Implementing dietary change among Hispanic Breast Cancer Survivors

描述(申请人提供)：与年龄和阶段相似的非西班牙裔白人女性相比，西班牙裔女性死于乳腺癌的可能性高20%。造成这种差异的原因之一可能是诊断后饮食行为的差异。为了缩小这一差距，并提高总体存活率，需要为拉美裔乳腺癌幸存者制定文化上适当的饮食干预措施，教导妇女如何食用高水果和蔬菜、低饱和脂肪的饮食。我们建议进行一项随机对照研究(n=70，每臂35例)来测试！关于最近完成治疗的拉美裔乳腺癌幸存者改变饮食行为的计划。致敬！Cocina para su！这是一个为期12周的课程，提供有关营养教育、餐饮准备和在小组环境中购买食物的实践教育和指导。所有参与者将被跟踪总共12个月，在基线、6个月和12个月进行临床评估，并使用激励性访谈技术每月进行电话联系。主要目的是确定饮食干预的效果(！1)每日水果/蔬菜的摄入量，以及2)从基线到6个月的每日脂肪摄入量。我们假设，与对照组相比，饮食干预将导致水果和蔬菜摄入量的较大增加和脂肪摄入量的较大减少。第二个目标是确定饮食干预与对照在以下方面的效果：1)水果和蔬菜摄入量的生物标记物，与乳腺癌风险相关的分子生物标记物，以及6个月和12个月时的人体测量；2)12个月时水果/蔬菜和脂肪的摄入量；3)饮食变化的中介，包括改变的准备程度、结果预期、自我效能、食物和营养技能、自我调节技能和坚持的障碍；以及4)6个月和12个月时生活质量和焦虑/抑郁的变化。如果这项干预措施成功，我们将利用研究结果1)为拉美裔乳腺癌幸存者实施以社区为基础的营养教育计划，2)为NCI R01应用程序的设计提供信息，这是一项大规模、多种族、多中心、随机、对照的综合饮食干预试验，将乳腺癌复发和生存率作为结果。 公共卫生相关性：与年龄和阶段相似的非西班牙裔白人女性相比，西班牙裔女性死于乳腺癌的可能性高出20%。造成这种差异的原因之一可能是诊断后饮食行为的差异。我们建议进行一项随机对照研究(n=70，每臂35例)来测试动手营养教育的效果！关于最近完成治疗的拉美裔乳腺癌幸存者改变饮食行为的计划。

DESCRIPTION (provided by applicant): Hispanic women are 20% more likely to die of breast cancer than non-Hispanic white women who are diagnosed at a similar age and stage. One reason for this disparity may be differences in post- diagnosis dietary behaviors. In order to reduce this disparity, and to improve overall survivorship, culturally appropriate dietary interventions that teach women how to eat a diet high in fruits and vegetables and low in saturated fat need to be developed for Hispanic breast cancer survivors. We propose to conduct a randomized controlled study (n=70, 35 per arm) to test the effects of the !Cocinar para su salud! Program on changing dietary behaviors among Hispanic breast cancer survivors who have recently completed treatment. The !Cocinar para su salud! program is a 12-week course that provides hands-on education and instruction in nutrition education, meal preparation, and food shopping in a group setting. All participants will be followed for a total of 12 months, have clinical assessments at baseline, 6 months, and 12 months, and monthly telephone contacts using motivational interview techniques. The Primary Aims are to determine the effect of the dietary intervention (!Cocinar para su salud! program) vs. control (standard written nutrition education materials for cancer survivors) on 1) daily servings of fruit/vegetable, and 2) daily servings of fat intake from baseline to 6 months. We hypothesize that the dietary intervention will result in a larger increase of fruit and vegetable intake and a larger reduction of fat intake, when compared to the control group. Secondary Aims are to determine the effect of the dietary intervention vs. control on 1) biomarkers of fruit and vegetable intake, molecular biomarkers associated with breast cancer risk, and anthropometric measures at 6 and 12 months; 2) fruit/vegetable and fat intake at 12 months; 3) mediators of dietary change, including readiness to change, outcome expectations, perceived self- efficacy, food and nutrition skills, self-regulation skills, and barriers to adherence; and 4) changes in quality of life and anxiety/depression at 6 and 12 months. If this intervention is successful, we will use study results to 1) implement community-based nutrition education programs for Hispanic breast cancer survivors, and 2) inform the design of an NCI R01 application for a large-scale, multiethnic, multi-center, randomized, controlled trial of a comprehensive dietary intervention that will include breast cancer recurrence and survival as outcomes. PUBLIC HEALTH RELEVANCE: Hispanic women are 20% more likely to die of breast cancer than non-Hispanic white women who are diagnosed at a similar age and stage. One reason for this disparity may be differences in post- diagnosis dietary behaviors. We propose to conduct a randomized controlled study (n=70, 35 per arm) to test the effects of the hands-on nutritional education !Cocinar para su salud! Program on changing dietary behaviors among Hispanic breast cancer survivors who have recently completed treatment.