Cook For Your Life: Maintaining diet and physical activity changes in Latina breast cancer survivors

为你的生活做饭：保持拉丁裔乳腺癌幸存者的饮食和身体活动变化

基本信息

批准号：
9245664
负责人：
Heather Greenlee
金额：
$ 59.76万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-04-15 至 2020-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9245664
关键词：
Acculturation Affect American American Cancer Society Attenuated Behavior Behavior Therapy Behavioral Biological Markers Blood Body Weight decreased Breast Cancer survivor Calories Cancer Survivor Clinic Visits Collection Communication Communities Comorbidity Control Locus Data Diet Dietary Assessment Dietary Fats Dose Eating Education Educational Curriculum Event Fasting Fatty acid glycerol esters Female Food Guidelines Health behavior Health behavior change Hormonal Hour Individual Inflammation Inflammatory Institutes Intake Intervention Knowledge Language Latina Life Link Long-Term Effects Mediator of activation protein Medical center Menopausal Status Metabolic Pathway Methods Minority Motivation Newsletter Not Hispanic or Latino Obesity Outcome Oxidative Stress Participant Pattern Persons Physical activity Pilot Projects Population Population Heterogeneity Publishing Randomized Randomized Controlled Trials Recommendation Recruitment Activity Reporting Resources Risk Role Self Efficacy Social support Standardization Strenuous Exercise Telephone Testing Theoretical model Underserved Population Weight Woman Work anticancer research arm base behavior change cancer recurrence cancer survival cognitive function cooking demographics design energy density executive function field trip fruits and vegetables hormone therapy improved intervention effect malignant breast neoplasm moderate-to-vigorous physical activity multi-site trial novel nutrition nutrition education outcome forecast programs public health relevance response saturated fat skills social cognitive theory sugar underserved minority web site

项目摘要

DESCRIPTION (provided by applicant): There are clear diet and physical activity guidelines for cancer survivors: eat a diet high in fruits/vegetables and low in energy-dense foods and engage in 150 minutes of moderate-to-vigorous physical activity each week. However, cancer survivors are provided with few, if any, resources to meet these guidelines and there are limited data supporting how cancer survivors can achieve sustained dietary change. There are even fewer behavioral change resources available to minority cancer survivors. Few studies have examined the separate and synergistic effects of in-person education and e-communication strategies in changing and maintaining health behaviors. Our prior R21 pilot study among Spanish-speaking Latina breast cancer survivors showed that our culturally-based 9-session (24-hours over 12 weeks) ¡Cocinar Para Su Salud! Curriculum increased fruit/vegetable intake up to 12 months, but did not decrease dietary fat (R21CA152903). A pilot study of a shortened 4-session (16-hours over 4 weeks) curriculum was less effective. Therefore, as an extension of our prior work, we will test a modified version of our curriculum that will include new content on decreasing energy density in food, increasing physical activity, and will include a hands-on skills building cooking component in every class. Social cognitive theory and the Trans theoretical model will frame the intervention. We will recruit 200 female Spanish- and English-speaking Latina breast cancer survivors to participate in a 12-month trial. The study will use a 2x2 factorial design. All participants will receive written materials on diet and physical activity recommendations for breast cancer survivors and a pedometer to encourage physical activity. Participants will be randomized to in-person education alone (6 4-hour sessions), e-communication alone (motivational e-newsletters plus an interactive website), in-person education plus e-communication, or control. Randomization will be stratified on preferred language (English vs. Spanish), menopausal status and current use of anti-hormonal therapy. Clinic visits, blood collection and dietary assessment will occur at baseline, 6 and 12 months. Monthly telephone calls will collect brief behavior change data and serve as retention support. The Primary Aim is to determine the separate and synergistic effects of the Cook for Your Life! Intervention among Latina breast cancer survivors assessed via increase in daily servings of fruits/vegetables and decrease in total daily energy density at 12 months. Secondary Aims will 1) examine effects of the intervention on physical activity and weight loss; 2) examine predictors of mediators of dietary change; and 3) examine the effects of the intervention on biomarkers of inflammation and oxidative stress associated with breast cancer recurrence risk. Study results will determine the best delivery method for the intervention in a diverse and underserved population of cancer survivors. If effective, the standardized intervention can be implemented by community groups and medical centers. Study results will be used to design a multi-site trial to test the long- term effects of a behavioral intervention on comorbidities, cancer recurrence and survival.

描述（由适用提供）：有明确的饮食和体育锻炼指南：癌症生存的指南：饮食中的水果/蔬菜饮食较高，能量浓缩食品低，并每周进行150分钟的中度至毒性体育锻炼。但是，癌症存活率很少（如果有的话）来满足这些准则，并且数据支持癌症存活方式如何实现持续饮食的数据有限。少数民族癌症生存可用的行为变化资源甚至更少。很少有研究研究了面对面教育和电子通讯策略在改变和维持健康行为方面的独立和协同作用。我们先前在讲西班牙语的拉丁裔乳腺癌存活中的R21试点研究表明，我们以文化为基础的9条经营（12周内24小时） âcocinar para su salud！课程增加了长达12个月的水果/蔬菜摄入量，但不会减少饮食脂肪（R21CA152903）。一项针对4周内缩短4次课程（16小时）课程的试点研究的效率较低。因此，作为我们先前工作的扩展，我们将测试课程的修改版本，该版本将包括有关降低食物能量密度，增加体育锻炼的新内容，并将包括动手技能在每个班级中建立烹饪组件。社会认知理论和跨理论模型将构成干预措施。我们将招募200名讲西班牙语和英语的拉丁裔乳腺癌存活，参加为期12个月的试验。该研究将使用2x2阶乘设计。所有参与者都将收到有关饮食和体育锻炼的书面材料，建议乳腺癌存活和计步器，以鼓励体育锻炼。参与者将仅随机进行面对面的教育（6个4小时的课程），仅电子通信（动机电子通讯和交互式网站），亲自教育以及电子通信或控制。随机分组将根据首选语言（英语与西班牙语），更年期的状态和抗激素治疗的当前使用。诊所就诊，血液收集和饮食评估将在基线，6个月和12个月进行。每月电话将收集简短的行为更改数据并作为保留支持。主要目的是确定厨师对您一生的独立和协同作用！通过增加水果/蔬菜的每日份量来评估的拉丁裔乳腺癌存活中的干预措施，并在12个月时每天的总能量密度降低。次要目的将1）检查干预对体育锻炼和体重减轻的影响； 2）检查饮食变化介体的预测因子； 3）检查干预对与乳腺癌复发风险相关的炎症和氧化应激的生物标志物的影响。研究结果将确定对潜水员和服务不足的癌症存活人群干预的最佳分娩方法。如果有效，则可以由社区团体和医疗中心实施标准化的干预措施。研究结果将用于设计多站点试验，以测试行为干预对合并症，癌症的长期影响。复发和生存。