A Self-efficacy Based Dietary Intervention

Study Overview
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Brief Summary
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To develop and test the effectiveness of a dietary intervention aiming to enhance self-efficacy through sending images through instant messaging.

Detailed Description
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Healthy eating is linked to improved survival and quality of life among cancer survivors. However, previous studies showed that most cancer survivors were not adhering to dietary recommendations despite having made changes post-diagnosis. Conventional nutrition counseling interventions are often used in this population. However, they are labor and cost intensive and involved multiple sessions with participants. Written materials have often been used to facilitate improvements of dietary quality beyond nutrition counseling sessions but are outdated. Therefore, we propose to develop and test the effectiveness of a dietary intervention aiming to enhance self-efficacy through sending images through instant messaging. Methods to increase self-efficacy include performance accomplishment, persuasion, modelling and peer-modelling. A prospective, randomized controlled trial design will be used to test the effectiveness of the intervention. A total of 168 adult Chinese cancer survivors, diagnosed with non-metastatic cancer (Stages 0-III), and have completed all active treatments, including surgery and adjuvant treatments such as chemotherapy and radiation therapy will be recruited. Participants will be randomly assigned into one of two groups at a 1:1 ratio, using computer-generated block randomization sequences. The first group will be an active control group. Participants in this group will receive knowledge-based dietary information through an instant messaging applications biweekly for 6 times. The second group will be the intervention group. Participants will receive biweekly self-efficacy enhancing materials for 6 times. Materials will provide information about behavior-health link, provide information on consequences, provide instruction, and provide opportunities for social comparison. For example, the materials will provide recipe ideas and meal planning samples from fellow cancer survivors. All materials will be developed by a registered dietitian and will be consistent with published dietary guidelines for cancer survivors. Participants will have follow-up appointments at 3 months. Their dietary quality and skin carotenoid status will be monitored. It is hypothesized that dietary quality will be better and skin carotenoid status will be higher for participants in the intervention group compared to participants in the active control group.

Official Title
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Eat Well After Cancer: a Randomized Controlled Trial of a Self-efficacy Based Dietary Intervention Among Chinese Cancer Survivors

Conditions
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Cancer

Intervention / Treatment
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* Behavioral: Self-efficacy based images through instant messaging
* Behavioral: Knowledge based images through instant messaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 or above Diagnosed with cancer, non-metastatic (Stages 0-III) Ability to read Chinese and speak Cantonese or Putonghua/Mandarin Completed all active treatments, including surgery and adjuvant treatments such as chemotherapy and radiation therapy Attending clinic with nutrition counseling at study site Exclusion Criteria: Ethnicity other than Chinese Diagnosed with mental, hearing, speech, or cognitive disabilities
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention: Self-efficacy based images<br>Intervention group with self-efficacy based images sent through instant messaging biweekly for 6 times. | Behavioral: Self-efficacy based images through instant messaging<br>* A total of 6 images will be sent to participants via instant messaging. Images will utilize concepts in the Theory of self-efficacy to increase dietary self-efficacy among participants and hence improve dietary quality beyond that of conventional nutrition counseling.<br>|
| Active Comparator: Active control: knowledge based images<br>Active control group with knowledge based images sent through instant messaging biweekly for 6 times. | Behavioral: Knowledge based images through instant messaging<br>* A total of 6 images will be sent to participants via instant messaging. Images will consist of information covered in nutrition counseling sessions, such as those related to serving sizes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline in mean dietary quality | Servings of fruit and vegetables per day, number of red meat servings per week and ratio of whole to refined grains measured by a 3-day dietary record self-completed by participants before baseline and 3-months follow-up | Baseline and 3 months | 
| Changes from baseline in mean skin carotenoid reading | Skin carotenoid status reading measured by a reflective spectroscopy machine | Baseline and 3 months |