Prevalence and Predictors of Low Serum 25-Hydroxyvitamin D among Female African-American Breast Cancer Survivors

Background: African-American breast cancer survivors commonly demonstrate low serum 25-hydroxyvitamin D (25(OH)D). Decreased cutaneous conversion, high levels of adiposity, and even breast cancer treatment may influence vitamin D status. Previous investigations have analyzed African-American women in aggregate with other breast cancer survivors and have not comprehensively addressed these influential factors

Comparative Effectiveness Trial of an Obesity Prevention Intervention in EFNEP and SNAP-ED: Primary Outcomes

There is a need to disseminate evidence-based childhood obesity prevention interventions on a broader scale to reduce obesity-related disparities among underserved children. The purpose of this study was to test the comparative effectiveness of an evidence-based obesity prevention intervention, Hip-Hop to Health (HH), delivered through Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) versus the standard curriculum delivered by the programs (Standard Nutrition Education (NE)). A nonequivalent control group design was delivered to compare the effectiveness of HH to NE on weight gain prevention and health behavior outcomes at EFNEP and SNAP-Ed sites. One hundred and fifty-three caregiver–child dyads (n = 103 in the HH group; n = 50 in the NE group) participated in the study. HH is an evidence-based dietary and physical activity intervention for low-income preschool children. The NE curriculum provided lessons for children that are consistent with the Dietary Guidelines for Americans 2010. Data were collected on demographics, anthropometrics, and behavioral variables for parent–child dyads at baseline and postintervention. Mixed model methods with random effects for site and participant were utilized. No differences in child or caregiver diet, physical activity, or screen time by group were found. No between-group differences in child BMI z-score were found; however, caregivers in the HH group lost significantly more weight than those in the NE group. Results from this trial can inform future dissemination efforts of evidenced-based programs for underserved families

Efficacy of a Weight Loss Intervention for African American Breast Cancer Survivors

African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior

Body composition changes in females treated for breast cancer: a review of the evidence

Body composition changes cannot be precisely captured using body weight or body mass index measures. Therefore, the primary purpose of this review was to characterize the patterns of body composition change in females treated for breast cancer including only studies that utilize imaging technologies to quantify adipose tissue and lean body mass (LBM). We reviewed PubMed for studies published between 1971‐2012 involving females diagnosed with breast cancer where computed axial tomography (CAT), dual energy x‐ray absorptiometry (DXA) or magnetic resonance imaging (MRI) were employed for body composition assessment. Of the initial 440 studies, 106 papers were evaluated and 36 papers met all eligibility criteria (15 observational and 21 intervention trials). Results of these studies revealed that body weight did not consistently increase. Importantly, studies also showed that body weight did not accurately depict changes in lean or adipose tissues. Further findings included that sarcopenic obesity as a consequence of breast cancer treatment was not definitive, as menopausal status may be a substantial moderator of body composition. Overall, the behavioral interventions did not exhibit consistent or profound effects on body composition outcomes; approximately half showed favorable influence on adiposity while the effects on LBM were not apparent. The use of tamoxifen had a clear negative impact on body composition. The majority of studies were conducted in predominantly white survivors, highlighting the need for trials in minority populations. Collectively, these studies were limited by age, race and/or menopause status matched control groups, overall size and statistical power. Very few studies simultaneously collected diet and exercise data‐ two potential factors that impact body composition. Future breast cancer trials should prioritize precise body composition methodologies to elucidate how these changes impact recurrence, prognosis and mortality, and to provide clinicians with appropriate advice regarding lifestyle recommendations in this growing sector of the population

Retaining traditionally hard to reach participants: Lessons learned from three childhood obesity studies

Retaining underserved populations, particularly low-income and/or minority participants in research trials, presents a unique set of challenges. In this paper, we describe the initial retention strategies and enhanced the retention strategies over time across three childhood obesity prevention trials. Hip-Hop to Health Jr. (HH) was a randomized controlled trial (RCT) testing a preschool-based obesity prevention intervention among predominately African-American children. Retention was 89% at 14-weeks, 71% at 1-year, and 73% at 2-year follow-up. Primary retention strategies for HH included: 1) collaboration with a community-based organization to enhance program credibility; 2) continuity of data collection locations; 3) collecting detailed contact information and provision of monetary compensation; and 4) developing a detailed tracking/search protocol. In a follow-up trial, Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial (HH Effectiveness), 95% of participants completed assessment at 14 weeks and 88% completed assessment at 1 year. For this trial, we emphasized staffing continuity in order to enhance participant relationship building and required data collection staff to have relevant community service experience. In a third study, we assessed dietary quality among participants in the Special Supplemental Nutrition Programfor Women, Infants, and Children (WIC) across three time points following the WIC food package shift instituted nationally in 2009. Retention rates were 91% at 12 months and 89% at 18 months. For our WIC\ study, we augmented retention by developing a home data collection protocol and increased focus on staff diversity training. We conclude with a summary of key strategies and suggestions for future research