October 14, 2016
An intervention focused on daily self-weighing as a self-monitoring strategy shows promise for preventing weight gain in breast cancer survivors. These findings are the result of a recent study co-authored by three researchers from the University of North Carolina at Chapel Hill.
The full article, titled “Preventing weight gain in African American breast cancer survivors using smart scales and activity trackers: a randomized controlled pilot study,” was published online Sept. 8 by the Journal of Cancer Survivorship.
Carmina Valle, PhD, research assistant professor of health behavior at the UNC Gillings School of Global Public Health, is first author and principal investigator of the study. Her co-authors are Deborah Tate, PhD, professor of health behavior and nutrition and director of the Communications for Health Applications and Interventions Core at the Gillings School, and Allison Deal, MS, senior biostatistician with the Biostatistics Shared Resource at UNC’s Lineberger Comprehensive Cancer Center (LCCC). Valle and Tate also are members of the LCCC.
Women often experience weight gain following a breast cancer diagnosis. Previous studies have demonstrated that breast cancer survivors who gain five to 10 percent or more above their prediagnosis weight have poorer survival rates. In contrast, weight maintenance in the first few years following diagnosis is associated with improved survival.
While African-American breast cancer survivors are more likely to experience obesity relative to other breast cancer survivors, and also may be at higher risk for weight gain after diagnosis, only a handful of weight control interventions have focused specifically on this population.
To address this concern, the investigators evaluated the feasibility and preliminary efficacy of two six-month, self-regulation interventions that focused on daily self-weighing and used objective monitoring and tailored feedback in an effort to prevent weight gain among African-American breast cancer survivors.
Thirty-five participants were assigned either to an intervention group with activity monitoring, an intervention group without activity monitoring or a control group. Interventions included a wireless scale (either with or without an accompanying activity tracker) that transmitted objective data to a mobile app and website, along with emailed lessons about weight management and tailored feedback based on the objective data. Participants completed both in-person and online assessments at the study baseline, after three months and after six months.
At the six-month mark, 97 percent of participants had completed assessments. The median weight change after six months was -0.9 percent in the intervention group with activity monitoring and -0.2 percent in the intervention group without activity monitoring, versus +0.2 percent in the control group. The proportion of participants who were at or below their baseline weight by the end of the study was 72.7, 53.8 and 45.5 percent, respectively.
Both intervention groups perceived daily self-weighing as a positive experience, and 100 percent said they would recommend the program to other breast cancer survivors. These findings suggest that daily self-monitoring of both weight and activity may be a feasible and accessible approach to promote weight gain prevention in breast cancer survivors.
“Our study showed that a distance- and technology-based intervention focused on daily self-weighing and small behavior changes was feasible and acceptable among breast cancer survivors,” Valle said. “Among the intervention group that self-monitored both weight and activity, the improvements we saw in weight, activity and dietary intake over time were encouraging, especially in light of recent media headlines purporting that trackers may undermine weight loss efforts. Our next step is to test this approach in a larger trial over a longer period of time. By capitalizing on technology, we can make this intervention scalable and accessible to more cancer survivors in the future.”