The impact of social deprivation on the response to a randomized controlled trial of a weight management intervention (BeWEL) for people at increased risk of colorectal cancer

A. Fisher, A. M. Craigie, M. Macleod, R. J. C. Steele, A. S. Anderson (Lead / Corresponding author)

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102 Downloads (Pure)

Abstract

Background: Although 45% of colorectal cancer (CRC) cases may be avoidable through appropriate lifestyle and weight management, health promotion interventions run the risk of widening health inequalities. The BeWEL randomised controlled trial assessed the impact of a diet and activity programme in overweight adults diagnosed with a colorectal adenoma, demonstrating a significantly greater weight loss at 12 months in intervention participants than controls. This study aims to compare BeWEL intervention outcomes by participant deprivation status.

Methods: The intervention group of the BeWEL trial (n=163) were classified by the Scottish Index of Multiple deprivation (SIMD) quintiles into ‘more deprived’ (SIMD 1 - 2, n = 58) and ‘less deprived’ (SIMD 3 - 5, n=105). Socio-economic and lifestyle variables were compared at baseline to identify potential challenges to intervention adherence in the more deprived. Between group differences at 12 months in primary outcome (change in body weight) and secondary outcomes (cardiovascular risk factors, diet, physical activity, knowledge of CRC risk and psychosocial variables) were assessed by deprivation status.

Results: At baseline, education (p=0.001), income (p<0.001), spending on physical activity (p=0.003) and success at previous weight loss attempts (p=0.007) were significantly lower in the most deprived. At 12 months, no between group differences by deprivation status were detected for changes in primary and main secondary outcomes.

Conclusions: Despite potential barriers faced by the more deprived participants, primary and most secondary outcomes were comparable between groups, indicating this intervention is unlikely to worsen health inequalities and is equally effective across socio-economic groups.
Original languageEnglish
Pages (from-to)306-313
Number of pages8
JournalJournal of Human Nutrition and Dietetics
Volume31
Issue number3
Early online date23 Nov 2017
DOIs
Publication statusPublished - 15 May 2018

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Life Style
Weight Loss
Colorectal Neoplasms
Randomized Controlled Trials
Economics
Diet
Weights and Measures
Body Weight Changes
Health
Health Promotion
Adenoma
Education

Keywords

  • Deprivation
  • Screening
  • Lifestyle
  • Intervention
  • Colorectal cancer

Cite this

@article{0ff35f0ccf834a28a117f3a3dc31a7bd,
title = "The impact of social deprivation on the response to a randomized controlled trial of a weight management intervention (BeWEL) for people at increased risk of colorectal cancer",
abstract = "Background: Although 45{\%} of colorectal cancer (CRC) cases may be avoidable through appropriate lifestyle and weight management, health promotion interventions run the risk of widening health inequalities. The BeWEL randomised controlled trial assessed the impact of a diet and activity programme in overweight adults diagnosed with a colorectal adenoma, demonstrating a significantly greater weight loss at 12 months in intervention participants than controls. This study aims to compare BeWEL intervention outcomes by participant deprivation status.Methods: The intervention group of the BeWEL trial (n=163) were classified by the Scottish Index of Multiple deprivation (SIMD) quintiles into ‘more deprived’ (SIMD 1 - 2, n = 58) and ‘less deprived’ (SIMD 3 - 5, n=105). Socio-economic and lifestyle variables were compared at baseline to identify potential challenges to intervention adherence in the more deprived. Between group differences at 12 months in primary outcome (change in body weight) and secondary outcomes (cardiovascular risk factors, diet, physical activity, knowledge of CRC risk and psychosocial variables) were assessed by deprivation status.Results: At baseline, education (p=0.001), income (p<0.001), spending on physical activity (p=0.003) and success at previous weight loss attempts (p=0.007) were significantly lower in the most deprived. At 12 months, no between group differences by deprivation status were detected for changes in primary and main secondary outcomes.Conclusions: Despite potential barriers faced by the more deprived participants, primary and most secondary outcomes were comparable between groups, indicating this intervention is unlikely to worsen health inequalities and is equally effective across socio-economic groups.",
keywords = "Deprivation, Screening, Lifestyle, Intervention, Colorectal cancer",
author = "A. Fisher and Craigie, {A. M.} and M. Macleod and Steele, {R. J. C.} and Anderson, {A. S.}",
note = "This study was funded by the MRC National Prevention Research Initiative (www.npri.org.uk), grant award No G0802030. National Prevention Research Initiative is a national research initiative administered by the Medical Research Council made up of the following funding partners: Alzheimer’s Research Trust; Alzheimer’s Society; Biotechnology and Biological Sciences Research Council; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Engineering and Physical Sciences Research Council; Health and Social Care Research and Development Office for Northern Ireland; Medical Research Council; Welsh Assembly Government; and World Cancer Research Fund. Further financial support was provided by NHS Research Scotland to carry out this work. The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates.",
year = "2018",
month = "5",
day = "15",
doi = "10.1111/jhn.12524",
language = "English",
volume = "31",
pages = "306--313",
journal = "Journal of Human Nutrition and Dietetics",
issn = "0952-3871",
publisher = "Wiley",
number = "3",

}

TY - JOUR

T1 - The impact of social deprivation on the response to a randomized controlled trial of a weight management intervention (BeWEL) for people at increased risk of colorectal cancer

AU - Fisher, A.

AU - Craigie, A. M.

AU - Macleod, M.

AU - Steele, R. J. C.

AU - Anderson, A. S.

N1 - This study was funded by the MRC National Prevention Research Initiative (www.npri.org.uk), grant award No G0802030. National Prevention Research Initiative is a national research initiative administered by the Medical Research Council made up of the following funding partners: Alzheimer’s Research Trust; Alzheimer’s Society; Biotechnology and Biological Sciences Research Council; Cancer Research UK; Chief Scientist Office, Scottish Government Health Directorate; Department of Health; Diabetes UK; Economic and Social Research Council; Engineering and Physical Sciences Research Council; Health and Social Care Research and Development Office for Northern Ireland; Medical Research Council; Welsh Assembly Government; and World Cancer Research Fund. Further financial support was provided by NHS Research Scotland to carry out this work. The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates.

PY - 2018/5/15

Y1 - 2018/5/15

N2 - Background: Although 45% of colorectal cancer (CRC) cases may be avoidable through appropriate lifestyle and weight management, health promotion interventions run the risk of widening health inequalities. The BeWEL randomised controlled trial assessed the impact of a diet and activity programme in overweight adults diagnosed with a colorectal adenoma, demonstrating a significantly greater weight loss at 12 months in intervention participants than controls. This study aims to compare BeWEL intervention outcomes by participant deprivation status.Methods: The intervention group of the BeWEL trial (n=163) were classified by the Scottish Index of Multiple deprivation (SIMD) quintiles into ‘more deprived’ (SIMD 1 - 2, n = 58) and ‘less deprived’ (SIMD 3 - 5, n=105). Socio-economic and lifestyle variables were compared at baseline to identify potential challenges to intervention adherence in the more deprived. Between group differences at 12 months in primary outcome (change in body weight) and secondary outcomes (cardiovascular risk factors, diet, physical activity, knowledge of CRC risk and psychosocial variables) were assessed by deprivation status.Results: At baseline, education (p=0.001), income (p<0.001), spending on physical activity (p=0.003) and success at previous weight loss attempts (p=0.007) were significantly lower in the most deprived. At 12 months, no between group differences by deprivation status were detected for changes in primary and main secondary outcomes.Conclusions: Despite potential barriers faced by the more deprived participants, primary and most secondary outcomes were comparable between groups, indicating this intervention is unlikely to worsen health inequalities and is equally effective across socio-economic groups.

AB - Background: Although 45% of colorectal cancer (CRC) cases may be avoidable through appropriate lifestyle and weight management, health promotion interventions run the risk of widening health inequalities. The BeWEL randomised controlled trial assessed the impact of a diet and activity programme in overweight adults diagnosed with a colorectal adenoma, demonstrating a significantly greater weight loss at 12 months in intervention participants than controls. This study aims to compare BeWEL intervention outcomes by participant deprivation status.Methods: The intervention group of the BeWEL trial (n=163) were classified by the Scottish Index of Multiple deprivation (SIMD) quintiles into ‘more deprived’ (SIMD 1 - 2, n = 58) and ‘less deprived’ (SIMD 3 - 5, n=105). Socio-economic and lifestyle variables were compared at baseline to identify potential challenges to intervention adherence in the more deprived. Between group differences at 12 months in primary outcome (change in body weight) and secondary outcomes (cardiovascular risk factors, diet, physical activity, knowledge of CRC risk and psychosocial variables) were assessed by deprivation status.Results: At baseline, education (p=0.001), income (p<0.001), spending on physical activity (p=0.003) and success at previous weight loss attempts (p=0.007) were significantly lower in the most deprived. At 12 months, no between group differences by deprivation status were detected for changes in primary and main secondary outcomes.Conclusions: Despite potential barriers faced by the more deprived participants, primary and most secondary outcomes were comparable between groups, indicating this intervention is unlikely to worsen health inequalities and is equally effective across socio-economic groups.

KW - Deprivation

KW - Screening

KW - Lifestyle

KW - Intervention

KW - Colorectal cancer

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DO - 10.1111/jhn.12524

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JO - Journal of Human Nutrition and Dietetics

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