Intensive Behavioral Intervention Research Articles

A Pilot Feasibility Study Assessing the Combined Effects of Early Behavioral Intervention and Propranolol on Autism Spectrum Disorder (ASD).

Autism spectrum disorder (ASD), a neurodevelopmental disorder typified by differences in social communication as well as restricted and repetitive behaviors, is often responsive to early behavioral intervention. However, there is limited information on whether such intervention can be augmented with pharmacological approaches. We conducted a double-blinded, placebo-controlled feasibility trial to examine the effects of the β-adrenergic antagonist propranolol combined with early intensive behavioral intervention (EIBI) for children with ASD. Nine participants with ASD, ages three to ten, undergoing EIBI were enrolled and randomized to a 12-week course of propranolol or placebo. Blinded assessments were conducted at baseline, 6 weeks, and 12 weeks. The primary outcome measures focusing on social interaction were the General Social Outcome Measure-2 (GSOM-2) and Social Responsiveness Scale-Second Edition (SRS-2). Five participants completed the 12-week visit. The sample size was insufficient to evaluate the treatment efficacy. However, side effects were infrequent, and participants were largely able to fully participate in the procedures. Conducting a larger clinical trial to investigate propranolol's effects on core ASD features within the context of behavioral therapy will be beneficial, as this will advance and individualize combined therapeutic approaches to ASD intervention. This initial study helps to understand feasibility constraints on performing such a study.

Evaluation of a rapport‐building intervention for early interventionists working with children on the autism spectrum

AbstractRapport, or the therapeutic relationship between a therapist and client, is essential for successful intervention. In behavior analytic interventions for autistic children, practitioners commonly use pairing to establish rapport. A limited body of research has evaluated how to train interventionists to pair with their child clients. Furthermore, fewer studies have examined the effects of pairing on client behavior. Therefore, we implemented behavioral skills training to teach interventionists pairing skills and assessed the effects of presession pairing on child interfering behavior using a concurrent multiple probe design (with replication). We implemented a pairing protocol before early intensive behavioral intervention sessions with four children (3–5 years old) on the autism spectrum. Interventionists mastered pairing skills during training sessions, which were generally maintained when working with child clients. When interventionists implemented presession pairing, child participants demonstrated fewer interfering behaviors. We discuss implications of our preliminary findings and future directions.

Efficacy of nonpharmacological interventions targeting social function in children and adults with autism spectrum disorder: A systematic review and meta-analysis.

This paper aimed to evaluate the use of nonpharmacological interventions for the management of autism spectrum disorder (ASD). The effects of acupuncture and behavioural therapy, two nonpharmalogical interventions, on social function in ASD patients are still controversial. This meta-analysis investigated the impact of these two treatments and compared their effects. Seven electronic databases were systematically searched to identify randomized controlled trials (RCTs) on the use of acupuncture or behavioural therapy for ASD. A meta-analysis was carried out using Review Manager 5.4 software. Continuous data are reported as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). An assessment of methodological quality using the Cochrane risk-of-bias (ROB) tool for trials was carried out. The Grading of Recommendation Assessment, Development, and Evaluation (GRADE) was applied to evaluate the quality (certainty) of evidence for results regarding social function indicators. Thirty RCTs on acupuncture and 36 on behavioural therapy were included. Compared with the control condition, body acupuncture (SMD: 0.76, 95% CI: [0.52, 1.01]; low certainty), modern acupuncture technology (SMD: 0.84, 95% CI: [0.32, 1.35]; low certainty), cognitive behavioural therapy (SMD: 0.42, 95% CI: [0.26, 0.58]; high certainty), the Denver model (SMD: 0.61, 95% CI: [0.23, 0.99]; moderate certainty) and social skills training (SMD: 0.56, 95% CI: [0.41, 0.71]; moderate certainty) improved social functioning. Behavioural therapies (such as CBT, the Denver model, social skills training), improved the social functioning of patients with ASD in the short and long term, as supported by high- and moderate-quality evidence. Acupuncture (including scalp acupuncture, body acupuncture and use of modern acupuncture technology) also improved social functioning, as supported by low- and very low-quality evidence. More high-quality evidence is needed to confirm the effect of acupoint catgut embedding and Early Intensive Behavioural Intervention (EIBI).

Comparing the Effectiveness of Discrete Trial Training Delivered via Telehealth and In-Person on Skill Acquisition.

The onset of the COVID-19 pandemic affected the delivery of early intensive behavioral intervention (EIBI) services. As a result, many EIBI service providers shifted to either temporarily or permanently providing some or all of their services via telehealth. Most published research on behavior analytic approaches to telehealth has focused on training others to implement behavior analytic interventions in an in-person setting. In contrast, relatively few researchers have evaluated direct EIBI service delivery via telehealth (i.e., professionals directly providing behavior analytic interventions to clients/learners using technology). Little is known about the effectiveness of behavior analytic interventions delivered remotely to learners via telehealth compared to standard in-person intervention delivery. The purpose of the present study was to directly compare the effectiveness of discrete trial training delivered remotely via telehealth and in-person on the acquisition of labeling occupations for children diagnosed with autism spectrum disorder in an EIBI program. The results and implications of the effectiveness of the different teaching modalities and observed generalization and maintenance will be discussed.Evaluating the effectiveness of behavior analytic interventions delivered remotely via telehealth compared to standard in-person delivery could help increase access to services for those in need.We found little difference in the acquisition of labeling occupations across the two modalities for all three participants.Future researchers should consider how to incorporate strategies to promote generalization into direct telehealth services.Future researchers should evaluate how learners without previous exposure to discrete trial training may perform during direct telehealth services.

The Betel Nut Intervention Trial (BENIT)-A Randomized Clinical Trial for Areca Nut and Betel Quid Cessation: Primary Outcomes.

Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials-NCT02942745) is the first known randomized trial designed for ANBQ chewers. We compared the intensive behavioral treatment intervention condition (IC) with the control condition (CC) in the BENIT and included a 5-stage early stopping rule. We report the primary analysis at stage 3. English-literate adults in Guam and Saipan who self-identified as ANBQ chewers with tobacco were enrolled between August 2016 and August 2020. IC participants (n = 88) received five in-person sessions over 22 days and a brochure containing quitting advice. CC participants (n = 88) received only the brochure. Participants were assessed at baseline and on day 22 of follow-up. Self-reported chewing status at day 22 was determined by a composite of two survey items with disparate wording and response options for cross-verification. Cessation rates were 38.6% (IC) and 9.1% (CC). Proportional hazards regression revealed a p = 0.0058, which met the Stage 3 criteria for significance, and an estimated reduction in ANBQ chewing for IC compared to the CC of 71% (95% CI: 41%-88%). Robust self-reported intervention effects at day 22 suggest that intensive cessation programs such as BENIT should be further developed and implemented on a larger scale.

53-LB: Do the Right Thing—Intensive Intervention and Resulting Costs for Youth with High Social Risk and Type 1 Diabetes (T1D)

Introduction: A subset of youth with T1D experience high social risk that increases likelihood of dangerous complications. Limited behavioral health resources often result in low intensity interventions for these youth, resulting in ineffective care. While sole focus on cost outcomes is not advised, given the reported role of cost as a barrier to more equitable care, examining the economic value of intensive interventions designed for high social risk may better inform stakeholder decisions. Methods: Three healthcare systems provided Direct Cost data for youth with avoidable health concerns (e.g., multiple DKA events) who received an intensive behavioral health intervention (Novel Interventions in Children’s Healthcare: NICH). Youth were included in analyses if they had T1D and at least 1 year of cost data prior to and following NICH enrollment. Outpatient, ED, and inpatient costs were combined, with variability in amount and type of cost data present across sites. Costs following enrollment were standardized to account for duration of available financial data (example: $18k over 1.5 years transformed to $12k per year). Results: Analysis included 53 youth: mean age 14.2±2.4 years; 87% Medicaid; 58% Female, 42% Male; 32% Black, 29% Non-Hispanic White, 28% Hispanic/Latinx, 7% Pacific Islander, 2% Asian, 2% other racial and ethnic groups. Mean yearly direct costs were $58.1k and $21.8k, prior to and following NICH enrollment, respectively, but not significantly different. After removing 3 outliers (> 3 SD from the mean), average yearly costs significantly decreased (p=.015) from $20.4k to $9.5k per youth, largely due to inpatient charges. Discussion: Intensive intervention for youth with T1D and high social risk shows promise in substantially reducing cost of care, suggesting that increased investment in effectively serving youth can improve health equity, as evidenced by fewer inpatient stays, and provide future financial benefits for institutions. Disclosure A. Reed: None. D. V. Wagner: None. J. C. Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. D. Naranjo: None. R. Padmanabhan: None. R. Navarro: None. E. Koblinski: None. K. A. Torres: None. C. Cruz: None. M. A. Harris: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust

Family-Based Behavioral Treatment for Childhood Obesity Implemented in Pediatric Primary Care

Intensive behavioral interventions for childhood overweight and obesity are recommended by national guidelines, but are currently offered primarily in specialty clinics. Evidence is lacking on their effectiveness in pediatric primary care settings. To evaluate the effects of family-based treatment for overweight or obesity implemented in pediatric primary care on children and their parents and siblings. This randomized clinical trial in 4 US settings enrolled 452 children aged 6 to 12 years with overweight or obesity, their parents, and 106 siblings. Participants were assigned to undergo family-based treatment or usual care and were followed up for 24 months. The trial was conducted from November 2017 through August 2021. Family-based treatment used a variety of behavioral techniques to develop healthy eating, physical activity, and parenting behaviors within families. The treatment goal was 26 sessions over a 24-month period with a coach trained in behavior change methods; the number of sessions was individualized based on family progress. The primary outcome was the child's change from baseline to 24 months in the percentage above the median body mass index (BMI) in the general US population normalized for age and sex. Secondary outcomes were the changes in this measure for siblings and in BMI for parents. Among 452 enrolled child-parent dyads, 226 were randomized to undergo family-based treatment and 226 to undergo usual care (child mean [SD] age, 9.8 [1.9] years; 53% female; mean percentage above median BMI, 59.4% [n = 27.0]; 153 [27.2%] were Black and 258 [57.1%] were White); 106 siblings were included. At 24 months, children receiving family-based treatment had better weight outcomes than those receiving usual care based on the difference in change in percentage above median BMI (-6.21% [95% CI, -10.14% to -2.29%]). Longitudinal growth models found that children, parents, and siblings undergoing family-based treatment all had outcomes superior to usual care that were evident at 6 months and maintained through 24 months (0- to 24-month changes in percentage above median BMI for family-based treatment and usual care were 0.00% [95% CI, -2.20% to 2.20%] vs 6.48% [95% CI, 4.35%-8.61%] for children; -1.05% [95% CI, -3.79% to 1.69%] vs 2.92% [95% CI, 0.58%-5.26%] for parents; and 0.03% [95% CI, -3.03% to 3.10%] vs 5.35% [95% CI, 2.70%-8.00%] for siblings). Family-based treatment for childhood overweight and obesity was successfully implemented in pediatric primary care settings and led to improved weight outcomes over 24 months for children and parents. Siblings who were not directly treated also had improved weight outcomes, suggesting that this treatment may offer a novel approach for families with multiple children. ClinicalTrials.gov Identifier: NCT02873715.

Effectiveness of smoking cessation interventions among persons with cancer: A systematic review.

Continued smoking after cancer diagnosis is associated with worse outcomes, however, many persons diagnosed with cancer who smoke are unable to quit successfully. Effective interventions are needed to promote quitting in this population. The purpose of this systematic review is to understand the most effective interventions for smoking cessation among persons with cancer and to identify gaps in knowledge and methodology to suggest directions for future research. Three electronic databases (The Cochrane Central Register of Controlled trials, MEDLINE, and EMBASE) were searched for studies of smoking cessation interventions among persons with cancer, published up to 1 July 2021. Title and abstract screening, full-text review, and data extraction was completed by two independent reviewers, via Covalence software, with any discordance resolved by a third reviewer. A quality assessment was completed using the Cochrane Risk of Bias Tool Version 2. Thirty-six articles were included in the review, including 17 randomized-controlled trials (RCTs) and 19 non-RCT studies. Of the 36 studies, 28 (77.8%) utilized an intervention that included both counseling and medication, with 24 (85.7%) providing medication to participants at no cost. Abstinence rates in the RCT intervention groups (n=17) ranged from 5.2% to 75%, while the non-RCTs found abstinence rates ranging from 15% to 46%. Overall, studies met a mean of 2.28 out of seven quality items, ranging from 0 to 6. Our study highlights the importance of utilizing intensive combined behavioral and pharmacological interventions for persons with cancer. While combined therapy interventions seem to be the most effective, more research is needed, as current studies have several quality issues, including the lack of biochemical verification for abstinence.

Predictors of Developmental and Adaptive Behaviour Outcomes in Response to Early Intensive Behavioural Intervention and the Early Start Denver Model

Many autistic children require support to meet their learning needs. Given the heterogeneity within the autism spectrum it is plausible that different types of support might be better suited to different children. However, knowledge on what interventions work best for which children is limited. We examined the outcomes of autistic preschool-aged children receiving one of two community early intervention approaches. Our main objective was to understand which baseline child characteristics might be associated with the degree of individual response to intervention—whether prognostically (i.e., irrespective of intervention received) or predictively (i.e., specifically in the context of one or other EI approach). Participants comprised two matched groups of preschool-aged autistic children receiving either Group-based Early Start Denver Model (G-ESDM; n = 42) delivered in a 1:3–4 staff:child ratio or an Early Intensive Behavioural Intervention (EIBI; n = 40) delivered in combination of 1:1 and 1:2 staff:child ratio. Over an approximate one-year follow-up period, children in both groups made significant gains in Developmental Quotient (DQ) scores, and trend-level gains in adaptive behaviour composite scores. Higher attention to a playful adult measured via an eye-tracking task was prognostically indicative of better verbal DQ and adaptive behaviour outcomes for the cohort overall. Moderation analyses indicated a single predictive effect—of pre-program sustained attention for subsequent NVDQ outcomes specific to those children receiving G-ESDM. These findings suggest that fine-grained measures of learning skills offer promise towards the selection and tailoring of intervention approaches to meet individual children’s learning needs.

A comparison of fixed and repetitive models to teach object imitation to children with autism.

A well-established imitative repertoire can facilitate the acquisition of functional communication, social behaviors, and observational learning. Although early intensive behavioral intervention programs for young children with autism incorporate imitation training, learners with autism may exhibit difficulties in acquiring an imitative repertoire. Few studies have evaluated the types of models responsible for acquisition when teaching imitation to children with autism. A preliminary evaluation with fixed and repetitive model targets suggested that children with autism may acquire imitation more rapidly when taught with repetitive models (Deshais & Vollmer, 2020). The purpose of the current study was to compare the rates of acquisition when teaching with repetitive and fixed models for six children with autism. The findings suggested that (a) fixed models resulted in the most efficient acquisition for 10 of 16 comparisons, (b) fixed and repetitive models had similar efficacy for four comparisons, (c) and the repetitive condition was most efficient for two comparisons.

A Comparison Controlled Study Examining Outcome for Children With Autism Receiving Intensive Behavioral Intervention (IBI).

This study evaluated the effects of a center-based Intensive Behavioral Intervention (IBI) model for preschool aged children with autism. Outcomes of 25 children receiving IBI was compared to the outcomes of 14 children receiving autism specific, eclectic, special education. Both provisions were described as appropriate treatment options by the professional agency who diagnosed the children, and the decision of where to enroll the child was made by the parents after consultations with the specialists. After 14 months of treatment, children from the IBI group improved significantly on standard scores in intellectual functioning and adaptive behavior and had a significant reduction in autism severity compared to the children in the autism specific, eclectic, special education group. Results suggest that preschool aged children with autism may make large gains in intellectual and adaptive functioning and improvement in autism severity with IBI, and that effects of IBI may be similar to that of EIBI. These findings must be interpreted with caution due to the limitations inherent in the present comparison-controlled design.

Barriers to Accessing Effective Treatments for Destructive Behavior.

The field of applied behavior analysis has developed and refined a comprehensive methodology for the assessment and successful treatment of destructive behavior: An individualized approach emphasizes (a) function of responding (or its cause) over its form; (b) objective and reliable measurement of behavior; (c) systematic procedures and their application; (d) rigorous, single-case experimental designs; and (e) determinations of successful intervention judged by improvements in the same individual's performance. Outcomes of this approach are often dramatic and reliably surpass those obtained by alternative means. However, significant barriers limit the accessibility of this proven therapy. Too few intensive behavioral intervention units, diagnosis- and age-dependent insurance authorization and reimbursement practices, long waitlists and slow approval processes, and the possibility of treatment relapse represent a few such barriers. This article describes these barriers and suggests some potential solutions.

Study protocol for the sheMATTERS study (iMproving cArdiovascular healTh in new moThERS): a randomized behavioral trial assessing the effect of a self-efficacy enhancing breastfeeding intervention on postpartum blood pressure and breastfeeding continuation in women with hypertensive disorders of pregnancy

BackgroundIndividuals with hypertensive disorders of pregnancy (HDP) have an elevated lifetime risk of chronic hypertension, metabolic syndrome, and premature cardiovascular disease. Because breastfeeding duration and exclusivity have been associated in observational studies with improved cardiovascular health, optimizing breastfeeding in those with HDP might be an unrealized cardio-prevention approach, in particular because individuals with HDP have more breastfeeding challenges. Breastfeeding supportive interventions targeting one’s breastfeeding self-efficacy have been shown to improve breastfeeding rates.MethodsWe designed an open-label, multi-center 1:1 randomized behavioral trial to test whether a previously validated self-efficacy enhancing breastfeeding intervention can improve breastfeeding duration and/or exclusivity, and lower postpartum blood pressure at 12 months. Randomization is computer-generated and stratified by site (four hospitals in Montreal, Quebec and one hospital in Kingston, Ontario; all in Canada). Included are breastfeeding participants with HDP (chronic/gestational hypertension or preeclampsia) who delivered a live singleton infant at > 34 weeks, speak English or French, and have no contraindications to breastfeeding. Informed and written consent is obtained at hospitalization for delivery or a re-admission with hypertension within 1 week of discharge. Participants assigned to the intervention group receive a breastfeeding self-efficacy-based intervention delivered by a trained lactation consultant in hospital, with continued reactive/proactive support by phone or text message for up to 6 months postpartum. Regardless of group assignment, participants are followed for self-reported outcomes, automated office blood pressure, and home blood pressure at several time points with end of follow-up at 12 months.DiscussionThis study will assess whether an intensive nurse-led behavioral intervention can improve breastfeeding rates and, in turn, postpartum blood pressure – an early marker for atherosclerotic cardiovascular disease. If effective, this form of enhanced breastfeeding support, along with closer BP and metabolic surveillance, can be implemented broadly in individuals lactating after HDP.Trial registrationClinicalTrials.gov, # NCT04580927, registered on Oct 9, 2020.

Parent Perceptions of the Effects of Early Intensive Behavioral Interventions for Children with Autism.

The current study aimed to understand parents' perceptions of the effects of early intensive behavioral intervention (EIBI) based on the principles of applied behavioral analysis (ABA) and the lasting outcomes for their children with Autism spectrum disorder (ASD). In particular, this study sought to examine parent perceptions of the relationship between the intensity of ABA interventions and current autism symptom severity, adaptive functioning, and school placement. The current study employed a convergent parallel mixed-methods design, which consisted of collecting, analyzing, interpreting, and combining both quantitative and qualitative data. Overall, results suggested that the intensity of previous ABA interventions was a unique predictor of current school placement. Additionally, results suggested that the intensity of previous ABA interventions was a unique predictor of adaptive skills, which was supported by parent interviews. However, the intensity of previous ABA interventions was not a unique predictor of current autism severity. Parent responses to interview questions revealed the imperative nature of the interventions and their effect on service delivery for their children with ASD. Overall, this study provided an increased understanding of parents' perceptions of the effectiveness of EIBI, which in turn may be central to understanding service utilization.

A follow-up study of early intensive behavioral intervention program for children with Autism in Syria

We examined the sustained effects of early intensive behavioral intervention (EIBI) on 66 children with autism spectrum disorder who participated in the Future Center’s EIBI program. Children were assessed using the childhood autism rating scale (CARS), autism behavior checklist (ABC), and adaptive behavior scale (ABS-Arabic) 3 years after leaving the program. Continued positive effects were observed in several areas, including adaptive behavior and autism symptoms. However, participants’ social skills might have declined on the ABS-Arabic after service withdrawal. Additionally, a significant negative association (p < .001) was found between participants’ performance on the CARS and the number of weekly trials. This is encouraging, given the lack of EIBI services and regional instability. Future research should increase the sample size and use a more rigorous design.

Včasná intenzívna behaviorálna intervencia u detí s poruchou autistického spektra

The paper deals with the early intensive behavioral intervention in children with autism spectrum disorder. The scientific method of learning referred to is based on intensive behavioral intervention, which is carried out early in the development of a child with autism spectrum disorder. It focuses on compensatory, i.e. it develops the child with autism spectrum disorder in all necessary areas such as social interaction and communication, play, self-care, motor skills and academic skills.

Competency drivers to support implementation of early intensive behavioral intervention in large-scale community-based services: Perspectives of caseworkers and organization representatives

Implementing evidence-based practices in “real-world” settings poses significant challenges. Organizations involved must address this issue by providing supportive infrastructures. Among the elements to consider are competency drivers, which refer to the selection, training, and supervision of caseworkers. The purpose of this study was to describe the perspectives of caseworkers and representatives on competency drivers that organizations put in place to support the implementation of early intensive behavioral intervention (EIBI) in large-scale community-based services. The sample consisted of 109 caseworkers and 23 organization representatives who completed questionnaires. Results demonstrated that respondents consider clinical support and training as key elements in EIBI implementation. However, despite recognizing these factors, respondents reported considerable variability in practices. It appears necessary to better define and plan the implementation of these competency drivers with a view to improving EIBI implementation.

Videoconference to supervise early intensive behavioral intervention: A preliminary evaluation of acceptability

AbstractAt present, early intensive behavioral intervention (EIBI) for children with autism spectrum disorders is the intervention that has the strongest empirical support. EIBI requires frequent supervision by qualified professionals. Norway, like many other countries, has a shortage of qualified supervisors, particularly in rural regions. This study used a reversal design to investigate how supervisors and supervisees perceive the quality of EIBI supervision and the local team's preparedness when supervision was provided either on‐site or via videoconference. Calculations were made on how much time could be saved on travel when part of the supervision was provided via videoconference. There were no significant differences in the supervisors' and supervisees' ratings of on‐site and videoconference supervision. Moreover, the supervisors found the local EIBI teams to be better prepared when supervision was provided via videoconference, and the videoconference supervision meetings were shorter. The study discusses the implications of these findings for the accessibility of EIBI and case capacity and proposes some areas for further research.

Evaluating the Prevent–Teach–Reinforce Model for High School Students With Autism Spectrum Disorder

This study evaluated the use of the Prevent–Teach–Reinforce (PTR) model as an intensive individualized behavior intervention. Three educators and three high school students with autism spectrum disorder participated in the study. A concurrent multiple baseline design across participants was used to demonstrate the outcomes. The results indicated that the educators implemented the PTR intervention plans with high levels of fidelity, and their implementation of the intervention plans led to decreases in problem behavior and increases in replacement behavior across all three participating students with autism spectrum disorder. The educators demonstrated using the Individualized Behavior Rating Scale Tool effectively as designed to monitor student progress, and the educators and students found the PTR intervention to be acceptable and satisfactory. All three educators expressed interest in continuing to implement the PTR intervention after the completion of the study. Implications and areas for future research are discussed.

Application of the Updated WCRF/AICR Cancer Prevention Score as an Outcome for Cancer Survivors Participating in a Tailored and Intensive Dietary and Physical Activity Intervention.

The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has defined evidence-based guidelines for cancer prevention. These recommendations have been operationalized into a quantitative index for individual assessment. Survivors of cancer are increasingly desiring guidance for diet and lifestyle, and in the absence of research in survivors, are often instructed to follow cancer prevention and public health guidelines. In this study, we examine the utility of the quantitative updated WCRF/AICR scoring criteria to assess change among cancer survivors with overweight/obesity (OW/OB) following an intensive behavioral intervention. We applied the WCRF/AICR scoring criteria (range 0-7) to examine changes over the duration of the study by paired t-tests. Two cancer survivor cohorts with OW/OB (n = 91) completed a six-month phase II clinical trial designed to improve dietary and physical activity patterns. At enrollment and post-intervention, participants completed assessments including anthropometrics, food frequency questionnaires, and objective evaluation of physical activity. Participants improved adherence to all scored recommendations, with a significant increase in mean score from enrollment (3.22 ± 1.06) to post-intervention (4.28 ± 1.04) (p &lt; 0.001). Mean BMI and waist circumference improved (both p &lt; 0.001). The greatest improvements were noted for fruit and non-starchy vegetable intakes (+39%, p &lt; 0.001); the greatest decreases were observed for processed meat consumption (-70%, p &lt; 0.001). The updated WCRF/AICR Score can be applied to cancer survivor intervention studies and provides a tool to compare trials in regard to the baseline status of populations enrolled and the success of the intervention. Future interventions incorporating standardized assessments will help guide effective strategies to improve the health and quality of life for cancer survivors.