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Grant Details

Grant Number: 5R21CA122143-02 Interpret this number
Primary Investigator: Demark-Wahnefried, Wendy
Organization: Duke University
Project Title: Daughters and Mothers (DAMES) Against Breast Cancer
Fiscal Year: 2008


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.



Publications

Effects Of Diet And Exercise On Weight-related Outcomes For Breast Cancer Survivors And Their Adult Daughters: An Analysis Of The Dames Trial
Authors: Tometich D.B. , Mosher C.E. , Winger J.G. , Badr H.J. , Snyder D.C. , Sloane R.J. , Demark-Wahnefried W. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2017-04-17 00:00:00.0; , .
PMID: 28417203
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Daughters And Mothers Against Breast Cancer (dames): Main Outcomes Of A Randomized Controlled Trial Of Weight Loss In Overweight Mothers With Breast Cancer And Their Overweight Daughters
Authors: Demark-Wahnefried W. , Jones L.W. , Snyder D.C. , Sloane R.J. , Kimmick G.G. , Hughes D.C. , Badr H.J. , Miller P.E. , Burke L.E. , Lipkus I.M. .
Source: Cancer, 2014-08-15 00:00:00.0; 120(16), p. 2522-34.
PMID: 24804802
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Development of a theory-based (PEN-3 and Health Belief Model), culturally relevant intervention on cervical cancer prevention among Latina immigrants using intervention mapping.
Authors: Scarinci I.C. , Bandura L. , Hidalgo B. , Cherrington A. .
Source: Health Promotion Practice, 2012 Jan; 13(1), p. 29-40.
PMID: 21422254
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Folic acid supplementation before and during pregnancy in the Newborn Epigenetics STudy (NEST).
Authors: Hoyo C. , Murtha A.P. , Schildkraut J.M. , Forman M.R. , Calingaert B. , Demark-Wahnefried W. , Kurtzberg J. , Jirtle R.L. , Murphy S.K. .
Source: Bmc Public Health, 2011-01-21 00:00:00.0; 11(1), p. 46.
EPub date: 2011-01-21 00:00:00.0.
PMID: 21255390
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Nutrition during and after cancer therapy.
Authors: Barrera S. , Demark-Wahnefried W. .
Source: Oncology (williston Park, N.y.), 2009 Feb; 23(2 Suppl Nurse Ed), p. 15-21.
PMID: 19856583
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Nutrition and the cancer survivor: evidence to guide oncology nursing practice.
Authors: Toles M. , Demark-Wahnefried W. .
Source: Seminars In Oncology Nursing, 2008 Aug; 24(3), p. 171-9.
PMID: 18687263
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Promoting a healthy lifestyle among cancer survivors.
Authors: Demark-Wahnefried W. , Jones L.W. .
Source: Hematology/oncology Clinics Of North America, 2008 Apr; 22(2), p. 319-42, viii.
PMID: 18395153
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Move onward, press forward, and take a deep breath: can lifestyle interventions improve the quality of life of women with breast cancer, and how can we be sure?
Authors: Demark-Wahnefried W. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2007-10-01 00:00:00.0; 25(28), p. 4344-5.
EPub date: 2007-10-01 00:00:00.0.
PMID: 17785702
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