Research Grants Awarded
Reducing Risk of Breast Cancer Recurrence in African American Women
Background: African American females have greater mortality from breast cancer and higher prevalence of obesity than Caucasians. Both cancer recurrence and mortality are more likely among obese women. Recent literature shows that clinical trials of a low fat diet for cancer survivors may reduce recurrence. Other literature shows that population-specific behavioral interventions work best for minorities. Accordingly, healthy living interventions (e.g., lower fat diets, exercise, weight loss if indicated) that target African Americans and were pre-tested in a survivor population may have potential for cancer control and reduced mortality and morbidity. Objective/Hypothesis: This study will test hypotheses regarding a behavioral change intervention that applies current principles of nutrition science, cancer awareness education, and offers a population specific program for African American cancer survivors. H.1. A population specific healthy living and cancer awareness program for African American women will improve diet and exercise habits, achieve weight loss when indicated, and increase awareness of breast cancer management and control. H.2. Enrollment, completion of the intervention program, and adherence to the healthy living plan will be associated with reduction of structural, clinical, and personal barriers to participation in health promotion programs, and offering participants the opportunity to succeed. Specific Aims: 1. Develop and evaluate a breast cancer behavioral change and cancer awareness program for African American breast cancer survivors that is likely to achieve a healthier lifestyle. 2. Offer a program that is tailored to the target population, culturally relevant, conceptually based, has community collaborators, and thus reduces structural, personal and clinical barriers to participation. 3. Demonstrate that the target population will enter, complete, and benefit from a population specific behavioral change and cancer awareness intervention. Study Design: A healthy lifestyle and cancer awareness intervention will enroll African American breast cancer survivors age 18 and over. It will be based on two successful behavioral change programs that the investigators previously offered to African American females. It will include a dietary change program similar to one used in the WINS study that reduced incidence of breast cancer recurrence by 24%. Participants will enroll in a 12 month program, be counseled and monitored by a dietician, and assessed for the extent of behavioral change and adherence to the program. Subjects: 60 African American cancer survivors who live in a city with high breast cancer mortality among minority women and high rates of obesity and unhealthy living practices. Potential Outcomes and Benefits of the Research: Benefits will accrue to the scientific community, breast cancer survivors, and agencies that plan and finance breast health services. The study can inform us: 1) if a healthy living/cancer awareness translation program for breast cancer survivors can reduce potential risk of recurrence and improve diet and exercise habits, achieve weight loss when indicated, improve behavior related to breast cancer prevention and control; 2) whether offering a population-specific program that reduces barriers to participation will result in program completion and adherence to the healthy living plan; 3) if a targeted intervention that is community based, culturally relevant, conceptually based can be adequately tested in African American breast cancer survivors.
The proposed study will seek to improve the health status and reduce risk of cancer recurrence among African American breast cancer survivors, in a city with racial disparities in breast cancer mortality and high prevalence of obesity. In collaboration with two community organizations that seek to improve health of African American females, participants will receive a population specific healthy living/cancer awareness intervention. It seeks to: a) inform women about the role of healthy living (e.g., low fat diets, exercise) in reducing risk of recurrence of breast cancer; b) offer them a validated program to effect behavioral change in diet, exercise, and breast health care and screening behavior. Based on results of recent studies, healthy living interventions that use advances in nutritional science may reduce the rate of cancer recurrence in breast cancer survivors. The PI and collaborating investigator have had prior experience with breast health and nutritional interventions for minority women, and have found that population-specific programs work best. The investigation will build on this prior work as it tests the feasibility of offering a healthy living and cancer awareness translation program to the target population. The study will enroll 60 African American women for a 12 month intervention. Behavioral change that results from the study may help reduce risk of cancer recurrence in the target population. Data obtained from the study can help us plan translation programs that reach specific high need populations and see what factors contribute to program entry, completion, and adherence to a healthy living plan.