A Weight Loss Intervention for African American Breast Cancer Survivors, 2006 Engaging African American breast cancer survivors in an intervention trial: culture, responsiveness and community Triple Negative Breast Tumors in African-American and Hispanic/Latina Women Are High in CD44+, Low in CD24+, and Have Loss of PTEN A breast cancer education and on-site screening intervention for unscreened African American women. Racial and ethnic differences in health status and health behavior among breast cancer survivors—Behavioral Risk Factor Surveillance System, 2009 Possible socioeconomic and ethnic disparities in quality of life in a cohort of breast cancer survivors Impact of race on breast cancer in lower socioeconomic status women. A Prospective Study of Body Size and Breast Cancer in Black Women Ethnicity and breast cancer: factors influencing differences in incidence and outcome. Healthy lifestyle intervention for African American uterine cancer survivors: Study protocol Efficacy of a Weight Loss Intervention for African American Breast Cancer Survivors. Sedentary time and breast cancer incidence in African American women Coping and distress among women under treatment for early stage breast cancer: comparing African Americans, Hispanics and non-Hispanic Whites. Differential Patterns of Risk Factors for Early-Onset Breast Cancer by ER Status in African American Women A Community-Based Exercise and Support Group Program in African-American Breast Cancer Survivors (ABCs). An intervention study on screening for breast cancer among single african-american women aged 65 and older. Comparing narrative and informational videos to increase mammography in low-income African American women.
Introduction Breast cancer survival rates are lower for African American women than for white women . Obesity , high-fat diets , and lack of regular physical activity increase risk for breast cancer recurrence , comorbid conditions , and premature death . Eighty-two percent of African American women are overweight or obese , partly because of unhealthy eating and exercise patterns . Although successful weight loss and lifestyle interventions for breast cancer survivors are documented , none has considered the needs of African American breast cancer survivors . This study assessed the feasibility and impact of Moving Forward , a culturally tailored weight loss program for African American breast cancer survivors . Methods The study used a pre-post design with a convenience sample of 23 African American breast cancer survivors . The 6-month intervention was theory-based and incorporated qualitative data from focus groups with the targeted community , urban African American breast cancer survivors .  Data on weight , body mass index ( BMI ) , diet , physical activity , social support , and quality of life were collected at baseline and at 6 months . Results After the intervention , we noted significant differences in weight , BMI , dietary fat intake , vegetable consumption , vigorous physical activity , and social support . Conclusion This is the first published report of Moving Forward , a weight loss intervention design ed for African American breast cancer survivors . Although a r and omized trial is needed to establish efficacy , the positive results of this intervention suggest that this weight loss intervention may be feasible for African American breast cancer survivors . Lifestyle interventions may reduce the disparities in breast cancer mortality rates Introduction Younger breast cancer survivors often lead extremely busy lives with multiple dem and s and responsibilities , making them difficult to recruit into clinical trials . African American women are even more difficult to recruit because of additional historical and cultural barriers . In a r and omized clinical trial of an intervention , we successfully used culturally informed , population -specific recruitment and retention strategies to engage younger African-American breast cancer survivors . Methods Caucasian and African American breast cancer survivors were recruited from multiple communities and sites . A variety of planned recruitment and retention strategies addressed cultural and population -specific barriers and were guided by three key principals : increasing familiarity with the study in the communities of interest ; increasing the availability and accessibility of study information and study participation ; and using cultural brokers . Results Accrual of younger African-American breast cancer survivors increased by 373 % in 11 months . The steepest rise in the numbers of African-American women recruited came when all strategies were in place and operating simultaneously . Retention rates were 87 % for both Caucasian and African American women . Discusssion/ Conclusions To successfully recruit busy , younger African American cancer survivors , it is important to use a multifaceted approach , addressing cultural and racial/ethnic barriers to research participation ; bridging gaps across cultures and communities ; including the role of faith and beliefs in considering research participation ; recognizing the dem and s of different life stages and economic situations and the place of research in the larger picture of peoples ’ lives . Design s for recruitment and retention need to be broadly conceptualized and specifically applied . Implication s for Cancer SurvivorsFor busy cancer survivors , willingness to participate in and complete research participation is enhanced by strategies that address barriers but also acknowledge the many dem and s on their time by making research familiar , available , accessible and credible Background African-American women have higher mortality from breast cancer than other ethnic groups . The association between poor survival and differences with tumor phenotypes is not well understood . The purpose of this study is to assess the clinical significance of ( 1 ) Stem cell-like markers CD44 and CD24 ; ( 2 ) PI3K/Akt pathway associated targets PTEN , activation of Akt , and FOXO1 ; and ( 3 ) the Insulin-like growth factor-1 ( IGF-I ) and IGF binding protein-3 ( IGFBP3 ) in different breast cancer subtypes , and compare the differences between African-American and Hispanic/Latina women who have similar social-economic-status . Methods A total of N=318 African-American and Hispanic/Latina women , with clinical ly-annotated information within the inclusion criteria were included .  Formalin fixed paraffin embedded tissues from these patients were tested for the different markers using immunohistochemistry techniques . Kaplan-Meier survival-curves and Cox-regression analyses were used to assess Relative Risk and Disease-Free-Survival ( DFS ) . Results The triple-negative-breast-cancer ( TNBC ) receptor-subtype was more prevalent among premenopausal women , and the Hormonal Receptor ( HR ) positive subtype was most common overall . TNBC tumors were more likely to have loss of PTEN , express high Ki67 , and have increased CD44+/CD24- expression . TNBC was also associated with higher plasma-IGF-I levels . HR-/HER2 + tumors showed high pAkt , decreased FOXO1 , and high CD24 + expression . The loss of PTEN impacted DFS significantly in African Americans , but not in Hispanics/Latinas after adjusted for treatment and other tumor pathological factors . The CD44+/CD24- and CD24+/CD44- phenotypes decreased DFS , but were not independent predictors for DFS . HER2-positive and TNBC type of cancers continued to exhibit significant decrease in DFS after adjusting for the selected biomarkers and treatment . Conclusions TNBC incidence is high among African-American and Hispanic/Latino women residing in South Los Angeles . Our study also shows for the first time that TNBC was significantly associated with PTEN loss , high Ki67 and the CD44+/CD24- phenotype . The loss of PTEN impacts DFS significantly in African Americans BACKGROUND This study tested a breast cancer education intervention for African American women with poor screening histories . Disparities in rates of later-stage disease and death may be related to lower screening rates due to behavioral ( e.g. , knowledge gap ) and structural ( e.g. , access ) barriers . METHODS 94 African American women ( low-income , poor screening histories ) were r and omly assigned for an educational and on-site screening intervention , or non-intervention status . Primary care sites were used for educational purpose s. Three-month post-intervention  mammography  was assessed . RESULTS The intervention group had significantly higher screening rates than the non-intervention group . The latter had a knowledge gap , poor screening history , cancer fears , and insurance differences relative to the screened women . Screening was predicted by behavioral , rather than structural factors . CONCLUSIONS Since low-income African American women face behavioral and structural barriers to breast cancer screening , an educational program that improves knowledge levels and is offered in primary care sites can effectively impact screening Purpose Differences in health status and behavioral risk factors may explain racial/ethnic breast cancer disparities . We examined racial/ethnic differences in health status and behaviors among female breast cancer survivors compared to females without breast cancer . Methods Using cross-sectional data from the 2009 Behavioral Risk Factor Surveillance System , a national state-based , r and om sample telephone survey , we explored differences in self-rated health , obesity and selected behaviors ( physical activity , smoking , alcohol use , fruit , and vegetable consumption ) among females aged 18 years and older , who reported a previous breast cancer diagnosis ( survivors , n = 10,035 ) and those who reported no breast cancer history ( n = 234,375 ) by race/ethnicity . Adjusted prevalences of health status and behaviors , accounting for sociodemographics , comorbidities and health care access , were estimated by race/ethnicity . Results Compared to all other racial/ethnic groups , more white females reported heavy alcohol consumption and more black females reported obesity regardless of their breast cancer status . Among breast cancer survivors , more whites ( 33.7 % ) were former smokers compared to blacks ( 24.5 % ) , “ others ” ( 20.5 % ) , and Hispanics ( 16.2 % ) ( p = 0.001 ) . Racial/ethnic differences in obesity also varied by reported time since diagnosis ( p value = 0.018 ) . Among long-term survivors ( diagnosed > 5 years before interview ) , more black survivors ( 34.8 % ) reported obesity compared to white survivors ( 23.0 % ) . Also , among “ other ” race survivors , long-term survivors ( 22.0 % ) reported more obesity than survivors diagnosed less than 5 years before interview ( 7.8 % ) . Conclusions These findings suggest opportunities to increase health behaviors and reduce racial disparities among breast cancer survivors . Implication s for Cancer SurvivorsEngaging in healthy behaviors can play a significant role in enhancing health outcomes and quality of life of breast cancer survivors . More research is needed to better underst and racial differences in obesity , smoking and alcohol consumption in order to develop effective , culturally appropriate interventions to promote a healthy lifestyle after a breast cancer diagnosis Background This paper describes the ethnic and socioeconomic correlates of functioning in a cohort of long-term nonrecurring breast cancer survivors . Methods Participants ( n = 804 ) in this study were women from the Health , Eating , Activity , and Lifestyle ( HEAL ) Study , a population -based , multicenter , multiethnic , prospect i ve study of women newly diagnosed with in situ or Stages I to IIIA breast cancer . Measurements occurred at three timepoints following diagnosis . Outcomes included st and ardized measures of functioning ( MOS SF-36 ) . Results Overall , these long-term survivors reported values on two physical function subscales of the SF-36 slightly lower than population norms . Black women reported statistically significantly lower physical functioning ( PF ) scores ( P = 0.01 ) , compared with White and Hispanic women , but higher mental health ( MH ) scores ( P < 0.01 ) compared with White and Hispanic women . In the final adjusted model , race was significantly related to PF , with Black participants and participants in the “ Other ” ethnic category reporting poorer functioning compared to the White referent group ( P < 0.01 , 0.05 ) . Not working outside the home , being retired or disabled and being unemployed ( on leave , looking for work ) were associated with poorer PF compared to currently working ( both P < 0.01 ) . Conclusion These data indicate that race/ethnicity influences psychosocial functioning in breast cancer survivors and can be used to identify need for targeted interventions to improve functioning Lower socioeconomic status and lack of access to care are often implicated as plausible causes for African American women to present with later stage breast cancer than Caucasian women . Our objective is to determine if racial differences are present in newly diagnosed breast cancer in women of equivalent socioeconomic status . A retrospective review of prospect ively gathered data from women with newly diagnosed breast cancer was performed . All women presented to the indigent ( uninsured and below the poverty line ) breast clinic for evaluation and treatment of their breast pathology . Data pertaining to epidemiologic factors , diagnosis , pathology , and treatment were collected . The data were analyzed by chi-squared and tailed t-tests . Between March 2002 and May 2004 , 52 women ( African American=36 , Caucasian=16 ) were diagnosed with breast cancer at our clinic . The median age for both groups at presentation was 56.6 years . The staging assessment based on the pathologic size of the tumor was also equivalent between African American and Caucasian women at 2.29 cm and 2.21 cm , respectively . Metastatic lymph node involvement occurred in 14 women ( African American=7 , Caucasian=7 ) , with 19.4 % African American and 43.8 % Caucasian being node positive ( p=0.068 ) . In fact , there were no statistically significant differences between the races for menarche , menopause , body mass index ( BMI ) , duration of symptoms before presentation , type of diagnostic biopsy or surgery chosen , histology , receptor status , utilization of chemotherapy and radiation , and length of follow-up . The only statistical differences found were in the age of the first live birth ( African American=19 , Caucasian=22 ; p=0.028 ) , the use of ultrasound in initial evaluation of a breast mass ( less use in African American ; p=0.012 ) , and utilization of sentinel lymph node biopsy  ( Caucasian=75 % , African American=42 % ; p=0.026 ) . Breast cancer in African American women traditionally presents at a more advanced stage and with poor prognostic features . However , when matched for lower socioeconomic status , racial disparities essentially disappear The relation of body mass index ( BMI ) and weight gain to breast cancer risk is complex , and little information is available on Black women , among whom the prevalence of obesity is high . We assessed  BMI and weight gain  in relation to breast cancer risk in prospect i ve data from the Black Women 's Health Study . In 1995 , 59,000 African American women enrolled in the Black Women 's Health Study by completing mailed question naires .  Data on anthropometric factors were obtained at baseline and every 2 years afterwards . In 10 years of follow-up , 1,062 incident cases of breast cancer occurred . Incidence rate ratios ( IRR ) were computed in multivariable Cox proportional hazards regression . BMI at age 18 years of ≥25 relative to < 20 was associated with a reduced risk of breast cancer among both premenopausal women ( IRR , 0.68 ; 95 % confidence interval , 0.46 - 0.98 ) and postmenopausal women ( IRR , 0.53 ; 95 % confidence interval , 0.35 - 0.81 ) . There was an inverse association of current BMI with premenopausal breast cancer but no association with postmenopausal breast cancer , either overall or among never-users of hormone therapy . Weight gain was not associated with postmenopausal breast cancer risk . In analyses restricted to breast cancers that were estrogen and progesterone receptor positive , IRRs for current BMI and weight gain were elevated but not statistically significant . The findings indicate that being overweight at age 18 years is associated with a reduced risk of both premenopausal and postmenopausal breast cancer in African American women . Underst and ing the reasons for the association may help eluci date the pathways through which adolescent exposures influence breast cancer risk . The lack of association of obesity with receptor-negative tumors in postmenopausal African American women may partially explain why breast cancer incidence in older Black women is not high relative to other ethnic groups in spite of the high prevalence of obesity in Black women . ( Cancer Epidemiol Biomarkers Prev 2007;16(9):1795–802 BACKGROUND The lower breast cancer incidence in minority women and the higher breast cancer mortality in African American women than in white women are largely unexplained . The influence of breast cancer risk factors on these differences has received little attention . METHODS Racial/ethnic differences in breast cancer incidence and outcome were examined in 156,570 postmenopausal women participating in the Women 's Health Initiative . Detailed information on breast cancer risk factors including mammography was collected , and participants were followed prospect ively for breast cancer incidence , pathological breast cancer characteristics , and breast cancer mortality . Comparisons of breast cancer incidence and mortality across racial/ethnic groups were estimated as hazard ratios ( HRs ) and 95 % confidence intervals ( CIs ) from Cox proportional hazard models . Tumor characteristics were compared as odds ratios ( ORs ) and 95 % confidence intervals in logistic regression models . RESULTS After median follow-up of 6.3 years , 3938 breast cancers were diagnosed .  Age-adjusted incidences for all minority groups ( i.e. , African American , Hispanic , American Indian/Alaskan Native , and Asian/Pacific Isl and er ) were lower than for white women , but adjustment for breast cancer risk factors accounted for the differences for all but African Americans ( HR = 0.75 , 95 % CI = 0.61 to 0.92 ) corresponding to 29 cases and 44 cases per 10,000 person years for African American and white women , respectively . Breast cancers in African American women had unfavorable characteristics ; 32 % of those in African Americans but only 10 % in whites were both high grade and estrogen receptor negative ( adjusted OR = 4.70 , 95 % CI = 3.12 to 7.09 ) . Moreover , after adjustment for prognostic factors , African American women had higher mortality after breast cancer than white women ( HR = 1.79 , 95 % CI = 1.05 to 3.05 ) corresponding to nine and six deaths per 10 000 person-years from diagnosis in African American and white women , respectively . CONCLUSION Differences in breast cancer incidence rates between most racial/ethnic groups were largely explained by risk factor distribution except in African Americans . However , breast cancers in African American women more commonly had characteristics of poor prognosis , which may contribute to their increased mortality after diagnosis Background Cancer of the uterine corpus is the most common gynecologic malignancy and the fourth most common cancer in U.S. women . There is a racial disparity in the survival from endometrial cancer and this may be addressed by culturally-tailored lifestyle interventions to help African American ( AA ) endometrial cancer survivors lose weight or maintain a healthy weight . Objective The overall purpose of this pilot study is to develop and evaluate a culturally-tailored lifestyle intervention to help AA uterine cancer survivors reduce their risk of cancer recurrence and improve their quality of life through healthy eating , physical activity , and weight management . While many interventions have been evaluated to assist cancer survivors through diet and physical activity , few have focused on AA women with a uterine cancer diagnosis . Methods Community-engaged research principles are being followed . This study was developed with input from the Augusta University ( AU ) College of Nursing Community Advisory Board ( CAB ) and the Division of Gynecologic Oncology at the Georgia Cancer Center at AU . Weekly sessions throughout a 12-week intervention will include physical activity and lectures on improving nutritional status . The pre/post-test design includes baseline and 6-month follow-up , where participants will complete a question naire that assesses knowledge and attitudes about physical activity , nutrition , uterine cancer , social support , and quality of life . Conclusions From this pilot study , we will learn more about the feasibility and integration of healthy lifestyle interventions in this patient population , and the results can provide an opportunity for a larger-scale , multi-center study with a r and omized controlled design Purpose 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 . Patients and Methods Early-stage ( I-III ) AABCS were r and omly assigned to a 6-month interventionist-guided ( n = 125 ) or self-guided ( n = 121 ) weight loss program supporting behavioral changes to promote a 5 % weight loss .  Anthropometric , body composition , and behavioral data were collected at baseline , postintervention ( 6 months ) , and follow-up ( 12 months ) . Descriptive statistics and mixed models analyses assessed differences between groups over time . Results Mean ( ± st and ard deviation ) age , and body mass index were 57.5 ( ± 10.1 ) years and 36.1 ( ± 6.2 ) kg/m2 , respectively , and 82 % had stage I or II breast cancer . Both groups lost weight . Mean and percentage of weight loss were greater in the guided versus self-guided group ( at 6 months : 3.5 kg v 1.3 kg ; P < .001 ; 3.6 % v 1.4 % ; P < .001 , respectively ; at 12 months : 2.7 kg v 1.6 kg ; P < .05 ; 2.6 % v 1.6 % ; P < .05 , respectively ) ; 44 % in the guided group and 19 % in the self-guided group met the 5 % goal . Body composition and behavioral changes were also greater in the interventionist-guided group at both time points . Conclusion The study supports the efficacy of a community-based interventionist-guided weight loss program targeting AABCS .  Although mean weight loss did not reach the targeted 5 % , the mean loss of > 3 % at 6 months is associated with improved health outcomes . Affordable , accessible health promotion programs represent a critical re source for AABCS Purpose The objective of this study was to evaluate whether time spent sitting at work or watching television was associated with breast cancer risk among African American women . Methods The Black Women ’s Health Study ( analytic cohort = 46,734 ) is an ongoing prospect i ve cohort study of African American women ages 21–69 at baseline ( 1995 ) . Question naire data were used to estimate sedentary time . Total time spent  sitting at work and watching television ( individually and combined ) at baseline and up date d through follow-up ( 1995–2001 ) and breast cancer incidence ( n = 2,041 incident cases , 1995–2013 ) was evaluated using proportional hazards regression . Results Higher total time spent sitting at baseline ( ≥10 vs. < 5 h/day , HR 1.27 , 95 % CI 1.06 , 1.53 ) and up date d through follow-up ( ≥10 vs. < 5 h/day , HR 1.38 , 95 % CI 1.14 , 1.66 ) was associated with an increased breast cancer risk . Associations were stronger for hormone receptor-negative tumors ( ≥10 vs. < 5 h/day , HR 1.70 , 95 % CI 1.12 , 2.55 ) compared to hormone receptor-positive tumors ( ≥10 vs. < 5 h/day , HR 1.16 , 95 % CI 0.88 , 1.52 ) , but tests for heterogeneity were not statistically significant ( p heterogeneity = 0.31 ) . Positive associations between total time spent sitting and breast cancer incidence did not differ by physical activity level or body composition measurements . Conclusions Our findings suggest that high sedentary time may increase risk for breast cancer among African American women This study examined coping and distress in African American ( n=8 ) , Hispanic ( n=53 ) , and non-Hispanic White ( n=70 ) women with early stage breast cancer . The participants were studied prospect ively across a year beginning at the time of surgery . African American women reported the lowest levels of distress ( particularly before surgery ) and depression symptoms . Hispanic women reported the highest levels of self-distraction as a coping response , non-Hispanic Whites reported the highest use of humor . Hispanics reported the highest levels of venting , African Americans reported the lowest levels . African American and Hispanic women reported more religious coping than non-Hispanic Whites . The data also provided evidence of a maladaptive spiral of distress and avoidant coping over time . Although some ethnic differences were identified , findings also point to a great many similarities across groups Background : Given the disproportionately high incidence of early-onset breast cancer and aggressive subtypes , such as estrogen receptor (ER)-negative tumors , in African American ( AA ) women , elucidation of risk factors for early onset of specific subtypes of breast cancer is needed . Methods : We evaluated associations of reproductive , anthropometric , and other factors with incidence of invasive breast cancer  by age at onset ( < 45 , ≥45 ) in 57,708 AA women in the prospect i ve Black Women 's Health Study . From 1995 to 2013 , we identified 529 invasive breast cancers among women < 45 years of age ( 151 ER− , 219 ER+ ) and 1,534 among women ≥45 years ( 385 ER− , 804 ER+ ) . We used multivariable Cox proportional hazards regression to estimate hazard ratios ( HRs ) for associations by age and ER status . Results : Higher parity , older age at first birth , never having breastfed , and abdominal adiposity were associated with increased risk of early-onset ER− breast cancer : HRs were 1.71 for ≥3 births versus one birth ; 2.29 for first birth after age 25 versus < 20 years ; 0.61 for ever having breastfed versus never ; and 1.64 for highest versus lowest tertile of waist-to-hip ratio . These factors were not associated with ER− cancer in older women or with ER+ cancer regardless of age . Conclusions : Differences in risk factors by ER subtype were observed for breast cancer diagnosed before the age of 45 years . Impact : Etiological heterogeneity by tumor subtype in early-onset breast cancer , in combination with a higher prevalence of the risk factors in AA women , may explain , in part , racial disparities in breast cancer incidence . Cancer Epidemiol Biomarkers Prev ; 26(2 ) ; 270–7 . © 2016 AACR African-American ( AA ) women have higher rates of breast cancer ( BCa ) mortality than Caucasian women , and a recent study using data from the Surveillance , Epidemiology and End Results ( SEER ) registry suggests that this disparity may be due , in part , to the poorer health status of AAs at diagnosis and not treatment related issues . R and omized controlled trials involving supervised aerobic and resistance exercise have shown improved body composition and improvement in cancer-related biomarkers in BCa patients and may lead to improved recurrence and survival rates ; however , most trials have focused on Caucasians and many have been conducted in academic- and clinic-based setting s. We evaluated the feasibility of conducting a 20-week , supervised , resistance training , group exercise intervention coupled with a support group and home walking program utilizing facilities and personnel at a community cancer support center ( The Gathering Place , Beachwood , Ohio ) in AA Stage I-III BCa survivors who were within 12 months of completing treatment ( surgery , chemotherapy , and /or breast irradiation )  ; and , evaluated the potential effects of this intervention on physical measures and cancer-related biomarkers . 27 patients provided informed consent and 19 participated in the program . On average , attendance rates were 70.0 % ± 19.1 % for the exercise sessions and 63.1 % ± 13.8 % for the support group . We observed a significant decrease in circulating C-peptide levels ( B : 893.9 ± 399.1 pg/mL ; EOI : 723.9 ± 319.0 pg/mL ; p=0.01 ) . Although we did not observe a significant decrease in weight in the entire sample , there was a significant decrease in waist circumference and percent total body fat among those who attended 70 % or more of the exercise sessions . In summary , we demonstrated that conducting lifestyle interventions in AA BCa survivors in a community setting is feasible . Future interventions should invoke strategies to enhance adherence and include a structured dietary intervention to enable greater weight loss PURPOSE : Older single African-American women are the population that is least likely to use screening procedures because of cognition-related , income-related , social-support-related and medical care-related barriers . This study aims to evaluate a breast screening intervention program developed according to socioeconomic , cultural , psychological and behavioral characteristics of older single African-American women . METHODS : Ten public housing complexes were r and omly assigned to either intervention or control group .  African-American women aged 65 and over were recruited into the study if they were widowed , divorced , separated or never-married in the preceding year , and did not have a history of breast cancer ( n = 325 ) . Delivered by lay health educators , the intervention program targeted increasing knowledge on breast health and breast screening , reducing emotional or psychological problems , and increasing support from the significant others of study women . Breast screening-related cognition and behavior were measured at pre-intervention and post-intervention . RESULTS : Comparisons of the pre-intervention and post-intervention measurements showed that while the proportion of women who had a clinical breast examination or mammogram in the preceding year was decreased at the post-intervention in the control group , it was increased in the intervention group . However , the differences did not reach a significant level . No consistent patterns could be found in changes of variables in knowledge , attitudes and beliefs . These results remained similar when potential confounding factors were adjusted using mixed model regression analyses . CONCLUSIONS : These results did not suggest significant effects of an intervention program which used lay health educators to promote breast cancer screening in older single African-American women OBJECTIVE Compare effects of narrative and informational videos on use of mammography , cancer-related beliefs , recall of core content and a range of reactions to the videos . METHOD African American women ( n=489 ) ages 40 and older were recruited from low-income neighborhoods in St. Louis , MO and r and omly assigned to watch a narrative video comprised of stories from African American breast cancer survivors ( Living Proof ) or a content-equivalent informational video using a more expository and didactic approach ( Facts for Life ) . Effects were measured immediately post-exposure and at 3- and 6-month follow-up . RESULTS The narrative video was better liked , enhanced recall , reduced counterarguing , increased breast cancer discussion s with family members and was perceived as more novel . Women who watched the narrative video also reported fewer barriers to mammography , more confidence that mammograms work , and were more likely to perceive cancer as an important problem affecting African Americans .  Use of mammography at 6-month follow-up did not differ for the narrative vs. informational groups overall ( 49 % vs. 40 % , p=.20 ) , but did among women with less than a high school education ( 65 % vs. 32 % , p<.01 ) , and trended in the same direction for those who had no close friends or family with breast cancer ( 49 % vs. 31 % , p=.06 ) and those who were less trusting of traditional cancer information sources ( 48 % vs. 30 % , p=.06 ) . CONCLUSIONS Narrative forms of communication may increase the effectiveness of interventions to reduce cancer health disparities . PRACTICE IMPLICATION S Narratives appear to have particular value in certain population sub-groups ; identifying these groups and matching them to specific communication approaches may increase effectiveness
Conclusions : The available literature suggests that African American breast cancer survivors adhere to interventions of various modalities and are capable of making modest to significant changes .
Background : African American breast cancer survivors have a higher incidence of estrogen receptor negative and basal-like ( e.g. , triple negative ) tumors , placing them at greater risk for poorer survival when compared to women of other racial and ethnic groups .
While access to equitable care , late disease stage at diagnosis , tumor biology , and sociodemographic characteristics contribute to health disparities , poor lifestyle characteristics ( i.e. , inactivity , obesity , and poor diet ) contribute equally to these disparities .
Lifestyle interventions hold promise in shielding African American survivors from second cancers , comorbidities , and premature mortality , but they are often underrepresented in studies promoting positive behaviors .
This review examined the available literature to document health behaviors and lifestyle intervention ( i.e. , obesity , physical activity , and sedentary behavior ) studies in African American breast cancer survivors .