Predictors of Weight Loss Success in Overweight Breast Cancer Survivors

项目总结（见说明）： 超重和不活动的乳腺癌幸存者癌症复发和死亡的风险更高。 研究表明，减肥和增加活动可能会改善结果。因此，美国癌症协会呼吁减肥和运动计划成为护理标准。 基于行为的减肥干预措施在乳腺癌幸存者中未得到充分利用，并且没有研究评估减肥成功的预测因素。执行功能是乳腺癌幸存者最常见的认知障碍，可能会影响他们改变生活方式的能力。 执行功能是对行为和认知的自上而下的控制，是健康相关行为的新兴预测因子。与癌症治疗相关的症状，如疲劳，也使行为改变成为一项挑战。我们的主要目的是确定在何种程度上的执行功能，作为衡量的任务表现和功能磁共振成像，占方差乳腺癌幸存者的减肥成功。我们还将确定其他癌症治疗相关症状（如疲劳）与干预成功之间的关系。在完成初步癌症治疗后，将为幸存者提供行为减肥干预。初始治疗（6个月）将侧重于减肥和增加运动。第二个6个月是维持阶段，减少与干预者的互动。将在基线、干预后即刻（6个月）和6个月维持期（12个月）后测量减肥成功的预测因素（执行功能、疲劳和心理困扰）。执行功能将使用一套全面的评估进行评估。在基线时，将在执行功能测试的同时获得fMRI。执行功能和其他治疗相关因素对减肥成功的影响将通过回归建模来确定，以解释变异性。在制定有效的干预措施的一个重要步骤是更好地了解超重BC幸存者减肥和运动成功的决定因素。从拟议项目中获得的知识将用于为幸存者量身定制干预措施，最大限度地减轻体重和锻炼。

PROJECT SUMMARY (See instructions): Overweight and inactive breast cancer survivors are at higher risk of cancer recurrence and mortality. Research suggests that losing weight and increasing activity may improve outcomes. As a result, the American Cancer Society has called for weight loss and exercise programs to be standard of care. Behaviorally based weight loss interventions have been under-utilized with breast cancer survivors and no studies have evaluated the predictors of weight loss success. Executive functions are the most common cognitive impairment in breast cancer survivors and may impact their ability to make lifestyle change. Executive functions are the top down control of behaviors and cognition and are an emerging predictor of health-related behaviors. Cancer treatment-related symptoms such as fatigue, also make behavior change a challenge. Our Primary Aim is to determine the degree to which executive functions, as measured by task performance and fMRI, account for the variance in breast cancer survivor's weight loss success. We will also determine the relationship between other cancer treatment-related symptoms, such as fatigue, and intervention success. A behavioral weight loss intervention will be provided to survivors after completing initial cancer therapy. Initial treatment (6 months) will focus on weight loss and increasing exercise. The second 6 months is a maintenance phase with reduced interaction with the interventionist. Predictors of weight loss success (executive functions, fatigue and psychological distress) will be measured at baseline, immediately post intervention (6 months), and after the 6 month maintenance phase (12 months). Executive functions will be assessed using a comprehensive battery of assessments. fMRI will be obtained concurrent with executive function testing at baseline. The impact of executive functions and other treatment-related factors on weight loss success will be determined with regression modeling to explain variability. An important step in the development of efficacious interventions is to better understand the determinants of weight loss and exercise success in overweight BC survivors. Knowledge gained from the proposed project will be used to tailor interventions for survivors that maximize weight loss and exercise.