African American (AA) survivors of breast cancer are at increased risk for second cancers and comorbid conditions due to genetic predisposition, sociodemographic, and lifestyle factors. Despite their increased vulnerability to premature death and disability, AA survivors are underrepresented in prospective studies that examine health behaviors and intervention studies that promote health behaviors that improve breast cancer- specific and overall survival.
Specific Aims : (1) To examine the relationship between physical activity (PA) and several outcomes including HRQOL, BMI, and comorbid conditions among women participating in the Women's Healthy Eating and Living (WHEL) Study by determining whether the strength of the association differs by race after adjusting for treatment related variables;(2) To examine the feasibility of recruiting and retaining 80 overweight and obese AA survivors of breast cancer to a 6 month aerobic and resistance training intervention and determine whether survivors will benefit from this type of intervention. Study Design: The WHEL Study is a randomized controlled trial designed to evaluate the effects of a dietary intervention on recurrence and survival. PA and outcome data for the WHEL Study were assessed at baseline, 12 months, and 48 months. Participants included 3088 women (n=118 AA) who were diagnosed 1 to 4 years prior to the enrollment date with early stage disease (Stage I to Stage IIIA). The design of the feasibility study is a randomized controlled trial. Participants will be randomized to a 6 month, home-based aerobic and resistance training intervention consisting of personalized telephone counseling, culturally-tailored print materials, pedometers, and resistance training bands or a usual care condition consisting of standard dietary information. Study outcomes for the feasibility study will be measures at baseline, 3 months, and 6 months. The sample will consist of 80 overweight and obese AA survivors of breast cancer. Objective/Hypothesis: We hypothesize that racial differences will exist in the health benefits associated with PA and that most (>80%) of our recruited survivors will remain in the intervention and experience improvements in accelerometer counts, body mass index, quality of life, and psychosocial constructs (e.g., self efficacy). Summary: In sum, the proposed study will provide preliminary data on the health benefits associated with PA among AA survivors of breast cancer and provide valuable information that will inform the development of future home-based PA interventions that are tailored to the needs of AA survivors of breast cancer.

Public Health Relevance

African American survivors of breast cancer are at increased risk for recurrence, premature mortality, and comorbidites. The development of interventions that are tailored to the individual needs of this vulnerable population may improve the quality and quality of their lives, as well as result in creation of research tools, and strategies that may help AA survivors adopt and maintain healthy lifestyle behaviors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Scientist Development Award - Research & Training (K01)
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Subcommittee B - Comprehensiveness (NCI)
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Davani, Behrous
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University of North Texas
Schools of Public Health
Fort Worth
United States
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Meadows, Rachel; Paxton, Raheem J (2018) Stage Validity of the Health Action Process Approach in African American Breast Cancer Survivors. J Immigr Minor Health 20:147-154
Swen, Melody; Mann, Amandeep; Paxton, Raheem J et al. (2017) Do Cancer-Related Fatigue and Physical Activity Vary by Age for Black Women With a History of Breast Cancer? Prev Chronic Dis 14:E122
Paxton, Raheem J; Zhang, Lingfeng; Wei, Changshuai et al. (2017) An exploratory decision tree analysis to predict physical activity compliance rates in breast cancer survivors. Ethn Health :1-13
Meadows, Rachel; Bonner, Timethia; Dobhal, Megha et al. (2017) Pathways between physical activity and quality of life in African-American breast cancer survivors. Support Care Cancer 25:489-495
Paxton, Raheem J; Hajek, Richard; Newcomb, Patricia et al. (2017) A Lifestyle Intervention via Email in Minority Breast Cancer Survivors: Randomized Parallel-Group Feasibility Study. JMIR Cancer 3:e13
Paxton, Raheem J; Anderson, Alexandra; Sarkar, Sonali et al. (2016) Breaking Up Sedentary Behavior: Perceptions From Cancer Survivors. Cancer Nurs 39:272-8
Paxton, Raheem J (2016) The health action process approach applied to African American breast cancer survivors. Psychooncology 25:648-55
Pandya, Ekta; Mistry, Jay; Dobhal, Megha et al. (2016) Construct Validity of the Late-Life Function and Disability Instrument in African American Breast Cancer Survivors. Healthcare (Basel) 4:
Paxton, Raheem J; Gao, Yong; Herrmann, Stephen D et al. (2015) Measurement properties of the sedentary behavior strategy self-management instrument in African-American breast cancer survivors. Am J Health Behav 39:175-82
Jones, Antwan; Paxton, Raheem J (2015) Neighborhood Disadvantage, Physical Activity Barriers, and Physical Activity among African American Breast Cancer Survivors. Prev Med Rep 2:622-627

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