The amount of cancer-related information available to the general population continues to grow, yet its effects are unclear. This study extends previous cross-sectional research establishing that cancer information seeking across a variety of sources is extensive and positively associated with engaging in health-related behaviors. We studied how active information seeking about cancer prevention influenced three healthy lifestyle behaviors using a two-round nationally representative sample of adults ages 40–70 (n=1795), using propensity scoring to control for potential confounders including baseline behavior. The adjusted odds of dieting at follow-up were 1.51 [95% CI: 1.05 to 2.19] times higher for those who reported baseline seeking from media and interpersonal sources relative to non-seekers. Baseline seekers ate 0.59 [95% CI: 0.28, 0.91] more fruits/vegetable servings per day and exercised 0.36 [95% CI: 0.12 to 0.60] more days per week at one-year follow-up compared to non-seekers. The effects of seeking from media and friends/family on eating fruits/vegetables and exercising were independent of seeking from physicians. We offer several explanations for why information seeking predicts healthy lifestyle behaviors: information obtained motivates these behaviors; information sought teaches specific techniques; the act of information seeking may reinforce a psychological commitment to dieting, eating fruits/vegetables, and exercising.

Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise and fruit and vegetable consumption among the general population. The current study builds upon this research by examining the effect of cancer patients’ active information seeking from media and (non-medical) interpersonal sources on fruit and vegetable consumption. The results of this longitudinal study are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry, comprising breast, prostate and colorectal cancer patients who completed mail surveys in the Fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting N=2013); of those 1293 were interviewed one year later and 845 were available for final analyses. We used multiple imputation to replace missing data and propensity scoring to adjust for effects of possible confounders. There is a positive effect of information seeking at baseline on fruit and vegetable servings at follow-up; seekers consumed 0.43 (95% CI: 0.28 to 0.58) daily servings more than non-seekers adjusting for baseline consumption and other confounders. Active information seeking from media and interpersonal sources may lead to improved nutrition among the cancer patient population.

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primary care ought to serve a more prominent role in care transition efforts. 6 Yet there are few concerted efforts underway to develop, implement, and assess primary care-based transitions programs. In a recently published environmental scan commissioned by the Agency for Healthcare Research and Quality (AHRQ), we assessed the current state of the literature on primary carebased care transitions programs. 7 We identified numerous peer-reviewed and non-peer-reviewed studies ranging from narrow interventions to more comprehensive multicomponent initiatives. While some of the included studies had methodological limitations (there were few rigorous controlled analyses), collectively, they shed light on the types of interventions that are likely to be successful, revealing practical considerations and policy changes needed for making these initiatives sustainable. In this piece, we summarize insights from the environmental scan and make a case for an enhanced and expanded role for primary care in the care transitions process. BUNDLED VERSUS SINGLE-COMPONENT INTERVENTIONS ARE MORE LIKELY TO SUCCEED First, we found that multi-component, or Bbundled,^programs addressing multiple care transitions challenges that patients and providers face were some of the most successful. These programs often utilize clinic-based care managers and include several distinct processes such as close follow-up with a provider, post-discharge phone calls, medication reconciliation, addressing transportation barriers, and scheduling follow-up with social workers and other critical primary care team members. 8-14 Conversely, studies examining the impact of more narrowly focused programs, such as implementing automated admission notifications, medication reconciliations, or post-discharge phone calls alone, were less encouraging. Second, primary care practices with bundled transitions programs tended to be initiated early in the patient's hospital course. While primary care notifications for patient hospitalizations alone were not enough to reduce readmissions, hospitalization alerts were frequently an important component of successful interventions. These bundled programs often Breached in^to patients in the hospital prior to discharge-either to assess the patient's biopsychosocial needs, obtain accurate patient or caregiver contact

Background Past research has linked patient-physician communication with improved emotional, physical, and social health. One component of communication, patient-clinician information engagement (PCIE) predicts improved short-term patient-reported outcomes such as treatment satisfaction through perceptions of feeling informed. However, the relationship between PCIE and longer term cancer-related problems has not previously been examined. Objective This study examines the influence of PCIE on self-reported problems associated with cancer diagnosis and treatment based on a longitudinal survey among a randomly selected sample from the 2005 Pennsylvania Cancer Registry. Methods We surveyed 1,293 respondents diagnosed with colorectal, breast, or prostate cancers in 2006 and 2007 (baseline response rate was 64%, retention rate was 65%). We predicted an index of cancer-related problems at one-year follow-up with the baseline cancer-related problem index and PCIE, controlling for demographic and clinical factors using regression analyses. The mean age of participants was 65 years, about half were female, and 86% were White. Results Having more cancer-related problems and PCIE at baseline significantly predicted more cancer-related problems at follow-up. Additionally, baseline cancer-related problems and PCIE interacted significantly (p=0.01) – PCIE was associated with more cancer-related problems at follow-up among participants who reported more rather than fewer symptoms at baseline. Conclusion If respondents reported engaging more with their physicians at baseline, they reported experiencing more cancer-related issues at follow-up; this pattern was stronger among those reporting more baseline problems. Increased discussion of cancer information with physicians may maintain the salience of these problems in cancer survivors’ minds over time.