A randomised controlled trial to assess the impact of a lifestyle intervention (ActWELL) in women invited to NHS breast screening

ISRCTN ISRCTN11057518
DOI https://doi.org/10.1186/ISRCTN11057518
Secondary identifying numbers Protocol V1.1, 22/06/2017
Submission date
15/02/2017
Registration date
21/07/2017
Last edited
05/08/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
It is estimated that 38% of breast cancer could be prevented by increasing physical activity, decreasing alcohol intake and losing weight. It is notable that weight gain in adult life is associated with a greater risk of the disease (e.g., an increase of 2-10 kg after age 50 is associated with a 30% increased risk). The aim of this study is to assess the impact of a lifestyle intervention (ActWELL) on body weight and physical activity in women attending NHS breast screening clinics.

Who can participate?
Women aged 50-70 who are overweight and attending routine breast screening in four Scottish breast screening service centres

What does the study involve?
Participants are randomly allocated to either the intervention group or the control group. Participants in the intervention group have two face-to-face visits with a lifestyle coach and a further nine phone calls over 12 months. They are given a diet and physical activity programme with the aim of weight management and change in physical activity. This is delivered in the community by Breast Cancer Now volunteer lifestyle coaches. Participants in the control group continue with usual care. After the study is completed they are offered a one-off session with a lifestyle coach if they wish. All participants attend measurement visits with a research nurse at the start of the study and at 12 months follow up and have one phone call at 3 months. This involves recording demographic details, physiological measures such as weight, waist circumference and blood pressure, one blood sample and health questions.

What are the possible benefits and risks of participating?
Possible benefits are weight loss and a healthier lifestyle which may lead to a reduced risk of obesity-related chronic (long-term) conditions which are a major cause of death in the UK. There are considered to be no risks of taking part.

Where is the study run from?
1. NHS Tayside (UK)
2. NHS Grampian (UK)
3. NHS Lothian (UK)
4. NHS Greater Glasgow and Clyde (UK)

When is the study starting and how long is it expected to run for?
January 2017 to December 2019

Who is funding the study?
Scottish Government (UK)

Who is the main contact?
Ms Stephanie Gallant
s.gallant@dundee.ac.uk

Contact information

Ms Stephanie Gallant
Public

University of Dundee
Division of Cancer Research
CPHNR
Mailbox 7, Level 7
Ninewells Hospital & Medical School
Dundee
DD1 9SY
United Kingdom

Phone +44 (0)1382 383994
Email s.gallant@dundee.ac.uk

Study information

Study designFour-centre 1:1 parallel-group randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleA randomised controlled trial to assess the impact of a lifestyle intervention (ActWELL) in women invited to NHS breast screening
Study acronymActWELL
Study hypothesisIn Scotland, the incidence of breast cancer is predicted to rise by 27% by 2030 and whilst there are measures to support reductions in morbidity and mortality, the breast cancer community is now turning to support weight management programmes in post-menopausal women. In Scotland, 72% of women aged 55 to 74 years have a BMI >25 kg/m2. A recent feasibility study of a lifestyle intervention initiated in the NHS breast screening sites and delivered in the community reported significant findings in weight loss and increased activity after 12 weeks in intervention versus control groups.

The aim of this study is to assess the impact of a lifestyle intervention (ActWELL) on body weight and physical activity in women invited to NHS breast screening clinics.
Ethics approval(s)East of Scotland Research Ethics Committee, 28/06/2017, ref: 17/ES/0073
ConditionBody weight and physical activity
InterventionThis study is a minimal contact, weight management and physical activity intervention initiated within the breast cancer screening setting.

Actwell is a randomised controlled trial of a lifestyle intervention and is 26 months in duration. Randomisation is via the online TRuST system provided by Tayside Clinical Trials Unit (TCTU):
1. Those in the intervention group will have 2 face to face visits with a lifestyle coach and a further 9 phone calls over 12 months. They will be given a diet and physical activity programme with the aim of weight management and change in physical activity. This will be delivered in the community by Breast Cancer Now volunteer Lifestyle Coaches.
2. The control group continue with usual care. After the study is completed they are offered a one of session with a lifestyle coach if they wish.

Participants will attend for baseline and 12 month follow-up measurement visits with a research nurse and have one phone call at 3 months. This will involve recording of demographic details, physiological measures e.g. weight, waist circumference, blood pressure, heart rate, one blood sample and health questions.
Intervention typeBehavioural
Primary outcome measure1. Physical activity, measured using Scottish Physical Activity Questionnaire (SPAQ) and ActivPAL activity monitors
2. Weight loss, measured by research nurses (locally provided and calibrated by clinical research centres)

All outcomes are measured at two measurement visits at baseline and 12 months. At 3 months there is a telephone call to assess self-reported weight, SPAQ and EQ5D along with three food questions.
Secondary outcome measures1. HbA1C, non-fasting lipids and non-fasting insulin, measured using a blood test analysed at University of Glasgow
2. Sedentary behaviour and modes of physical activity, measured using SPAQ
3. Eating habits, measured using modified questionnaire from the Scottish Health Survey
4. Alcohol intake, measured using Audit C
5. Psycho-social variables, measured using Modified Illness Perception Questionnaire and various questions
6. Economic outcomes, measured using EQ5D- L and health resource usage questions
7. Blood pressure, measured using blood pressure monitor
All outcomes are measured at two measurement visits at baseline and 12 months. At 3 months there is a telephone call to assess self-reported weight, SPAQ and EQ5D along with three food questions.
Overall study start date01/01/2017
Overall study end date31/12/2019

Eligibility

Participant type(s)Healthy volunteer
Age groupMixed
Lower age limit50 Years
Upper age limit70 Years
SexFemale
Target number of participants552
Total final enrolment560
Participant inclusion criteria1. Invited to attend, or attended, routine breast screening clinics (not recall clinics)
2. Measured BMI >25 kg/m2
3. Women aged 50-70 years
Participant exclusion criteria1. Currently undergoing treatment for any malignant condition
2. Reported contra-indication to physical activity (e.g. recent surgery)
3. Reported contra-indication to weight management (e.g. currently following a recovery programme for weight gain)
4. Diagnosis of Type 1 diabetes
5. No telephone contact
6. Current use of insulin
7. Unable to consent
8. On a special or prescribed diet e.g. gluten free
Recruitment start date05/09/2017
Recruitment end date14/08/2018

Locations

Countries of recruitment

  • Scotland
  • United Kingdom

Study participating centres

NHS Tayside
Ninewells Hospital
Dundee
DD1 9SY
United Kingdom
NHS Grampian
Aberdeen
AB25 2ZN
United Kingdom
NHS Lothian
Edinburgh
EH1 3EG
United Kingdom
NHS Greater Glasgow and Clyde
G12 0XH
United Kingdom

Sponsor information

University of Dundee
University/education

Tayside Medical Science Centre
Ninewells Hospital & Medical School
Research & Development Office
Residency Block, Level 3
George Pirie Way
Dundee
DD1 9SY
Scotland
United Kingdom

Phone +44 (0)1382 383877
Email f.nuritova@dundee.ac.uk
Website http://www.dundee.ac.uk/
ROR logo "ROR" https://ror.org/03h2bxq36
NHS Tayside
Hospital/treatment centre

Tayside Medical Science Centre
Ninewells Hospital & Medical School
Research & Development Office
Residency Block, Level 3
George Pirie Way
Dundee
DD1 9SY
Scotland
United Kingdom

Phone +44 (0)1382 383837
Email liz.coote@nhs.net
Website http://www.nhstayside.scot.nhs.uk/index.htm
ROR logo "ROR" https://ror.org/000ywep40

Funders

Funder type

Government

Scottish Government

No information available

Results and Publications

Intention to publish date31/12/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal
IPD sharing planAccess to collated participant data will be restricted to the CI and appropriate study staff. Data will be held on university secure servers.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 08/11/2018 Yes No
Results article feasibility and optimisation results 05/06/2020 08/06/2020 Yes No
Results article 06/03/2021 18/06/2021 Yes No
HRA research summary 28/06/2023 No No
Other publications Letter 05/06/2021 05/08/2024 Yes No
Other publications SWAT 76 evaluation 08/02/2021 05/08/2024 Yes No

Editorial Notes

05/08/2024: Publication references added.
07/06/2023: Internal review.
18/06/2021: The following changes have been made:
1. Publication reference added.
2. The total final enrolment number has been added from the reference.
08/06/2020: Publication reference added.
02/06/2020: The recruitment start date was changed from 01/07/2017 to 05/09/2017.
12/11/2018: Publication reference added.
11/10/2018: The recruitment end date was changed from 31/08/2018 to 14/08/2018.