Moving Forward: A weight loss program for African-American breast cancer survivors

描述(由申请人提供)：即使在控制了年龄、SES、确诊时的肿瘤阶段、激素受体状态、组织学和更年期状态后，非裔美国人(AA)女性的乳腺癌(BC)存活率仍显著低于欧洲裔美国人(EA)女性。这种差异在芝加哥尤为明显，AA女性的死亡率比EA女性高出116%。患有BC的AA女性不仅比EA女性更有可能死于癌症，而且她们也更有可能死于糖尿病和高血压等并发症。饮食不佳、缺乏体育锻炼和肥胖都会导致乳腺癌的进展，并导致许多并发症的发展和恶化。迫切需要努力降低患乳腺癌的AA妇女的高死亡率。解决饮食不良、缺乏体力活动和肥胖率高的问题，可能是近期降低AA BC幸存者乳腺癌和各种原因死亡率的最佳机会。尽管有几项研究检查了EA BC幸存者的减肥干预措施，但还没有专门针对AA BC幸存者制定的干预措施。接下来是一项为期六个月的认知行为社区减肥干预，该干预是与AA BC幸存者合作开发的。这项申请提出了一项随机干预研究，以检验与与AA BC幸存者合作开发的为期6个月的认知行为社区减肥干预措施对240名被诊断为I、II或III期乳腺癌的肥胖AA妇女的BMI以及行为、生物学和心理社会结果的影响。我们已经与芝加哥公园区(CPD)合作，在六个以AA为主的芝加哥社区内实施这项研究。除了拥有一支经验丰富的跨学科研究团队外，该项目还有其他几个优势，包括在关注AA BC幸存者减肥方面的创新；对AA BC幸存者中与乳腺癌和合并症相关的发病率和死亡率产生积极影响的潜力；以及CPD社区计划的可持续性潜力。

DESCRIPTION (provided by applicant): Breast cancer (BC) survival rates are significantly lower for African-American (AA) women compared to European American (EA) women even after controlling for age, SES, tumor stage at diagnosis, hormone receptor status, histology, and menopausal status. This disparity is particularly evident in Chicago where mortality rates for AA women exceed those for EA women by 116 percent. Not only are AA women with BC more likely than EA women to die from their cancer, they are also more likely to die from comorbid conditions including diabetes and hypertension. Poor diet, lack of physical activity, and obesity contribute to breast cancer progression and the development and exacerbation of many comorbid conditions. Efforts to reduce the high mortality rates observed in AA women with breast cancer are critically needed. Addressing poor diet, lack of physical activity, and high rates of obesity may provide the best near-term opportunity to decrease breast cancer and all-cause mortality among AA BC survivors. Although several studies have examined weight loss interventions among EA BC survivors, no interventions developed specifically for AA BC survivors have been examined. Moving Forward is a six-month cognitive-behavioral community-based weight loss intervention that was developed in collaboration with AA BC survivors. This application proposes a randomized intervention study to examine the effects of Moving Forward, compared to a six-month cognitive-behavioral community-based weight loss intervention that was developed in collaboration with AA BC survivors, on BMI and behavioral, biological, and psychosocial outcomes in 240 obese AA women diagnosed with Stage I, II, or III breast cancer. We have partnered with the Chicago Park District (CPD) to implement the study within six predominantly AA Chicago communities. In addition to having an experienced, interdisciplinary study team, this project has several other strengths including innovation in its focus on weight loss in AA BC survivors; the potential for having a positive impact on morbidity and mortality related to breast cancer and comorbid conditions among AA BC survivors; and the potential for sustainability within CPD community programs.