title: A qualitative evaluation of a group phone-based weight loss intervention for rural breast cancer survivors: Themes and mechanisms of success.
abstract: Obesity is prevalent in breast cancer survivors and is a significant risk factor for recurrence and mortality. Weight management interventions for survivors have been diverse in design (in-person vs. phone-based, group vs. individual) and yielded varying weight loss results. Given these issues, participants themselves may provide insight into treatment-based factors that contributed to their weight loss outcomes. Here, we report qualitative results from interviews with survivors in a group phone-based weight loss intervention, with the objective of identifying mechanisms that facilitated or hindered adherence and weight loss. We explored interest in paying for continued treatment as an indicator of dissemination potential.
  
  
  
  Individual interviews were conducted with 186 rural, obese breast cancer survivors upon completion of a 6-month weight loss intervention that produced clinically meaningful weight loss (>5 %) in 91 % of participants. A thematic analysis of the interview data was performed.
  
  
  
  Five themes were identified as impacting adherence and success: (1) accountability; (2) importance of the group, with varying levels of connectedness; (3) dietary convenience; (4) difficulty maintaining intervention components that required more effort; and (5) importance of internal motivation to attributions of physical activity success or failure. Most were interested in paying to continue the program if it were extended beyond the study.
  
  
  
  Key intervention components that participants attributed to their success included supportive group processes and convenience. Results highlight the group phone-based approach as a potential venue for disseminating an effective weight loss program for breast cancer survivors.
  
  
  
  NCT01441011.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA. tfazzino@kumc.edu.
authors.forename: Tera L
authors.initials: TL
authors.lastname: Fazzino
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.|Department of Psychology, University of Kansas, Lawrence, KS, USA.
authors.forename: Nora J
authors.initials: NJ
authors.lastname: Sporn
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.|Department of Psychology, University of Kansas, Lawrence, KS, USA.
authors.forename: Christie A
authors.initials: CA
authors.lastname: Befort
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D012424:Rural Population; D017741:Survivors; D015431:Weight Loss / Q000502:physiology*
keywords: Breast cancer; Cancer survivorship; Qualitative evaluation; Weight loss