A community based participatory research approach to evaluate barriers and facilitators for behavioral weight loss intervention implementation in a predominantly black community.
Clinical Snapshot
PICO Framework
| P — Population | Black breast cancer survivors (BBCS) from a predominantly Black community |
| I — Intervention | Community-based participatory research approach using semi-structured interviews |
| C — Comparator | Not applicable (qualitative exploration) |
| O — Outcomes | Barriers and facilitators to behavioral weight loss intervention implementation |
Bottom Line
This small qualitative study identified important barriers to weight loss intervention participation among Black breast cancer survivors, including food access, safety concerns, cost, time constraints, and technology challenges. Participants preferred community-based coaches delivering combined virtual and in-person sessions. While the sample size is very small (n=8) and methodological details limited, the findings highlight critical health equity considerations for cancer survivorship programs. The study suggests that effective weight loss interventions for this population require multimodal approaches addressing social determinants of health, community integration, and flexible delivery methods. These insights could inform more equitable program design, though larger studies are needed to confirm transferability across different communities and healthcare systems.
Key Findings
P Value: Not applicable for qualitative research
Effect Size: Not applicable for qualitative research
Primary Outcome: Multiple barriers identified: lack of affordable healthy food access, safety concerns, lack of affordable fitness memberships, time constraints, technology learning curves
Nnt Or Sensitivity: Key facilitator: preference for integrated community-based coach with combined virtual and in-person sessions
Confidence Interval: Not applicable for qualitative research
Clinical Application
Recommendations appear feasible but require community infrastructure and resource investment Findings may apply to Aboriginal and Torres Strait Islander cancer survivors and other culturally diverse communities, though specific barriers may differ. Could inform Cancer Australia survivorship programs and community health initiatives Black breast cancer survivors and potentially other minority cancer survivor populations
Abstract
PURPOSE: Breast cancer survivors with overweight or obesity have worse breast cancer specific survival and outcomes as compared to those with average weight by Yung and Ligibel (Clin Adv Hematol Oncol 14:790-797, 2016) and Druesne-Pecollo et al. (Breast Cancer Res Treat 135:647-654, 2012). Our pilot Group-basEd Telehealth behavioral Weight Los (GET-WEL) Program showed that fewer Black breast cancer survivors (BBCS) enrolled and lost less weight than White breast cancer survivors by Allison et al. (Obesity Science and Practice 10:e70023, 2024). This study is aimed at using a community-based participatory research approach to assess barriers and facilitators of implementing a behavioral weight loss intervention among BBCS. METHODS: Eight BBCS from a predominantly Black community were invited to participate in semi-structured interviews that were voice recorded, transcribed, coded, and analyzed via comparative thematic analysis. RESULTS: Thematic analyses revealed multiple barriers within participants. These included lack of affordable healthy food access, safety concerns with regards to outdoor activities, lack of affordable fitness center memberships, time constraints related to competing work/life obligations, and steep learning curves with technology use. Most BBCS preferred an integrated community-based coach to guide their weight loss interventions via a combination of both virtual and in-person sessions. CONCLUSION: Our results indicate that a multimodal approach including nutrition education, reducing physical activity barriers, limiting time constraints by implementing both in-person and virtual platforms, and assisting with technology courses, is necessary to improve the equitable implementation of weight loss interventions. BBCS recommended utilizing established community facilities and leveraging known community members such as nutrition counselors and physical trainers to increase successful implementation.
References
- 1.De Jesus, E., Woo, S., Krouse, R. S., Guerra, C. E., Rendle, K. A., Cadet, T., Allison, K. C., & Tchou, J. (2026). A community based participatory research approach to evaluate barriers and facilitators for behavioral weight loss intervention implementation in a predominantly black community. Supportive Care in Cancer. https://doi.org/10.1016/j.jclinepi.2013.08.015
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