Implementing dietary change among Hispanic Breast Cancer Survivors

描述（由申请人提供）：西班牙裔妇女死于乳腺癌的可能性比在相似年龄和阶段诊断的非西班牙裔白色妇女高20%。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，并提高整体生存率，需要为西班牙裔乳腺癌幸存者制定文化上适当的饮食干预措施，教导妇女如何吃高水果和蔬菜以及低饱和脂肪的饮食。我们建议进行一项随机对照研究（n=70，每组35），以测试的效果！祝你健康！改变最近完成治疗的西班牙裔乳腺癌幸存者饮食行为的计划。了！祝你健康！计划是一个为期12周的课程，提供实践教育和指导营养教育，膳食准备，并在一组设置食品购物。所有受试者将接受总共12个月的随访，在基线、6个月和12个月时进行临床评估，并使用动机访谈技术每月进行一次电话联系。主要目的是确定饮食干预的效果（！祝你健康！方案）与对照（癌症幸存者的标准书面营养教育材料）在1）水果/蔬菜的每日份量，和2）从基线到6个月的脂肪摄入的每日份量上的比较。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大幅增加，脂肪摄入量大幅减少。次要目的是确定饮食干预与对照对以下方面的影响：1）水果和蔬菜摄入的生物标志物、与乳腺癌风险相关的分子生物标志物以及6个月和12个月时的人体测量; 2）12个月时的水果/蔬菜和脂肪摄入; 3）饮食改变的媒介物，包括改变的准备、结果期望、感知的自我效能、食物和营养技能、自我调节技能，以及依从性障碍;以及4）在6个月和12个月时生活质量和焦虑/抑郁的变化。如果这种干预是成功的，我们将使用研究结果1）实施以社区为基础的营养教育计划，为西班牙裔乳腺癌幸存者，2）通知NCI R 01申请的设计，用于大规模，多种族，多中心，随机，综合饮食干预的对照试验，包括乳腺癌复发和生存作为结果。 公共卫生相关性：西班牙裔女性死于乳腺癌的可能性比非西班牙裔白色女性高出20%，后者在相似的年龄和阶段被诊断出来。这种差异的一个原因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，每组35），以测试动手营养教育的效果！祝你健康！改变最近完成治疗的西班牙裔乳腺癌幸存者饮食行为的计划。

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.