Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention Among Breast Cancer Survivors

Julie B Wang; John P Pierce; Guadalupe X Ayala; Lisa A Cadmus-Bertram; Shirley W Flatt; Hala Madanat; Vicky A Newman; Jeanne F Nichols; Loki Natarajan

doi:10.1007/s12160-015-9716-1

Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention Among Breast Cancer Survivors

Ann Behav Med. 2015 Dec;49(6):819-27. doi: 10.1007/s12160-015-9716-1.

Authors

Julie B Wang¹, John P Pierce^{2

3}, Guadalupe X Ayala^{4

5}, Lisa A Cadmus-Bertram⁶, Shirley W Flatt⁷, Hala Madanat^{5

8}, Vicky A Newman⁷, Jeanne F Nichols⁹, Loki Natarajan^{10

7}

Affiliations

¹ University of California, San Diego, 530 Parnassus Avenue, Library Room 366, San Francisco, CA,, 94143, USA.
² University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, MC 0901, La Jolla, 92093-0901, CA, USA. jppierce@ucsd.edu.
³ University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA,, 92093-0901, USA. jppierce@ucsd.edu.
⁴ San Diego State University, Graduate School of Public Health, 5500 Campanile, MC 4124, San Diego, CA, 92182-4124, USA.
⁵ San Diego State University, Institute for Behavioral And Community Health, 9245 Sky Park Court, Ste. 221, San Diego, CA 92123-4311, USA.
⁶ University of Wisconsin - Madison, Department of Kinesiology, 2000 Observatory Drive, Madison, WI, 53706, USA.
⁷ University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA,, 92093-0901, USA.
⁸ San Diego State University, Graduate School of Public Health, 5500 Campanile MC 4162, San Diego, CA, 92182-4162, USA.
⁹ San Diego State University, Institute for Behavioral And Community Health, 9500 Gilman Drive, MC 0811, La Jolla, CA, 92093-0811, USA.
¹⁰ University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, MC 0901, La Jolla, 92093-0901, CA, USA.

Abstract

Background: Depressive symptoms can lower adherence and change in dietary studies. Behavioral activation may reduce these effects.

Purpose: This study aims to assess relationships among depressive symptoms on adherence and dietary change in the Women's Healthy Eating and Living (WHEL) Study

Methods: Secondary analyses from the WHEL Study, which achieved major dietary change in breast cancer survivors (N = 2817), were conducted. Logistic regressions were undertaken of baseline depressive symptoms (six-item Center for Epidemiologic Studies Depression Scale (CES-D)) with (1) completion of 1- and 4-year study assessments and (2) validated change in dietary behavior in the intervention group.

Results: In the comparison group (vs. intervention), depressive symptoms lowered completion of dietary recalls and clinic visits [4 years: odds ratio (OR) = 2.0; 95 % confidence interval (CI) = 1.4-3.0]. The behaviorally oriented intervention achieved major change in those furthest from study targets, although changes were lower in those with depressive symptoms: fruit/vegetable (+37.2 %), fiber (+49.0 %), and fat (-22.4 %).

Conclusions: Behavioral activation in dietary change interventions can overcome the impact of depressive symptoms.

Keywords: Adherence; Behavioral activation; Depressive symptoms; Dietary change.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Breast Neoplasms / psychology*
Depression / psychology*
Diet / psychology*
Dietary Fiber
Feeding Behavior / psychology
Female
Fruit
Health Behavior*
Humans
Middle Aged
Survivors / psychology*
Vegetables

Abstract

Publication types

MeSH terms

Grants and funding