The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial

Harvie, Michelle; Pegington, Mary; McMullan, Debbie; Bundred, Nigel; Livingstone, Karen; Campbell, Anna; Wolstenholme, Jane; Lovato, Eleanora; Campbell, Helen; Adams, Judith; Speed, Sean; Morris, Julie; Howell, Sacha; Howell, Anthony

Abstract

Background
Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women.

Methods
Overweight or obese (n = 243) and normal weight (n = 166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes.

Results
Forty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight −2.3 (−3.5, −1.0) kg, body fat −1.6 (−2.6, −0.7) kg, community vs. control; weight −2.4 (−3.6, −1.1) kg, body fat −1.4 (−2.4, −0.5) kg (all p < 0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective.

Conclusions
The programmes were equally effective for weight control, but the community programme had additional benefits.

Clinical trial registration
ISRCTN68576140

Citation

Harvie, M., Pegington, M., McMullan, D., Bundred, N., Livingstone, K., Campbell, A., Wolstenholme, J., Lovato, E., Campbell, H., Adams, J., Speed, S., Morris, J., Howell, S., & Howell, A. (2019). The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial. British Journal of Cancer, 121(6), 443–454. https://doi.org/10.1038/s41416-019-0522-6

• Journal Article Type: Article
• Acceptance Date: Jun 28, 2019
• Online Publication Date: Aug 1, 2019
• Publication Date: Aug 1, 2019
• Deposit Date: Aug 9, 2019
• Publicly Available Date: Aug 2, 2020
• Journal: British Journal of Cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Cancer Research UK
• Peer Reviewed: Peer Reviewed
• Volume: 121
• Issue: 6
• Pages: 443–454
• DOI: https://doi.org/10.1038/s41416-019-0522-6
• Keywords: weight control; breast cancer diagnosis; home programme; community programme
• Public URL: http://researchrepository.napier.ac.uk/Output/2040006
• Contract Date: Aug 9, 2019