Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention A
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ORIGINAL ARTICLE
Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention Among Breast Cancer Survivors Julie B. Wang, PhD, MPH 1 & John P. Pierce, PhD 2,3 & Guadalupe X. Ayala, PhD, MPH 4,5 & Lisa A. Cadmus-Bertram, PhD 6 & Shirley W. Flatt, MS 3 & Hala Madanat, PhD 5,7 & Vicky A. Newman, MS, RD 3 & Jeanne F. Nichols, PhD, FACSM 8 & Loki Natarajan, PhD 2,3
# The Author(s) 2015. This article is published with open access at Springerlink.com
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.
* John P. Pierce [email protected]
Keywords Dietary change . Depressive symptoms . Adherence . Behavioral activation
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
3
University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA, 92093-0901, USA
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
San Diego State University, Graduate School of Public Health, 5500 Campanile MC 4162, San Diego, CA 92182-4162, USA
8
San Diego State University, Institute for Behavioral And Community Health, 9500 Gilman Drive, MC 0811, La Jolla, CA 92093-0811, USA
Introduction Increasing consumption of plant-based foods and reducing energy from fat are public health goals to reduce the incidence of a number of diseases including both cardiovascular disease
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