P4-12-07: Outcomes of a Behavioral Weight Control Intervention among Rural Breast Cancer Survivors.
Authors: CA Befort, JR Klemp, HL Austin, S Krigel, DK Sullivan, KH Schmitz, MG Perri, CJ Fabian
Journal: Cancer Research (2011)

Abstract Background: Obese breast cancer survivors have 1.5 to 2.5 fold increased risk of recurrence and death compared to their normal weight counterparts. Rural women, who comprise over 20% of the U.S. population of women, have significantly higher obesity rates as well as breast cancer treatment-related disparities. Thus, weight control intervention is a key strategy for secondary breast cancer prevention in this population. However, access can be challenging in the rural setting. Using conference call technology to deliver group-based intervention is well-suited for rural breast cancer survivors because it is easily accessible and provides real-time peer support. The purpose of this one-arm treatment study was to examine the impact of a 6-month group phone-based behavioral weight control intervention on anthropomorphic, diet, physical activity, and psychosocial/quality of life outcomes. Methods: Eligible participants were post-menopausal breast cancer survivors (Stage I-IIIc, 3 months to 10 years since surgery, radiation, or chemotherapy, &amp;lt; 75 years of age, BMI 27–45 kg/m2) who resided in a rural area. The weight control intervention included a reduced calorie diet with 2 prepackaged meals and ≥5 fruit and vegetables servings daily, home-based physical activity gradually increased to 225 min/week of moderate intensity exercise, weekly self-monitoring logs, and weekly 60-minute group phone sessions that addressed behavioral modification and breast cancer survivorship topics. Group size ranged from 9 to 13 women. Measures included anthropometrics, two 24-hour dietary recall interviews, and questionnaires measuring physical activity, fatigue, depression, body image and sexuality, and self-efficacy for diet and physical activity behavior change. Results: Participants (n = 34) were 58.9 ± 7.8 years-old, 3.1 ± 1.6 years out from treatment, had a baseline BMI of 33.7 ± 4.4 kg/m2, and 63% were on anti-hormone therapy. Average sessions attendance among all participants, including 3 non-completers, was 90%. Ninety-one percent of participants (n = 31) attended &amp;gt; 75% of intervention sessions and completed post-treatment data collection visits. At 6 months, significant changes were observed for weight (−12.5 ± 5.8 kg, 13.9% of baseline weight), waist circumference (−9.4 ± 6.3 cm), daily energy intake (−349 ± 550 kcal/day), fruits and vegetables (+3.7 ± 4.3 servings/day), percent kcal from fat (−12.6 ± 8.6%), and physical activity (+1235 ± 832 kcal/week; all p's &amp;lt; .001). Significant improvements were also seen for Body Image subscales (Strength and Health, Social Barriers, Appearance and Sexuality), Depression, and Self-Efficacy for diet and physical activity behaviors (all p's &amp;lt; .05). Discussion: The intervention produced significant improvements in weight, diet, physical activity, and quality of life outcomes that compare favorably to the literature. The group phone-based treatment delivery approach appears feasible and effective for weight control intervention among obese rural breast cancer survivors. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-12-07.