Implementing dietary change among Hispanic Breast Cancer Survivors

描述（由申请人提供）：西班牙裔女性死于乳腺癌的可能性比非西班牙裔白人女性高20%，这些女性在相似的年龄和阶段被诊断出来。造成这种差异的一个原因可能是诊断后饮食行为的差异。为了减少这种差异，提高总体存活率，需要为西班牙裔乳腺癌幸存者制定符合文化的饮食干预措施，教女性如何吃高水果和蔬菜、低饱和脂肪的饮食。我们建议进行一项随机对照研究（n=70，每组35人）来检验该方法的效果。我们一起欢呼吧！在最近完成治疗的西班牙裔乳腺癌幸存者中改变饮食行为的项目。!我们一起欢呼吧！该计划是一个为期12周的课程，提供实践教育和指导，包括营养教育，膳食准备和食品购物。所有参与者将被随访12个月，在基线、6个月和12个月进行临床评估，并使用动机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(！我们一起欢呼吧！对照（癌症幸存者的标准书面营养教育材料）1)每日水果/蔬菜摄入量，2)每日脂肪摄入量，从基线到6个月。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更大增加，脂肪摄入量的更大减少。次要目的是确定饮食干预与对照对1)6个月和12个月时水果和蔬菜摄入量的生物标志物、与乳腺癌风险相关的分子生物标志物和人体测量指标的影响；2) 12个月时的水果/蔬菜和脂肪摄入量；3)饮食改变的中介因素，包括改变的准备程度、结果预期、自我效能感、食物和营养技能、自我调节技能和坚持障碍；4) 6个月和12个月时生活质量和焦虑/抑郁的变化。如果这项干预成功，我们将利用研究结果：1)为西班牙裔乳腺癌幸存者实施社区营养教育计划；2)为NCI R01申请设计一项大规模、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作为结果。

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.