Long-term outcomes of the FRESH START trial: exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity.

Academic Article


  • BACKGROUND: This study examined whether changes in self-efficacy explain the effects of a mailed print intervention on long-term dietary practices of breast and prostate cancer survivors. The relationship between change in self-efficacy and long-term physical activity (PA) also was examined. METHODS: Breast and prostate cancer survivors (N = 543) from 39 US states and two Canadian provinces participated in the FRESH START intervention trial. Participants were randomly assigned to receive a 10-month program of mailed print materials on diet and PA available in the public domain or a 10-month program of tailored materials designed to increase fruit and vegetable (F&V) intake, decrease fat intake, and/or increase PA. Changes in self-efficacy for F&V intake and fat restriction were analyzed as potential mediators of the intervention's effects on diet at 2-year follow-up. Because we previously found that change in self-efficacy for PA did not vary by group assignment, the relationship between change in self-efficacy and PA at 2-year follow-up was examined across study conditions. RESULTS: Results suggest that change in self-efficacy for fat restriction partially explained the intervention's effect on fat intake (mean indirect effect = -0.28), and change in self-efficacy for F&V consumption partially explained the intervention's effect on daily F&V intake (mean indirect effect = .11). Change in self-efficacy for fat restriction partially accounted for the intervention's impact on overall diet quality among men only (mean indirect effect = 0.60). Finally, change in self-efficacy for PA predicted PA at 2-year follow-up. CONCLUSIONS: Findings suggest that self-efficacy may influence long-term maintenance of healthy lifestyle practices among cancer survivors.
  • Published In

  • Keywords

  • Adult, Aged, Aged, 80 and over, Breast Neoplasms, Canada, Diet, Exercise, Female, Follow-Up Studies, Health Behavior, Humans, Life Style, Male, Middle Aged, Prostatic Neoplasms, Quality of Life, Regression Analysis, Self Efficacy, Surveys and Questionnaires, Survivors, Time Factors, Treatment Outcome, United States
  • Digital Object Identifier (doi)

    Author List

  • Mosher CE; Lipkus I; Sloane R; Snyder DC; Lobach DF; Demark-Wahnefried W
  • Start Page

  • 876
  • End Page

  • 885
  • Volume

  • 22
  • Issue

  • 4