HEALTHY WEIGHT MANAGEMENT FOR BREAST CANCER SURVIVORS

体重增加通常发生在诊断为乳腺癌的女性身上。确诊后体重增加可能会增加复发的风险，而乳腺癌确诊时肥胖是一个公认的负面预后因素。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，这表明减少能量摄入或增加锻炼的行为策略可能会影响体重增加的长期模式。以社会学习理论为基础的新的行为技能培训计划，以促进采用和保持身体活动，在其他不活跃的成年人群体中证明了成功。此外，我们已经证明，密集的、创新的电话咨询干预可以促进乳腺癌复发风险女性的饮食摄入量发生重大变化。在这个探索性项目中要检验的假设是，基于电话的咨询也可以有助于促进采用和保持更多的体力活动，从而促进超重和肥胖的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体力活动、改善身体形象、自我接纳和健康的饮食态度和行为。该项目将使用的课程的核心内容是基于行为技能培训计划，该计划已被证明在其他不活跃的成年人目标群体中有效，并结合认知-行为技术和情感处理，以促进接受并满足乳腺癌幸存者的独特需求和特征。这项研究的具体目的是：(1)与等待名单对照组相比，考察增加体力活动和促进健康饮食态度和行为的团体计划对强化治疗结束(16周)和一年时测量的体重变化的影响；(2)与对照组相比，检验个性化电话咨询增加身体活动和促进健康饮食态度和行为对测量的体重变化的额外影响；以及(3)收集有关乳腺癌幸存者体力活动水平变化的初步数据，这些幸存者参加了一项基于小组的计划和个性化的电话咨询，以促进健康的体重管理。

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.