Read on Twitter
New report finds lack of diet/PA/wt mgmt physician-initiated recommendation for individuals living with and beyond cancer.
A few points on this report and the need for strategies that lead to actionable outcomes:
1/ https://pubmed.ncbi.nlm.nih.gov/33389166/
A few points on this report and the need for strategies that lead to actionable outcomes:
1/ https://pubmed.ncbi.nlm.nih.gov/33389166/
Prevalence of MD recommendations to improve diet, increase PA/exercise, and lose or control weight were low
Despite evidence re:exercise/diet interventions improving survivor outcomes. Why the gap?
1. Docs don’t know the evidence
2. Docs don’t have time
3. Docs don’t know HOW
2/
Despite evidence re:exercise/diet interventions improving survivor outcomes. Why the gap?
1. Docs don’t know the evidence
2. Docs don’t have time
3. Docs don’t know HOW
2/
What do we mean by this?
Yes, docs know that exercise are diet are good. But the specific need for an exercise prescription or actual dietary interventions are beyond what they can/want to tackle in detail and with the coaching needed to ACTIVATE behavior change.
3/
Yes, docs know that exercise are diet are good. But the specific need for an exercise prescription or actual dietary interventions are beyond what they can/want to tackle in detail and with the coaching needed to ACTIVATE behavior change.
3/
So, what happens?
Well intentioned & v good docs make “recommendations” for diet and exercise for survivors.
Well, saying words doesn’t translate to ACTION.
Why:
- individualization
- motivation
- conditional understanding
Are all missing here.
4/
Well intentioned & v good docs make “recommendations” for diet and exercise for survivors.
Well, saying words doesn’t translate to ACTION.
Why:
- individualization
- motivation
- conditional understanding
Are all missing here.
4/
Response:
Docs don’t have time to assess & prescribe exercise/diet
Docs aren’t health coaches
YES & YES, all true and all OK. But this means we have to take the next step of actively getting the patient in front of someone who can assess, prescribe, coach behaviors.
5/
Docs don’t have time to assess & prescribe exercise/diet
Docs aren’t health coaches
YES & YES, all true and all OK. But this means we have to take the next step of actively getting the patient in front of someone who can assess, prescribe, coach behaviors.
5/
This is where the actionable strategy comes in:
Go beyond ‘recommend’. Actually send/refer/consult to a provider that can take action by engaging the patient.
When you write the prescription, state to the patient “I want you to go to...or I want you to see...” it is impactful
6/
Go beyond ‘recommend’. Actually send/refer/consult to a provider that can take action by engaging the patient.
When you write the prescription, state to the patient “I want you to go to...or I want you to see...” it is impactful
6/
The other v subtle statement here of HUGE importance is this:
Dietary habits/PA and exercise levels/obesity rates in the cancer cohort was NOT DIFFERENT FROM THE GENERAL POPULATION.
The human being will behave like most human beings do after their cancer treatment.
WOW...
7/
Dietary habits/PA and exercise levels/obesity rates in the cancer cohort was NOT DIFFERENT FROM THE GENERAL POPULATION.
The human being will behave like most human beings do after their cancer treatment.
WOW...
7/
This means that cancer treatment doesn’t magically result in people making sudden and dramatic changes in behavior to improve their health.
Why would we expect them to...unless we engage them and encourage them to.
What do we need to change this cycle?
8/
Why would we expect them to...unless we engage them and encourage them to.
What do we need to change this cycle?
8/
1. Implement standard oncology clinical practice of assessing PA levels and diet/wt.
2. ADVISE pts about changes needing to be made and then
3. REFER them to a program/professional that can engage them in support.
Here is a how to guide:
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21579
9/
2. ADVISE pts about changes needing to be made and then
3. REFER them to a program/professional that can engage them in support.
Here is a how to guide:
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21579
9/
Ongoing, repeatedly ask, advise, refer.
Everyone needs some level of support for behavior change. Where do you send them?
Here’s some insight:
10/ https://pubmed.ncbi.nlm.nih.gov/32212338/
Everyone needs some level of support for behavior change. Where do you send them?
Here’s some insight:
10/ https://pubmed.ncbi.nlm.nih.gov/32212338/
Yes, this is hard. Harder than just saying words to a patient, harder than just handing them a piece of paper.
If we want to influence behaviors we have hard work to do. No short cuts, no excuses
If we want to effectively change the health of this population we need ACTION
11/11
If we want to influence behaviors we have hard work to do. No short cuts, no excuses
If we want to effectively change the health of this population we need ACTION
11/11
