Moving Forward: A Weight Loss Intervention for African-American Breast Cancer Survivors
Condition: Breast Cancer
MeSH terms: Breast Neoplasms; Weight Loss
Study type: Interventional

Summary: 
      This is a randomized intervention study to examine the effects of the Moving Forward Guided
      Weigh Loss Intervention compared to a self-guided weight loss program on BMI and behavioral,
      biological, and psychosocial outcomes in overweight and obese African American women
      diagnosed with Stage I, II, or III breast cancer.
    

Detailed description: 
      This is a randomized study with 300 African American (AA) breast cancer survivors to be
      conducted in Chicago Park District (CPD) facilities. The study will be based in six
      predominantly AA communities in Chicago (Roseland, Pullman, Englewood, Chatham, Austin, South
      Shore, Woodlawn, Calumet Heights, North Lawndale and Grand Crossing). These communities have
      at least one CPD fitness center, have populations that are at least 90% or more AA and have
      similar socioeconomic statuses. Fifty AA breast cancer survivors will be recruited from each
      community (25 treatment/ 25 control).

      The Moving Forward intervention integrates concepts from Social Cognitive Theory (SCT) and
      the Socio-Ecological Model (SEM) to promote independent behavior change. SCT suggests that
      behavior can be explained by the dynamic interaction between behavior, personal factors
      (e.g., self-efficacy), and the environment (e.g, social support). Self-efficacy is a person's
      confidence in performing a particular behavior and overcoming barriers to that behavior. A
      number of studies have supported the mediating role of self-efficacy in making independent
      health behavior changes.

      The overall goal of Moving Forward is to make independent changes in health behaviors to
      promote a healthy weight. The weight loss goal will be consistent with the recommendations of
      an expert panel at National Institutes of Health (NIH). Dietary goals aimed at producing
      weight loss, decreasing BC recurrence risk, and improving overall health include 1) a
      decrease in daily caloric intake (based on weight in pounds X 12 kcal/day with 500-750
      calories subtracted to create an energy deficit); 2) a decrease in dietary fat consumption to
      20% of total calories; 3) an increase in fruit and vegetable consumption to 7 daily servings;
      and 4) an increase in fiber to 25 grams per day. For exercise, participants will gradually
      increase their activity to a minimum of 180 minutes per week at 55-65% maximal heart rate.
    

Intervention name(s): MF-WLP; SG-WLP
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The first meeting each week includes a 60-minute class that addresses health knowledge, attitudes, and self-monitoring of weight, food and physical activity; realistic goal setting; stimulus control; problem solving; cognitive restructuring and relapse prevention. Other class activities include weekly weigh-in; increasing awareness of portions by weighing and measuring foods; creating stimulus control plans for home, car and work; identifying barriers to healthy eating and/or exercise; going on a field trip to a local grocery store to practice reading food labels; creating an eating out management plan; and identifying high risk situations and brainstorming ways to manage them. This meeting also includes a 60-minute exercise class. The second meeting each week is a stand-alone 60-minute exercise class that will incorporate a variety of activities. A one-year CPD fitness club membership and home exercise DVDs will be provided.; Control participants will be provided with a 24-week weight loss curriculum; this includes a binder with their personal daily caloric recommendation, all intervention handouts, a copy caloric guidelines and useful weight loss tools. Upon randomization, each control participant will be introduced to the program materials and encouraged to tailor the weight loss program for themselves. The study team will call each control participant once a month during this 6-month program period to check in. In addition, after the follow-up data collection, control participants will receive a one-year membership to the CPD fitness center.
Other intervention name(s): Moving Forward Guided Weight Loss Program; Self-guided Weight Loss Program
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: African American; Overweight; Adults