Measures Of Health Behaviors Research Articles

Supplemental Material for Longitudinal Measurement Invariance of the Behavioral Health Measure in a Clinical Sample

Supplemental Material for Longitudinal Measurement Invariance of the Behavioral Health Measure in a Clinical Sample

Augmenting cancer registry data with health survey data with no cases in common: the relationship between pre-diagnosis health behaviour and post-diagnosis survival in oesophageal cancer

BackgroundFor epidemiological research, cancer registry datasets often need to be augmented with additional data. Data linkage is not feasible when there are no cases in common between data sets. We present a novel approach to augmenting cancer registry data by imputing pre-diagnosis health behaviour and estimating its relationship with post-diagnosis survival time.MethodsSix measures of pre-diagnosis health behaviours (focussing on tobacco smoking, ‘at risk’ alcohol consumption, overweight and exercise) were imputed for 28,000 cancer registry data records of US oesophageal cancers using cold deck imputation from an unrelated health behaviour dataset. Each data point was imputed twice. This calibration allowed us to estimate the misclassification rate. We applied statistical correction for the misclassification to estimate the relative risk of dying within 1 year of diagnosis for each of the imputed behaviour variables. Subgroup analyses were conducted for adenocarcinoma and squamous cell carcinoma separately.ResultsSimulated survival data confirmed that accurate estimates of true relative risks could be retrieved for health behaviours with greater than 5% prevalence, although confidence intervals were wide. Applied to real datasets, the estimated relative risks were largely consistent with current knowledge. For example, tobacco smoking status 5 years prior to diagnosis was associated with an increased age-adjusted risk of all cause death within 1 year of diagnosis for oesophageal squamous cell carcinoma (RR = 1.99 95% CI 1.24,3.12) but not oesophageal adenocarcinoma RR = 1.61, 95% CI 0.79,2.57).ConclusionsWe have demonstrated a novel imputation-based algorithm for augmenting cancer registry data for epidemiological research which can be used when there are no cases in common between data sets. The algorithm allows investigation of research questions which could not be addressed through direct data linkage.

A structural equation modeling approach to understanding pathways linking survivorship care plans to survivor-level outcomes.

Several high-profile organizations have mandated the delivery of survivorship care plans (SCPs) despite mixed evidence regarding the effectiveness of SCPs on key survivor-level outcomes. There is a need to understand the types of survivor-level outcomes the SCPs are likely to change. Informed by existing frameworks and the literature, the objective of this study was to understand the pathways linking the receipt of a SCP to key survivor-level outcomes including patient-centered communication (PCC), health self-efficacy, changes in health behaviors, and improvements in overall health. We used structural equation modeling to test the direct and indirect pathways linking the receipt of an SCP to patient-centered communication (PCC), health self-efficacy, and latent measures of health behaviors and physical health in a nationally representative sample of breast and colorectal cancer survivors from the Health Information National Trends Survey. The receipt of an SCP did not have a significant effect on key survivor-level outcomes and was removed from the final structural model. The final structural model fit the data adequately well (Chi-square p value = 0.03, RMSEA = 0.07, CFI = .88, and WRMR = 0.73). PCC had a significant direct effect on physical health but not on health behaviors. Health self-efficacy had a significant direct effect on physical health and health behaviors. The receipt of an SCP alone is unlikely to facilitate changes in PCC, health self-efficacy, health behaviors, or physical health. A SCP is a single component of a larger model of survivorship care and should be accompanied by ongoing efforts that promote PCC, health self-efficacy, and changes in health behaviors resulting in improvements to physical health.

Pathways among masculinity, femininity, and health behaviors in emerging adulthood

The Bem Sex Role Inventory (BSRI) is a widely-used measure of psychological masculinity, femininity, and androgyny (Bem in Journal of Consulting and Clinical Psychology, 54, 196–205, 1977). Psychological androgyny is correlated with a host of positive outcomes, including self-esteem (Buckley and Carter in Sex Roles, 53, 647–661, 2005) and social adjustment (Markstrom-Adams in Sex Roles, 21, 325-340, 1989). However, little work has explored how gender role orientation relates to overall and risky health behaviors in college students. This study was designed to examine the potential pathways among gender role orientation, adaptability, and health behaviors in a sample of emerging adults. The sample included 199 students (mean age = 19.7 years) recruited from a mid-sized regional university in the Southwest U.S. Participants completed an online survey that included measures of gender role orientation, adaptability, physical health, and risky health behaviors. Quantitative analyses revealed that higher levels of masculinity and femininity predicted more positive health behaviors among both college men and women. Implications for emerging adult populations are discussed.

Healthy aging and the University of the Third Age – Health behavior and subjective health outcomes in older adults

IntroductionBy participating in the University of the Third Age (U3A), retirees are offered the opportunity for activation and development in the later years of life. However, little is known how certain aspects of healthy aging, such as health-related behavior and subjective health outcomes, differ between U3A students and other older adults not taking part in any form of education. To address this, the aim of the present study was to compare selected aspects of healthy aging in a group of U3A members with older adults not taking part in any form of lifelong learning. The study also establishes relationships between the tested variables and predictors of health behavior. Materials and methods277 older adults (130 U3A members and 147 non-members) aged 60–92 (M = 68.84, SD = 5.32) completed measures of health behavior, self-rated physical health, self-rated sense of own health responsibility and satisfaction with life. ResultsThe U3A attendees presented significantly higher scores for general health behavior and some of its components, and declared higher self-rated health than their peers not affiliated to any educational organization. Self-rated health, responsibility for health and satisfaction with life were positively correlated with general health behavior and most of their categories. but the correlation coefficients differed between both groups. A hierarchical regression model demonstrated the predictive roles of attendance in U3A, sociodemographic and subjective factors in health behavior undertaking. ConclusionsThe study results may help to identify older adults who should be targeted in interventions aimed at supporting healthy aging.

Validating a GPS-based approach to detect health facility visits against maternal response to prompted recall survey.

IntroductionCommon approaches to measure health behaviors rely on participant responses and are subject to bias. Technology-based alternatives, particularly using GPS, address these biases while opening new channels for research. This study describes the development and implementation of a GPS-based approach to detect health facility visits in rural Pune district, India.MethodsParticipants were mothers of under-five year old children within the Vadu Demographic Surveillance area. Participants received GPS-enabled smartphones pre-installed with a location-aware application to continuously record and transmit participant location data to a central server. Data were analyzed to identify health facility visits according to a parameter-based approach, optimal thresholds of which were calibrated through a simulation exercise. Lists of GPS-detected health facility visits were generated at each of six follow-up home visits and reviewed with participants through prompted recall survey, confirming visits which were correctly identified. Detected visits were analyzed using logistic regression to explore factors associated with the identification of false positive GPS-detected visits.ResultsWe enrolled 200 participants and completed 1098 follow-up visits over the six-month study period. Prompted recall surveys were completed for 694 follow-up visits with one or more GPS-detected health facility visits. While the approach performed well during calibration (positive predictive value (PPV) 78%), performance was poor when applied to participant data. Only 440 of 22 251 detected visits were confirmed (PPV 2%). False positives increased as participants spent more time in areas of high health facility density (odds ratio (OR) = 2.29, 95% confidence interval (CI) = 1.62-3.25). Visits detected at facilities other than hospitals and clinics were also more likely to be false positives (OR = 2.78, 95% CI = 1.65-4.67) as were visits detected to facilities nearby participant homes, with the likelihood decreasing as distance increased (OR = 0.89, 95% CI = 0.82-0.97). Visit duration was not associated with confirmation status.ConclusionsThe optimal parameter combination for health facility visits simulated by field workers substantially overestimated health visits from participant GPS data. This study provides useful insights into the challenges in detecting health facility visits where providers are numerous, highly clustered within urban centers and located near residential areas of the population which they serve.

Trajectories of changes in distress in counseling center clients: a replication study

ABSTRACT Objective: Latent growth mixture modeling (LGMM) and latent class growth analysis (LCGA) are methods of identifying subgroups of individuals with similar trajectories during the course of psychotherapy. Due to inconsistent methodology, previous LGMM/LCGA psychotherapy research has led to inconsistent findings. The purpose of this study was to contribute to our understanding of individual differences in change trajectories during psychotherapy using LGMM/LCGA by attempting to replicate a previous study by Owen et al. (2015. Trajectories of change in psychotherapy. Journal of Clinical Psychology, 71(9), 817–827). Method: This study used LGMM/LCGA to model trajectories of change in a sample of 2538 psychotherapy clients at a university student counseling center. This was a secondary analysis of naturalistically-collected outcome data using The Behavioral Health Measure. Results: LGMM models did not converge. A 2-class LCGA model was selected based on fit statistics and parsimony. One class was labeled as Slow and Steady Change Before Plateau, whereas the other was labeled as Early Rapid Change Before Plateau. We also extended these findings by considering variables associated with class membership. Conclusions: These classes followed similar trajectories to two of the classes identified by Owen et al. These results indicate that latent trajectory modeling may lead to replicable findings. Furthermore, these results have implications for managing expectations about change in psychotherapy.

Brief online interventions for LGBTQ young adult mental and behavioral health: A randomized controlled trial in a high-stigma, low-resource context.

To identify scalable interventions for improving sexual minority mental health and health-risk behavior, this study tested the efficacy of two self-guided online writing interventions-expressive writing and self-affirmation. To reach sexual minority young adults living in high-stigma, low-resource settings, we developed and tested these interventions in Appalachian Tennessee. In consultation with sexual minority young adults (n = 10) and stakeholders (n = 10) living in Appalachian Tennessee, we adapted these two writing interventions that we then delivered to 108 local sexual minority young adults (Mage = 23.68, SD = 3.11). Participants, representing diverse sexual and gender identities and socioeconomic backgrounds, were randomly assigned to participate in a 3-session expressive writing intervention, self-affirmation intervention, or neutral control. Participants completed mental health and health-risk behavior measures at baseline, postintervention, and 3-month follow-up. Compared to the neutral control, expressive writing exerted 3-month improvements in depressive symptoms (d = 0.48) and general psychological distress (d = 0.36) whereas self-affirmation exerted improvement in suicidal ideation (d = 0.62) and drug abuse (d = 0.59). Participants who were exposed to greater contextual minority stressors common in rural regions (i.e., discrimination and victimization) experienced significantly greater 3-month reductions in depression from expressive writing and self-affirmation compared to control. Those who experienced greater discrimination also experienced significantly greater 3-month reductions in suicidality from self-affirmation compared to control. Brief writing interventions exert significant impact on the mental health of young adult sexual minorities, especially those exposed to minority stress. Future research can consider strategies for population-level implementation, especially in high-stigma, low-resource settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Self-reported health behaviors and longitudinal cognitive performance in late middle age: Results from the Wisconsin Registry for Alzheimer's Prevention.

BackgroundStudies have suggested associations between self-reported engagement in health behaviors and reduced risk of cognitive decline. Most studies explore these relationships using one health behavior, often cross-sectionally or with dementia as the outcome. In this study, we explored whether several individual self-reported health behaviors were associated with cognitive decline when considered simultaneously, using data from the Wisconsin Registry for Alzheimer’s Prevention (WRAP), an Alzheimer’s disease risk-enriched cohort who were non-demented and in late midlife at baseline.MethodWe analyzed longitudinal cognitive data from 828 participants in WRAP, with a mean age at baseline cognitive assessment of 57 (range = 36–78, sd = 6.8) and an average of 6.3 years (standard deviation = 1.9, range = 2–10) of follow-up. The primary outcome was a multi-domain cognitive composite, and secondary outcomes were immediate/delayed memory and executive function composites. Predictors of interest were self-reported measures of physical activity, cognitive activity, adherence to a Mediterranean-style diet (MIND), and interactions with each other and age. We conducted linear mixed effects analyses within an Information-theoretic (IT) model averaging (MA) approach on a set of models including covariates and combinations of these 2- and 3-way interactions. The IT approach was selected due to the large number of interactions of interest and to avoid pitfalls of traditional model selection approaches.ResultsModel-averaged results identified no significant self-reported health behavior*age interactions in relationship to the primary composite outcome. In secondary outcomes, higher MIND diet scores associated with slower decline in executive function. Men showed faster decline than women on delayed memory, independent of health behaviors. There were no other significant interactions among any other health behaviors and cognitive trajectories.ConclusionsWhen multiple covariates and health behaviors were considered simultaneously, there were limited weak associations with cognitive decline in this age range. These results may be explained alone or in combination by three alternative explanations: 1) the range of cognitive decline is in middle age is too small to observe relationships with health behaviors, 2) the putative associations of these health behaviors on cognition may not be robust in this age range, or 3) the self-reported measures of the health behaviors may not be optimal for predicting cognitive decline. More study may be needed that incorporates sensitive measures of health behaviors, AD biomarker profiles, and/or other disease comorbidities.

English

English

Remote Therapy to Improve Outcomes in Lung Transplant Recipients: Design of the INSPIRE-III Randomized Clinical Trial.

Background.Impaired functional capacity and emotional distress are associated with lower quality of life (QoL) and worse clinical outcomes in post lung transplant patients. Strategies to increase physical activity and reduce distress are needed.Methods.The Investigational Study of Psychological Interventions in Recipients of Lung Transplant-III study is a single site, parallel group randomized clinical trial in which 150 lung transplant recipients will be randomly assigned to 3 months of telephone-delivered coping skills training combined with aerobic exercise (CSTEX) or to a Standard of Care plus Education control group. The primary endpoints are a global measure of distress and distance walked on the 6-Minute Walk Test. Secondary outcomes include measures of transplant-specific QoL, frailty, health behaviors, and chronic lung allograft dysfunction–free survival.Results.Participants will be evaluated at baseline, at the conclusion of 3 months of weekly treatment, at 1-year follow-up, and followed annually thereafter for clinical events for up to 4 years (median = 2 y). We also will determine whether functional capacity, distress, and health behaviors (eg, physical activity, medication adherence, and volume of air forcefully exhaled in 1 second (FEV1), mediate the effects of the CSTEX intervention on clinical outcomes.Conclusions.Should the CSTEX intervention result in better outcomes compared with the standard of care plus post-transplant education, the remotely delivered CSTEX intervention can be made available to all lung transplant recipients as a way of enhancing their QoL and improving clinical outcomes.

Association between heart-focused anxiety, depressive symptoms, health behaviors and healthcare utilization in patients with coronary heart disease

ObjectiveTo analyze the association between heart-focused anxiety, depressive symptoms, health behaviors and healthcare utilization in patients with coronary heart disease (CHD). MethodsN = 1007 patients with CHD were recruited in hospital and followed for one year in a two-site cohort study. Heart focused anxiety (Cardiac Anxiety Questionnaire [CAQ] with the three subscales fear, attention, and avoidance), depressive symptoms (depression module from the Patient Health Questionnaire [PHQ-9]), health behaviors and healthcare utilization (smoking status, alcohol consumption, physical activity, outpatient physician/psychotherapist visits) were assessed six months after the initial hospitalization. Multiple regression models were used for statistical analysis. ResultsAbout one third of the sample exhibited clinically significant CAQ scores. Higher CAQ-avoidance scores were associated with current smoking (OR = 1.62; 95%CI: 1.33–1.98), reduced alcohol intake (OR = 0.83; 95%CI: 0.71–0.98), non-participation in a coronary exercise group (OR = 1.76; 95%CI: 1.42–2.17), less regular physical activity (OR = 2.69; 95%CI: 2.32–3.12), and more frequent contact to general practitioners (GPs; b = 0.07, SE: 0.03). CAQ-attention was associated with non-smoking (OR = 0.51; 95%CI: 0.37–0.70), exercise group participation (OR = 0.69; 95%CI: 0.51–0.94), more frequent regular physical activity (OR = 0.55; 95%CI: 0.44–0.68), and more frequent contact to specialists for internal medicine (b = 0.09, SE: 0.04). CAQ-fear was not associated with any of the health behavior or healthcare use measures. Depressive symptoms were associated with reduced regular physical activity (OR = 1.05; 95%CI: 1.02–1.08) and increased contact to mental care specialists (b = 0.03, SE: 0.01) and GPs (b = 0.02, SE: 0.01). ConclusionsHeart-focused anxiety and depressive symptoms may impede secondary prevention in patients with CHD and increase outpatient healthcare utilization.

Impact of Peer Specialist Services on Residential Stability and Behavioral Health Status Among Formerly Homeless Veterans With Cooccurring Mental Health and Substance Use Conditions.

This study tested the impacts of peer specialists on housing stability, substance abuse, and mental health status for previously homeless Veterans with cooccurring mental health issues and substance abuse. Veterans living in the US Housing and Urban Development-Veterans Administration Supported Housing (HUD-VASH) program were randomized to peer specialist services that worked independently from HUD-VASH case managers (ie, not part of a case manager/peer specialist dyad) and to treatment as usual that included case management services. Peer specialist services were community-based, using a structured curriculum for recovery with up to 40 weekly sessions. Standardized self-report measures were collected at 3 timepoints. The intent-to-treat analysis tested treatment effects using a generalized additive mixed-effects model that allows for different nonlinear relationships between outcomes and time for treatment and control groups. A secondary analysis was conducted for Veterans who received services from peer specialists that were adherent to the intervention protocol. Treated Veterans did not spend more days in housing compared with control Veterans during any part of the study at the 95% level of confidence. Veterans assigned to protocol adherent peer specialists showed greater housing stability between about 400 and 800 days postbaseline. Neither analysis detected significant effects for the behavioral health measures. Some impact of peer specialist services was found for housing stability but not for behavioral health problems. Future studies may need more sensitive measures for early steps in recovery and may need longer time frames to effectively impact this highly challenged population.

An Internet-Based Therapeutic Tool for American Indian/Alaska Native Adults With Posttraumatic Stress Disorder: User Testing and Developmental Feasibility Study.

BackgroundPosttraumatic stress disorder (PTSD) is a major public health concern among American Indian and Alaska Native populations. Primary care clinics are often the first point of contact for American Indian and Alaska Natives seeking health care and are feasible locations for trauma-focused interventions.ObjectiveWeb-based therapeutic interventions have the potential to reduce PTSD symptoms by offering psychoeducation and symptom self-management tools. We investigated the feasibility of a culturally adapted Web-based therapeutic intervention in two American Indian and Alaska Native–serving primary care sites. We developed and tested a self-guided Web-based therapeutic intervention aimed at improving knowledge and awareness of, and provision of guidance, support, and symptom-management for, PTSD symptoms.MethodsA community-based participatory research process was used to refine adaptations to the veteran’s administration’s PTSD Coach Online, to develop new content, and to guide and interpret the results of the feasibility pilot. This process resulted in a 16-guide intervention “Health is Our Tradition: Balance and Harmony after Trauma” website. The feasibility pilot included 24 American Indian and Alaska Natives aged 18 years and older who scored positive on a primary care PTSD screener. Enrolled participants completed a demographic questionnaire, an experience with technology questionnaire, and baseline behavioral health measures. Once measures were complete, research staff described weekly text messages, minimum study expectations for website use, and demonstrated how to use the website. Feasibility measures included self-reported website use, ratings of satisfaction and perceived effectiveness, and website metrics. Feasibility of obtaining measures for an effectiveness trial was also assessed to include behavioral health symptoms and service utilization through self-report instruments and electronic health record queries. Self-reported measures were collected at enrollment and at 6 and 12 weeks post enrollment. Electronic health records were collected from 12 months before study enrollment to 3 months following study enrollment. Changes between enrollment and follow-up were examined with paired t tests, analysis of variance or logistic regression, or the Wilcoxon signed rank test for nonnormally distributed data.ResultsThe culturally adapted website and associated text message reminders were perceived as satisfactory and effective by participants with no differences by age or gender. The majority of participants (86%, 19/24) reported use of the website at 6 weeks and nearly all (91%, 20/22) at 12 weeks. At 6 weeks, 55% (12/22) of participants reported using the website at the recommended intensity (at least three times weekly), dropping to 36% (8/22) at 12 weeks. Participant use of modules varied from 8% (2/24) to 100% (24/24), with guide completion rates being greater for guides that were only psychoeducational in nature compared with guides that were interactive. There were no significant changes in patterns of diagnoses, screening, medications, or service utilization during exposure to the website.Conclusions“Health is Our Tradition: Balance and Harmony after Trauma” shows promise for an effectiveness pilot.

EXAMINING PSYCHOSOCIAL FACTORS, HEALTH BEHAVIORS, AND WHITE MATTER LESIONS IN OLDER ADULTS

Prior to the onset of dementia, subclinical indices of brain pathology may reliably predict cognitive decline, even among older adults with high cognitive reserve. Evidence suggests that positive psychosocial experiences and healthy behaviors buffer cognitive decline. However, their relationship with brain outcomes in cognitively intact older adults is not well understood. Therefore, the current study examined the cross-sectional association between perceived social support, generalized anxiety, psychosocial stress, physical activity, sleep quality, and magnetic resonance imaging (MRI)-assessed white matter lesions (WML), among a diverse sample of older adults. We also examined sex and race as effect modifiers. Data were analyzed from 129 participants (mean age=67.40y, 69% female, 43% African American) enrolled in the Healthy Heart & Mind Study. Participants completed psychosocial and health behavior measures and MRI-assessed periventricular and deep WML were ascertained. Multiple regression analyses assessed relations of psychosocial responses and physical activity to WML, adjusting for known covariates. Significant general anxiety x sex interactions on deep WML (p<.05), significant physical activity x race interactions on total WML, frontal lobe WML and deep WML, respectively, and total sleep quality x race interactions on deep WML, were observed (p<.05). Conditional effects showed greater physical activity and sleep quality were associated with lower WML in African-American women; greater social belonging was associated with lower WML in American-American men; and lower anxiety was associated with lower WML in African-American women and White men. Results suggest positive psychosocial factors and health behaviors may influence subclinical brain pathology via unique pathways.

ALCOHOL USE SCREENING AND INTEGRATED BEHAVIORAL HEALTH IN GERIATRIC PRIMARY CARE IN THE DEEP SOUTH

This longitudinal behavioral health surveillance and integrated care project aims to assess physical and mental health and substance use in a geriatric primary care setting. Approximately 230 patients (mean age = 76; 74% female; 16% African American) attending an interdisciplinary geriatrics clinic in Alabama have taken part in baseline behavioral health screenings since 2014. Behavioral health measures include cognitive status, self-reported mood, subjective and objective health literacy, and alcohol use. All measures are administered by clinical psychology graduate students. Patients had an average of 5.83 medical diagnoses. Only 26.2% of patients had scores indicating cognitive functioning within normal limits; 32.6% had scores indicative of mild neurocognitive disorder, and 41.2% had scores indicative of dementia. Over 80% of patients had adequate self-reported health literacy; however, measurements of objective health literacy indicated a significant number of individuals have difficulty following medical directions independently. Over 30% of patients reported clinically significant levels of depression or anxiety, and 16.5% of patients reported at least one indicator of hazardous alcohol use. Specifically, 50.7% of patients consume alcohol on at least a yearly basis with 38.2% endorsing at least one problematic drinking behavior and 11.6% scoring in the clinically significant range for alcohol misuse. Moreover, 22.7% report use of opioid pain medication. The results of this study demonstrate that routine hazardous alcohol use screening as one component of integrated behavioral health care within geriatric primary care increases detection of hazardous alcohol use among older adults.

Patient Prototypes

Abstract. Despite large bodies of research examining perceptions of illnesses and perceptions of people who engage in various health behaviors, very little research has examined perceptions of people who have a specific illness. The aims of this research were to create a measure of “patient prototypes,” mental representations of the type of person who has a specific illness, and to examine their associations with other health cognitions and behaviors. Two survey studies (Study 1: N = 208 and Study 2: N = 246) assessed patient prototype favorability for three illnesses (skin cancer, Human papillomavirus (HPV), and type 2 diabetes) as well as constructs from the common-sense model and prototype willingness model. Patient prototypes for the three illnesses were distinct in terms of specific traits and overall favorability. Generally, patient prototype favorability was unrelated to illness representation dimensions in the common-sense model but was positively associated with some constructs in the prototype/willingness model. All three prototypes were positively correlated with perceived vulnerability. The skin cancer prototype was positively correlated with measures of behavioral willingness, behavioral intention, and actual health behavior (UV exposure). Limitations include the use of young adult participants who have relatively little experience with the illnesses examined. Measures of patient prototype favorability and health behaviors need to be further examined and refined. The novel construct of patient prototype favorability provides a foundation for future inquiry into the role that patient perceptions play in health behavior and the implications for the prototype/willingness model and the common-sense model.

CN52 - A pilot trial to investigate the impact of a personalised self-management lifestyle programme using mobile technology on the health and wellbeing of cancer survivors

BackgroundCancer survivorship is increasing yet cancer treatment can cause de-conditioning and reduce physical capacity. Consequently there is a need to identify interventions which can improve health. This study investigated the impact of a personalised self-management programme on the physical and psychological health of cancer survivors with lifestyle related health risks. MethodsFor the purpose of this research the Moving on Programme was developed which is an intervention for cancer survivors to self-manage lifestyle. A randomised control pilot trial was conducted on 123 cancer survivors with a BMI > 25. Participants were randomly assigned to the control (n=61) or intervention (n=62) groups. The intervention group attended the Moving on Programme and engaged in personalised goal-setting to incrementally increase physical activity and made dietary changes. Participants in the control group received only brief standard advice. Objective measures of health behaviour were collected via Fitbit. Data on anthropometric, physiological, dietary behaviour and psychological measures were collected on all participants at baseline, three and six months. A sample of participants were interviewed (n=13) to examine acceptability of the intervention. ResultsOverall, the results demonstrate a positive effect of the Moving on Programme. There was a significant reduction in BMI observed within the intervention group (p=0.05) in the first three months. Positive participant outcomes also included improvement in physical and psychological wellbeing, and social functioning with reduced fatigue. Qualitative data demonstrated the acceptability of the intervention and participants identified that the Moving on Programme fulfils a deficit that exists in cancer survivorship and rehabilitation. ConclusionsThe Moving on Programme designed for this study, demonstrated physical and psychological benefits to participants. The use of behaviour change techniques and mobile technology was used effectively as an acceptable intervention that supports weight loss, promotes healthier behaviours and improves wellbeing in cancer survivors. Clinical trial identificationISRCTN18676721 https://doi.org/10.1186/ISRCTN18676721. Legal entity responsible for the studyThe authors. FundingIrish Cancer Society. DisclosureAll authors have declared no conflicts of interest.

Examining the Impact of a Personalized Self-Management Lifestyle Program Using Mobile Technology on the Health and Well-Being of Cancer Survivors: Protocol and Rationale for a Randomized Controlled Trial (The Moving On Study).

BackgroundCancer survivorship in Ireland is increasing in both frequency and longevity. However, a significant proportion of cancer survivors are overweight. This has negative implications for long-term health outcomes, including increased risk of subsequent and secondary cancers. There is a need to identify interventions, which can improve physical and psychological outcomes that are practical in modern oncology care. Mobile health (mHealth) interventions demonstrate potential for positive health behavior change, but there is little evidence for the efficacy of mobile technology to improve health outcomes in cancer survivors.ObjectiveThis study aims to investigate whether a personalized mHealth self-management lifestyle program is acceptable to participants and can improve physical and psychological outcomes of a subgroup of cancer survivors with increased health risks related to lifestyle behaviors.MethodsA sample of 123 cancer survivors (body mass index >25 kg/m2) was randomly assigned to the control (n=61) or intervention (n=62) group. The intervention group attended a 4-hour tailored lifestyle information session with a physiotherapist, dietician, and clinical psychologist to support self-management of health behavior. Over the following 12 weeks, participants engaged in personalized goal setting to incrementally increase physical activity (with feedback and review of goals through short message service text messaging contact). Objective measures of health behavior (ie, physical activity) were collected using Fitbit (Fitbit, Inc). Data on anthropometric, physiological, dietary behavior, and psychological measures were collected at baseline (T0), 12 weeks (T1; intervention end), and 24 weeks (T2; follow-up). Semistructured interviews were conducted to explore the retrospective acceptability of the Moving On program from the perspective of the recipients.ResultsThis paper details the protocol for the Moving On study. The project was funded in August 2017. Enrolment started in December 2017. Data collection completed in September 2018. Data analysis is underway, and results are expected in winter 2019.ConclusionsThe results of this study will determine the efficacy and acceptability of an mHealth intervention using behavior change techniques to promote health behaviors that support physical health and well-being in cancer survivors and will therefore have implications for health care providers, patients, health psychologists, and technologists.International Registered Report Identifier (IRRID)DERR1-10.2196/13214

710-P: The Relationship between Health Literacy, Cardiovascular Disease Knowledge, and Diabetes Prevention Knowledge in Middle Eastern Patients at a Free Clinic

This study's purpose was to investigate the level of health literacy, cardiovascular disease (CVD) knowledge and diabetes prevention knowledge, as well as the relationship among them, in the Middle Eastern population. A survey was conducted among the Middle Eastern patients of a free health clinic to obtain information on the health literacy and knowledge of these patients. A total of 73 surveys were collected and analyzed in this study. Print literacy and numeracy were strongly correlated with each other (r=0.4949, P&amp;lt;0.0001). Both print literacy and numeracy were significantly correlated with the Diabetes Prevention knowledge score (print literacy: r=0.2764, P=0.0179; numeracy: r=0.4110, P=0.0003), but not with the CVD knowledge score. The Diabetes Prevention knowledge score had a high correlation with the CVD knowledge score (r=0.6980, P&amp;lt;0.0001). Furthermore, print literacy was significantly associated with self-reported health status (r=0.2637, P=0.0242). Our results support that health literacy was associated with some disease-specific knowledge and self-reported health status in the Middle Eastern population. Future research that includes measures of health behaviors and objective measure of health status could help provide more insight into the interactions between these variables in this understudied population. Disclosure C. Kawata: None. L. Jiang: None.