Abstract PS8-26: The new normal; adjusting to remote ways of providing bespoke weight management support to breast cancer survivors during the COVID-19 global pandemic
Authors: Pickering Katie , Wane Sarah , Speake Helen , Crank Helen , Anderson Annie , Cain Henry , Copeland Rob , Lee Daniela , Gray Joanne , McNally Richard , Hargreaves Jackie , Cohen Judith , Northgraves Matthew , Wilson Caroline , Saxton John 
Published: February 2021

Abstract
PurposeNEWDAY-ABC (North England Women’s Diet and ActivitY After Breast Cancer) trial is a bespoke weight management and behaviour change intervention for women treated for early-stage estrogen-receptor positive breast cancer (BC) with a body mass index (BMI) of ≥25 kg/m2. Many women are overweight or report further weight gain during and after BC-treatment. Due to the complex nature of weight management, NEWDAY-ABC was co-designed with BC-survivors and health care professionals (HCPs) prior to the COVID-19 outbreak. However, because of the COVID-19 pandemic, refinements had to be made to the intervention to enable remote (virtual) delivery options, allowing the trial to proceed while adhering to government social distancing and shielding guidance.
MethodsPrior to the COVID-19 outbreak, initial focus groups (FG) were conducted with n=16 BC-survivors and n=21 HCPs. Framework analysis was used to categorise what BC-survivors want from a weight management intervention. Participants (n=9) subsequently attended a two-stage successive interactive co-design workshop. Workshop 1 explored: i) techniques to motivate change; ii) approaches to overcome challenges to intervention adherence; iii) core components of the intervention. Workshop 2 explored: i) language and graphics used for the support and educational materials; ii) delivery mechanisms; iii) refinement of workshop 1 ideas.
Results / findingsCo-design revealed the intervention should address: i) self-confidence and self-esteem; ii) reassurance of safe physical activity (PA) and dietary guidance for BC-survivors; iii) knowledge about what happens to the body after treatment. In terms of intervention delivery: i) self-monitoring of weight should be optional; ii) content should be as visual as possible iii) emotional needs are as important to address as PA and dietary recommendations; iv) one-to-one facilitator support is as important as group peer-support.
To integrate all these elements, the NEWDAY-ABC intervention included face-to-face group support sessions. However, due to the COVID-19 pandemic, remote delivery options had to be embedded into the intervention design to enable this support to be provided via means that are accessible to all eligible participants, whilst adhering to the guidance on social distancing and shielding of vulnerable populations.
Key considerations include:•Participant and session leader’s ability to access and engage with remote delivery•Creating a peer supportive environment remotely•Remote platform security•Effectiveness of remote delivery in achieving clinically meaningful weight loss
ConclusionsThe COVID-19 pandemic has forced cancer care to quickly adapt to ways of providing remote support to meet the needs of cancer patients and survivors. While this presents many challenges, including issues of accessibility, privacy and accessing peer support, use of virtual delivery platforms and new technologies means that BC-survivors can still access this bespoke weight management intervention during an extended period of post-pandemic social distancing. The effectiveness of the NEWDAY-ABC intervention in providing the required level of peer support, guidance and self-confidence needed for clinically meaningful weight loss with virtual delivery options will be tested in a randomised controlled trial.
Citation Format: Katie Pickering, Sarah Wane, Helen Speake, Helen Crank, Annie Anderson, Henry Cain, Rob Copeland, Daniela Lee, Joanne Gray, Richard McNally, Jackie Hargreaves, Judith Cohen, Matthew Northgraves, Caroline Wilson, John Saxton. The new normal; adjusting to remote ways of providing bespoke weight management support to breast cancer survivors during the COVID-19 global pandemic [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-26.