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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

Authors

Michelle Harvie

Mary Pegington

Debbie McMullan

Nigel Bundred

Karen Livingstone

Jane Wolstenholme

Eleanora Lovato

Helen Campbell

Judith Adams

Sean Speed

Julie Morris

Sacha Howell

Anthony Howell



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

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

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0).







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