Effectiveness of different methods for delivering tailored nutrition education to low income, ethnically diverse adults

<p>Abstract</p> <p>Background</p> <p>Computer-tailored written nutrition interventions have been shown to be more effective than non-tailored materials in changing diet, but continued research is needed. Your Healthy Life/Su Vida Saludable (YHL-SVS) was an intervention study with low income, ethnically diverse, English and Spanish-speaking participants to determine which methods of delivering tailored written nutrition materials were most effective in lowering fat and increasing fruit and vegetable (F&V) intake.</p> <p>Methods</p> <p>YHL-SVS was a randomized controlled trial with four experimental conditions: 1) Nontailored (NT) comparison group; 2) Single Tailored (ST) packet; 3) Multiple Tailored (MT) packet mailed in four installments; 4) Multiple Re-Tailored (MRT) MT packets re-tailored between mailings via brief phone surveys. A baseline telephone survey collected information for tailoring as well as evaluation. Follow-up evaluation surveys were collected 4- and 7-months later. Primary outcomes included F&V intake and fat related behaviors. Descriptive statistics, paired t-test and ANOVA were used to examine the effectiveness of different methods of delivering tailored nutrition information.</p> <p>Results</p> <p>Both the ST and MT groups reported significantly higher F&V intake at 4-months than the NT and MRT groups. At 7 months, only the MT group still had significantly higher F&V intake compared to the NT group. For changes in fat-related behaviors, both the MT and MRT groups showed more change than NT at 4 months, but at 7 months, while these differences persisted, they were no longer statistically significant. There was a significant interaction of experimental group by education for change in F&V intake (P = .0085) with the lowest educational group demonstrating the most change.</p> <p>Conclusion</p> <p>In this study, tailored interventions were more effective than non-tailored interventions in improving the short-term dietary behaviors of low income, ethnically diverse participants. Delivery of information in multiple smaller doses over time appeared to improve effectiveness. Future studies should determine which variables are mediators of dietary change and whether these differ by participant demographics. Moreover, future research should differentiate the effects of tailoring vs. cultural adaptation in ethnically diverse populations and study the dissemination of tailored interventions into community-based settings.</p> <p>Trial registration</p> <p>Current Controlled Trials # NCT00301691.</p

Comparison of Acquisition Parameters and Breast Dose in Digital Mammography and Screen-Film Mammography in the American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial

The purpose of our study was to compare the technical performance of full-field digital mammography (FFDM) and screen-film mammography

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with Use of a Logistic Regression Model

To determine which factors contributed to the Digital Mammographic Imaging Screening Trial (DMIST) cancer detection results

Assessing Fat-Related Dietary Behaviors among Black Women: Reliability and Validity of a New Food Habits Questionnaire

Objective To describe the development of the SisterTalk Food Habits Questionnaire (STFHQ). Design Formative research was conducted to adapt previous tools for the study’s target population. A pilot tool (168 questions) was tested. The new 94-question tool was then used for evaluation of the SisterTalk project. Lastly, a 4-week reliability calibration study of the revised STFHQ was conducted in comparison with a food frequency questionnaire (FFQ). Analysis Reliability was assessed using test-retest correlations. Validity was assessed by correlations between STFHQ scores with FFQ calculated calories, total fat (g) and percentage of calories from fat. Three scoring methods (ie, introductory, product, and detail) were calculated along with inclusion or exclusion of dining out questions and alternate methods of scoring for food items not consumed. Results Reliability (correlation) was 0.87. Inclusion of dining out questions and imputation of zero for food items never consumed were more highly associated with fat intake than other scoring methods. The introductory score was most highly correlated with fat (g), whereas the product and detail scoring methods correlated highest with percentage of calories from fat. Responsiveness to the SisterTalk intervention was highest with the detail score. Conclusions and Implications The STFHQ is a reliable and valid tool that may be useful for evaluating dietary change for black women

Assessing Fat-Related Dietary Behaviors among Black Women: Reliability and Validity of a New Food Habits Questionnaire

Objective To describe the development of the SisterTalk Food Habits Questionnaire (STFHQ). Design Formative research was conducted to adapt previous tools for the study’s target population. A pilot tool (168 questions) was tested. The new 94-question tool was then used for evaluation of the SisterTalk project. Lastly, a 4-week reliability calibration study of the revised STFHQ was conducted in comparison with a food frequency questionnaire (FFQ). Analysis Reliability was assessed using test-retest correlations. Validity was assessed by correlations between STFHQ scores with FFQ calculated calories, total fat (g) and percentage of calories from fat. Three scoring methods (ie, introductory, product, and detail) were calculated along with inclusion or exclusion of dining out questions and alternate methods of scoring for food items not consumed. Results Reliability (correlation) was 0.87. Inclusion of dining out questions and imputation of zero for food items never consumed were more highly associated with fat intake than other scoring methods. The introductory score was most highly correlated with fat (g), whereas the product and detail scoring methods correlated highest with percentage of calories from fat. Responsiveness to the SisterTalk intervention was highest with the detail score. Conclusions and Implications The STFHQ is a reliable and valid tool that may be useful for evaluating dietary change for black women

Use of BI-RADS 3–Probably Benign Category in the American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial

The Breast Imaging Reporting and Data System 3 category can be appropriately utilized by breast imaging radiologists without substantial risk to women but it continues to represent a compliance challenge

Determination of a Phase II Dose of Panobinostat in Combination with 5-Azacitidine in Patients with Myelodysplastic Syndromes, Chronic Myelomonocytic Leukemia, or Acute Myeloid Leukemia

Abstract Abstract 459 BACKGROUND: 5-Azacitidine (AZA), a demethylating agent, is approved for treatment of myelodysplastic syndromes (MDS) and provides complete remission (CR) in 17% of patients (pts) and a median overall survival of 24.5 months, thus highlighting an unmet need in this population. Panobinostat, a potent pan-deacetylase inhibitor (pan-DACi), has demonstrated anti-tumor activity in pts with MDS and acute myeloid leukemia (AML). Preclinical studies suggest a combination of AZA and a pan-DACi may, in part through synergistic gene reactivation and apoptosis induction, improve outcomes in pts with MDS, AML, and chronic myelomonocytic leukemia (CMML) and appears to be a promising new approach in this population. AIMS: The primary objective of this phase I, open-label, multicenter, dose-escalation study is to determine maximum tolerated dose (MTD) of panobinostat with a fixed dose of AZA. Secondary objectives are to characterize safety and tolerability, with an exploratory objective to evaluate preliminary anti-leukemic activity of panobinostat in combination with AZA. METHODS: Adult pts (ECOG ≤ 2) with IPSS intermediate-2 or high-risk MDS, CMML, or AML with multi-lineage dysplasia and 20%–30% marrow blasts, not initially eligible for hematopoietic stem-cell transplantation, were treated with oral panobinostat (20 mg/day starting dose and 10-mg dose increments) during a 28-day cycle on days 3, 5, 8, 10, 12, and 15 in combination with a fixed dose of AZA (75 mg/m2 sc) on days 1–7 of each cycle. On the basis of the occurrence of dose-limiting toxicities (DLTs) during the first treatment cycle and an overall assessment of safety and tolerability data from all cycles, a phase II dose was recommended. Safety and tolerability were described as type, duration, frequency, relatedness, and severity of adverse events (AEs) according to CTCAE, v3.0. The adaptive Bayesian logistic regression model was used to guide panobinostat dose escalation with overdose control at all dose levels. Cycle extension, up to day 42, is allowed in cases of toxicity. The minimum exposure criterion for determining MTD was 6 scheduled doses of panobinostat and 7 scheduled doses of AZA during cycle 1. RESULTS: A total of 31 pts, with a median age of 70 years (range 34–81), in 3 cohorts were enrolled. Of these pts, 6 were treated at a dose level of 20 mg, 18 at 30 mg, and 7 at 40 mg of panobinostat; 28 pts were evaluable for MTD. Safety and efficacy data are based on 29 and 16 pts, respectively. One DLT (febrile neutropenia) was observed at 20 mg, 3 DLTs (dehydration/fatigue, colitis, a 1-day echocardiogram T-wave inversion, and an atrial fibrillation/syncope) were seen at 30 mg, and 2 DLTs (hyperbilirubinemia and nausea/vomiting) were reported in the 40-mg cohort. On the basis of the occurrence of DLTs and overall safety and tolerability data in cycle 1, dose levels at and above 40 mg were not further evaluated. Additional pts were enrolled at 30 mg. The most frequent AEs suspected to be related to the study treatment were gastrointestinal issues and fatigue. Grade 3/4 treatment-related AEs included thrombocytopenia (8 [28%]), neutropenia (5 [17%]), and febrile neutropenia (6 [21%]). Other frequent AEs of all grades, regardless of study drug relationship, included nausea (19 [67%]), fatigue (18 [62%]), diarrhea (16 [55%]), vomiting (15 [52%]), thrombocytopenia (13 [45%]), and decreased appetite (12 [41%]). The most common serious AEs (SAEs), regardless of study drug relationship, were febrile neutropenia (8 [28%]) and asthenia (5 [17%]). Based on the DLTs observed in cycle 1 and overall assessment of safety and tolerability, a phase II dose of 30 mg was recommended. Preliminary efficacy data for 8 pts with AML and 8 with MDS/CMML show 4 pts (2 at 30 mg, 2 at 40 mg) achieving CR or morphological CR (CRi) and 6 pts (4 at 30 mg, 2 at 40 mg) showing stable disease (SD). Hematologic improvement was seen in 4 pts, 2 of whom relapsed. CONCLUSIONS: Current data show that oral panobinostat at 30 mg/day on days 1, 3, 5, 8, 10, and 12 of a 28-day cycle can be safely combined with AZA at the registered label dose in pts with intermediate-2 or high-risk MDS, CMML, or AML. Additional pts will be evaluated in an expansion phase to further characterize the safety profile and activity at the 30-mg dose level. To date, preliminary efficacy shows that CR/CRi was achieved in 4 pts, SD was achieved in 6 pts, and HI was observed in 4 pts. Disclosures: Ottmann: Novartis Corporation: Consultancy; Bristol-Myers Squibb: Consultancy, Research Funding. DeAngelo:Novartis Corporation: Membership on an entity's Board of Directors or advisory committees. Sekeres:Celgene Corporation: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees. Zahlten:Novartis AG: Employee of Novartis, Employment. Squier:Novartis Corporation: Employment. Acharyya:Novartis Corporation: Employment. Winiger:Novartis AG: Employment, Equity Ownership, Honoraria. Fenaux:Celgene Corporation: Honoraria, Research Funding; Amgen: Honoraria; Roche: Research Funding; Janssen Cilag: Research Funding

Comparison of Soft-copy and Hard-copy Reading for Full-Field Digital Mammography

Purpose: To compare radiologists' performance in detecting breast cancer when reading full-field digital mammographic (FFDM) images either displayed on monitors or printed on film