Breast cancer (BC) survival rates are significantly lower for African-American (AA) women compared to European American (EA) women even after controlling for age, SES, tumor stage at diagnosis, hormone receptor status, histology, and menopausal status. This disparity is particularly evident in Chicago where mortality rates for AA women exceed those for EA women by 116 percent. Not only are AA women with BC more likely than EA women to die from their cancer, they are also more likely to die from comorbid conditions including diabetes and hypertension. Poor diet, lack of physical activity, and obesity contribute to breast cancer progression and the development and exacerbation of many comorbid conditions. Efforts to reduce the high mortality rates observed in AA women with breast cancer are critically needed. Addressing poor diet, lack of physical activity, and high rates of obesity may provide the best near-term opportunity to decrease breast cancer and all-cause mortality among AA BC survivors. Although several studies have examined weight loss interventions among EA BC survivors, no interventions developed specifically for AA BC survivors have been examined. Moving Forward is a six-month cognitive-behavioral community-based weight loss intervention that was developed in collaboration with AA BC survivors. This application proposes a randomized intervention study to examine the effects of Moving Forward, compared to a six-month cognitive-behavioral community-based weight loss intervention that was developed in collaboration with AA BC survivors, on BMI and behavioral, biological, and psychosocial outcomes in 240 obese AA women diagnosed with Stage I, II, or III breast cancer. We have partnered with the Chicago Park District (CPD) to implement the study within six predominantly AA Chicago communities. In addition to having an experienced, interdisciplinary study team, this project has several other strengths including innovation in its focus on weight loss in AA BC survivors;the potential for having a positive impact on morbidity and mortality related to breast cancer and comorbid conditions among AA BC survivors;and the potential for sustainability within CPD community programs.

Public Health Relevance

Breast cancer mortality rates are consistently higher for African-American women (AA) as compared to European American (EA) women. Furthermore, AA women with breast cancer are more likely than EA women with breast cancer to die from co-morbid conditions such as hypertension and diabetes. Obesity, poor diet and sedentary lifestyles may contribute to these disparities. Weight loss interventions, developed for AA breast cancer survivors, are needed. The proposed study will explore the efficacy of a weight loss intervention on BMI, biological markers of breast cancer progression and co-morbid conditions and psychosocial factors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Psychosocial Risk and Disease Prevention Study Section (PRDP)
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Alfano, Catherine M
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University of Illinois at Chicago
Internal Medicine/Medicine
Schools of Medicine
United States
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Stolley, Melinda; Sheean, Patricia; Gerber, Ben et al. (2017) Efficacy of a Weight Loss Intervention for African American Breast Cancer Survivors. J Clin Oncol 35:2820-2828
Sheean, Patricia; Liang, Huifang; Schiffer, Linda et al. (2016) Assessing the prevalence of compromised bone health among overweight and obese African-American breast cancer survivors: a case-control study. J Cancer Surviv 10:21-30
Stolley, Melinda R; Sharp, Lisa K; Fantuzzi, Giamila et al. (2015) Study design and protocol for moving forward: a weight loss intervention trial for African-American breast cancer survivors. BMC Cancer 15:1018