||5R01CA074000-04 Interpret this number
||Dana-Farber Cancer Institute
||Multirisk Factor Intervention for Colon Polyp Patients
Colorectal cancer (CRC) is the second leading cause of cancer death; over
150,000 adults are diagnosed with CRC in the United States each year.
Adenomatous polyps are a highly prevalent and treatable precursor to CRC.
Consistent evidence suggests physical activity, smoking, and diets that are
low in fruits/vegetables and high in red meat increase risk for polyps and
CRC. Thus decreasing lifestyle risk factors could especially benefit polyp
patients. Having polyps diagnosed may be a teachable moment when at-risk
individuals may be particularly motivated to change their risk behaviors.
The US Preventive Health Services Task Force suggests that those ages 50 and
older seek CRC screening, which offers the opportunity to link interventions
to this potentially important teachable moment in a large at-risk group.
The proposed two-site randomized trial will evaluate a state-of-the-art
comprehensive multiple risk factor intervention for polyp patients using a
case management model. Polyp patients (N=1425) who agree to participate
will be surveyed at baseline (following colon polyp removal) and randomly
assigned to either: (1) comprehensive multiple risk factor intervention,
including provider recommendations for behavior change, a goal setting
session with a health educator, tailored self-help materials, telephone
counseling, and personal progress reports; or (2) usual care. Primary
outcomes to be assessed include changes in: (1) fruit, vegetable, and red
meat consumption; (2) physical activity level; (3) multiple risk factor
profile; and (4) smoking cessation (among smokers only). Follow-up
assessments will occur at 6 and 12 months after polyp removal, and
self-reported changes in diet and smoking will be biochemically validated.
A theory-based intervention protocol (based on "social ecological" Model),
computer-assisted counseling, and tailored progress reports will maximize
standardization of implementation across the two study sites. The
intervention is suited to the managed care environment, thus increasing its
potential generalize ability and disseminability. A process tracking system
will enable a detailed cost-effectiveness evaluation.