HEALTHY WEIGHT MANAGEMENT FOR BREAST CANCER SURVIVORS

体重增加通常发生在女性乳腺癌诊断后。诊断后体重增加可能会增加复发的风险，诊断乳腺癌时肥胖是一个既定的负面预后因素。体重控制是许多乳腺癌幸存者非常关心的问题。诊断后体重增加与能量摄入呈正相关，与体力活动水平呈负相关，表明减少能量摄入或增加运动的行为策略可能会影响体重增加的长期模式。新的行为技能训练计划，以促进采用和维持身体活动的基础上，社会学习理论已经证明成功的其他群体的不活跃的成年人。此外，我们已经证明，密集的，创新的电话咨询干预可以促进有乳腺癌复发风险的女性饮食摄入量的重大变化。在这个探索性项目中要测试的假设是，基于电话的咨询也可以有助于促进增加体力活动的采用和维持，从而促进超重和肥胖乳腺癌幸存者的体重减轻。健康体重管理的一种方法强调增加身体活动、改善身体形象、自我接受以及健康的饮食态度和行为。在这个项目中使用的课程的核心内容是基于一个行为技能培训计划，已被证明是有效的，在其他目标群体的不活跃的成年人，与认知行为技术和情感处理的结合，以促进接受和解决乳腺癌幸存者的独特需求和特点。本研究的具体目的是：（1）研究以小组为基础的计划，以增加体力活动和促进健康的饮食态度和行为对测量的体重变化在强化治疗期结束时的影响（16周）和一年时，与等待名单对照组相比;（二）研究个性化电话咨询对增加体力活动和促进健康饮食态度和行为的额外影响，治疗期（16周）和1年时，与对照组相比;（3）收集参与基于小组的计划和个体化电话咨询以促进健康体重管理的乳腺癌幸存者预期可能发生的身体活动水平变化的初步数据。

Weight gain commonly occurs in women following the diagnosis of breast cancer. Post-diagnosis weight gain may increase risk for recurrence, and obesity at diagnosis of breast cancer is an established negative prognostic factor. Weight control is of great concern to many breast cancer survivors. Post-diagnosis weight gain is positively associated with energy intake and inversely related to physical activity level, suggest that behavioral strategies to reduce energy intake or increase exercise are likely to influence the long-term pattern of weight gain. Newer behavioral skills training programs to promote the adoption and maintenance of physical activity based on social learning theory have demonstrated success in other groups of inactive adults. Also, we have demonstrated than an intensive, innovative telephone-based counseling intervention can promote major changes in the dietary intakes for women at risk for breast cancer recurrence. The hypothesis to be tested in this exploratory project is that telephone-based counseling can also be useful in facilitating the adoption and maintenance of increased physical activity, and thus, promote weight loss in overweight and obese breast cancer survivors. One approach to healthy weight management emphasizes increased physical activity, improved body image, self- acceptance, and healthy eating attitudes and behaviors. The core content of the curriculum to be used in this project is based on a behavioral skills training program that has been shown to be effective in other target groups of inactive adults, with the incorporation of cognitive-behavioral techniques and emotional processing to promote acceptance and address the unique needs and characteristics of breast cancer survivors. The specific aims of this study are: (1) To examine the effect of a group- based program to increase physical activity and promote healthy eating attitudes and behaviors on measured weight change at the end of an intensive treatment period (16 weeks) and at one year, compared to a wait-list control group; (2) To examine the additional effect of individualized telephone counseling to increase physical activity and promote healthy eating attitudes and behaviors on measured weight change at the end of an intensive treatment period (16 weeks) and at one year, compared to the control group; and (3) To collect preliminary data on the change in level of physical activity that may be expected to occur in breast cancer survivors who participate in a group-based program and individualized telephone counseling to promote healthy weight management.