Weight Management After Cancer for Survivors in Rural Communities

Development and Pilot Testing of a Novel Intervention to Reduce Cardiovascular Disease Risk Among Breast Cancer Survivors Living in Rural, Medically Underserved Communities

This study is testing a new program called WeCan-Rural, designed to help breast cancer survivors manage symptoms and build healthy habits like eating well, staying active, and managing their weight. These changes may help lower the risk of heart disease after cancer treatment.

The study will answer two main questions:

• Can study team successfully recruit and keep participants in the study, and will the participants find the program helpful and easy to follow?
• Will participants who join the program see better results in areas like weight, symptoms, diet, physical activity, and confidence in managing the participant's health compared to those who receive standard care?

Here's what participants will do:

• Visit the participant's clinic twice (about 12 weeks apart) to be weighed, have the blood pressure checked, give a blood sample, and complete a short walking test
• Fill out online surveys about the participant's health, diet, physical activity, symptoms, and confidence in managing the participant's health
• Be randomly assigned (like flipping a coin) to either receive the WeCan-Rural program or standard health information
• If assigned to the program, attend 12 weekly one-hour video sessions on Zoom with a trained therapist

Breast cancer survivors often face long-term health challenges after treatment, including a higher risk of heart disease. This risk is especially high for women living in rural areas, where access to healthcare and healthy food may be limited, and opportunities for physical activity may be harder to find. Many survivors also deal with ongoing symptoms like pain, fatigue, and emotional distress, which can make it harder to eat well, stay active, and manage their weight.

This study will test a program called WeCan-Rural, designed to help breast cancer survivors improve their health and lower their risk of heart disease. The program teaches skills for healthy eating, physical activity, and managing symptoms that can get in the way of a healthy lifestyle. It includes 12 weekly sessions delivered remotely through Zoom, so participants can join from home. Each session lasts about an hour and covers topics like nutrition, exercise, and ways to cope with symptoms using strategies like relaxation and pacing.

Participants will receive tools to help them track their progress, including a wireless activity tracker, a scale, and a blood pressure monitor. They'll also get printed materials and access to online videos showing how to do recommended exercises. If needed, participants will be provided with a tablet and data plan to make sure they can join the sessions.

The study will include 40 breast cancer survivors who have completed treatment and are living in rural, medically underserved areas. Half will receive the WeCan-Rural program, and half will receive standard health information from the National Cancer Institute. Researchers will look at how easy it is to recruit and keep participants in the program, how satisfied participants are with it, and whether it helps improve the participant's weight, symptoms, diet, physical activity, and confidence in managing the participant's health. The study will also measure changes in heart health indicators like blood pressure, cholesterol, and blood sugar.

If the program is found to be helpful and well-received, it may be tested in a larger study in the future.

Inclusion Criteria:

• aged 18 years or older
• female (biological sex)
• diagnosis of stage I-III breast cancer
• completed treatments with curative intent (with the exception of hormonal treatments) in the last 5 years
• body mass index >30
• healthy enough to participate in home-based physical activity
• able to speak/read English
• reports rating of ≥4 (i.e., moderate or more severe) out of 10 for one or more of the following symptoms at its worst in the last month (per the MD Anderson Symptom Inventory): pain, fatigue, sadness, and/or distress

Exclusion Criteria:

• visual, hearing or cognitive impairment or severe mental illness interfering with participation