Skip to main content
An official website of the United States government
Grant Details

Grant Number: 5P01CA229997-05 Interpret this number
Primary Investigator: Demark-Wahnefried, Wendy
Organization: University Of Alabama At Birmingham
Project Title: Adapting Multiple Behavior Interventions That Effectively Improve (AMPLIFI) Cancer Survivor Health
Fiscal Year: 2022


Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health By 2020, the number of cancer survivors in the US will exceed 20 million due to trends toward aging, and improved cancer screening and treatment. Cancer survivorship is a victory, but it comes at a price. Once an individual is diagnosed with cancer, they are at much higher risk for second malignancies, cardiovascular disease, diabetes, osteoporosis, and functional decline (resulting in a loss of independence). Currently, the costs for these downstream effects are estimated to be at least $135 billion annually. Unhealthy lifestyle behaviors (e.g., a poor diet resulting in obesity and physical inactivity) associate with poorer outcomes after a cancer diagnosis. These behaviors also tend to cluster, i.e., people who practice one unhealthy behavior tend to practice another. It is hypothesized that cancer survivors may be able to improve their overall health and reduce comorbidity through lifestyle modification, particularly since estimates indicate that only 15-47% of cancer survivors adhere to national guidelines for weight status, diet and physical activity. While effective interventions in each of these domains exists, there has been little effort to disseminate these interventions broad scale and to survivors most in need (older, rural, minorities). Moreover, there is a relative dearth of research in determining optimal means of combining interventions, which is critical since many survivors practice more than one, or multiple suboptimal behaviors. The overarching aims AMPLIFI are to learn how to: 1) improve health behaviors in cancer survivors who practice multiple suboptimal health behaviors; and 2) adapt efficacious interventions to optimize their reach by the use of technology among cancer survivors, while also collecting data to inform the future dissemination and implementation (D&I) potential of these interventions. AMPLIFI involves 3 highly interrelated research projects supported by 4 highly integrated cores. It will enlist the efforts of 852 survivors of a broad array of cancers that have favorable 5-year cancer-free survival rates (oversampling those who are older, rural and minority) and gather the input of 48 key stakeholders to accomplish the following Specific Aims: 1) Understand how to adapt efficacious interventions for widespread dissemination through the use of technology, while maintaining the integrity of key components which drive behavior change; 2) Optimize acceptability and use of interventions (largely developed and tested in homogeneous samples of breast cancer survivors) to older, rural, minority survivors of many cancer types; 3) Test the efficacy of the adapted interventions delivered alone, in sequence, or combined; 4) Contribute to the science of D&I research by developing a new adaptation model; and 5) Determine factors that improve the D&I potential of distance-delivered health behavior change interventions by determining how they mediate behavior change and in whom they work best. Our ultimate goal is to improve the health of the highly vulnerable and ever increasing population of cancer survivors.


Dietary Barriers Appear to Influence the Effects of a Dyadic Web-Based Lifestyle Intervention on Caloric Intake and Adiposity: A Mediation Analysis of the DUET Trial.
Authors: Kaur H. , Pavela G. , Pekmezi D.W. , Rogers L.Q. , Cole W.W. , Parrish K.B. , Sayer R.D. , Wyatt H.R. , Demark-Wahnefried W. .
Source: Nutrients, 2023-11-25; 15(23), .
EPub date: 2023-11-25.
PMID: 38068776
Related Citations

Defining Radiation Treatment Interruption Rates During the COVID-19 Pandemic: Findings From an Academic Center in an Underserved Urban Setting.
Authors: Gaudio E. , Ammar N. , Gunturkun F. , Akkus C. , Brakefield W. , Wakefield D.V. , Pisu M. , Davis R. , Shaban-Nejad A. , Schwartz D.L. .
Source: International journal of radiation oncology, biology, physics, 2023-06-01; 116(2), p. 379-393.
EPub date: 2022-09-30.
PMID: 36183931
Related Citations

Results of DUET: A Web-Based Weight Loss Randomized Controlled Feasibility Trial among Cancer Survivors and Their Chosen Partners.
Authors: Demark-Wahnefried W. , Oster R.A. , Crane T.E. , Rogers L.Q. , Cole W.W. , Kaur H. , Farrell D. , Parrish K.B. , Badr H.J. , Wolin K.Y. , et al. .
Source: Cancers, 2023-03-03; 15(5), .
EPub date: 2023-03-03.
PMID: 36900368
Related Citations

A Web-based Lifestyle Intervention for Cancer Survivors: Feasibility and Acceptability of SurvivorSHINE.
Authors: Williams V.A. , Brown N.I. , Johnson R. , Ainsworth M.C. , Farrell D. , Barnes M. , Perumean-Chaney S. , Fontaine K. , Martin M.Y. , Pekmezi D. , et al. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2022 Dec; 37(6), p. 1773-1781.
EPub date: 2021-06-01.
PMID: 34061334
Related Citations

Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) cancer survivor health: program project protocols for remote lifestyle intervention and assessment in 3 inter-related randomized controlled trials among survivors of obesity-related cancers.
Authors: Pekmezi D. , Fontaine K. , Rogers L.Q. , Pisu M. , Martin M.Y. , Schoenberger-Godwin Y.M. , Oster R.A. , Kenzik K. , Ivankova N.V. , Demark-Wahnefried W. .
Source: BMC cancer, 2022-04-29; 22(1), p. 471.
EPub date: 2022-04-29.
PMID: 35488238
Related Citations

Test/Retest Reliability and Validity of Remote vs. In-Person Anthropometric and Physical Performance Assessments in Cancer Survivors and Supportive Partners.
Authors: Hoenemeyer T.W. , Cole W.W. , Oster R.A. , Pekmezi D.W. , Pye A. , Demark-Wahnefried W. .
Source: Cancers, 2022-02-21; 14(4), .
EPub date: 2022-02-21.
PMID: 35205823
Related Citations

Web-Based Lifestyle Interventions for Survivors of Cancer: Usability Study.
Authors: Williams V. , Brown N. , Moore J.X. , Farrell D. , Perumean-Chaney S. , Schleicher E. , Fontaine K. , Demark-Wahnefried W. , Pekmezi D. .
Source: JMIR formative research, 2022-02-21; 6(2), p. e30974.
EPub date: 2022-02-21.
PMID: 35188468
Related Citations

Developing a virtual assessment protocol for the AMPLIFI Randomized Controlled Trial due to COVID-19: From assessing participants' preference to preparing the team.
Authors: Pisu M. , Omairi I. , Hoenemeyer T. , Halilova K.I. , Schoenberger Y.M. , Rogers L.Q. , Kenzik K.M. , Oster R.A. , Ivankova N.V. , Pekmezi D. , et al. .
Source: Contemporary clinical trials, 2021 Dec; 111, p. 106604.
EPub date: 2021-10-29.
PMID: 34757221
Related Citations

Features That Middle-aged and Older Cancer Survivors Want in Web-Based Healthy Lifestyle Interventions: Qualitative Descriptive Study.
Authors: Ivankova N.V. , Rogers L.Q. , Herbey I.I. , Martin M.Y. , Pisu M. , Pekmezi D. , Thompson L. , Schoenberger-Godwin Y.M. , Oster R.A. , Fontaine K. , et al. .
Source: JMIR cancer, 2021-10-06; 7(4), p. e26226.
EPub date: 2021-10-06.
PMID: 34612832
Related Citations

Narrative Review of Web-based Healthy Lifestyle Interventions for Cancer Survivors.
Authors: Williams V. , Brown N. , Becks A. , Pekmezi D. , Demark-Wahnefried W. .
Source: Annals of reviews and research, 2020; 5(4), .
EPub date: 2020-03-10.
PMID: 33294850
Related Citations

Back to Top