The feasibility and acceptability of a diet and exercise trial in overweight and obese black breast cancer survivors: The Stepping STONE study

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• 作者：Vanessa B. Sheppard^a ; ^b ; ^{vls3@georgetown.edu" class="auth_mail" title="E-mail the corresponding author} ; Jennifer Hicks^b ; Kepher Makambi^c ; Alejandra Hurtado-de-Mendoza^a ; Wendy Demark-Wahnefried^d ; Lucile Adams-Campbell^b
• 关键词：African American ; Black ; Breast cancer ; Survivors ; Physical activity
• 刊名：Contemporary Clinical Trials
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：46
• 期：Complete
• 页码：106-113
• 全文大小：508 K

文摘

Black breast cancer survivors have high rates of obesity and low physical activity levels. Little is known about the acceptability and feasibility of interventions in this population.

Objective

A two-arm RCT was launched to assess the efficacy of a culturally targeted 12-week multimodal lifestyle intervention in overweight and obese black survivors.

Methods

Intervention components included nutrition education, exercise groups, and survivor-led motivational interviewing phone sessions. The analytic sample included women who completed the trial (intervention n = 10; control n = 12). Anthropometric measures, physical activity, and VO_2max were assessed at baseline and follow-up. Change scores (intervention vs. control) were assessed with Wilcoxon rank-sum tests. A process evaluation assessed intervention acceptability.

Results

Overall adherence was 70% and overall satisfaction was high (86%). Despite the 5% weight loss target, the intervention group lost 0.8% but BMI improved. Total physical activity levels increased in the intervention vs. control arm (+ 3501 MET min/week vs. + 965 MET min/week, respectively). VO_2max improved in the intervention group (+ 0.10 ± 1.03 kg/L/min). Intervention participants reduced energy intake (− 207.3 ± 31.5 kcals) and showed improvements in fat intake (− 15.5 ± 3.8 g), fiber (+ 3.2 ± 1.2 g) and % energy from fat (− 4.8 ± 3.1%). Survivors suggested providing diet/exercise information within a cancer context.

Conclusions

Group and individualized intervention strategies are acceptable to black survivors. Observed differences between self-report and objective outcomes may suggest reporting bias or changes in body composition. Increasing supervised intervention components and assessment of body composition will be important for future trials.