Experience and Perceptions With a Phone‐Based Weight Loss Intervention Among Overweight and Obese Survivors of Breast Cancer Enduring Cancer‐Related Fatigue in France: A Qualitative Study Within a Randomized Clinical Trial

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Abstract
Introduction: The MEDEA randomized clinical trial evaluated the impact of a telephone‐based weight loss intervention focused on calorie restriction and lifestyle behavior change among overweight and obese breast cancer (BC) patients on cancer‐related fatigue in France. The intervention was linguistically and culturally adapted from the North American BWEL‐A011401. Since patient acceptability and engagement with weight loss interventions are influenced by cross‐country cultural differences in dietary, social, and behavioral habits, we conducted a qualitative study to explore these factors and inform future implementation. Methods: Among 220 patients with Stage I–III BC who participated in MEDEA, 110 were randomized to receive the weight loss intervention delivered by dietitians through 24 semistructured calls over 12 months. Twenty patients receiving the intervention accepted participation in four focus groups to explore barriers and facilitators for uptake and engagement, as well as acceptability, satisfaction, and improvement suggestions. A thematic content analysis was performed using Nvivo12 software. Results: Four focus groups were conducted. Overall, patients generally expressed positive perceptions of the intervention, highlighting several key themes: (1) satisfaction with the intervention, reporting objective benefits, including measurable weight loss and reduced symptom burden; (2) recognition of intervention as a catalyst for sustainable behavioral change; and (3) appreciation for the convenience of a telephone‐based format. However, participants also identified several barriers to uptake and engagement, along with suggestions for improvement: (1) The need for tools to sustain engagement such as postintervention follow‐up calls, psychological support, and resources for self‐monitoring; (2) for the importance of further cultural adaptation; and (3) a call for a more patient‐centered research ecosystem, encompassing the selection of relevant patient‐reported outcomes, improved communication, and enhanced community‐building efforts). Conclusions: The MEDEA intervention was found to be acceptable and positively experienced, suggesting that a North American weight loss program seems adaptable to a different language and cultural context. This qualitative analysis also informed refinements to optimize weight loss interventions in a European context. Trial Registration: ClinicalTrials.gov identifier: NCT04303924
Funding Information
  • Institut National Du Cancer (RISP 2018-13684)
  • Fondation Gustave Roussy

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