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Rural Women Connecting for Better Health

22. november 2016 oppdatert av: University of Kansas Medical Center

Group Phone-Based Weight Control for Rural Breast Cancer Survivors

Women who are obese at breast cancer diagnosis have a 1.5 to 2.5 increased risk of recurrence and death compared to their normal weight counterparts. Moreover, weight gain and decreased physical activity are common after diagnosis and also increase the likelihood of breast cancer recurrence and death. Rural women suffer from health disparities in breast cancer diagnosis and treatment. Women of the most rural counties also have the highest prevalence of obesity compared to urban women. To address these disparities, the overarching objective of this proposal is to develop a clinically effective and cost efficient strategy for delivering a weight control intervention to rural breast cancer survivors. Group phone-based treatment via conference call is a novel treatment delivery approach that the investigators have shown to be effective for initial weight loss among rural breast cancer survivors and more effective than the standard individual phone-based approach among rural women. This innovative method of providing group treatment addresses access barriers in rural areas and may be especially ideal for rural breast cancer survivors because it provides social support in conjunction with a level of anonymity. However, the impact of group phone counseling during extended care for weight loss maintenance beyond 6 months remains unknown. Weight loss maintenance is the more challenging phase of treatment when weight regain is common, and this regain presents a potential risk for breast cancer recurrence. This randomized controlled trial will evaluate the effects of group phone-based treatment for weight loss maintenance among rural breast cancer survivors, compared to an established mail-based education comparison condition, subsequent to a 6 month group phone-based weight loss phase for both conditions. In addition to the intervention impact on weight loss maintenance, the study will provide estimates of incremental cost-effectiveness per kg loss between the two conditions and the impact on secondary outcomes including quality of life, breast cancer risk biomarkers, dietary intake, and physical activity.

Studieoversikt

Detaljert beskrivelse

Phase 1 - Weight Loss (0-6 months)

  • Weekly group phone counseling sessions for all participants (12-14 women per group) via conference call for 26 consecutive weeks
  • Low-calorie, low-fat diet recommended, including 2 pre-packaged entrees, five one-cup servings of fruits and vegetables and meal replacement shakes (provided free of charge)
  • Physical activity program program recommended, beginning with 15 minutes per day, 3 days a week, working toward a goal of 225 minutes a week
  • Experienced group counselor facilitates all sessions

Phase 2 - Weight Loss Maintenance (6-18 months)

  • Participants randomized to either group phone counseling or mail-based comparison with no phone counseling
  • Weight loss maintenance group condition includes 26 bi-weekly phone sessions, while mail-based comparison includes 26 bi-weekly newsletters in the mail
  • Focus is on problem-solving

Phase 3 - Transition to Self-Reliance (18-24 months)

  • Lasts from 18-24 months
  • No sessions or newsletter mailings
  • Participants are encouraged to continue to self-monitor throughout this period

Studietype

Intervensjonell

Registrering (Faktiske)

210

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Kansas
      • Kansas City, Kansas, Forente stater, 66160
        • University of Kansas Medical Center

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

Ikke eldre enn 75 år (Barn, Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

Inclusion Criteria:

  • Breast cancer patients with a BMI 27-45 kg/m2
  • Diagnosis of Stage 0-IIIc disease within the past 10 years (except Stage 0, treated with mastectomy only)
  • Have completed all local and systemic therapy at least 3 months prior to entry
  • Have clearance from their oncologist or current medical provider to participate in a weight control study
  • Must be ≤ 75 years old
  • Post-menopausal
  • Participants must live in a rural area
  • Have access to a phone
  • Able to participate in the physical activity component of the intervention, i.e., be able to walk briskly unassisted and without serious medical risk
  • Weight stable within ten pounds three months prior to entry

Exclusion Criteria:

  • Women with insulin-dependent diabetes
  • Ongoing participation in a formal weight loss program
  • Ongoing use of pharmacotherapy for weight loss
  • Ongoing use of medications that seriously affect weight and metabolism (e.g., steroids, phentermine)
  • Positive screen for current substance abuse, major depression, or binge eating disorder
  • Any cardiac or pulmonary disease preventing participation
  • Treatment for any other cancers within the past year
  • Previous bariatric surgery

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Group (GRP) phone counseling
The group phone counseling includes 26 bi-weekly phone sessions from 6 to 18 months and focuses on group problem-solving. Women continue in the same group as in weight loss intervention phase.
Bi-weekly phone counseling sessions from 6 - 18 months
Aktiv komparator: Mail-based Comparison Condition
Participants in this group will receive a newsletter by mail every other week for 12 months starting after the initial 6 month weight loss period. The newsletters will provide problem-solving tips and will review nutrition and physical activity information.
Bi-weekly newsletter mailings from 6 - 18 months

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Weight loss maintenance
Tidsramme: 6 - 18 months
Examine the impact of group phone-based treatment on weight loss maintenance from 6 to 18 months, compared to a mail-based education COMPARISON condition, following a 6-month weight loss phase among obese rural breast cancer survivors.
6 - 18 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Quality of life
Tidsramme: Baseline and 6, 12, 18, and 24 months
Compare the effects of treatment conditions on aspects of quality of life important for breast cancer survivorship, including general physical, social, and emotional well-being, fatigue, arthralgia, lymphedema symptoms, menopausal symptoms, and depressive symptoms.
Baseline and 6, 12, 18, and 24 months
Breast cancer risk biomarkers
Tidsramme: Baseline and 6 and 18 months
Examine the association of weight change with changes in selected breast cancer risk biomarkers, including bioavailable estradiol, testosterone, and fasting insulin. Examine whether modulation of biomarkers is sustained during weight loss maintenance.
Baseline and 6 and 18 months
Cost effectiveness
Tidsramme: 18 months
Compare the incremental cost-effectiveness of weight loss maintenance (kg below baseline) between group and control conditions. Costs include fixed and variable provider costs (facility, time, phone charges, supplies) and fixed and variable participant costs (time, out-of-pocket expenses).
18 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Christie Befort, Ph.D., University of Kansas Medical Center

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. august 2011

Primær fullføring (Faktiske)

1. april 2015

Studiet fullført (Faktiske)

1. oktober 2015

Datoer for studieregistrering

Først innsendt

23. september 2011

Først innsendt som oppfylte QC-kriteriene

26. september 2011

Først lagt ut (Anslag)

27. september 2011

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

23. november 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

22. november 2016

Sist bekreftet

1. november 2016

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 12633
  • 1R01CA155014-01A1 (U.S. NIH-stipend/kontrakt)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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