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Open Access Publications from the University of California

Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention Among Breast Cancer Survivors

  • Author(s): Wang, JB
  • Pierce, JP
  • Ayala, GX
  • Cadmus-Bertram, LA
  • Flatt, SW
  • Madanat, H
  • Newman, VA
  • Nichols, JF
  • Natarajan, L
  • et al.

© 2015, The Author(s). Background: Depressive symptoms can lower adherence and change in dietary studies. Behavioral activation may reduce these effects. Purpose: This study aims to assess relationships among depressive symptoms on adherence and dietary change in the Women’s Healthy Eating and Living (WHEL) Study Methods: Secondary analyses from the WHEL Study, which achieved major dietary change in breast cancer survivors (N = 2817), were conducted. Logistic regressions were undertaken of baseline depressive symptoms (six-item Center for Epidemiologic Studies Depression Scale (CES-D)) with (1) completion of 1- and 4-year study assessments and (2) validated change in dietary behavior in the intervention group. Results: In the comparison group (vs. intervention), depressive symptoms lowered completion of dietary recalls and clinic visits [4 years: odds ratio (OR) = 2.0; 95 % confidence interval (CI) = 1.4–3.0]. The behaviorally oriented intervention achieved major change in those furthest from study targets, although changes were lower in those with depressive symptoms: fruit/vegetable (+37.2 %), fiber (+49.0 %), and fat (−22.4 %). Conclusions: Behavioral activation in dietary change interventions can overcome the impact of depressive symptoms.

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