Feasibility and efficacy of a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy: a randomized controlled pilot study.

PURPOSE: Weight gain is common among breast cancer patients and may contribute to poorer treatment outcomes. Most programs target breast cancer survivors after the completion of therapy and focus on weight reduction. This study examined the feasibility and preliminary efficacy of an intervention designed to prevent primary weight gain among women receiving neoadjuvant chemotherapy for breast cancer. METHODS: Thirty-eight newly diagnosed stage II or III breast cancer patients were randomized to the BALANCE intervention or usual care within 3 weeks of starting neoadjuvant chemotherapy. The intervention used a size acceptance-based approach and encouraged home-based resistance and moderate-intensity aerobic exercise as well as a low energy-dense diet to prevent weight gain. Assessments were conducted at baseline, mid-chemotherapy (3 months), and post-chemotherapy (6 months). Intervention feasibility, acceptability, and preliminary effects on anthropometric, quality of life, and circulating biomarker measures were evaluated. RESULTS: Intervention participant retention (100%) and in-person session attendance (80%) were high during the intervention period, although attendance dropped to 43% for telephone-delivered sessions. The majority of participants reported being satisfied with the intervention during chemotherapy (88%). Participants in the intervention group had greater reductions in waist circumference (p = .03) and greater improvements in self-reported vitality scores (p = .03) than the control group at the end of chemotherapy. Significant effects on biomarkers were not observed. CONCLUSIONS: A size acceptance weight management program is feasible during neoadjuvant chemotherapy among breast cancer patients and may have beneficial effects on waist circumference and patient vitality. TRIAL REGISTRATION: This study was registered as a clinical trial at www.clinicaltrials.gov (NCT00533338).

Living Situation and Physical Activity in the COVID-19 Pandemic Among American Private University Students.

Many university students experienced changes during the COVID-19 pandemic, including potential changes in physical activity (PA) levels and living situation. As PA behaviors in young adulthood help establish life-long habits and future health outcomes, the purpose of this study was to investigate overall change in PA, as well as change in PA due to living situation, among private university students during the COVID-19 pandemic. Private university students (n = 109) between 18 and 25 years of age completed an online survey that included the International Physical Activity Questionnaire - Short Form. T-tests examined changes in overall time spent in PA from before to during the COVID-19 pandemic, and the differences in MET-minute distributions between groups. Students performed significantly less activity during the COVID-19 pandemic than before (t(108) = 3.51, p = .001, d = 0.493), with 70.6% of all students meeting exercise recommendations before the pandemic and 51.4% after. Students living with vs. without a parent/guardian attained similar PA levels (t(107) = -.114, p = .910) before the pandemic (73.1% vs. 69.9%, respectively), but students living with a parent/guardian engaged in significantly less PA (t(107) = 2.04, p = .044, d = 0.475) than those living without a parent/guardian during the pandemic (37.5% vs. 57.1%, respectively). The declines in PA suggest the need for targeted interventions and education among private university students. In order to maximize the health benefits of PA, it is crucial that activity engagement return to at least pre-COVID-19 levels.

Dietary behaviors and food insecurity among Houston college students during the COVID-19 pandemic.

Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic.

Effects of treatment factors, comorbidities and health-related quality of life on self-efficacy for physical activity in cancer survivors.

OBJECTIVE: The physical and psychological benefits of exercise for cancer survivors are well documented. Researchers have examined self-efficacy (SE) as a target for promoting exercise; however, the predictors of SE, including treatment factors and comorbidities, have not been examined extensively. The purpose of this cross-sectional analysis was to examine how variables related to cancer and cancer treatment, comorbid health problems, health-related quality of life (QOL), and depression relate to SE for physical activity in cancer survivors. METHODS: This secondary analysis examined treatment factors, comorbidity, and QOL data from 148 breast cancer and 134 prostate cancer survivors who had participated in studies examining exercise and QOL. A predictive regression model was developed by testing each variable individually with SE and including the variables that had a significance of

Social-cognitive theory predictors of exercise behavior in endometrial cancer survivors.

OBJECTIVE: This study evaluated whether social-cognitive theory (SCT) variables, as measured by questionnaire and ecological momentary assessment (EMA), predicted exercise in endometrial cancer survivors. METHOD: One hundred posttreatment endometrial cancer survivors received a 6-month home-based exercise intervention. EMAs were conducted by using hand-held computers for 10- to 12-day periods every 2 months. Participants rated morning self-efficacy and positive and negative outcome expectations by using the computer, recorded exercise information in real time and at night, and wore accelerometers. At the midpoint of each assessment period, participants completed SCT questionnaires. Using linear mixed-effects models, the authors tested whether morning SCT variables predicted minutes of exercise that day (Question 1) and whether exercise minutes at time point Tj could be predicted by questionnaire measures of SCT variables from time point Tj-1 (Question 2). RESULTS: Morning self-efficacy significantly predicted that day's exercise minutes (p < .0001). Morning positive outcome expectations were also associated with exercise minutes (p = .0003), but the relationship was attenuated when self-efficacy was included in the model (p = .4032). Morning negative outcome expectations were not associated with exercise minutes. Of the questionnaire measures of SCT variables, only exercise self-efficacy predicted exercise at the next time point (p = .003). CONCLUSIONS: The consistency of the relationship between self-efficacy and exercise minutes over short (same day) and longer (Tj to Tj-1) time periods provides support for a causal relationship. The strength of the relationship between morning self-efficacy and exercise minutes suggest that real-time interventions that target daily variation in self-efficacy may benefit endometrial cancer survivors' exercise adherence.

Outcome expectations, expectancy accessibility, and exercise in endometrial cancer survivors.

Studies have shown that expectations about exercise outcomes are associated with exercise behavior. Outcome expectations can be assessed by self-report questionnaires, but a new method-the expectancy accessibility task-may convey unique information about outcome expectations that is less subject to respondent biases. This method involves measuring the reaction time to endorse or reject an outcome We examined the relationship of self-reported outcome expectations and expectancy accessibility tasks in a pilot study of sedentary endometrial cancer survivors (N = 20). After measuring outcome expectations and expectancy accessibility, participants were given an exercise program and asked to monitor exercise for 7 days using diaries and accelerometers. Analyses revealed no relationship between outcome expectation scores and exercise, but shorter response times to endorse positive exercise outcomes was related to more exercise in the next week (p = .02).