Indiana University-Purdue University Indianapolis (IUPUI) / Given the numerous benefits of a healthy diet and exercise for cancer survivors, there has been an increase in the number of lifestyle intervention trials for this population in recent years. However, the extent to which adherence to a diet and exercise intervention predicts health-related outcomes among cancer survivors is currently unknown. To address this question, data from the Reach out to ENhancE Wellness in Older Cancer Survivors (RENEW) diet and exercise intervention trial were analyzed. RENEW was a yearlong telephone and mailed print intervention for 641 older (>65 years of age), overweight (body mass index: 25.0-39.9), long-term (>5 years post-diagnosis) survivors of colorectal, breast, and prostate cancer. Participants were randomized to the diet and exercise intervention or a delayed-intervention control condition. The RENEW telephone counseling sessions were based on determinants of behavior derived from Social Cognitive Theory (SCT) (e.g., building social support, enhancing self-efficacy). These factors have been hypothesized to improve health behaviors, which in turn should improve health outcomes. Thus, drawing on SCT and prior diet and exercise research with cancer survivors, I hypothesized that telephone counseling session attendance would be indirectly related to health-related outcomes (i.e., physical function, basic and advanced lower extremity function, mental health, and body mass index) through intervention-period strength and endurance exercise and dietary behavior (i.e., fruit and vegetable intake, saturated fat intake). The proposed model showed good fit to the data; however, not all of the hypothesized relationships were supported. Specifically, increased telephone counseling session attendance was related to engagement in all of the health behaviors over the intervention period. In turn, (a) increased endurance exercise was related to improvement in all of the health-related outcomes with the exception of mental health; (b) increased strength exercise was solely related to improved mental health; (c) increased fruit and vegetable intake was only related to improved basic lower extremity function; and (d) saturated fat intake was not related to any of the health-related outcomes. Taken together, these findings suggest that SCT determinants of behavior and the importance of session attendance should continue to be emphasized in diet and exercise interventions. Continued exploration of the relationship between adherence to a diet and exercise intervention and health-related outcomes will inform the development of more cost-effective and efficacious interventions for cancer and other medical populations.

Indiana University-Purdue University Indianapolis (IUPUI) / Background. Traditionally, departmental appointment type (basic science or clinical) and/or degree earned (PhD, MD, or MD-PhD) have served as proxies for how we conceptualize clinical and basic science faculty. However, the landscape in which faculty work has considerably changed and now challenges the meaning of these cohorts. Within this context I introduce a behavior-based role variable that is defined by how faculty spend their time in four academic activities: teaching, research, patient care, and administrative duties. Methods. Two approaches to role were compared to department type and degree earned in terms of their effects on how faculty report their perceptions and experiences of faculty vitality and its related constructs. One approach included the percent of time faculty spent engaged in each of the four academic activities. The second approach included role groups described by a time allocation rubric. This study included faculty from four U.S. medical schools (N = 1,497) and data from the 2011 Indiana University School of Medicine Faculty Vitality Survey. Observed variable path analysis evaluated models that included traditional demographic variables, the role variable, and faculty vitality constructs (e.g., productivity, professional engagement, and career satisfaction). Results. Role group effects on faculty vitality constructs were much stronger than those of percent time variables, suggesting that patterns of how faculty distribute their time are more important than exactly how much time they allocate to single activities. Role group effects were generally similar to, and sometimes stronger than, those of department type and degree earned. Further, the number of activities that faculty participate in is as important a predictor of how faculty experience vitality constructs as their role groups. Conclusions. How faculty spend their time is a valuable and significant addition to vitality models and offers several advantages over traditional cohort variables. Insights into faculty behavior can also show how institutional missions are (or are not) being served. These data can inform hiring practices, development of academic tracks, and faculty development interventions. As institutions continue to unbundle faculty roles and faculty become increasingly differentiated, the role variable can offer a simple way to study faculty, especially across multiple institutions.