Diet Behavior Change for Bowel Symptom Management in Rectal Cancer Survivors: the Altering Intake, Managing Symptoms (AIMS) Intervention

Authors: Sun V, Crane TE, Slack SD, Yung A, Wright S, Krouse RS, Thomson CA

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018

Abstract Body:
Purpose of the Study: To describe the design of the Altering Intake, Managing Symptoms (AIMS) intervention to manage bowel symptoms in rectal cancer survivors, a population that reports high bowel symptom burden after surgery/treatment. Methods: AIMS is a telephone-based intervention delivered in ten 40-60 minute sessions over 4 months to rectal cancer survivors who are 1-13 years post-surgery. A workbook is provided to participants as a support reference. Based on the Chronic Care Self- Management Model (CCM), AIMS applies social cognitive theory to increase self-efficacy and enhance self-management of bowel symptoms. Survivors receive support to modify their diets based on the hypothesis that tailored coaching will attenuate symptoms while improving diet quality. Motivational interviewing-based behavioral approaches are applied; these include goal setting, self-monitoring, identification of barriers, and problem- solving. Diet health is assessed by repeat 24-hour dietary recalls combined with food and symptom diaries to promote survivor-directed behavior change. Results: To date 10 rectal cancer survivors have completed a 16 week intervention. Preliminary results suggest high satisfaction of the intervention in completers. Among non-completers (N=5), all consented to participate; one non-completer participated in 4 sessions only. This suggests that rectal cancer survivors may feel the need to consent, but not have intrinsic motivation to participate or that the workbook may provide ample support in their estimation. To address this, the follow-on study will include a run-in period to evaluate readiness to change prior to randomization. Exit interviews from active participants are expected to inform on the selection of proposed approaches. Conclusions: AIMS is one of the first intervention to address diet behavior changes for symptom management in rectal cancer survivors. The single site, single group pilot study currently underway will assess the feasibility and acceptability of the intervention. Findings will inform the design and development of future multi-site Phase II and III randomized trials.

Keywords: Bowel dysfunction, rectal cancer, survivorship, diet