Daughters and Mothers Against Breast Cancer (DAMES): main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters

Wendy Demark-Wahnefried, Lee W Jones, Denise C Snyder, Richard J Sloane, Gretchen G Kimmick, Daniel C Hughes, Hoda J Badr, Paige E Miller, Lora E Burke, Isaac M Lipkus, Wendy Demark-Wahnefried, Lee W Jones, Denise C Snyder, Richard J Sloane, Gretchen G Kimmick, Daniel C Hughes, Hoda J Badr, Paige E Miller, Lora E Burke, Isaac M Lipkus

Abstract

Background: Few studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members. Given the role of obesity in the primary and tertiary prevention of breast cancer, the authors explored the feasibility of a mother-daughter weight loss intervention.

Methods: A randomized controlled trial of a mailed weight loss intervention was undertaken among 68 mother-daughter dyads (n = 136), each comprised of a survivor of breast cancer (AJCC stage 0-III) and her adult biological daughter. All women had body mass indices ≥ 25 kg/m(2) and underwent in-person assessments at baseline, 6 months, and 12 months, with accelerometry and exercise capacity performed on a subset of individuals. All women received a personalized workbook and 6 newsletters over a 1-year period that promoted weight loss; exercise; and a nutrient-rich, low-energy density diet. A total of 25 dyads received individually tailored instruction (individual), 25 dyads received team-tailored instruction (TEAM), and 18 dyads received standardized brochures (control).

Results: The trial met its accrual target, experienced 90% retention, and caused no serious adverse events. Significant differences in baseline to 12-month changes were observed between individual versus control mothers for body mass index, weight, and waist circumference (WC); significant differences also were observed in the WC of corresponding daughters (P < .05). Significant differences were found between individual versus control and team versus control dyads for WC (P = .0002 and .018, respectively), minutes per week of physical activity (P = .031 and .036, respectively), and exercise capacity (P = .047 for both).

Conclusions: Significant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members. For greater impact, more research is needed to expand this work beyond the mother-daughter dyad.

Keywords: breast neoplasms; diet; exercise; intervention studies; obesity; survivors; weight loss.

© 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards Of Reporting Trials) diagram for the current study is shown. BMI indicates body mass index.
Figure 2
Figure 2
Illustration of intervention materials used in the DAMES (Daughters and MothErS Against Breast Cancer) trial is shown.

References

    1. Demark-Wahnefried W, Platz EA, Ligibel JA, et al. The role of obesity in cancer survival and recurrence. Cancer Epidemiol Biomarkers Prev. 2012;21:1244–1259.
    1. Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:242–274.
    1. Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005;23:5814–5830.
    1. National Coalition for Cancer Survivorship. 2013. . Accessed October 3.
    1. Kim Y, Wellisch DK, Spillers RL. Effects of psychological distress on quality of life of adult daughters and their mothers with cancer. Psychooncology. 2008;17:1129–1136.
    1. Wiggs CM. Mothers and daughters: intertwining relationships and the lived experience of breast cancer. Health Care Women Int. 2011;32:990–1008.
    1. Sinicrope PS, Brockman TA, Patten CA, et al. Factors associated with breast cancer prevention communication between mothers and daughters. J Womens Health (Larchmt) 2008;17:1017–1023.
    1. Noone J, Young HM. Rural mothers' experiences and perceptions of their role in pregnancy prevention for their adolescent daughters. J Obstet Gynecol Neonatal Nurs. 2010;39:27–36.
    1. Ransdell LB, Dratt J, Kennedy C, O'Neill S, DeVoe D. Daughters and mothers exercising together (DAMET): a 12-week pilot project designed to improve physical self-perception and increase recreational physical activity. Women Health. 2001;33:101–116.
    1. Ransdell LB, Taylor A, Oakland D, Schmidt J, Moyer-Mileur L, Shultz B. Daughters and mothers exercising together: effects of home- and community-based programs. Med Sci Sports Exerc. 2003;35:286–296.
    1. Winzenberg TM, Oldenburg B, Frendin S, De WL, Jones G. A mother-based intervention trial for osteoporosis prevention in children. Prev Med. 2006;42:21–26.
    1. Stolley MR, Fitzgibbon ML. Effects of an obesity prevention program on the eating behavior of African American mothers and daughters. Health Educ Behav. 1997;24:152–164.
    1. Wallace JP, Raglin JS, Jastremski CA. Twelve month adherence of adults who joined a fitness program with a spouse vs without a spouse. J Sports Med Phys Fitness. 1995;35:206–213.
    1. Kim Y, Kashy DA, Wellisch DK, Spillers RL, Kaw CK, Smith TG. Quality of life of couples dealing with cancer: dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers. Ann Behav Med. 2008;35:230–238.
    1. Kim Y, Carver CS, Spillers RL, Crammer C, Zhou ES. Individual and dyadic relations between spiritual well-being and quality of life among cancer survivors and their spousal caregivers. Psychooncology. 2011;20:762–770.
    1. Nezu AM, Nezu CM, Felgoise SH, McClure KS, Houts PS. Project Genesis: assessing the efficacy of problem-solving therapy for distressed adult cancer patients. J Consult Clin Psychol. 2003;71:1036–1048.
    1. Godin G, Jobin J, Bouillon J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health. 1986;77:359–362.
    1. Lohman T, Martorell R, Roche A. Anthropometric Standardization Manual. Champaign. IL: Human Kinetics; 1988
    1. Jones LW, Eves ND, Haykowsky M, Joy AA, Douglas PS. Cardiorespiratory exercise testing in clinical oncology research: systematic review and practice recommendations. Lancet Oncol. 2008;9:757–765.
    1. Balady GJ, Arena R, Sietsema K, et al. American Heart Association Exercise, Cardiac Rehabilitation; Prevention Committee of the Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council on Peripheral Vascular Disease; Interdisciplinary Council on Quality of Care and Outcomes Research. Clinician's Guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association. Circulation. 2010;122:191–225.
    1. Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB. Evaluation of the Healthy Eating Index-2005. J Am Diet Assoc. 2008;108:1854–1864.
    1. Miller PE, Mitchell DC, Harala PL, Pettit JM, Smiciklas-Wright H, Hartman TJ. Development and evaluation of a method for calculating the Healthy Eating Index-2005 using the Nutrition Data System for Research. Public Health Nutr. 2011;14:306–313.
    1. Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care. 1992;30:473–483.
    1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs. NJ: Prentice Hall; 1986.
    1. Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR. The development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987;16:825–836.
    1. Sloane R, Snyder DC, Demark-Wahnefried W, Lobach D, Kraus WE. Comparing the 7-day physical activity recall with a triaxial accelerometer for measuring time in exercise. Med Sci Sports Exerc. 2009;41:1334–1340.
    1. Doyle C, Kushi LH, Byers T, et al. 2006 Nutrition, Physical Activity and Cancer Survivorship Advisory Committee; American Cancer Society. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006;56:323–353.
    1. United States Department of Agriculture Center For Nutrition Policy and Promotion. US Dietary Guidelines. 2010. . Accessed October 3, 2013.
    1. Frankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc. 2005;105:775–789.
    1. Prochaska JO, Velicer WF, Rossi JS, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychol. 1994;13:39–46.
    1. Kelley HH, Holmes JG, Kerr NL, Reis HT, Rusbult CE, Van Lange PAM. An Atlas of Interpersonal Situations. New York: Cambridge University Press; 2003.
    1. Lyons RF, Michelson KD, Sullivan MJ, Coyne JC. Coping as a communal process. J Soc Pers Relations. 1998;15:579–605.
    1. Cohen J. NJ: Lawrence Erlbaum Associates; 1988. Statistical Power Analysis for the Behavioral Sciences. Hillsdale.
    1. Zhang S, Midthune D, Guenther PM, et al. A new multivariate measurement error model with zero-inflated dietary data, and its application to dietary assessment. Ann Appl Stat. 2011;5:1456–1487.
    1. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34:1481–1486.
    1. McLean N, Griffin S, Toney K, Hardeman W. Family involvement in weight control, weight maintenance and weight-loss interventions: a systematic review of randomised trials. Int J Obes Relat Metab Disord. 2003;27:987–1005.
    1. Glenny AM, O'Meara S, Melville A, Sheldon TA, Wilson C. The treatment and prevention of obesity: a systematic review of the literature. Int J Obes Relat Metab Disord. 1997;21:715–737.
    1. Wiehs KL, Fisher L, Baird M. Families, health, and behavior. Family Systems Health. 1999;20:7–46.
    1. Lewis MA, McBride CM, Pollak KI, Puleo E, Butterfield RM, Emmons KM. Understanding health behavior change among couples: an interdependence and communal coping approach. Soc Sci Med. 2006;62:1369–1380.
    1. Brownell KD, Kelman JH, Stunkard AJ. Treatment of obese children with and without their mothers: changes in weight and blood pressure. Pediatrics. 1983;71:515–523.
    1. Gorin A, Phelan S, Tate D, Sherwood N, Jeffery R, Wing R. Involving support partners in obesity treatment. J Consult Clin Psychol. 2005;73:341–343.
    1. Ristovski-Slijepcevic S, Chapman GE, Beagan BL. Being a ‘good motherÇ: dietary governmentality in the family food practices of three ethnocultural groups in Canada. Health (London) 2010;14:467–483.
    1. Badr H, Krebs P. A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology. 2013;22:1688–1704.
    1. Rossi AS, Rossi PH. Of Human Bonding: Parent-Child Relationships Across the Lifecourse. New York: Aldine; 1990.
    1. Demark-Wahnefried W, Clipp EC, Lipkus IM, et al. Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol. 2007;25:2709–2718.
    1. Morey MC, Snyder DC, Sloane R, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009;301:1883–1891.
    1. Mosher CE, Fuemmeler BF, Sloane R, et al. Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors' dietary outcomes. Psychooncology. 2008;17:1014–1023.

Source: PubMed

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