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（由申请人提供）：癌症幸存者有明确的饮食和身体活动指南：多吃水果/蔬菜和低能量食物，每周进行 150 分钟的中度至剧烈身体活动。然而，为癌症幸存者提供的资源很少（如果有的话），并且支持癌症幸存者如何实现持续饮食改变的数据也有限。少数癌症幸存者可用的行为改变资源甚至更少。分开和我们之前针对讲西班牙语的拉丁裔乳腺癌幸存者进行的 R21 试点研究表明，我们基于文化的 9 次会议（12 周内 24 小时）具有协同效应。 ¡ Cocinar Para Su Salud! 课程增加了水果/蔬菜的摄入量长达 12 个月，但没有减少膳食脂肪 (R21CA152903)。一项缩短 4 节课程（4 周内 16 小时）课程的试点研究效果较差。作为我们之前工作的延伸，我们将测试课程的修改版本，其中将包括关于降低食物能量密度、增加身体活动的新内容，并将包括实践技能我们将招募 200 名讲西班牙语和英语的拉丁裔乳腺癌幸存者参加为期 12 个月的试验。所有参与者都将收到有关乳腺癌幸存者的饮食和身体活动建议的书面材料以及鼓励身体活动的计步器，参与者将被随机分配到单独的面对面教育（6 次 4 小时课程）和单独的电子通信（励志的电子通讯加互动网站）、现场教育加电子通讯或控制将根据首选语言（英语与西班牙语）、绝经状况和当前使用的抗激素治疗、血液进行分层。收集和饮食评估将在基线、6 个月和 12 个月时进行，每月电话收集简短的行为变化数据并作为保留支持，以确定“为您的生活做饭”的单独和协同效应。通过增加每日水果/蔬菜摄入量和减少 12 个月时的每日总能量密度来评估拉丁裔乳腺癌幸存者的干预措施，其次要目标将是 1) 检查干预措施对身体活动和体重减轻的影响 2) 检查中介因素的预测因素。饮食改变的影响；3）检查干预措施对与乳腺癌复发风险相关的炎症和氧化应激生物标志物的影响。研究结果将确定对多样化且服务不足的癌症幸存者群体进行干预的最佳实施方法。如果有效，干预措施可以由社区团体和医疗中心实施，研究结果将用于设计多中心试验，以测试行为干预对合并症、癌症复发和生存的长期影响。