Co-designed weight management intervention for women recovering from oestrogen-receptor positive breast cancer.

BACKGROUND: Weight gain is commonly observed during and after breast cancer treatment and is associated with poorer survival outcomes, particularly in women with oestrogen receptor-positive (ER +) disease. The aim of this study was to co-design (with patients) a programme of tailored, personalised support (intervention), including high-quality support materials, to help female breast cancer patients (BCPs) with ER + disease to develop the skills and confidence needed for sustainable weight loss.  METHODS: ER + BCPs were recruited from two UK National Health Service (NHS) Trusts. The selection criteria included (i) recent experience of breast cancer treatment (within 36 months of completing primary treatment); (ii) participation in a recent focus group study investigating weight management perceptions and experiences; (iii) willingness to share experiences and contribute to discussions on the support structures needed for sustainable dietary and physical activity behaviour change. Co-design workshops included presentations and interactive activities and were facilitated by an experienced co-design researcher (HH), assisted by other members of the research team (KP, SW and JS). RESULTS: Two groups of BCPs from the North of England (N = 4) and South Yorkshire (N = 5) participated in a two-stage co-design process. The stage 1 and stage 2 co-design workshops were held two weeks apart and took place between Jan-March 2019, with each workshop being approximately 2 h in duration. Guided by the Behaviour Change Wheel, a theoretically-informed weight management intervention was developed on the basis of co-designed strategies to overcome physical and emotional barriers to dietary and physical activity behaviour change. BCPs were instrumental in designing all key features of the intervention, in terms of Capability (e.g., evidence-based information, peer-support and shared experiences), Opportunity (e.g., flexible approach to weight management based on core principles) and Motivation (e.g., appropriate use of goal-setting and high-quality resources, including motivational factsheets) for behaviour change. CONCLUSION: This co-design approach enabled the development of a theoretically-informed intervention with a content, structure and delivery model that has the potential to address the weight management challenges faced by BCPs diagnosed with ER + disease. Future research is required to evaluate the effectiveness of the intervention for eliciting clinically-important and sustainable weight loss in this population.

Reactivity: an issue for short-term pedometer studies?

OBJECTIVES: To investigate the influence of wearing a pedometer and recording daily step counts on ambulatory activity. METHODS: During the first visit to the laboratory, 50 healthy volunteers, blinded to the study aim, were provided with a sealed pedometer (New-Lifestyles NL-2000) and informed that it was a "body posture monitor" (sealed condition). Participants wore the pedometer throughout waking hours for one week. Upon returning to the laboratory step counts were downloaded and participants were informed that the device was actually a pedometer. They were requested to wear it unsealed for a second one-week period, and to record their step counts in an activity log (unsealed condition). RESULTS: Mean (SD) daily step counts reported in the sealed condition (9541 (3186) steps/day) were significantly lower than step counts reported in the unsealed condition (11385 (3763) steps/day) (p<0.001). CONCLUSIONS: Step counts increased significantly in the unsealed condition. Possible mechanisms for this include the knowledge of wearing a pedometer, the visible step count display and the completion of the activity log. This has validity implications for short-term studies (duration