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

Contemp Clin Trials. 2016 Jan:46:106-113. doi: 10.1016/j.cct.2015.12.005. Epub 2015 Dec 4.

Abstract

Purpose: 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 VO2max 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 (+3501METmin/week vs. +965METmin/week, respectively). VO2max improved in the intervention group (+0.10±1.03kg/L/min). Intervention participants reduced energy intake (-207.3±31.5kcals) and showed improvements in fat intake (-15.5±3.8g), fiber (+3.2±1.2g) 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.

Keywords: African American; Black; Breast cancer; Physical activity; Survivors.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anthropometry
  • Black or African American*
  • Body Composition
  • Body Mass Index
  • Breast Neoplasms*
  • Diet Therapy / methods*
  • Energy Intake
  • Exercise Therapy / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Life Style
  • Middle Aged
  • Motivational Interviewing / methods*
  • Motor Activity
  • Obesity / therapy*
  • Overweight / therapy
  • Oxygen Consumption
  • Patient Acceptance of Health Care*
  • Patient Compliance
  • Patient Education as Topic / methods*
  • Patient Satisfaction
  • Physical Fitness
  • Survivors*
  • Treatment Outcome