@Article{info:doi/10.2196/32291,
author="Yeary, Karen H Kim
and Clark, Nikia
and Saad-Harfouche, Frances
and Erwin, Deborah
and Kuliszewski, Margaret Gates
and Li, Qiang
and McCann, Susan E
and Yu, Han
and Lincourt, Catherine
and Zoellner, Jamie
and Tang, Li",
title="Cruciferous Vegetable Intervention to Reduce the Risk of Cancer Recurrence in Non--Muscle-Invasive Bladder Cancer Survivors: Development Using a Systematic Process",
journal="JMIR Cancer",
year="2022",
month="Feb",
day="15",
volume="8",
number="1",
pages="e32291",
keywords="non--muscle invasive bladder cancer survivors; dietary intervention; cruciferous vegetable; cancer survivorship; cancer recurrence",
abstract="Background: Bladder cancer is one of the top 10 most common cancers in the United States. Most bladder cancers (70{\%}-80{\%}) are diagnosed at early stages as non--muscle-invasive bladder cancer (NMIBC), which can be removed surgically. However, 50{\%} to 80{\%} of NMIBC cases recur within 5 years, and 15{\%} to 30{\%} progress with poor survival. Current treatments are limited and expensive. A wealth of preclinical and epidemiological evidence suggests that dietary isothiocyanates in cruciferous vegetables (Cruciferae) could be a novel, noninvasive, and cost-effective strategy to control NMIBC recurrence and progression. Objective: The aim of this study is to develop a scalable dietary intervention that increases isothiocyanate exposure through Cruciferae intake in NMIBC survivors. Methods: We worked with a community advisory board (N=8) to identify relevant factors, evidence-based behavior change techniques, and behavioral theory constructs used to increase Cruciferae intake in NMIBC survivors; use the PEN-3 Model focused on incorporating cultural factors salient to the group's shared experiences to review the intervention components (eg, the saliency of behavioral messages); administer the revised intervention to community partners for their feedback; and refine the intervention. Results: We developed a multicomponent intervention for NMIBC survivors consisting of a magazine, tracking book, live telephone call script, and interactive voice messages. Entitled POW-R Health: Power to Redefine Your Health, the intervention incorporated findings from our adaptation process to ensure saliency to NMIBC survivors. Conclusions: This is the first evidence-based, theoretically grounded dietary intervention developed to reduce bladder cancer recurrence in NMIBC survivors using a systematic process for community adaptation. This study provides a model for others who aim to develop behavioral, community-relevant interventions for cancer prevention and control with the overall goal of wide-scale implementation and dissemination. ",
issn="2369-1999",
doi="10.2196/32291",
url="https://cancer.jmir.org/2022/1/e32291",
url="https://doi.org/10.2196/32291",
url="http://www.ncbi.nlm.nih.gov/pubmed/35166681"
}