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(申请人提供)：乳腺癌是女性最常见的诊断癌症，估计三分之一的乳腺癌幸存者是肥胖的。肥胖的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佳(例如心血管疾病、免疫功能受损、死亡)有关。对于幸存者和伴侣来说，痛苦、疲劳和心理困扰都很常见。这些症状可能会成为健康饮食和体力活动的障碍，这两种行为是减肥和保持体重所必需的。研究表明，夫妻之间的健康行为之间存在显著的正向关系。二元健康行为改变干预措施已证明有效，甚至可能比只针对一个人的干预措施更有效。针对癌症幸存者的行为减肥干预通常不涉及伴侣。此外，行为减肥干预很少涉及与饮食不良和缺乏运动有关的生理和心理症状。我们建议开发和测试一种新的针对肥胖乳腺癌幸存者及其伴侣的二元性行为体重和症状管理干预的可行性、可接受性和初步疗效。拟议的项目包括两个阶段。第一阶段将包括干预、发展和完善。干预的发展将由研究小组先前的工作、社区应对和行为改变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个二元组)的二元组获得的信息指导。然后，将用5个二元组测试干预方案，以协助细化干预内容。在第二阶段，将审查干预的可行性、可接受性和初步效果。接受辅助治疗后第一年的肥胖乳腺癌幸存者和他们的超重或肥胖伴侣(N=20对)将接受每周6次和每两周6次的治疗，总共12次，间隔大约5个月。干预将以夫妻为基础的形式提供，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DUADS进行评估。研究结果将包括体重、症状(即疼痛、疲劳、痛苦)、饮食行为和体力活动。探索性结果检查与癌症幸存者及其伴侣的健康结果相关的生物标记物(例如，胰岛素、促炎细胞因子)。这项研究的结果将提供有关二元干预的价值的初步数据，以减轻体重，改善饮食，增加体力活动，同时解决经常成为减肥/维持障碍的症状。这些发现将直接有可能通过影响体重而产生显著的公共健康益处，而体重一直被认为与不良的健康质量有关 生命和糟糕的健康结果。

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