Training overweight/obese older women at high risk for breast cancer to use web-based weight loss tools: The HELP pilot study.

Abstract

233 Background: Excess weight is one of the few modifiable risk factors for incident breast cancer. Many programs can achieve a 7% weight loss but few can maintain it over time. Training women to use self-help resources over the internet has potential for reducing intervention costs and ensuring program maintenance. Methods: 50 overweight/obese (BMI≥27.5 kg/m2) women at increased risk of breast cancer (Gail score≥1.7) were identified from a mammography registry and enrolled in the HELP pilot study and randomized with 2:1 probability to a 12-week lifestyle intervention or a comparison group. Twelve telephone-based coaching calls trained participants to use a free, publicly available website to set goals and track performance for dietary intake and physical activity. The comparison group received information but no training. At baseline and 12 weeks, participants were weighed, fitted with an accelerometer for physical activity pattern, and completed questionnaires. Results: At baseline, participants were 60.9±0.79 years of age with a BMI of 33.1±0.60 kg/m2; 39% were daily internet users. Thirty-three were randomized to the intervention group with 91% completing follow-up. Fifty-four percent were able to use the website reliably and found it to be helpful, including 44% of previously nondaily internet users. At 12 weeks, intervention group participants who found the website helpful had lost 5.6±0.7 kg, or 6.7% of initial weight, intervention participants who did not find it helpful lost 0.8±0.9kg or 1.1% of initial weight and the comparison group gained 1.0±0.94 kg (89% follow-up) The between-group difference weight change was 4.2 kg (p<.0001). 74% of intervention group participants lost weight, compared to only 34% of women assigned to the comparison group. Conclusions: A 12-session telephone coaching program to train women to use publicly available web-based weight loss programs effectively achieved a large short-term weight loss among the majority of participants. Further follow-up is needed to identify how well the initial weight loss is maintained without further intervention assistance.