Grant Number:	5R01CA155014-05 Interpret this number
Primary Investigator:	Befort, Christie
Organization:	University Of Kansas Medical Center
Project Title:	Group Phone-Based Weight Control Among Rural Breast Cancer Survivors
Fiscal Year:	2015

DESCRIPTION (provided by applicant): 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 application 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 we 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. Rural breast cancer survivors are more likely to be isolated, to have heightened concerns about privacy, and to report difficulty adjusting to breast cancer. At the same time, they have less access to professional support services, and thus are more likely to have unmet support needs surrounding both cancer and weight management. The opportunity to engage in lifestyle change with other survivors by phone may provide social support in a confidential setting at the same time it enhances diet, physical activity, and weight, as well as quality of life. However, the impact of group phone counseling during extended care for weight loss maintenance beyond six 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 six 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. We aim to produce long-term weight loss maintenance, associated biomarker modulation, and improved quality of life in a cost-effective way that can be extended to hard-to-reach rural survivors.




Rural breast cancer survivors are able to maintain diet quality improvements during a weight loss maintenance intervention.
Authors: Marchello N.J. , Gibbs H.D. , Sullivan D.K. , Taylor M.K. , Hamilton-Reeves J.M. , Beltramo A.F. , Befort C.A. .
Source: Journal of cancer survivorship : research and practice, 2021 Aug; 15(4), p. 576-584.
EPub date: 2020-10-15.
PMID: 33063248
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Effects of Weight Loss and Weight Regain on Circulating Biomarkers in Overweight/Obese Breast Cancer Survivors Enrolled in a Weight Loss Trial in the Rural Midwest.
Authors: Befort C.A. , Kimler B.F. , Bantis L.E. , Phillips T.A. , Fabian C.J. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2020 Jul; 29(7), p. 1321-1328.
EPub date: 2020-04-10.
PMID: 32277008
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Late breast cancer treatment-related symptoms and functioning: associations with physical activity adoption and maintenance during a lifestyle intervention for rural survivors.
Authors: Fazzino T.L. , Klemp J. , Befort C. .
Source: Breast cancer research and treatment, 2018 Apr; 168(3), p. 755-761.
EPub date: 2017-12-22.
PMID: 29273954
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Change in Physical Activity During a Weight Management Intervention for Breast Cancer Survivors: Association with Weight Outcomes.
Authors: Fazzino T.L. , Fabian C. , Befort C.A. .
Source: Obesity (Silver Spring, Md.), 2017 Nov; 25 Suppl 2(Suppl 2), p. S109-S115.
PMID: 29086523
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Weight fluctuation during adulthood and weight gain since breast cancer diagnosis predict multiple dimensions of body image among rural breast cancer survivors.
Authors: Fazzino T.L. , Hunter R.C. , Sporn N. , Christifano D.N. , Befort C.A. .
Source: Psycho-oncology, 2017 Mar; 26(3), p. 392-399.
EPub date: 2015-11-12.
PMID: 26564108
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Alcohol Intake Among Breast Cancer Survivors: Change in Alcohol Use During a Weight Management Intervention.
Authors: Fazzino T.L. , Fleming K. , Befort C. .
Source: JMIR cancer, 2016-11-09; 2(2), p. e15.
EPub date: 2016-11-09.
PMID: 28410181
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Diet Quality of Breast Cancer Survivors after a Six-Month Weight Management Intervention: Improvements and Association with Weight Loss.
Authors: Christifano D.N. , Fazzino T.L. , Sullivan D.K. , Befort C.A. .
Source: Nutrition and cancer, 2016 Nov-Dec; 68(8), p. 1301-1308.
EPub date: 2016-09-16.
PMID: 27635676
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Weight loss maintenance strategies among rural breast cancer survivors: The rural women connecting for better health trial.
Authors: Befort C.A. , Klemp J.R. , Sullivan D.K. , Shireman T. , Diaz F.J. , Schmitz K. , Perri M.G. , Fabian C. .
Source: Obesity (Silver Spring, Md.), 2016 Oct; 24(10), p. 2070-7.
EPub date: 2016-09-01.
PMID: 27581328
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A qualitative evaluation of a group phone-based weight loss intervention for rural breast cancer survivors: Themes and mechanisms of success.
Authors: Fazzino T.L. , Sporn N.J. , Befort C.A. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016 Jul; 24(7), p. 3165-73.
EPub date: 2016-03-02.
PMID: 26932848
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Effective recruitment of rural breast cancer survivors into a lifestyle intervention.
Authors: Befort C.A. , Bennett L. , Christifano D. , Klemp J.R. , Krebill H. .
Source: Psycho-oncology, 2015 Apr; 24(4), p. 487-90.
EPub date: 2014-06-21.
PMID: 24953687
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Protocol and recruitment results from a randomized controlled trial comparing group phone-based versus newsletter interventions for weight loss maintenance among rural breast cancer survivors.
Authors: Befort C.A. , Klemp J.R. , Fabian C. , Perri M.G. , Sullivan D.K. , Schmitz K.H. , Diaz F.J. , Shireman T. .
Source: Contemporary clinical trials, 2014 Mar; 37(2), p. 261-71.
EPub date: 2014-01-31.
PMID: 24486636
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Fatalistic cancer beliefs and information sources among rural and urban adults in the USA.
Authors: Befort C.A. , Nazir N. , Engelman K. , Choi W. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2013 Sep; 28(3), p. 521-6.
PMID: 23813489
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