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Development and Evaluation of the Curriculum for BOLD (Bronx Oncology Living Daily) Healthy Living: a Diabetes Prevention and Control Program for Underserved Cancer Survivors

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Abstract

Underserved minority communities have few resources for addressing comorbidity risk reduction among long-term cancer survivors. To address this community need, we developed and piloted the Bronx Oncology Living Daily (BOLD) Healthy Living program, the first known diabetes prevention and control program to target cancer survivors and co-survivors in Bronx County, NY. The program aimed to facilitate lifestyle change and improve health-related quality of life (HRQoL) through weekly group nutrition education (60–90 min) and exercise (60 min) classes. We examined baseline characteristics of participants using simple descriptive statistics and evaluated program implementation and impact using the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework. The curriculum, which drew from the social-ecological framework and motivational and cognitive behavioral strategies, consisted of 12 culturally and medically tailored modules with options for implementation as a 12- or 4-week program. Seven programs (four 12 weeks and three 4 weeks in length, respectively) were implemented at five community site locations. Sixty-six cancer survivors and 17 cancer co-survivors (mean age 60.5 ± 10.2 years) enrolled in one of the programs. Most participants were female (95.2 %) minority (55.4 % black, 26.5 % Hispanic/Latino) breast cancer survivors (75.7 %). Median program attendance was 62.5 % and did not significantly differ by program length; however, 67.3 % of participants achieved ≥60 % attendance among the 12-week programs, compared to 41.9 % among the 4-week programs, and this difference was statistically significant (p = 0.02). Overall, participants reported significant pre/post improvements in perceived health as good/excellent (66.0 to 75.5 %; p = 0.001) and borderline significant decreases in perceived pain as moderate/severe (45.5 to 38.2 %; p = 0.05). More than 90 % of participants reported that the program helped them to achieve their short-term goals, motivated them to engage in healthier behaviors, and felt that the nutrition and exercise classes were relevant to their needs. These results indicate that a short-term lifestyle intervention program for adult cancer survivors was acceptable in our community and motivated cancer survivors to improve their HRQoL. The curriculum can be used as a tool to facilitate development of similar programs in the future.

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Acknowledgments

The BOLD program and all of its facets were initiated and developed at the Albert Einstein College of Medicine’s Cancer Center. The BOLD Healthy Living program was funded by Mount Sinai School of Medicine’s Communities IMPACT Diabetes Center Legacy Grant, the Entertainment Industry Foundation’s Revlon Run/Walk, and the New Yankee Stadium Community Benefits Fund, Inc. In addition, this publication was supported in part by the Diabetes Research and Training Center Grant P60 DK020541, CTSA Grant UL1 TR001073, TL1 TR001072, and KL2 TR001071 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional support was provided by the Commission on Dietetic Registration Doctoral Scholarship of the Academy of Nutrition and Dietetics.

Conflict of Interest

The authors do not have any potential conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA

    Beth A. Conlon, Michelle Kahan, Melissa Martinez, Kathleen Isaac, Rebecca Skyhart, Judith Wylie-Rosett & Alyson Moadel-Robblee

  2. Division of Athletic Training, Health and Exercise Science, Long Island University, Brooklyn, NY, 11201, USA

    Amerigo Rossi

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  1. Beth A. Conlon
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  2. Michelle Kahan
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  7. Judith Wylie-Rosett
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Correspondence to Beth A. Conlon.

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Conlon, B.A., Kahan, M., Martinez, M. et al. Development and Evaluation of the Curriculum for BOLD (Bronx Oncology Living Daily) Healthy Living: a Diabetes Prevention and Control Program for Underserved Cancer Survivors. J Canc Educ 30, 535–545 (2015). https://doi.org/10.1007/s13187-014-0750-7

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