Breast Cancer Risk Reduction in American Indian Women

Institution: University of California, Davis
Investigator(s): Marlene von Friederichs-Fitzwater, Ph.D. - Linda Navarro,  -
Award Cycle: 2008 (Cycle 14) Grant #: 14BB-3100 Award: $10,000
Award Type: CRC Full Research Award
Research Priorities
Community Impact of Breast Cancer>Disparities: eliminating the unequal burden of breast cancer

Initial Award Abstract (2008)

Breast carcinoma in past generations was reported to be very rare among American Indian women, but incidence and mortality rates have been increasing in the past 20 years, and are projected to continue to increase. Breast cancer is now the second leading cause of cancer death among American Indian women. Mortality from breast cancer could be reduced by more than 30% in American Indian women if current recommendations for screening were followed. American Indians have had the poorest cancer screening rates of any ethnic group (42% of American Indian women 50 years of age and older were screened in California in 2007), and those with breast cancer have had the lowest 5-year survival rate when compared to other ethnic groups. Older American Indian women (65 and over) are even less likely to be screened for breast cancer.

Obesity has also become a major health problem for American Indians in the past 1-2 generations and is believed to be associated with turning away from traditional diets to Western diets of fast food and high-fat foods and a rapid change from active to sedentary lifestyles. Obesity is linked not only to diabetes and heart disease, but is a risk factor for breast cancer, particularly in post-menopausal women. Intervention studies are urgently needed in American Indian communities to develop and test effective strategies for weight reduction. The goals of this study are to increase breast cancer screening rates from 42% to 70% or higher; and to demonstrate sustained breast cancer risk reduction screening rates and lifestyle behavior changes. The Program is designed to increase knowledge about breast health and breast cancer risk reduction; to reduce psychosocial and psycho-cultural barriers to mammogram screening; and to integrate traditional health beliefs and behaviors with Western medicine to encourage and support the adoption of healthy lifestyles by American Indian women, specifically to reduce dietary fat intake and increase moderate daily physical activity.

Four urban and tribal health clinic partner research sites will recruit and enroll 500 American Indian women who will receive the Motherís Wisdom Breast Health Program interactive, multimedia DVD (plays on standard DVD player and TV monitor); a Personal Journal with stories of behavior change, recipes, and food and physical activity logs; and an electronic pedometer. Community health workers from the four clinics will be trained as Community Health Guides and will serve as navigators to guide the women from enrollment through mammography screening and lifestyle behavior modification. Data will be collected at pre- and 10, 30, 60, and 120 day intervals. The women will be supported with opportunities to share experiences, ideas and challenges in regular Talking Circles (small groups) and by regular contact from the Community Health Guides.

Final Report (2009)

This one-year planning grant enabled the academic and community investigators to address scientific and collaborative issues raised during the peer review of a CRC Full Award application in collaboration with the UC Davis American Indian Advisory Council and the partnering American Indian health clinics. Through a series of meetings, a workshop and consultations with the CBCRP staff and advisors, the team achieved the necessary strengthening of the scientific elements and the collaborative elements of the application resulting in meeting the final goals of submitting a draft research plan to the CBCRP for feedback and the submission of a revised CRC application by the January 2009 grant submission deadline.