Behavioral Weight and Symptom Management for Breast Cancer Survivors and Partners

乳腺癌幸存者和伴侣的行为体重和症状管理

• 批准号: 9404518
• 负责人: Caroline Dorfman
• 金额: $ 0.07万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9404518
• 关键词: Address; Adjuvant; Aftercare; Arthritis; Behavior; Behavioral; Biological; Biological Markers; Body Weight decreased; Breast Cancer survivor; Cancer Intervention; Cancer Survivor; Cardiovascular Diseases; Caregivers; Cessation of life; Chronic Disease; Comorbidity; Coping Behavior; Couples; Data; Diabetes Mellitus; Diagnosis; Diet; Disease Outcome; Disease Progression; Distress; Eating; Eating Behavior; Fatigue; Focus Groups; General Population; Gold; Growth; Guidelines; Health; Health Benefit; Health behavior; Health behavior change; Healthy Eating; Heart Rate; IL8 gene; Immunity; Impairment; Individual; Inflammatory; Insulin; Interleukin-6; Intervention; Link; Maintenance; Measures; Medical; Modeling; Monitor; Morbidity - disease rate; Obesity; Outcome; Outcome Study; Overweight; Pain; Participant; Phase; Physical activity; Population; Procedures; Process; Protocols documentation; Psychological Factors; Public Health; Quality of life; Recurrence; Research; Survivors; Symptoms; TNF gene; Testing; Treatment Efficacy; Weight; Weight Gain; Weight maintenance regimen; Woman; Work; adiponectin; arm; base; behavior change; cancer diagnosis; cancer recurrence; cancer risk; cardiovascular disorder risk; caregiving; common symptom; commune; coping; cytokine; disorder risk; high risk; immune function; improved; improved functioning; innovation; malignant breast neoplasm; mortality; novel; phase 1 study; phase 2 study; physical conditioning; physical symptom; pilot trial; primary caregiver; psychologic; psychological distress; psychological symptom; public health relevance; symptom management; therapy development; tumor initiation; weight loss intervention; weight maintenance

 DESCRIPTION (provided by applicant): Breast cancer is the most commonly diagnosed cancer in women, and estimates suggest that one third of breast cancer survivors are obese. The partners of obese breast cancer survivors are also likely to be overweight or obese. Being overweight or obese is associated with increased risk of disease progression, recurrence, and death for breast cancer survivors as well as poor health outcomes for partners (e.g., cardiovascular disease, impaired immune functioning, mortality). For both survivors and partners, pain, fatigue, and psychological distress are common. These symptoms can serve as barriers to healthy eating and physical activity, two behaviors necessary for weight loss and maintenance. Research suggests a significant and positive relationship between health behaviors within couples. Dyadic health behavior change interventions have demonstrated efficacy and may even be more efficacious than interventions targeting only one individual. Behavioral weight loss interventions for cancer survivors have not typically involved the partner. Further, behavioral weight loss interventions rarely address physical and psychological symptoms that are related to poor eating and inactivity. We propose to develop and test the feasibility, acceptability, and initial efficacy of a novel dyadic behavioral weight and symptom management intervention for obese breast cancer survivors and their partners. The proposed project consists of two phases. Phase I will include intervention development and refinement. Intervention development will be guided by the research team's prior work, the interdependence model of communal coping and behavior change, and information obtained from dyads participating in focus groups (N=3 focus groups, N=15 dyads). The intervention protocol will then be tested with 5 dyads to assist with refinement of intervention content. During phase II, the feasibility, acceptability and initial efficacy of the intervention will be examined. Obese brest cancer survivors in the first year following adjuvant treatment and their overweight or obese partners (N=20 dyads) will receive 6 weekly and 6 biweekly sessions for a total of 12 sessions spaced across approximately 5 months. The intervention will be provided in a couples-based format where each dyad will meet separately with the therapist. Dyads will be assessed at pre-, post-, and 3-months post-treatment. Study outcomes will be weight, symptoms (i.e., pain, fatigue, distress), eating behavior, and physical activity. Exploratory outcomes examine biomarkers (e.g., insulin, pro-inflammatory cytokines) associated with health outcomes for cancer survivors and their partners. The results of this study will provide preliminary data about the value of a dyadic intervention to decrease weight, improve diet, and increase physical activity while addressing symptoms that frequently serve as barriers to weight loss/maintenance. These findings will have the direct potential to produce significant public health benefit by impacting weight, a variable that has been consistently linked to poor quality of life and poor health outcomes.

 描述（由申请人提供）：乳腺癌是女性中最常见的癌症，估计有三分之一的乳腺癌幸存者肥胖。肥胖乳腺癌幸存者的伴侣也可能超重或肥胖。超重或肥胖与乳腺癌幸存者疾病进展、复发和死亡的风险增加以及伴侣健康状况不良有关（例如，心血管疾病、免疫功能受损、死亡率）。对于幸存者和伴侣来说，疼痛，疲劳和心理困扰是常见的。这些症状可以成为健康饮食和身体活动的障碍，这是减肥和维持体重所必需的两种行为。研究表明，夫妻之间的健康行为之间存在显著的积极关系。双元健康行为改变干预措施已经证明是有效的，甚至可能比只针对一个人的干预措施更有效。癌症幸存者的行为减肥干预通常不涉及伴侣。此外，行为减肥干预措施很少解决与不良饮食和不活动有关的身体和心理症状。我们建议开发和测试的可行性，可接受性和初步疗效的一种新型的二元行为体重和症状管理干预肥胖乳腺癌幸存者和他们的合作伙伴。拟议项目包括两个阶段。第一阶段将包括制定和完善干预措施。干预措施的制定将由研究小组的前期工作，社区应对和行为变化的相互依赖模型，以及从参与焦点小组（N=3个焦点小组，N=15个二人组）的二人组中获得的信息指导。然后，将使用5对组合对干预方案进行测试，以帮助完善干预内容。在第二阶段，将审查干预措施的可行性、可接受性和初步疗效。辅助治疗后第一年的肥胖乳腺癌幸存者及其超重或肥胖伴侣（N=20对）将接受6次每周一次和6次每两周一次的治疗，共12次，间隔约5个月。干预将以夫妇为基础的格式提供，每个二人组将分别与治疗师会面。将在治疗前、治疗后和治疗后3个月对二联体进行评估。研究结果将是体重、症状（即，疼痛、疲劳、痛苦）、饮食行为和身体活动。探索性结果检查生物标志物（例如，胰岛素，促炎细胞因子）与癌症幸存者及其伴侣的健康结果相关。本研究的结果将提供有关二元干预价值的初步数据，以减轻体重、改善饮食和增加身体活动，同时解决经常阻碍减肥/维持体重的症状。这些发现将有直接的潜力，通过影响体重产生重大的公共卫生效益，体重是一个变量，一直与低质量的 生活和健康状况不佳。

项目成果

DEVELOPMENT, FEASIBILITY, AND ACCEPTABILITY OF A BEHAVIORAL WEIGHT AND SYMPTOM MANAGEMENT INTERVENTION FOR BREAST CANCER SURVIVORS AND INTIMATE PARTNERS.

• DOI: 10.48252/jcr57
• 发表时间: 2022
• 期刊: Journal of cancer rehabilitation
• 作者: Dorfman CS;Somers TJ;Shelby RA;Winger JG;Patel ML;Kimmick G;Craighead L;Keefe FJ
• 通讯作者: Keefe FJ