Moving Forward: A weight loss program for African-American breast cancer survivo

描述（由申请人提供）：即使在控制了年龄、SES、诊断时的肿瘤分期、激素受体状态、组织学和绝经状态后，非洲裔美国人（AA）女性的乳腺癌（BC）生存率仍显著低于欧洲裔美国人（EA）女性。这种差异在芝加哥尤为明显，AA女性的死亡率超过EA女性116%。患有BC的AA女性不仅比EA女性更有可能死于癌症，而且更有可能死于糖尿病和高血压等共病。不良饮食、缺乏体育活动和肥胖会导致乳腺癌进展以及许多共病疾病的发展和恶化。迫切需要努力降低AA妇女乳腺癌的高死亡率。解决不良饮食，缺乏体力活动和肥胖率高的问题可能会提供最佳的近期机会，以减少乳腺癌和AA BC幸存者的全因死亡率。虽然有几项研究已经检查了EA BC幸存者的减肥干预措施，但没有专门针对AA BC幸存者开发的干预措施。向前迈进是一个为期六个月的认知行为社区减肥干预，是与AA BC幸存者合作开发的。该申请提出了一项随机干预研究，以检查向前移动的影响，与与AA BC幸存者合作开发的6个月认知行为社区减肥干预相比，对240名诊断为I期，II期或III期乳腺癌的肥胖AA女性的BMI和行为，生物学和心理社会结局。我们与芝加哥公园区（CPD）合作，在六个主要的AA芝加哥社区内实施这项研究。除了拥有一支经验丰富的跨学科研究团队外，该项目还有其他几个优势，包括重点关注AA BC幸存者减肥的创新;对AA BC幸存者中与乳腺癌和共病状况相关的发病率和死亡率产生积极影响的潜力;以及CPD社区计划的可持续性潜力。

DESCRIPTION (provided by applicant): Breast cancer (BC) survival rates are significantly lower for African-American (AA) women compared to European American (EA) women even after controlling for age, SES, tumor stage at diagnosis, hormone receptor status, histology, and menopausal status. This disparity is particularly evident in Chicago where mortality rates for AA women exceed those for EA women by 116 percent. Not only are AA women with BC more likely than EA women to die from their cancer, they are also more likely to die from comorbid conditions including diabetes and hypertension. Poor diet, lack of physical activity, and obesity contribute to breast cancer progression and the development and exacerbation of many comorbid conditions. Efforts to reduce the high mortality rates observed in AA women with breast cancer are critically needed. Addressing poor diet, lack of physical activity, and high rates of obesity may provide the best near-term opportunity to decrease breast cancer and all-cause mortality among AA BC survivors. Although several studies have examined weight loss interventions among EA BC survivors, no interventions developed specifically for AA BC survivors have been examined. Moving Forward is a six-month cognitive-behavioral community-based weight loss intervention that was developed in collaboration with AA BC survivors. This application proposes a randomized intervention study to examine the effects of Moving Forward, compared to a six-month cognitive-behavioral community-based weight loss intervention that was developed in collaboration with AA BC survivors, on BMI and behavioral, biological, and psychosocial outcomes in 240 obese AA women diagnosed with Stage I, II, or III breast cancer. We have partnered with the Chicago Park District (CPD) to implement the study within six predominantly AA Chicago communities. In addition to having an experienced, interdisciplinary study team, this project has several other strengths including innovation in its focus on weight loss in AA BC survivors; the potential for having a positive impact on morbidity and mortality related to breast cancer and comorbid conditions among AA BC survivors; and the potential for sustainability within CPD community programs.