ASPO Abstracts
Comparison of Lifestyle Behavioral Goal Completion in Rural Versus Urban Ovarian Cancer Survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose: Rural cancer survivors have been reported to exhibit lower adherence to health-promoting lifestyle behavior recommendations than urban cancer survivors. There is a dearth of evidence related to remotely delivered health promotion interventions and no studies specific to remote delivery in ovarian cancer survivors. Methods: Using diet (food frequency questionnaire) and physical activity (Actigraph) data from the Lifestyle Intervention for Ovarian cancer Enhanced Survival (LIVES) study, we examined the difference in behavioral goal acquisition for rural versus urban survivors. LIVES was a 24-month, 1:1 randomized, controlled trial in which intervention participants were asked to consume four servings of vegetables and two servings of fruit daily and to increase physical activity by an average of 4,000 steps per day. Participants engaged in telehealth delivered coaching calls with trained nutrition science students who utilized Motivational Interviewing techniques to support behavior change. Zip code data were used to assign Rural-Urban Commuting Area Code (1-3 = urban, 4-10 = rural). Results: Of the 553 intervention participants with zip code data, 466 (84.3%) were classified as urban- and 87 (15.7%) as rural-dwelling. Average age (59.7±9.6 years) did not differ between groups. At baseline, rural participants were less likely than urban participants to eat two servings of fruits/day (OR: 0.58; 95%CI: 0.36, 0.92). There were no differences in achievement of fruit, vegetable, and/or physical activity goals by rurality at any timepoint. Participants meeting the vegetable goal nearly doubled for both groups between baseline and 24-months (26.7% to 48.3% for rural; 31.7% to 57.0% for urban). By 24-months, 34.5% of rural (n=30) and 31.3% of urban (n=146) survivors were meeting the step goal. Mean minutes of moderate to vigorous physical activity/day increased by 0.18±15.2 and 5.66±21.9 respectively for rural and urban survivors (p-value=0.47). Conclusions: The remotely delivered, telehealth coaching model used for LIVES was found to be equally effective at increasing diet and physical activity goal completion in rural and urban ovarian cancer survivors, suggesting remote health coaching as a means to promote lifestyle guideline adherence in rural survivors.
Keywords: rural, ovarian cancer, lifestyle, survivorship, telehealth