Telephone Counseling Produces Major Dietary Change in Women at Risk for Breast Cancer Recurrence

Abstract

An innovative telephone counseling protocol is being used to motivate women in die intervention group of a large randomized clinical trial of diet and breast cancer recurrence to assist them in attaining the intervention dietary pattern. The objective of this study was to determine whether compliance with the counseling protocol during the first 12 months of participation was positively associated with dietary behavior change (adherence), particularly in those women with lower versus higher dietary adherence at baseline. Subjects were 427 women in the intervention group who had completed both baseline and 12-month dietary assessments (average of four 24-hour recalls in 3-week period). At study entry, all were between 18 and 70 years of age, resided in the Southwest, and had been treated for breast cancer within the last 4 years. Dairy dietary behavioral targets were: 5 servings of vegetables, 2 (8-oz) servings of vegetable juice, 3 servings of fruit, 30 grams of fiber, and 15–20% of energy from fat A dietary adherence score was calculated based on these dietary targets, with a 600 score equivalent to 100% adherence (baseline median 282). Compliance with the counseling protocol was based on the ratio of completed to optimum number of calls/month during the first 12 months (median protocol compliance 68% during first 12 months).Baseline Dietary AdherenceCounseling Protocol ComplianceNBaseline Adherence Score (mean)12-mo. Adherence Score (mean)Change Baseline to 12-mo.Low (<282)Low (<68%)118192396+204High (≥68%)95207512+305High (≥282)Low(<68%)95385569+184High (≥68%)119414602+188Counseling improved dietary adherence in all groups, but protocol compliance most benefitted those women with low baseline dietary adherence (P <.001).