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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Daughters And MothErS (DAMES) Against Breast Cancer Excessive body weight (body mass index [BMI] > 25 kg/m2) is a major problem across the entire breast cancer continuum. First, an elevated BMI is a strong independent predictor of post-menopausal breast cancer risk. Second, at the time of a breast cancer diagnosis, an elevated BMI is an acknowledged negative prognostic indicator. Finally, accumulating evidence suggests that weight gain after diagnosis is associated with poorer disease-free and overall survival. Thus, being overweight poses a substantial risk for the woman with breast cancer & also is likely to exacerbate primary risk among her overweight first-degree female relatives who genetically are more susceptible to this disease. Previous studies point to the "teachable moment" created in the wake of a cancer diagnosis as an opportune time for health promotion; however, "Can we use the cancer diagnosis as a teachable moment to promote weight loss, not only among women with breast cancer, but also their overweight daughters?" & "Can we effectively utilize the mother-daughter bond to enhance the efficacy of a diet & exercise intervention to induce weight-loss in both individuals?" A feasibility study is proposed by a seasoned investigative team who has noteworthy expertise in delivering home-based, diet & exercise interventions among cancer survivors. A total of 67 dyads (each comprised of a newly-diagnosed, overweight post-menopausal breast cancer survivor & her overweight daughter), will be randomized to 1 of 3 study conditions: 1) a tailored diet & exercise intervention that emphasizes the mother-daughter bond in a "partner- assisted" approach (N=25 dyads); 2) a tailored diet & exercise intervention that is delivered independently to mothers & daughters (N=25 dyads); or 3) an attention control arm which receives standardized diet & exercise materials (N=17 dyads). The primary aim of this pilot study is to explore the uptake & acceptability of the interventions, i.e., overall accrual, use of study materials, attrition, etc. We also will explore secondary outcomes; e.g., changes in BMI, physical activity & dietary intake measured over the 12-month study period. Finally, mediators/moderators of change, as well as changes in the mother-daughter bond also will be explored. Knowledge gained from this study will be used to refine intervention materials & collect necessary data on effect sizes & variation to design a larger trial. Being overweight poses a substantial risk for a woman with breast cancer and also is likely to exacerbate primary risk among her overweight, first-degree female relatives who genetically are more susceptible to the disease. This project will determine the feasibility of a home-based, diet and exercise intervention focused on weight loss in both mothers diagnosed with breast cancer and their overweight adult daughters.