The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis:a randomised controlled trial

Background: Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women. Methods: Overweight or obese (n = 243) and normal weight (n = 166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes. Results: Forty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight −2.3 (−3.5, −1.0) kg, body fat −1.6 (−2.6, −0.7) kg, community vs. control; weight −2.4 (−3.6, −1.1) kg, body fat −1.4 (−2.4, −0.5) kg (all p &lt; 0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective. Conclusions: The programmes were equally effective for weight control, but the community programme had additional benefits. Clinical trial registration: ISRCTN68576140.</p

Preventing weight gain in African American breast cancer survivors using smart scales and activity trackers: a randomized controlled pilot study

PURPOSE: This study evaluated the feasibility and preliminary efficacy of two 6-month, self-regulation interventions that focused on daily self-weighing (DSW), and used objective monitoring and tailored feedback about weight (±activity), to prevent weight gain among African American breast cancer survivors. METHODS: Participants (n=35) were randomized to an intervention + activity monitoring (INT+), intervention (INT), or control (CON) group. Interventions included a wireless scale (±activity tracker) that transmitted objective data to a mobile app/website, emailed lessons, and tailored feedback based on objective weight (±activity data). Participants completed in-person and online assessments at baseline, 3 and 6 months. RESULTS: Ninety-four percent of participants completed assessments at 3 months, and 97% at 6 months. Median (IQR) weight change after 6 months was −0.9% (−4.4−0.1) in the INT+ (p=0.075; p=0.067 vs. CON) and −0.2% (−4.2−1.3) in the INT groups (p=0.463; p=0.357 vs. CON), versus a 0.2% (−0.7−1.7) gain in the CON group. The proportion of INT+, INT and CON participants that were at or below baseline weight was 72.7%, 53.8% and 45.5% respectively (effect sizes d=.64, d=.18). Most INT+ participants weighed and wore trackers ≥5 days/week (INT+, 81.9% vs. INT, 38.5% vs. CON, 0%; p< 0.0005; INT+, 72.7%). Both intervention groups perceived DSW as positive, and 100% would recommend the program to other breast cancer survivors. CONCLUSION: An intervention focused on DSW as a self-monitoring strategy shows promise for preventing weight gain in breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Daily self-monitoring of weight and activity may be a feasible and accessible approach to promote weight gain prevention in breast cancer survivors

A qualitative synthesis of trials promoting physical activity behavior change among post-treatment breast cancer survivors

Background: Health outcome trials have provided strong evidence that participating in regular physical activity can improve the quality of life and health of post-treatment breast cancer survivors. Focus is now needed on how to promote changes in physical activity behaviour among this group. Purpose: This systematic review examines the efficacy of behavioral interventions for promoting physical activity among post-treatment breast cancer survivors. Methods: Behavioural intervention studies published up until July 2012 were identified through a systematic search of two databases: MEDLINE and CINAHL; and by searching reference lists of relevant publications and scanning citation libraries of project staff. Results: Eight out of the ten identified studies reported positive intervention effects on aerobic physical activity behaviour, ranging from during the intervention period to 6 months post-intervention. Only two studies reported intervention effect-sizes. The identification of factors related to efficacy was not possible due to the limited number and heterogeneity of studies included, as well as the lack of effect sizes reported. Nonetheless, an examination of the eight studies that did yield significant intervention effects suggests that 12-week interventions employing behavior change techniques (e.g., self-monitoring, goal-setting) derived from a variety of theories and delivered in a variety of settings (i.e., one-on-one, group, home) can be effective at changing the aerobic physical activity behavior of breast cancer survivors in the mid-to long-term. Conclusion: Behavioral interventions do hold promise for effectively changing physical activity behavior among breast cancer survivors. However, future research is needed to address the lack of studies exploring long-term intervention effects, mediators of intervention effects and interventions promoting resistance-training activity, and to address issues impacting on validity, such as the limited use of objective physical activity measures and the use of convenience samples. Implications for cancer survivors: Identifying effective ways of assisting breast cancer survivors to adopt and maintain physical activity is important for enhancing the well-being and health outcomes of this group