eHealth Weight Loss Program in African American Breast Cancer Survivors

Virtual Weight Loss Program for African-American Breast Cancer Survivors

This randomized pilot clinical trial studies how well a virtual weight loss program (SparkPeople) works in helping female African American breast cancer survivors maintain a healthy weight. Many patients with breast cancer are overweight or gain weight after diagnosis. SparkPeople is a free web-based weight loss program that features educational and motivational articles and videos, self-monitoring tools, incentives, social support communities (including discussion forums, teams, challenges, and expert blogs), and options for content to be delivered to members' email. It is a comprehensive program that includes advice on diet, physical activity, and behavioral strategies (such as self-monitoring diet and exercise), and emphasizes safe weight loss and receiving medical attention regularly when needed. A web-based program such as SparkPeople may help breast cancer survivors maintain a healthy weight, which may reduce the risk of cancer returning and patient fatigue, and improve patient quality of life.

Study Overview

• Status: Completed
• Conditions: Stage 0 Breast Cancer; Cancer Survivor; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIC Breast Cancer
• Intervention / Treatment: Behavioral: Behavioral Dietary Intervention; Behavioral: Exercise Intervention; Device: Activity Monitoring Device

Detailed Description

PRIMARY OBJECTIVES:

I. Determine feasibility of using a free online commercial weight loss program (SparkPeople) in African-American (AA) breast cancer survivors, as measured by: 1) Accrual: percent (%) patients recruited and completing baseline assessments; 2) Study retention: % patients completing 6 month follow-up assessment; 3) Intervention adherence and sustainability (measured at 3, 6, 12 months): a) use of website- number of log-ins, time spent, and use of features such as food diaries, joining teams, posting on message boards (provided by SparkPeople); b) use of Fitbit monitor- % patients who wore the monitor and synced data; c) satisfaction (e.g., ease of use of website, usefulness of content, extra training and support needed) and barriers to participation (e.g., lack of computer access, lack of skills, time, interest, etc.).

SECONDARY OBJECTIVES:

I. Collect preliminary data on effect sizes of changes in our outcomes and potential mediators associated with the use of the online weight loss program.

OUTLINE: Patients are randomized to 1 of 2 groups.

All patients receive a handout of their personalized goals for weight loss, diet, and physical activity, with instructions to proceed slowly and as tolerated. Patients also wear a Fitbit monitoring device to monitor physical activity levels daily.

GROUP I: Patients receive one 30-minute session with the research assistant for training on how to use the SparkPeople website, and may request additional training if needed. Patients are instructed to self-monitor their diet at least weekly using SparkPeople and physical activity levels daily using the Fitbit monitoring device, which integrates with the SparkPeople program. Patients receive weekly motivational reminders to log into the website for 3 months via email, text, or phone, based on patient preference (active phase). Patients then enter the maintenance phase for an additional 3 months without reminders.

GROUP II: Patients receive the weight loss handout and a Fitbit health monitoring device and proceed with their usual life. After 6 months, patients receive the SparkPeople treatment as in Group I.

• Study Type: Interventional
• Enrollment (Actual): 35
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New Jersey
    • New Brunswick, New Jersey, United States, 08901
      • Rutgers Robert Wood Johnson Medical School

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Patients must have evidence of histologically confirmed breast cancer, stage 0, I, II or III, and be at least 2 years post diagnosis
• Patient is self-identified as African-American
• Patient is overweight or obese (body mass index [BMI] >= 25 kg/m^2)
• Patient is able to understand and read English
• Patient must have home internet or smartphone access
• Patient must give informed consent for this new study

Exclusion Criteria:

• Patient has a serious medical condition (e.g., stroke, liver or renal failure, congestive heart failure, myocardial infarction or cardiac surgery in past year, angina pectoris) that would compromise the safety of the patient or compromise the patient's ability to complete the study, at the discretion of the investigator
• Patient has serious psychiatric condition (e.g., bipolar disorder, schizophrenia or other psychosis, bulimia or anorexia nervosa, suicide attempt within 6 months or current active suicidal ideation) that would compromise the patient's ability to complete the study, at the discretion of the investigator
• Patient has severe disabilities limiting moderate physical activity, such as severe orthopedic conditions
• Patient is planning major surgery within the next 6 months
• Patient is taking medications or supplements for weight loss currently or within the past 3 months
• Patient has successfully lost 5% of body weight in the previous 6 months or has had bariatric surgery
• Patient is pregnant, breastfeeding, has given birth within the last 3 months or planning pregnancy within the next 12 months; if participant becomes pregnant during the course of the study, she will be removed from further participation
• Patient is anticipating leaving the area within the next 12 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group I (SparkPeople program); Participants receive one 30-minute session with the research assistant for training on how to use the SparkPeople website, and they may request additional training if needed. Participants are instructed to self-monitor their diet at least weekly using the SparkPeople tool, and to self-monitor their activity daily using the Fitbit monitoring device. Participants receive weekly motivational reminders to log into the website for 3 months via email, text, or phone, based on patient preference (active phase). Participants then enter the maintenance phase for 3 months without reminders. All participants answer survey questions on quality of life and social cognitive theory variables and undergo anthropometric measurements at baseline, 3, and 6 months.	Behavioral: Behavioral Dietary Intervention; Use SparkPeople web-based program; Behavioral: Exercise Intervention; Use Fitbit monitor and SparkPeople web-based program; Device: Activity Monitoring Device; Wear Fitbit activity monitoring device; Other Names: Monitor
Active Comparator: Group II (wait list); Participants receive the weight loss handout and a Fitbit activity monitoring device and proceed with their usual life. After 6 months, patients receive the SparkPeople treatment as in Group I. All participants answer survey questions on quality of life and social cognitive theory variables and undergo anthropometric measurements at baseline, 3 and 6 months.	Device: Activity Monitoring Device; Wear Fitbit activity monitoring device; Other Names: Monitor

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Recruitment Rate	Number of eligible participants who were enrolled and randomly assigned. Feasibility is defined as >= 75% recruitment rate.	12 months
Retention Rate	Number of participants completing study. Feasibility will be defined as >= 80% retention rate.	6 months
Adherence to SparkPeople- Logged in	average number of days logged per week in to SparkPeople website	0-3 months after intervention
Adherence to SparkPeople- Logged in	Average number of days per week logged in to SparkPeople website	4-6 months after intervention
Adherence to SparkPeople- Logged Food	Average number of days per week logged food into SparkPeople	0-3 months after intervention
Adherence to SparkPeople- Logged Food	Average number of days per week logged food into SparkPeople	4-6 months after intervention
Acceptability of SparkPeople	Usefulness of SparkPeople website on 1 (not useful at all) to 4 (very useful) scale	0-3 months after intervention
Acceptability of SparkPeople	Usefulness of SparkPeople website on 1 (not useful at all) to 4 (very useful) scale	4-6 months after intervention
Adherence to Fitbit	average days used Fitbit per week	0-3 months after intervention
Adherence to Fitbit	average days used Fitbit per week	4-6 months after intervention
Acceptability of Fitbit	Usefulness of Fitbit, rated on 1 (not useful at all) to 4 (very useful) scale	0-3 months after intervention
Acceptability of Fitbit	Usefulness of Fitbit, rated on 1 (not useful at all) to 4 (very useful) scale	4-6 months after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Weight	Change in weight from baseline	baseline and 3 months
Change in Weight	Change in weight from baseline	baseline and 6 months
Change in Waist Circumference	Change in waist circumference from baseline	baseline and 3 months
Change in Waist Circumference	Change in waist circumference from baseline	baseline and 6 months
Change in Caloric Intake	Changes in caloric intake per day, measured by 24-hour recall	baseline and 3 months
Change in Caloric Intake	Changes in caloric intake per day, measured by 24-hour recall	baseline and 6 months
Change in Physical Activity	change in average number of steps per day measured using Fitbit monitor	baseline and 3 months
Change in Physical Activity	change in average number of steps per day measured using Fitbit monitor	baseline and 6 months
Cardiopulmonary Fitness	change in fitness, measured by the 6-minute walk test	baseline and 3 months
Cardiopulmonary Fitness	change in fitness, measured by the 6-minute walk test	baseline and 6 months
Change in Quality of Life	measured using Quality of Life in Adult Cancer Survivors Scale (minimum 65, maximum 257); higher scores mean worse quality of life	baseline and 3 months
Change in Quality of Life	measured using Quality of Life in Adult Cancer Survivors Scale (minimum 65, maximum 257); higher scores mean worse quality of life	baseline and 6 months
Self-efficacy, Eating Healthy Foods	change in self-efficacy, eating healthy foods, measured with Health Beliefs Survey, scale range 0 (certain I cannot) to 100 (certain I can)	baseline and 3 months
Self-efficacy, Eating Healthy Foods	change in self-efficacy, eating healthy foods, measured with Health Beliefs Survey, scale range 0 (certain I cannot) to 100 (certain I can)	baseline and 6 months
Social Support for Healthy Nutrition	change in social support for healthy nutrition, measured by Health Beliefs Survey, scale range 1 (strongly disagree) to 5 (strongly agree); a higher number, e.g., 5 (strongly agree) is the more favorable outcome	baseline and 3 months
Social Support for Healthy Nutrition	change in social support for healthy nutrition, measured by Health Beliefs Survey, scale range 1 (strongly disagree) to 5 (strongly agree); a higher number, e.g., 5 (strongly agree) is the more favorable outcome	baseline and 6 months

Collaborators and Investigators

• Sponsor: Rutgers, The State University of New Jersey
• Collaborators: National Cancer Institute (NCI)
• Investigators: Principal Investigator: Jeanne Ferrante, Rutgers Cancer Institute of New Jersey

Publications and helpful links

General Publications

• Ferrante JM, Devine KA, Bator A, Rodgers A, Ohman-Strickland PA, Bandera EV, Hwang KO. Feasibility and potential efficacy of commercial mHealth/eHealth tools for weight loss in African American breast cancer survivors: pilot randomized controlled trial. Transl Behav Med. 2020 Oct 8;10(4):938-948. doi: 10.1093/tbm/iby124.

Study record dates

Study Major Dates

• Study Start (Actual): January 8, 2016
• Primary Completion (Actual): July 20, 2018
• Study Completion (Actual): July 29, 2018

Study Registration Dates

• First Submitted: March 1, 2016
• First Submitted That Met QC Criteria: March 1, 2016
• First Posted (Estimate): March 7, 2016

Study Record Updates

• Last Update Posted (Actual): April 13, 2021
• Last Update Submitted That Met QC Criteria: April 9, 2021
• Last Verified: April 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Skin Diseases; Neoplasms by Histologic Type; Neoplasms; Neoplasms by Site; Carcinoma; Neoplasms, Glandular and Epithelial; Breast Diseases; Body Weight; Body Weight Changes; Carcinoma in Situ; Breast Neoplasms; Weight Loss; Breast Carcinoma In Situ
• Other Study ID Numbers: Pro20150001595 (Other Identifier: Rutgers University eIRB); NCI-2015-02137 (Registry Identifier: CTRP (Clinical Trial Reporting Program)); 131404 (Other Identifier: Rutgers Cancer Institute of New Jersey); R21CA191431 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No