2007 Final Program - Society of Behavioral Medicine

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SOCIETY of BEHAVIORAL MEDICINE Rapid Communications Posters Friday, March 23, 2007 • 6:30 PM-8:00 PM • Poster Session C efficacy for physical activity. Higher levels of self-efficacy for physical activity were associated with higher levels of physical activity, which is consistent with what has been observed in the general population and other studies with breast cancer survivors. Future studies should examine how these factors relate to physical activity behavior over time, and should explore other determinants of self-efficacy. CORRESPONDING AUTHOR: Heidi Perkins, PhD, Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, 77030; hperkins@mdanderson.org 3460 AS IF SMOKING WERE NOT BAD ENOUGH: DIETARY PATTERNS AMONG SMOKERS AND NONSMOKERS Jennifer McClure, PhD, 1 Gwen Alexander, PhD, 5 Jody Hinchman, MA, 2 Dennis Tolsma, PhD, 2 Cheri Rolnick, PhD, 3 Judy Mouchwar, MD 4 and Christine Johnson, PhD 5 1 Center for Health Studies, Group Health Cooperative, Seattle, WA; 2 Kaiser Permanente-Georgia, Atlanta, GA; 3 HealthPartners, Minneanapolis, MN; 4 Kaiser Permantente-Colorado, Denver, CO and 5 Henry Ford Health System, Detriot, MI. Smoking increases one’s risk for disease. This risk may be compounded by other unhealthy behaviors, such as poor diet. Understanding the association between smoking and diet is important for planning appropriate behavioral intervention programs for smokers. We examined this association among 2542 adults randomly recruited from 5 healthcare organizations to participate in an online dietary intervention program (MENU). Participants completed a survey of their typical fruit and vegetable intake at baseline and answered questions regarding potential mediators/moderators of dietary behavior. Current smokers (n= 265) and non-smokers (n = 2264) did not differ in terms of their age (mean = 46 years), gender (68% female), BMI (mean= 29), race (69% Caucasian) or health plan membership. Smokers reported less daily intake of fruits (P
2007 SBM Annual Meeting & Scientific Sessions March 21-24, 2007 FINAL PROGRAM Rapid Communications Posters Friday, March 23, 2007 • 6:30 PM-8:00 PM • Poster Session C status (Karnofsky Performance Status, KPS), signs/symptoms of treatment toxicities (Sym/S), patient ratings of fatigue (Fatigue Severity Index) and quality of life disruption due to physical symptoms (PCS; MOS SF-36). In addition to baseline physical status, predictors were hopelessness (Beck Hopelessness Scale) and social support (Perceived Social Support-Family & Friends). RESULTS: Using hierarchical multiple regression, hopelessness predicted poorer physical status at both 4- (β = -.34, p < .01) and 10-months (β = -.30, p < .05), whereas social support did not. Follow-up regressions clarified that hopelessness predicted fatigue at 4- (β = .28) and 10-months (β = .48, ps < .05), KPS (β = -.40) and Sym/S (β =.36, ps < .01) at 4-months, and PCS at 10-months (β = -.29, p < .05). CONCLUSIONS: These results show that hopelessness in response to recurrence can be especially burdensome. In this example, it related to poorer physical status months later, which included ratings of performance status and signs and symptoms of treatment toxicities as assessed by a nurse, and not the participant. This effect was not lessened by concurrent social support from family and friends. CORRESPONDING AUTHOR: Namrata Ahuja, BS in progress, Department of Psychology, The Ohio State University, Columbus, OH, 43202; ahuja.16@osu.edu 3463 PERCEIVED ABILITY TO RELAX MEDIATES INTERVENTION-RELATED CHANGE IN EVENING CORTISOL AMONG BREAST CANCER PATIENTS Kristin M. Phillips, MS, Suzanne C. Lechner, PhD, Charles S. Carver, PhD, Bonnie Blomberg, PhD and Michael H. Antoni, PhD University of Miami, Coral Gables, FL. Previous work demonstrated that a Cognitive-Behavioral Stress Management (CBSM) intervention reduced evening serum cortisol over 10-weeks among breast cancer (BRCA) patients. The present study used sophisticated analyses to examine change over a longer period of time in evening serum cortisol levels in a larger sample. We hypothesized CBSM would decrease cortisol levels at 6 & 12 month follow-up and self-perceived ability to relax might mediate intervention effects on cortisol reduction. One hundred eighteen women (age M= 49.4,SD=7.68) were recruited 4-8 weeks postsurgery for non-metastatic breast cancer (Stage 0=21, I=49 II=44, III=4) and had not begun chemotherapy at entry. They were randomized to a 10-week CBSM group intervention (n=58) or oneday seminar (n=60) and were assessed at study entry (T1) & 6 (T2) & 12 (T3) month follow-up. Perceived ability to relax was measured using the Measure of Current Status (MOCSrelax). Using latent growth-curve modeling (intent-to-treat) and controlling for chemotherapy, we tested whether CBSM was related to ability to relax. The model fit the data (χ2(1)=0.034,p=0.8544). Condition related significantly to slope of MOCSrelax (z=2.400), indicating differential change over time; there were significant differences between groups at T2 (z=1.974) & T3 (z=2.522): those receiving CBSM had greater perceived ability to relax than controls. Next we tested whether the intervention predicted decreases in cortisol. The model fit the data (χ2(2)=0.773,p=0.6779). Condition related significantly to slope of cortisol change (z=-2.133): women receiving CBSM showed reduced evening cortisol levels over time, whereas those in the control group had no appreciable decline ~ 119 ~ in cortisol. When the MOCSrelax path was added to the model (χ2(11)= 14.051, p=0.3702), the direct effect of condition on cortisol was no longer significant, indicating successful mediation. Thus, perceived ability to relax was one explanation for the CBSMrelated reductions in evening cortisol among women being treated for breast cancer. CORRESPONDING AUTHOR: Kristin M. Phillips, MS, University of Miami, Coral Gables, FL, 33146; kphillips@miami.edu 3464 RELATIONSHIPS OF EXERCISE AND SURVIVAL TIME TO MENTAL HEALTH AND BODY ESTEEM OF CANCER SURVIVORS Christina Wagner, PhD 1 and Silvia Bigatti, PhD 2 1 Behavioral Sciences, Rush University Medical Center, Chicago, IL and 2 Psychology, IUPUI, Indianapolis, IN. Mood and body image may be disturbed following breast cancer treatment and exercise may ameliorate these symptoms. Unfortunately, long-term survivors have received less research attention than women soon after diagnosis, and the long-term consequences of treatment on body image, mental health and health behavior remain unclear. The present study assessed anxiety and depression (POMS-SF-36), satisfaction with body appearance and function (Body Esteem Scale) and exercise (Godin Leisure Time Index) of 95 breast cancer survivors who completed mail-based surveys to elucidate the impact of exercise, survival time, and their interaction on mental health. Survival time ranged from 1 to 37 years with a median of 5 years and mean of 6.5 years (SD = 5.5). An ANCOVA and MANCOVA, controlling age and hormone therapy, revealed short-term survivors exercised significantly more, but long-term survivors reported greater satisfaction with body appearance and function. Regressions for each dependent variable examined exercise and survival time in the first step followed by their interaction in the second. The models for body function, body appearance, and tension-anxiety were significant explaining 13%, 8%, and 9% of variance. Exercise entered the equation for body function and tension-anxiety, while survival entered the regression equation for tension-anxiety only. While the model for body appearance was significant, individual predictors did not reach significance. The interaction of exercise and survival time did not account for additional variance. These findings indicate breast cancer survivors who exercise more report higher satisfaction with their body function and less tension-anxiety, and increased survival time is associated with decreased tension-anxiety. Importantly, exercise seems to impact survivor’s body image and mood regardless of time since diagnosis. CORRESPONDING AUTHOR: Christina Wagner, PhD, Behavioral Sciences, Rush Medical Center, Chicago, IL, Chrisitna_D_Wagner@rush.edu
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2007 Final Program - Society of Behavioral Medicine

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