Diffusion and dissemination of evidence-based dietary srategies for the prevention of cancer

OBJECTIVE: The purpose was to determine what strategies have been evaluated to disseminate cancer control interventions that promote the uptake of adult healthy diet? METHODS: A systematic review was conducted. Studies were identified by searching MEDLINE, PREMEDLINE, Cancer LIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists and by contacting technical experts. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions in individuals, healthcare providers, or institutions. Studies of children or adolescents only were excluded. RESULTS: One hundred one articles were retrieved for full text screening. Nine reports of seven distinct studies were included; four were randomized trials, one was a cohort design and three were descriptive studies. Six studies were rated as methodologically weak, and one was rated as moderate. Studies were not meta-analyzed because of heterogeneity, low methodological quality, and incomplete data reporting. No beneficial dissemination strategies were found except one that looks promising, the use of peer educators in the worksite, which led to a short-term increase in fruit and vegetable intake. CONCLUSIONS AND IMPLICATIONS: Overall, the quality of the evidence is not strong and is primarily descriptive rather than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies, and to compare dissemination and diffusion strategies with different messages and different target audiences

The Effectiveness of a Pram-Walking Exercise Programme in Reducing Depressive Symptomatology for Postnatal Women

The purpose of the research project was to examine the effects of exercise, social support and depression on postnatal women who reported experiencing Postnatal Depression (PND). A 12 week randomised controlled trial was conducted investigating the effects of an exercise intervention group (3 sessions/wk of 60%-75% intensity) compared to a social support group (1 session/wk). Participants in both groups had given birth in the past 12 months and were experiencing depressive symptomatology. Pre-test data of physical fitness and structured questionnaires were compared to post-test effects. The exercise intervention consisted of a pram walking program for mothers and their babies and the social support intervention involved non-structured sessions, similar to a play group. The primary outcomes were to reduce the depressive syptomatology and improve fitness levels of participants in the pram walking group. Secondary outcomes were to improve the social support levels of the participants in both groups and explore women's views about the programs. It was hypothesised that the pram walking group would improve their feelings of depression and fitness levels compared to the social support group, but that both groups would improve their perceived levels of social support. The results showed that mothers in the pram walking intervention group improved their fitness levels (VO2 max = p 0.05). These results are encouraging and suggest that a pram walking intervention has the potential to improve depressive symptomatology and fitness levels for women who reported experiencing postnatal depression. Therefore, a direct association between improvement in fitness was related to improvement in depression for the pram walking group. However, it is also suggested that other factors in combination with improvements in fitness influenced improvements in depressive levels. Tailored pram walking programs have the potential to provide primary and secondary treatment options for postnatal women. It is a recommendation that pram walking programs for mothers with PND be implemented as pilot research into existing available services. These conclusions and recommendations are tentative and could be confirmed with larger studies with larger cohorts