy behavior changes among cancer survivors

Tuesday, November 5, 2013 : 11:30 a.m. - 11:45 a.m.

Katherine Clegg Smith, PhD, Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Kisha Coa, MPH, Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ann Carroll Klassen, PhD, Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA
Laura Caulfield, PhD, Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD
Lillian Shockney, RN, BS, MAS, School of Medicine, School of Nursing, Johns Hopkins University, Baltimore, MD
Kathy Helzlsouer, MD, MHS, Prevention and Research Center, Mercy Medical Center, Baltimore, MD
Allison Baker, BA, Community Health and Prevention, Drexel University School of Public Health, Philadelphia, PA
As of June 2012, there were approximately 13.7 million U.S. cancer survivors, of which 64% have survived five or more years post-diagnosis. Cancer survivors are at increased risk of cancer recurrence, a second incidence of cancer, development of other chronic diseases. Survivors also report poorer health than adults who have not had cancer. Interventions seeking to promote behavior change have been proposed as one strategy for improving the health outcomes and quality of life of long-term cancer survivors. However, there is limited research exploring the feasibility of implementing behavior change interventions within clinical settings.

We conducted in-depth, semi-structured interviews with 32 clinicians (10 oncologists, 5 surgeons, 6 primary care providers, 7 nurses, and dieticians, social workers and patient navigators) who care for prostate, breast, and/or non-Hodgkin's lymphoma cancer survivors. Interviews were structured around caring for long-term survivors, and clinical perceptions of the importance of promoting behavior change, with a particular emphasis on dietary change.

Clinicians reported that many cancer survivors ask questions about dietary changes. Survivors often ask whether specific foods are good or bad for the cancer, and about supplements. Most clinicians recommended a well-balanced healthy diet rather than cancer-specific ‘super foods.' However, they noted lack of time and expertise as barriers to providing detailed dietary messages or interventions. While dieticians were mentioned as possible interventionists, they are infrequently accessible to cancer survivors.

Given that survivors inquire about diet, there is an opportunity to promote behavior change; however approaches must work within the constraints of the existing clinical structure.

Learning Areas:

Administer health education strategies, interventions and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe the importance of health promotion for long-term cancer survivors Discuss current clinical practices around promotion of healthy diet for patients with a history of non-Hodgkin’s lymphoma, breast and prostate cancer Identify barriers and opportunities for behavioral interventions within the cancer care model

Keyword(s): Cancer, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on this project and I have been working on nutrition topics in relation to chronic disease and also cancer survivorship
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.