Skip to main content
An official website of the United States government
Grant Details

Grant Number: 5R01CA123228-05 Interpret this number
Primary Investigator: Emmons, Karen
Organization: Dana-Farber Cancer Inst
Project Title: Multiple Risk Behavior Intervention in Health Care Settings
Fiscal Year: 2011


DESCRIPTION (provided by applicant): Healthy Directions was a cancer prevention intervention designed to reduce behavioral risk factors for cancer among working class, multi-ethnic adults in the health care setting. The intervention targeted multiple risk factors (red meat, fruit & vegetables, multi-vitamins, physical activity). Participants in the intervention health centers had significantly greater change in the multiple risk behavior score, which reflects simultaneous change across the 4 risk factors. In addition, the intervention led to significant changes in the individual risk factors, including increased consumption of fruit and vegetable and multi-vitamins, and significantly decreased rates of red meat intake. However, the intervention reach was less than ideal, and there was no significant impact on physical activity. Further, Healthy Directions utilized extensive telephone counseling, which is heavily labor intensive. It is critical that we seek less costly means of delivering cancer prevention interventions. The proposed study is an efficacy study of Healthy Directions-2 (HD-2), which is designed to: (1) increase reach of the intervention into the target population; (2) extend the intervention to include smoking, and increase efficacy of the intervention across all target risk behaviors; and (3) promote and assess long-term maintenance of behavior change. HD-2, a randomized control trial conducted in 10 health centers, will assess whether the intervention effectiveness can be maximized while transferring some of the intervention components to less labor intensive and more disseminable formats. Health centers will be randomized into intervention or usual care. The intervention includes: (1) 'prescription' and brief endorsement of behavior change by the participant's provider; (2) two telephone counseling calls; (3) automated phone reminders; (4) tailored print materials delivered through one of 3 modalities, including the web, email, or print materials; (5) companion materials/resources for social network members; and (6) linkages to key community-based resources. Participants will select modes of interacting with the intervention (e.g. web, email, or print) that are appropriate for their resources/ interests. The self-help condition will receive print materials on the target risk factors, 12 mailings on general health, and access to the HVMA website. Follow-ups will be conducted 1- and 12- mos. post-intervention. The primary outcome is change in the multiple behavior risk score; secondary outcomes include change in each of the 4 risk factors, as well as intervention dose delivered, reach, impact, and cost-effectiveness.


The effect of a lifestyle risk reduction intervention on lifestyle adherence and health-related quality of life in nonsmall cell lung cancer survivors: Feasibility study outcomes.
Authors: Cooley M.E. , Blonquist T.M. , Hong F. , Nayak M.M. , Crouter S.E. , Hayman L.L. , Jaklitsch M.T. , Emmons K.M. , Bueno R. .
Source: Psycho-oncology, 2019 Apr; 28(4), p. 920-923.
EPub date: 2019-02-12.
PMID: 30673155
Related Citations

Social Support for Changing Multiple Behaviors: Factors Associated With Seeking Support and the Impact of Offered Support.
Authors: Greaney M.L. , Puleo E. , Sprunck-Harrild K. , Haines J. , Houghton S.C. , Emmons K.M. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2018 Apr; 45(2), p. 198-206.
EPub date: 2017-07-07.
PMID: 28683577
Related Citations

NUMB phosphorylation destabilizes p53 and promotes self-renewal of tumor-initiating cells by a NANOG-dependent mechanism in liver cancer.
Authors: Siddique H.R. , Feldman D.E. , Chen C.L. , Punj V. , Tokumitsu H. , Machida K. .
Source: Hepatology (Baltimore, Md.), 2015 Nov; 62(5), p. 1466-79.
EPub date: 2015-08-28.
PMID: 26174965
Related Citations

A randomized comparative effectiveness study of Healthy Directions 2--a multiple risk behavior intervention for primary care.
Authors: Emmons K.M. , Puleo E. , Greaney M.L. , Gillman M.W. , Bennett G.G. , Haines J. , Sprunck-Harrild K. , Viswanath K. .
Source: Preventive medicine, 2014 Jul; 64, p. 96-102.
EPub date: 2014-03-16.
PMID: 24642140
Related Citations

Factors associated with choice of web or print intervention materials in the healthy directions 2 study.
Authors: Greaney M.L. , Puleo E. , Bennett G.G. , Haines J. , Viswanath K. , Gillman M.W. , Sprunck-Harrild K. , Coeling M. , Rusinak D. , Emmons K.M. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2014 Feb; 41(1), p. 52-62.
EPub date: 2013-05-29.
PMID: 23720532
Related Citations

The TBC1D15 oncoprotein controls stem cell self-renewal through destabilization of the Numb-p53 complex.
Authors: Feldman D.E. , Chen C. , Punj V. , Machida K. .
Source: PloS one, 2013; 8(2), p. e57312.
EPub date: 2013-02-27.
PMID: 23468968
Related Citations

Electronic reminders for cancer prevention: factors associated with preference for automated voice reminders or text messages.
Authors: Greaney M.L. , Puleo E. , Sprunck-Harrild K. , Bennett G.G. , Cunningham M.A. , Gillman M.W. , Coeling M. , Emmons K.M. .
Source: Preventive medicine, 2012 Aug; 55(2), p. 151-4.
EPub date: 2012-05-30.
PMID: 22659227
Related Citations

Use of email and telephone prompts to increase self-monitoring in a Web-based intervention: randomized controlled trial.
Authors: Greaney M.L. , Sprunck-Harrild K. , Bennett G.G. , Puleo E. , Haines J. , Viswanath K.V. , Emmons K.M. .
Source: Journal of medical Internet research, 2012-07-27; 14(4), p. e96.
EPub date: 2012-07-27.
PMID: 22842775
Related Citations

Behavioral medicine and the health of our nation: accelerating our impact.
Authors: Emmons K. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2012 Apr; 43(2), p. 153-61.
PMID: 22076696
Related Citations

Systems antecedents for dissemination and implementation: a review and analysis of measures.
Authors: Emmons K.M. , Weiner B. , Fernandez M.E. , Tu S.P. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2012 Feb; 39(1), p. 87-105.
EPub date: 2011-07-01.
PMID: 21724933
Related Citations

Relationships between Social Resources and Healthful Behaviors across the Age Spectrum.
Authors: Lewis K.H. , Gillman M.W. , Greaney M.L. , Puleo E. , Bennett G.G. , Emmons K.M. .
Source: Journal of aging research, 2012; 2012, p. 501072.
EPub date: 2012-08-30.
PMID: 22970369
Related Citations

Prevalence and implications of multiple cancer screening needs among Hispanic community health center patients.
Authors: Emmons K.M. , Cleghorn D. , Tellez T. , Greaney M.L. , Sprunck K.M. , Bastani R. , Battaglia T. , Michaelson J.S. , Puleo E. .
Source: Cancer causes & control : CCC, 2011 Sep; 22(9), p. 1343-9.
EPub date: 2011-07-05.
PMID: 21728056
Related Citations

Back to Top