Daughters And MothErS (DAMES) Against Breast Cancer

描述（由申请人提供）：女儿和母亲（DAMES）对抗乳腺癌体重过重（体重指数[BMI] > 25 kg/m2）是整个乳腺癌连续体的主要问题。首先，BMI升高是绝经后乳腺癌风险的一个强有力的独立预测因素。其次，在乳腺癌诊断时，BMI升高是公认的负面预后指标。最后，越来越多的证据表明，诊断后体重增加与无病生存率和总生存率相关。因此，超重对患有乳腺癌的妇女构成了很大的风险，也可能加剧她的超重一级女性亲属中的主要风险，这些亲属在遗传上更容易患这种疾病。以前的研究指出，在癌症诊断后创造的“可教时刻”是促进健康的适当时机;然而，“我们能否利用癌症诊断作为可教时刻来促进减肥，不仅在乳腺癌妇女中，而且在她们超重的女儿中？我们能否有效地利用母女关系来提高饮食和运动干预的效果，从而使两个人都减肥？“一个经验丰富的调查小组提出了一项可行性研究，该小组在癌症幸存者中提供家庭，饮食和运动干预方面具有值得注意的专业知识。共67对（每一组由一名新诊断的超重绝经后乳腺癌幸存者和她超重的女儿组成），将被随机分配到3种研究条件中的一种：1）定制的饮食和运动干预，以“伴侣辅助”的方式强调母女关系。（N=25对）; 2）量身定制的饮食和运动干预，独立提供给母亲和女儿（N=25对）;或3）接受标准化饮食和运动材料的注意力控制臂（N=17对）。这项试点研究的主要目的是探讨干预措施的吸收和可接受性，即，总体累积、研究材料的使用、自然减员等。我们还将探讨次要结局;例如，在12个月的研究期间测量的BMI，身体活动和饮食摄入量的变化。最后，调解人/主持人的变化，以及在母女关系的变化也将进行探讨。从本研究中获得的知识将用于完善干预材料，并收集有关效应量和变异的必要数据，以设计更大规模的试验。超重对乳腺癌妇女构成了很大的风险，也可能加剧她超重的一级女性亲属的主要风险，这些亲属在遗传上更容易患乳腺癌。该项目将确定以家庭为基础的饮食和运动干预的可行性，重点是在被诊断患有乳腺癌的母亲及其超重的成年女儿中减肥。

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.