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Table 1 The BCPP and MDPP programmes

From: Testing a breast cancer prevention and a multiple disease prevention weight loss programme amongst women within the UK NHS breast screening programme—a randomised feasibility study

Timeline   Health care professional Modality of contact BCPP MDPP
  Disease risk information     
Median (range)-6.5 (0 – 63) months Personalised breast cancer risk information   had been received  prior to invitation to the  lifestyle programmes  (10 year and lifetime – derived  from  the Tyrer-Cuzick model)  Clinician in the high risk clinic (High or above average risk) or Letter (average or below average risk) Face to face / phone
Letter
Time 0 Reminder of personalised breast cancer risk Research dietitian Face to face
  Advice that weight loss of ≥5% and adherence to PA and alcohol recommendations could lead to significant reductions in risk of BC (25%) [21, 22] Research dietitian Face to face
  General advice that 5% weight loss could reduce their risk of T2D (60%) [23] and CVD (30%) [24] Research dietitian Face to face  
  NHS health check tests Research dietitian/research practitioner Face to face  
  Personalised feedback  of:
CVD risk (10-year and lifetime risk and heart age from QRISK2) [19]
T2D risk (QDiabetes and measured HbA1c) [20]
Research dietitian Face to face  
  Personalised estimate of change  in CVD risk from predicted reductions in blood pressure and total cholesterol) (i.e. a 1 mm/Hg reduction in systolic blood pressure per 1% weight loss up to a 10% weight loss [25] and a 1% reduction in total cholesterol for every 1% weight loss up to a 15% weight loss) [26].
Personalised estimate of change  in Q diabetes risk by entering the target reduced weight in the QDiabetes tool
Research dietitian Face to face  
  NHS Health Check results sent to general practitioner to allow appropriate follow up and clinical management, e.g. checking abnormal result, consideration of medications for raised cholesterol, blood pressure and HbA1c.  General practitioner Face to face/phone  
  Lifestyle advice and behavioural support     
Time 0 Dietary advice to follow an intermittent (5:2) or daily energy restricted Mediterranean diet Research dietitian Face to face
  Physical activity advice (150 mins/moderate intensity CV & 40 mins of resistance exercise /week) [27] tailored to participant’s preferences, abilities and co-morbidities, with referral to local services where appropriatea Research dietitian Face to face
  Advised  to  limit alcohol intake to <10 units/week due to its effect on weight and weight independent effects on disease risk   Face to face
  Tutorial for use of the trial website & self-monitoring Research dietitian Face to face
  Referral to NHS smoking cessation or  alcohol services if reporting high-risk alcohol intakes with Alcohol Use Disorders Identification Test (AUDIT) scores >8 [28] Participants asked to self- refer to  relevant  services Face to face
0 – 6 months Scheduled review calls at weeks  1, 4 and 8 Research dietitian Phone
  Weekly  personalised e mails
(weeks 2,3,5,6,7,9-26)
Research dietitian E mail
  Monthly trial newsletter Automated E mail
  3 and 6 month weight review   Research dietitian Face to face
  Self-management using the trial website Participants Web
6- 12 months Automated monthly email from the trial  website:
Positive feedback for records showing weight loss or weight maintenance
Encouraged re-engagement with the programmes if weight had increased by ≥1kg or if no website entries recorded.
Automated E mail
  Self -management using the trial website Participants Web
  1. aSuitability to follow a home based PA programme was confirmed using the adult pre-physical activity screening system tool [29], with family doctor clearance where necessary