BeWEL the impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas

The study aims to evaluate the impact of a an intervention programme (?BeWEL?) on body weight change, cardiovascular risk factors, diet and physical activity in healthy individuals attending routine NHS clinics who have had pre-cancerous bowel polyps removed but are at risk of developing future cancer and other obesity related conditions. The findings will be relevant to increasing understanding of how the NHS can deliver effective lifestyle interventions to people from diverse backgrounds. It will also provide information on patients? experience of the BeWEL programme and on NHS cost implications.

Colorectal cancer (CRC) is a major public health problem and often co-exists with other disorders including obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). The proposed work aims to evaluate the impact of the ?BeWEL? intervention programme on body weight changes, cardiovascular risk factors, diet and physical activity in healthy individuals with excess body weight attending routine NHS clinics who have had pre-cancerous bowel polyps removed, but are at risk of developing future cancer and other obesity related conditions. Men from the poorest backgrounds have the highest rates of screen detected adenomas and the proposed work offers a rare opportunity to engage with a hard to reach group. The 3 year study will be a two-arm, multi-centre, randomised controlled trial of the BeWEL intervention against usual care. Participants will be men and women aged 50 to 74 years, with a BMI 25m/kg2, who have been treated for the removal of a colorectal adenoma. They will be recruited after discharge from follow-up clinics. The pre-trial development will take 6 months, participants will be recruited over a 12 month period and undertake the intervention and follow up for 12 months with a further 6 months for data collection, analysis and interpretation. The Intervention Group (IG) will receive the ?BeWEL? personalised, multiple contact, intervention programme (based on the clinically successful US diabetes prevention programme), personal body weight scales and invitations to undertake supervised monthly body weight recordings. The impact of the programme will be assessed by quantitative, qualitative and economic analysis. The main outcomes measures will be physical activity, dietary intake and psycho-social variables as well as body weight, markers of insulin resistance and cardiovascular risk. The research will also provide information on what factors influence decisions to engage in the programme, the response to the intervention by deprivation category, patients? experience of the intervention, and the NHS cost implications. The findings will be relevant to increasing understanding of how the NHS can deliver effective lifestyle interventions to people from diverse social backgrounds and has particular relevance for combining disease prevention strategies with early detection procedures.