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（由适用提供）：乳腺癌是女性最常见的癌症，估计表明乳腺癌生存中的三分之一是肥胖的。肥胖的乳腺癌生存的伴侣也可能超重或肥胖。超重或肥胖与疾病进展，复发和乳腺癌生存的死亡风险增加以及伴侣的健康状况不佳有关（例如心血管疾病，免疫学功能受损，死亡率）。对于冲浪者和伴侣，疼痛，疲劳和心理困扰都是常见的。这些症状可以成为健康饮食和体育锻炼的障碍，这是减肥和维持所需的两种行为。研究表明，夫妻内的健康行为之间存在显着和积极的关系。二元健康行为改变干预措施已经表现出效率，甚至比仅针对一个人的干预措施更有效。癌症生存的行为减肥干预措施通常不涉及伴侣。此外，行为减肥干预措施很少解决与不良饮食和不活跃有关的身体和心理症状。我们建议对肥胖乳腺癌存活及其伴侣的新型二元行为体重和症状管理干预的新型二元行为体重和症状管理干预的可行性，可接受性和初始效率。拟议的项目包括两个阶段。第一阶段将包括干预开发和完善。干预开发将由研究团队的先前工作，公共应对和行为改变的相互依赖模型以及从参与焦点小组的二元组获得的信息（n = 3个焦点小组，n = 15个二元组）获得指导。然后，将使用5个二元组对干预方案进行测试，以协助改进干预含量。在第二阶段，将检查干预措施的可行性，可接受性和初始效率。调整治疗后的第一年，肥胖的勇敢癌症的存活及其超重或肥胖伴侣（n = 20个二元组）将每周进行6次和6个每两周一次的课程，总共在大约5个月中分布了12个课程。干预措施将以基于夫妻的格式提供，每个二元组将与治疗师分开相遇。二元组将在治疗前，后和3个月进行评估。研究结果将是体重，症状（即疼痛，疲劳，困扰），饮食行为和体育锻炼。探索性结果考试生物标志物（例如胰岛素，促炎细胞因子）与癌症生存的健康结果及其伴侣有关。这项研究的结果将提供有关减轻体重，改善饮食和增加体育锻炼的二元干预价值的初步数据，同时解决经常作为减肥/维持障碍的症状。这些发现将具有直接潜力，可以通过影响体重来产生重大的公共卫生益处，这一变量一直与质量差的差异有关 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