title: The feasibility and acceptability of a diet and exercise trial in overweight and obese black breast cancer survivors: The Stepping STONE study.
abstract: OBJECTIVE
  Black breast cancer survivors have high rates of obesity and low physical activity levels. Little is known about the acceptability and feasibility of interventions in this population.
  
  
  OBJECTIVE
  A two-arm RCT was launched to assess the efficacy of a culturally targeted 12-week multimodal lifestyle intervention in overweight and obese black survivors.
  
  
  METHODS
  Intervention components included nutrition education, exercise groups, and survivor-led motivational interviewing phone sessions. The analytic sample included women who completed the trial (intervention n=10; control n=12). Anthropometric measures, physical activity, and VO2max were assessed at baseline and follow-up. Change scores (intervention vs. control) were assessed with Wilcoxon rank-sum tests. A process evaluation assessed intervention acceptability.
  
  
  RESULTS
  Overall adherence was 70% and overall satisfaction was high (86%). Despite the 5% weight loss target, the intervention group lost 0.8% but BMI improved. Total physical activity levels increased in the intervention vs. control arm (+3501METmin/week vs. +965METmin/week, respectively). VO2max improved in the intervention group (+0.10±1.03kg/L/min). Intervention participants reduced energy intake (-207.3±31.5kcals) and showed improvements in fat intake (-15.5±3.8g), fiber (+3.2±1.2g) and % energy from fat (-4.8±3.1%). Survivors suggested providing diet/exercise information within a cancer context.
  
  
  CONCLUSIONS
  Group and individualized intervention strategies are acceptable to black survivors. Observed differences between self-report and objective outcomes may suggest reporting bias or changes in body composition. Increasing supervised intervention components and assessment of body composition will be important for future trials.
authors.affiliation: Breast Cancer Program, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St., NW Suite 4100, Washington, DC 20007, USA; Office of Minority Health & Health Disparities Research, Lombardi Comprehensive Cancer Center, Georgetown University, 1000 New Jersey Ave., SE, Washington, DC 20003, USA. Electronic address: vls3@georgetown.edu.
authors.forename: Vanessa B
authors.initials: VB
authors.lastname: Sheppard
authors.affiliation: Office of Minority Health & Health Disparities Research, Lombardi Comprehensive Cancer Center, Georgetown University, 1000 New Jersey Ave., SE, Washington, DC 20003, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hicks
authors.affiliation: Department of Biostatistics, Georgetown University, 4000 Reservoir Rd., NW, Washington, DC 20057, USA.
authors.forename: Kepher
authors.initials: K
authors.lastname: Makambi
authors.affiliation: Breast Cancer Program, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St., NW Suite 4100, Washington, DC 20007, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Hurtado-de-Mendoza
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center, 1824 6th Ave S, Birmingham, AL, 35233, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.affiliation: Office of Minority Health & Health Disparities Research, Lombardi Comprehensive Cancer Center, Georgetown University, 1000 New Jersey Ave., SE, Washington, DC 20003, USA.
authors.forename: Lucile
authors.initials: L
authors.lastname: Adams-Campbell
mesh_terms: D000328:Adult; D001741:Black or African American; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D001943:Breast Neoplasms; D004035:Diet Therapy / Q000379:methods*; D002149:Energy Intake; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D009043:Motor Activity; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy; D010101:Oxygen Consumption; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D010809:Physical Fitness; D017741:Survivors; D016896:Treatment Outcome
keywords: African American; Black; Breast cancer; Physical activity; Survivors