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Browsing by Author "Kelleher, Sarah A."

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    Adult Cancer Survivorship: An Evaluation of Survivorship Care Planning and Follow-Up
    Kelleher, Sarah A. (Virginia Tech, 2014-05-05)
    Over 1 million Americans are diagnosed with cancer in a given year and currently there are approximately 12 million cancer survivors in the United States. With improved detection strategies and medical advances, the number of cancer survivors continues to rise, making survivorship care an increasingly important phase along the continuum of cancer care. The purpose of the current study was to investigate the emerging field of survivorship care, including care planning and follow-up, in survivors of different types of cancer. We quantitatively evaluated the post-treatment care received by 123 cancer survivors, including the use of survivorship care plans and the impact of these care plans and subsequent follow-up on a variety of behavioral health outcomes. We qualitatively assessed survivorship care providers' (n = 8) perspectives on comprehensive survivorship care and experiences delivering post-treatment services. The majority of participants (54%) are receiving a moderate level of survivorship care, including minimal receipt of a written care plan (31%) and some amount of referrals for mental health, diet, and physical activity (28%). Results suggest significantly lower general psychological distress (F [1, 104] = 8.316, p = .005) and higher coping self-efficacy (F [1, 104] = 6.627, p = .011) for those who received some form of written care plan versus those who did not. These results imply that written care plan documents have the potential to lead to higher psychosocial functioning for survivors of cancer. The qualitative data provide initial evidence supporting the value of SCPs for patients and providers. Critical barriers to implementation of comprehensive survivorship care and SCPs, from the providers' perspective, include the fragmented healthcare system and resources. The current study is an important step toward increasing knowledge of and potential intervention targets to improve cancer survivorship experiences – from both the patients' and providers' perspectives. Future directions include developing a standardized system for delivering survivorship care and SCPs, and increasing the evidence base to examine the impact of SCPs on short- and long-term patient-reported and clinical outcomes, increase the focus on patient-centered care, and explore the impact of SCPs delivered to vulnerable groups of survivors.
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    Colon Cancer Survivorship Experiences
    Kelleher, Sarah A. (Virginia Tech, 2010-12-07)
    The purpose of this project is to explore potential social cognitive and psychosocial predictors of lifestyle changes, including diet and physical activity behaviors, in a sample of colorectal cancer survivors who are at high risk of developing a second colorectal cancer. Participants, recruited from Georgetown University's Lombardi Comprehensive Cancer Center, are colorectal cancer survivors from families at high or confirmed risk of having a hereditary colorectal cancer syndrome. Results indicate that, at the bivariate level, many of the psychosocial and social cognitive variables of interest are significantly associated with one another as well as with various health behaviors and health behavior changes. Correlational data indicate that lower distress is associated with higher psychosocial functioning, self-efficacy, and self-regulatory ability. In addition, the data also suggest that individuals with higher self-efficacy display higher self-regulation and more positive outcome expectations related to health behaviors. Overall, participants were more likely to increase healthy behaviors or remain consistent with moderately healthy lifestyles practiced prior to their colorectal cancer diagnosis and treatment, and decrease unhealthy behaviors. Implications and directions for future research are discussed within the paper.
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    Resist diabetes: A randomized clinical trial for resistance training maintenance in adults with prediabetes
    Davy, Brenda M.; Winett, Richard A.; Savla, Jyoti S.; Marinik, Elaina L.; Baugh, Mary Elizabeth; Flack, Kyle D.; Halliday, Tanya M.; Kelleher, Sarah A.; Winett, Sheila G.; Williams, David M.; Boshra, Soheir (PLOS, 2017-02-23)
    Objective To determine whether a social cognitive theory (SCT)-based intervention improves resistance training (RT) maintenance and strength, and reduces prediabetes prevalence. Research design and methods Sedentary, overweight/obese (BMI: 25±39.9 kg/m2) adults aged 50±69 (N = 170) with prediabetes participated in the 15-month trial. Participants completed a supervised 3-month RT (2×/wk) phase and were randomly assigned (N = 159) to one of two 6-month maintenance conditions: SCT or standard care. Participants continued RT at a self-selected facility. The final 6-month period involved no contact. Assessments occurred at baseline and months 3, 9, and 15. The SCT faded-contact intervention consisted of nine tailored transition (i.e., supervised training to training alone) and nine follow-up sessions. Standard care involved six generic follow-up sessions. Primary outcomes were prevalence of normoglycemia and muscular strength. Results The retention rate was 76%. Four serious adverse events were reported. After 3 months of RT, 34% of participants were no longer prediabetic. This prevalence of normoglycemia was maintained through month 15 (30%), with no group difference. There was an 18% increase in the odds of being normoglycemic for each % increase in fat-free mass. Increases in muscular strength were evident at month 3 and maintained through month 15 (P<0.001), which represented improvements of 21% and 14% for chest and leg press, respectively. Results did not demonstrate a greater reduction in prediabetes prevalence in the SCT condition. Conclusions Resistance training is an effective, maintainable strategy for reducing prediabetes prevalence and increasing muscular strength. Future research which promotes RT initiation and maintenance in clinical and community settings is warranted.