Abstract B4: A home-based intervention among older long-term cancer survivors improves physical activity, diet quality, weight status, and physical functioning: Results of the RENEW (Reach-out to ENhancE Wellness) trial Free

B4

Cancer survival rates are ever increasing; currently two-thirds of cancer patients will be alive at least 5 years after diagnosis. Despite these gains, many cancer survivors are left with significant comorbidity and accelerated functional decline. Older survivors experience greater declines in function, threatening independence and resulting in increased health care costs. The aim of the RENEW trial was to determine if a year-long, diet-exercise intervention delivered to older long-term cancer survivors via telephone prompts, counseling, and mailed materials could effectively improve health behaviors, and result in improved weight status, and physical functioning. Cancer cases were ascertained from cancer registries and self-referral: 20,015 letters of invitation were posted, 1,208 survivors were screened [eligibility criteria: age 65+; breast, prostate or colorectal cancer diagnosed at least 5-years prior with no evidence of recurrence; body mass index (BMI-kg/m²) 25-40; <150 minutes of moderate-to-vigorous physical activity/week; community-dwelling; and no medical conditions precluding unsupervised exercise], and 641 participants were enrolled. Baseline and follow-up data were collected largely via computer-assisted telephone interviews using the following validated measures: physical functioning (SF-36 Physical Function Subscale and Late Life Function Basic and Advanced Lower Extremity Subscales); physical activity (Community Healthy Activities for Physical Activity in Older Adults Survey); diet quality [revised Healthy Eating Index (HEI) from 2-day dietary recalls]; and BMI. Participants were randomized to immediate- (n=319) or delayed- (n=322) intervention arms. At 1-year a 12.9% rate of attrition was observed. Baseline-to-follow-up change scores [means (SD); crude unadjusted p-values] in the intervention vs. delayed intervention arms were as follows: SF-36 physical functioning [-2.5 (1.1) vs. -5.3 (1.0) points; p=.04]; Basic Lower Extremity [+0.4 (0.7) vs. -2.1 (0.7) points; p=.005]; Advanced Lower Extremity [-0.4 (0.6) vs. -2.6 (0.6) points; p=.01]; Moderate-to-Vigorous Physical Activity [+44.9 (5.9) vs. +29.7 (6.2) minutes/week (111.7); p=.02]; HEI [+7.1 (0.9) vs. +1.4 (0.8) points; p<.0001]; and BMI [-0.8 (0.1) vs. -0.3 (0.1); p<.0001]. These preliminary findings suggest that older, long-term cancer survivors respond favorably to tailored home-based interventions and effectively improve not only their behaviors, but also experience significant and clinically meaningful improvements in body weight status and physical functioning.

Citation Information: Cancer Prev Res 2008;1(7 Suppl):B4.