A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial

Annie S. Anderson; Huey Yi Chong; Angela M. Craigie; Peter T. Donnan; Stephanie Gallant; Amy Hickman; Chloe McAdam; Jennifer McKell; Paul McNamee; E. Jane Macaskill; Nanette Mutrie; Ronan E. O’Carroll; Petra Rauchhaus; Naveed Sattar; Martine Stead; Shaun Treweek

doi:10.1186/s12966-021-01099-7

A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial

Annie S. Anderson^* (Corresponding Author), Huey Yi Chong, Angela M. Craigie, Peter T. Donnan, Stephanie Gallant, Amy Hickman, Chloe McAdam, Jennifer McKell, Paul McNamee, E. Jane Macaskill, Nanette Mutrie, Ronan E. O’Carroll, Petra Rauchhaus, Naveed Sattar, Martine Stead, Shaun Treweek

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle. The breast cancer-pooling project demonstrated that sustained weight loss of 2 to 4.5 kg is associated with an 18% lower risk of breast cancer, highlighting the importance of small changes in body weight. Our study aimed to assess the effectiveness a volunteer-delivered, community based, weight management programme (ActWELL) for women with a BMI > 25 kg/m 2 attending NHS Scotland Breast Screening clinics.

METHODS: A multicentre, 1:1 parallel group, randomised controlled trial was undertaken in 560 women aged 50 to 70 years with BMI > 25 kg/m 2. On completion of baseline measures, all participants received a breast cancer prevention leaflet. Intervention group participants received the ActWELL intervention which focussed on personalised diet advice and pedometer walking plans. The programme was delivered in leisure centres by (the charity) Breast Cancer Now volunteer coaches. Primary outcomes were changes between groups at 12 months in body weight (kg) and physical activity (accelerometer measured step count).

RESULTS: Two hundred seventy-nine women were allocated to the intervention group and 281 to the comparison group. Twelve-month data were available from 240 (81%) intervention and 227 (85%) comparison group participants. Coaches delivered 523 coaching sessions and 1915 support calls to 279 intervention participants. Mean weight change was - 2.5 kg (95% CI - 3.1 to - 1.9) in the intervention group and - 1.2 kg (- 1.8 to 0.6) in the comparison group. The adjusted mean difference was - 1.3 kg (95% CI - 2.2 to - 0.4, P = 0.003). The odds ratio for losing 5% weight was 2.20 (95% CI 1.4 to 3.4, p = 0.0005) in favour of the intervention. The adjusted mean difference in step counts between groups was 483 steps/day (95% CI - 635 to 1602) (NS).

CONCLUSIONS: A community weight management intervention initiated at breast screening clinics and delivered by volunteer coaches doubled the likelihood of clinically significant weight loss at 12 months (compared with usual care) offering significant potential to decrease breast cancer risk.

TRIAL REGISTRATION: Database of registration: ISCRTN. Registration number: 11057518 . Date trial registered:21.07.2017. Date of enrolment of first participant: 01.09.2017.

Original language	English
Article number	34
Number of pages	21
Journal	The International Journal of Behavioral Nutrition and Physical Activity
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12966-021-01099-7
Publication status	Published - 6 Mar 2021

Keywords

Breast cancer body weight lifestyle
Intervention screening
physical activity
Cost-effectiveness analysis
Physical activity

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Anderson, A. S., Chong, H. Y., Craigie, A. M., Donnan, P. T., Gallant, S., Hickman, A., McAdam, C., McKell, J., McNamee, P., Macaskill, E. J., Mutrie, N., O’Carroll, R. E., Rauchhaus, P., Sattar, N., Stead, M., & Treweek, S. (2021). A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial. The International Journal of Behavioral Nutrition and Physical Activity, 18(1), [34]. https://doi.org/10.1186/s12966-021-01099-7

A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics : a randomised controlled trial. / Anderson, Annie S. (Corresponding Author); Chong, Huey Yi; Craigie, Angela M.; Donnan, Peter T.; Gallant, Stephanie; Hickman, Amy; McAdam, Chloe; McKell, Jennifer; McNamee, Paul; Macaskill, E. Jane; Mutrie, Nanette; O’Carroll, Ronan E.; Rauchhaus, Petra; Sattar, Naveed; Stead, Martine; Treweek, Shaun.

In: The International Journal of Behavioral Nutrition and Physical Activity, Vol. 18, No. 1, 34, 06.03.2021.

Research output: Contribution to journal › Article › peer-review

Anderson, AS, Chong, HY, Craigie, AM, Donnan, PT, Gallant, S, Hickman, A, McAdam, C, McKell, J, McNamee, P, Macaskill, EJ, Mutrie, N, O’Carroll, RE, Rauchhaus, P, Sattar, N, Stead, M & Treweek, S 2021, 'A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial', The International Journal of Behavioral Nutrition and Physical Activity, vol. 18, no. 1, 34. https://doi.org/10.1186/s12966-021-01099-7

Anderson AS, Chong HY, Craigie AM, Donnan PT, Gallant S, Hickman A et al. A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial. The International Journal of Behavioral Nutrition and Physical Activity. 2021 Mar 6;18(1). 34. https://doi.org/10.1186/s12966-021-01099-7

Anderson, Annie S. ; Chong, Huey Yi ; Craigie, Angela M. ; Donnan, Peter T. ; Gallant, Stephanie ; Hickman, Amy ; McAdam, Chloe ; McKell, Jennifer ; McNamee, Paul ; Macaskill, E. Jane ; Mutrie, Nanette ; O’Carroll, Ronan E. ; Rauchhaus, Petra ; Sattar, Naveed ; Stead, Martine ; Treweek, Shaun. / A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics : a randomised controlled trial. In: The International Journal of Behavioral Nutrition and Physical Activity. 2021 ; Vol. 18, No. 1.

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abstract = "BACKGROUND: It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle. The breast cancer-pooling project demonstrated that sustained weight loss of 2 to 4.5 kg is associated with an 18% lower risk of breast cancer, highlighting the importance of small changes in body weight. Our study aimed to assess the effectiveness a volunteer-delivered, community based, weight management programme (ActWELL) for women with a BMI > 25 kg/m 2 attending NHS Scotland Breast Screening clinics. METHODS: A multicentre, 1:1 parallel group, randomised controlled trial was undertaken in 560 women aged 50 to 70 years with BMI > 25 kg/m 2. On completion of baseline measures, all participants received a breast cancer prevention leaflet. Intervention group participants received the ActWELL intervention which focussed on personalised diet advice and pedometer walking plans. The programme was delivered in leisure centres by (the charity) Breast Cancer Now volunteer coaches. Primary outcomes were changes between groups at 12 months in body weight (kg) and physical activity (accelerometer measured step count). RESULTS: Two hundred seventy-nine women were allocated to the intervention group and 281 to the comparison group. Twelve-month data were available from 240 (81%) intervention and 227 (85%) comparison group participants. Coaches delivered 523 coaching sessions and 1915 support calls to 279 intervention participants. Mean weight change was - 2.5 kg (95% CI - 3.1 to - 1.9) in the intervention group and - 1.2 kg (- 1.8 to 0.6) in the comparison group. The adjusted mean difference was - 1.3 kg (95% CI - 2.2 to - 0.4, P = 0.003). The odds ratio for losing 5% weight was 2.20 (95% CI 1.4 to 3.4, p = 0.0005) in favour of the intervention. The adjusted mean difference in step counts between groups was 483 steps/day (95% CI - 635 to 1602) (NS).CONCLUSIONS: A community weight management intervention initiated at breast screening clinics and delivered by volunteer coaches doubled the likelihood of clinically significant weight loss at 12 months (compared with usual care) offering significant potential to decrease breast cancer risk.TRIAL REGISTRATION: Database of registration: ISCRTN. Registration number: 11057518 . Date trial registered:21.07.2017. Date of enrolment of first participant: 01.09.2017.",

keywords = "Breast cancer body weight lifestyle, Intervention screening, physical activity, Cost-effectiveness analysis, Physical activity",

author = "Anderson, {Annie S.} and Chong, {Huey Yi} and Craigie, {Angela M.} and Donnan, {Peter T.} and Stephanie Gallant and Amy Hickman and Chloe McAdam and Jennifer McKell and Paul McNamee and Macaskill, {E. Jane} and Nanette Mutrie and O{\textquoteright}Carroll, {Ronan E.} and Petra Rauchhaus and Naveed Sattar and Martine Stead and Shaun Treweek",

note = "Acknowledgements Our thanks to Elizabeth Banks who advised and assisted with many aspects of the study and also to the many women who commented on the development and design of this study including those on our Public Advisory Team (Pamela Deponio, Maggie Taylor and Mary Wotherspoon). Funding This work was supported by The Scottish Government, grant number BC/Screening/17/01. The funders provided independent referee reports which guided the final study design. The funders have read this manuscript. In-kind support was given by Breast Cancer Now for facilitating this study.",

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T1 - A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics

T2 - a randomised controlled trial

AU - Anderson, Annie S.

AU - Chong, Huey Yi

AU - Craigie, Angela M.

AU - Donnan, Peter T.

AU - Gallant, Stephanie

AU - Hickman, Amy

AU - McAdam, Chloe

AU - McKell, Jennifer

AU - McNamee, Paul

AU - Macaskill, E. Jane

AU - Mutrie, Nanette

AU - O’Carroll, Ronan E.

AU - Rauchhaus, Petra

AU - Sattar, Naveed

AU - Stead, Martine

AU - Treweek, Shaun

N1 - Acknowledgements Our thanks to Elizabeth Banks who advised and assisted with many aspects of the study and also to the many women who commented on the development and design of this study including those on our Public Advisory Team (Pamela Deponio, Maggie Taylor and Mary Wotherspoon). Funding This work was supported by The Scottish Government, grant number BC/Screening/17/01. The funders provided independent referee reports which guided the final study design. The funders have read this manuscript. In-kind support was given by Breast Cancer Now for facilitating this study.

PY - 2021/3/6

Y1 - 2021/3/6

N2 - BACKGROUND: It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle. The breast cancer-pooling project demonstrated that sustained weight loss of 2 to 4.5 kg is associated with an 18% lower risk of breast cancer, highlighting the importance of small changes in body weight. Our study aimed to assess the effectiveness a volunteer-delivered, community based, weight management programme (ActWELL) for women with a BMI > 25 kg/m 2 attending NHS Scotland Breast Screening clinics. METHODS: A multicentre, 1:1 parallel group, randomised controlled trial was undertaken in 560 women aged 50 to 70 years with BMI > 25 kg/m 2. On completion of baseline measures, all participants received a breast cancer prevention leaflet. Intervention group participants received the ActWELL intervention which focussed on personalised diet advice and pedometer walking plans. The programme was delivered in leisure centres by (the charity) Breast Cancer Now volunteer coaches. Primary outcomes were changes between groups at 12 months in body weight (kg) and physical activity (accelerometer measured step count). RESULTS: Two hundred seventy-nine women were allocated to the intervention group and 281 to the comparison group. Twelve-month data were available from 240 (81%) intervention and 227 (85%) comparison group participants. Coaches delivered 523 coaching sessions and 1915 support calls to 279 intervention participants. Mean weight change was - 2.5 kg (95% CI - 3.1 to - 1.9) in the intervention group and - 1.2 kg (- 1.8 to 0.6) in the comparison group. The adjusted mean difference was - 1.3 kg (95% CI - 2.2 to - 0.4, P = 0.003). The odds ratio for losing 5% weight was 2.20 (95% CI 1.4 to 3.4, p = 0.0005) in favour of the intervention. The adjusted mean difference in step counts between groups was 483 steps/day (95% CI - 635 to 1602) (NS).CONCLUSIONS: A community weight management intervention initiated at breast screening clinics and delivered by volunteer coaches doubled the likelihood of clinically significant weight loss at 12 months (compared with usual care) offering significant potential to decrease breast cancer risk.TRIAL REGISTRATION: Database of registration: ISCRTN. Registration number: 11057518 . Date trial registered:21.07.2017. Date of enrolment of first participant: 01.09.2017.

AB - BACKGROUND: It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle. The breast cancer-pooling project demonstrated that sustained weight loss of 2 to 4.5 kg is associated with an 18% lower risk of breast cancer, highlighting the importance of small changes in body weight. Our study aimed to assess the effectiveness a volunteer-delivered, community based, weight management programme (ActWELL) for women with a BMI > 25 kg/m 2 attending NHS Scotland Breast Screening clinics. METHODS: A multicentre, 1:1 parallel group, randomised controlled trial was undertaken in 560 women aged 50 to 70 years with BMI > 25 kg/m 2. On completion of baseline measures, all participants received a breast cancer prevention leaflet. Intervention group participants received the ActWELL intervention which focussed on personalised diet advice and pedometer walking plans. The programme was delivered in leisure centres by (the charity) Breast Cancer Now volunteer coaches. Primary outcomes were changes between groups at 12 months in body weight (kg) and physical activity (accelerometer measured step count). RESULTS: Two hundred seventy-nine women were allocated to the intervention group and 281 to the comparison group. Twelve-month data were available from 240 (81%) intervention and 227 (85%) comparison group participants. Coaches delivered 523 coaching sessions and 1915 support calls to 279 intervention participants. Mean weight change was - 2.5 kg (95% CI - 3.1 to - 1.9) in the intervention group and - 1.2 kg (- 1.8 to 0.6) in the comparison group. The adjusted mean difference was - 1.3 kg (95% CI - 2.2 to - 0.4, P = 0.003). The odds ratio for losing 5% weight was 2.20 (95% CI 1.4 to 3.4, p = 0.0005) in favour of the intervention. The adjusted mean difference in step counts between groups was 483 steps/day (95% CI - 635 to 1602) (NS).CONCLUSIONS: A community weight management intervention initiated at breast screening clinics and delivered by volunteer coaches doubled the likelihood of clinically significant weight loss at 12 months (compared with usual care) offering significant potential to decrease breast cancer risk.TRIAL REGISTRATION: Database of registration: ISCRTN. Registration number: 11057518 . Date trial registered:21.07.2017. Date of enrolment of first participant: 01.09.2017.

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KW - Intervention screening

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KW - Cost-effectiveness analysis

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