Group Phone-based Weight Control among Rural Breast Cancer Survivors

农村乳腺癌幸存者通过电话进行团体体重控制

• 批准号: 8478064
• 负责人: Christie Befort
• 金额: $ 53.34万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8478064
• 关键词: Address; Arthralgia; Behavioral; Bioavailable; Biological Markers; Biomarker of Dietary Intake; Body Weight Changes; Body Weight decreased; C-reactive protein; Cancer Survivor; Cancer Survivorship; Cessation of life; Charge; Chronic; Counseling; County; Deterioration; Diagnosis; Diet; Education; Emotional; Estradiol; Fasting; Fatigue; Future; High Prevalence; High Risk Woman; Individual; Insulin; Intervention; Leptin; Life; Life Style; Long-Term Care; Lymphedema; Mails; Maintenance; Malignant Neoplasms; Menopausal Symptom; Methods; Obesity; Outcome; Overweight; Participant; Personal Satisfaction; Phase; Physical activity; Privacy; Provider; Psyche structure; Quality of life; Randomized Controlled Trials; Recurrence; Reporting; Research; Risk; Rural; Second Primary Cancers; Services; Social support; Survivors; Symptoms; Telephone; Testosterone; Time; Uninsured Medical Expense; Weight; Weight Gain; Weight maintenance regimen; Woman; Work; adiponectin; base; breast cancer diagnosis; cancer recurrence; cancer risk; cancer therapy; cost; cost effective; cost effectiveness; cost efficient; depressive symptoms; group support; health disparity; improved; innovation; malignant breast neoplasm; metropolitan; mortality; multi-site trial; novel; programs; rural area; secondary outcome; social; symposium; treatment effect

DESCRIPTION (provided by applicant): Women who are obese at breast cancer diagnosis have a 1.5 to 2.5 increased risk of recurrence and death compared to their normal weight counterparts. Moreover, weight gain and decreased physical activity are common after diagnosis and also increase the likelihood of breast cancer recurrence and death. Rural women suffer from health disparities in breast cancer diagnosis and treatment. Women of the most rural counties also have the highest prevalence of obesity compared to urban women. To address these disparities, the overarching objective of this application is to develop a clinically effective and cost efficient strategy for delivering a weight control intervention to rural breast cancer survivors. Group phone-based treatment via conference call is a novel treatment delivery approach that we have shown to be effective for initial weight loss among rural breast cancer survivors and more effective than the standard individual phone-based approach among rural women. This innovative method of providing group treatment addresses access barriers in rural areas and may be especially ideal for rural breast cancer survivors because it provides social support in conjunction with a level of anonymity. Rural breast cancer survivors are more likely to be isolated, to have heightened concerns about privacy, and to report difficulty adjusting to breast cancer. At the same time, they have less access to professional support services, and thus are more likely to have unmet support needs surrounding both cancer and weight management. The opportunity to engage in lifestyle change with other survivors by phone may provide social support in a confidential setting at the same time it enhances diet, physical activity, and weight, as well as quality of life. However, the impact of group phone counseling during extended care for weight loss maintenance beyond six months remains unknown. Weight loss maintenance is the more challenging phase of treatment when weight regain is common, and this regain presents a potential risk for breast cancer recurrence. This randomized controlled trial will evaluate the effects of group phone-based treatment for weight loss maintenance among rural breast cancer survivors, compared to an established mail- based education comparison condition, subsequent to a six month group phone-based weight loss phase for both conditions. In addition to the intervention impact on weight loss maintenance, the study will provide estimates of incremental cost-effectiveness per kg loss between the two conditions and the impact on secondary outcomes including quality of life, breast cancer risk biomarkers, dietary intake, and physical activity. We aim to produce long-term weight loss maintenance, associated biomarker modulation, and improved quality of life in a cost-effective way that can be extended to hard-to-reach rural survivors.

描述（由申请人提供）：与正常体重的女性相比，乳腺癌诊断时肥胖的女性复发和死亡的风险增加1.5至2.5。此外，体重增加和体力活动减少在诊断后很常见，也增加了乳腺癌复发和死亡的可能性。农村妇女在乳腺癌诊断和治疗方面存在健康差距。与城市妇女相比，大多数农村县的妇女肥胖症发病率也最高。为了解决这些差异，本申请的总体目标是开发一种临床有效且具有成本效益的策略，为农村乳腺癌幸存者提供体重控制干预。通过电话会议进行的小组电话治疗是一种新的治疗方法，我们已经证明，这种方法对农村乳腺癌幸存者的初始体重减轻有效，并且比农村妇女中标准的个人电话治疗方法更有效。这种提供集体治疗的创新方法解决了农村地区的准入障碍，对农村乳腺癌幸存者来说可能特别理想，因为它提供了社会支持和一定程度的匿名。农村乳腺癌幸存者更有可能被孤立，对隐私的关注程度更高，并报告难以适应乳腺癌。与此同时，他们获得专业支持服务的机会较少，因此更有可能在癌症和体重管理方面有未满足的支持需求。通过电话与其他幸存者一起改变生活方式的机会可以在保密的环境中提供社会支持，同时改善饮食，体育活动和体重以及生活质量。然而，小组电话咨询的影响，在延长护理减肥维持超过六个月仍然未知。当体重反弹很常见时，体重减轻的维持是治疗中更具挑战性的阶段，这种反弹存在乳腺癌复发的潜在风险。这项随机对照试验将评估基于电话的分组治疗对农村乳腺癌幸存者体重减轻维持的影响，与建立的基于邮件的教育比较条件相比，在两种条件下进行为期六个月的基于电话的分组减肥阶段。除了对减肥维持的干预影响外，该研究还将提供两种情况之间每公斤体重减少的增量成本效益估计，以及对次要结果的影响，包括生活质量，乳腺癌风险生物标志物，饮食摄入量和身体活动。我们的目标是以具有成本效益的方式产生长期的减肥维持，相关的生物标志物调节和改善生活质量，可以扩展到难以接触的农村幸存者。