Progress 08/01/04 to 07/31/07
Outputs
OUTPUTS: The Cornell University Program on Breast Cancer and Environmental Risk Factors (BCERF) carried out both scholarly research and public education on cancer risk linked to diet/lifestyle and chemical exposures. Seven new fact sheets were produced examining: breast cancer risk factors associated with diet and lifestyle, ochratoxin A, breast cancer risk associated with ionizing radiation, herbal medicines, dietary carbohydrates, and vegetables and fruits (revised) and farm family pesticide exposure. Three more fact sheets on physical activity and breast cancer risk and the association of obesity with breast cancer and cancer in general are in press. A total of 55 fact sheets and their bibliographies are now posted on BCERF's web site http://envirocancer.cornell.edu/. The associated bibliographic database was expanded to 11,179 citations. Five articles in the BCERF newsletter (reaching 3,900 people monthly) were composed on antibiotic and breast cancer risk, obesity and
environment, abortion and breast cancer risk, risk of low level radiation, and the recent decline in breast cancer incidence. Three tip sheets for low literacy readers were revised, printed, and posted on the BCERF web site. Review articles and electronic research updates were nationally disseminated to policy makers, scientists, and environmental groups. A resource binder of BCERF materials was sent to 400 occupational health nurses in the Northeast. An average evaluation score of 4.7 (strongly agree equals 5) was given for the overall usefulness of the materials. Farm families were reached via an annual farm show (75,000 yearly participants). Substantial progress was made with research projects to test and evaluate environment-based risk reduction strategies in rural communities. A pilot study of an environmentally based healthy eating and active living model intervention for rural communities was completed. In the study community, 205 women joined one of 12 community walking teams.
Led by volunteer team leaders, the members of the walking teams logged a total of more than 70 million steps, the equivalent of about 30 thousand miles. Community chef volunteers added healthy food options to 22 separate community events that reached 542 community residents. A follow-up in four communities incorporated lessons from the pilot study. Improvements were made in participant reporting, pedometer use, definition of changes in the food environment and development of independence from investigators. Data analysis is incomplete but we can report that on average 71% of enrolled participants reported walking and that on average 41% of the enrolled met their goal. Results of the effects on the eating and social environments are under analysis.
PARTICIPANTS: Individuals Drs. Carol Devine and Barbour Warren acted as Co-principle Investigators on this project. Mary Maley worked as a project assistant and Yvonne Chu and Laura Sugarwala acted as student assistants. Partner Organizations Partner organizations for this project were Cornell Co-operative Extension of Delaware County New York and Cornell Co-operative Extension of Chautauqua County New York. Collaborators and contacts Collaborations were conducted with Jeannie Darling of Cornell Co-operative Extension of Delaware County New York and Linda Burton of Cornell Co-operative Extension of Delaware County New York. Training or professional development: We provided in-service education for 200 participants in the project. Two undergraduate students were also trained and participated in carrying out and analyzing the intervention project.
TARGET AUDIENCES: Target audiences: The target audience for this project is employed women living in rural communities. Efforts: Instruction in the background of the project and the proper use of pedometers was provided for the 200 participants at the start of the project. Project leaders were contacted to discuss issues in the execution of the intervention on a regular basis over the course of the project the intervention.
Impacts
The BCERF website was totally revamped and remained a highly active site. During 2006 there were on average 75,000 hits per month to internal pages within the BCERF website. Over a nine month period there were 112,667 fact sheet downloads (equivalent to 412/day). Assessment tools and procedures used for our study of an environmental approach to obesity prevention were shared with nutrition and health professionals via a BCERF web tutorial entitled: How to Develop an Environmental Intervention for Preventing Overweight and Obesity. Web casts of three hour long presentations were also posted: 1) Environmental Chemicals and Breast Cancer, Why is There Concern? 2) Critical Periods of Susceptibility for Breast Cancer Risk and 3) Diet, Lifestyle and Breast Cancer Risk. Our environmental approach for weight gain prevention was disseminated at scientific and professional meetings. An estimated 1,500 researchers, health professionals, extension educators, and community leaders
were reached at such meetings. Dr Warren was interviewed by popular magazines, newspapers and radio stations. These include: Scientific American (circulation 638,000), All You magazine (circulation 500,000), Pink magazine (readership of 600,000), the Philadelphia news (circ. 638,000), Women's Health Advisor (circ. 38,000) and radio stations in Salt Lake City, Utah (KUTR AM 820; 10,000 listeners), and Winnipeg, Canada; (Radio CJOB; 1,000,000 listeners). Presentations were also given to the public (about 250 participants). BCERF has conducted work shops (approximately 50 attendees) on the use of our program to prevent weight gain and a detailed description has been posted on our web site. Our pilot intervention produced very favorable results. Over 10 weeks, the 205 participants had logged over 70 million walking steps or about 30,000 miles. 166 people (81%) met the project goal (adding 2000 steps at least 3 days/week) for 3 or more weeks and 95 (46%) met the goal for more than 7 weeks.
The greatest increase was seen in participants who reported the fewest steps at baseline. At the end of the intervention, healthy food options had been added at 22 separate community events attended by a total of 542 people. Compared to baseline levels, intervention participants (123-135) were significantly more likely at the end of the intervention to report that they walked regularly, participated in a walking group, brought healthy dishes to community events, chose healthy dishes at community events, and encouraged others to bring healthy dishes and to try healthy dishes at community events. Volunteer leaders were also more likely to say they were confident in their ability to improve the healthy eating and physical activity environment in their community and that they intended to continue to improve the community environment for healthy eating and active living. This program and its effectiveness were presented in 2005 and 2006 at two national meetings (USDA Priester Conference
and American Public Health Association annual meeting). A follow up study incorporating modifications in problem areas of the initial study has been recently completed and is undergoing analysis.
Publications
- Warren, B.S. and Devine, C.M. (2004). Herbal medicines and breast cancer risk. Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Warren, B.S. and Devine, C.M. (2005). Vegetables and fruits and breast cancer risk. Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Warren, B.S. and Devine, C.M. (2004). Understanding breast cancer risk and risk factors. Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Warren, B.S. and Devine, C.M. (2005). National Academy Panel Decides All Levels of Radiation Exposure Carry Some Risk. The Ribbon, Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State. 10(3), http://envirocancer.cornell.edu/Newsletter/articles/v10Radiation.cfm
- Warren, B.S. and Devine, C.M. (2005).Preschool Diet and Adult Risk of Breast Cancer: Considerations of Fundamental Issues in Carcinogenesis and Acrylamide Exposure The Ribbon, Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State Warren, 10(4) .
- Maley, M. and Devine, C.M. (2005).Obesity and Breast Cancer: An Environmental Approach, Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State, 10(3) http://envirocancer.cornell.edu/Newsletter/articles/v10Obesity.cfm
- Warren, B.S. and Devine, C.M. (2006). Research Commentary: Induced abortion is not associated with breast cancer risk. The Ribbon, Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State. 10(3), http://envirocancer.cornell.edu/Newsletter/articles/v11ResearchCommen tary.cfm
- Warren, B.S. and Devine, C.M. (2005). The Recent Decline in Breast Cancer Incidence: What is its Relationship to Hormone Therapy Use? The Ribbon, Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State. 10(3), http://envirocancer.cornell.edu/Newsletter/articles/v12Decline.cfm
- Warren, B.S. and Devine, C.M. (2004). Smoking and breast cancer risk. In: Smoking Concerns Sourcebook, First Edition. K. Bellenir, ed. (Detroit, Omnigraphics), pp195-202.
- Warren, B.S. and Devine, C.M. (2004). Family History, Inheritance and Breast Cancer Risk. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp133-145.
- Warren, B.S. and Devine, C.M. (2004). Hormone Treatments and Breast Cancer Risk. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp145-152.
- Warren, B.S. and Devine, C.M. (2004). Phytoestrogens and Breast Cancer Risk. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp231-238.
- Warren, B.S. and Devine, C.M. (2004). Breast cancer in Women from Different Ethnic Groups. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp133-145.
- Warren, B.S. and Devine, C.M. (2005). Vegetables and fruits and breast cancer risk. Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Boyce, J.D. Jr. (2004). Ionizing radiation and breast cancer risk. Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Clark, H. and Snedeker S. (2005). Pesticides and breast cancer: An evaluation of dibromochloropropane (DBCP). Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Clark, H. and Snedeker S. (2004). Ochratoxin A: Its cancer risk and potential for exposure. Fact Sheet Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State
- Warren, B.S. and Devine, C.M. (2004). Are Antibiotics Linked to Breast Cancer? The Ribbon, Cornell University Program on Breast Cancer and Environmental Risk Factors in New York State 9(2), http://envirocancer.cornell.edu/Newsletter/articles/v9rc.antibiotics. cfm.
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Progress 01/01/05 to 12/31/05
Outputs
The Cornell University Program on Breast Cancer and Environmental Risk Factors (BCERF) carried out both scholarly research and public education on cancer risk linked to diet/lifestyle and chemical exposures. Five new fact sheets were produced evaluating: risk factors associated with diet and lifestyle and breast cancer risk; herbal medicines and breast cancer risk; vegetables and fruits and breast cancer risk; ionizing radiation and breast cancer risk, and the cancer risk of the mycotoxin, ochratoxin-A. A total of 53 fact sheets and their bibliographies are now posted on BCERFs web site http://envirocancer.cornell.edu/. The bibliographic database was expanded to 10,393 citations. Articles in the BCERF on-line newsletter were composed on acrylamide exposures from foods, antibiotics and breast cancer risk, low level radiation exposure and environmental approaches to obesity. Three tip sheets for low literacy readers were revised, printed, and posted on the BCERF web
site. Review articles and electronic research updates were nationally disseminated to policy makers, scientists, and environmental groups.. Web-streamed videos: 1) Environmental Chemicals and Breast Cancer, Why is There Concern? and 2) Critical Periods of Susceptibility for Breast Cancer Risk were made available on the BCERF web site. A resource binder of BCERF materials was sent to 400 occupational health nurses in the Northeast. An average evaluation score of 4.7 (strongly agree equals 5) was given for the overall usefulness of the materials. Farm families were reached via a farm show (75,000 participants). Substantial progress was made with a research project to test and evaluate environment-based risk reduction strategies in a rural community. A community needs assessment was carried out using: 1) a random sample telephone survey of 100 adult women; 2) interviews with 17 local leaders; 3) focused group discussion with community leaders; 4) PhotoVoice imaging and interpretation of
local eating and physical activity environment; 5) a physical activity resources inventory mapping the built environment; 6) a foods available inventory survey of healthy foods in grocery and convenience stores; 7) a social environment assessment of attitudes and beliefs about obesity, food and physical activity opportunities and norms. The results of this assessment were presented to the community and the investigators will collaborate with the community to choose locally viable interventions.
Impacts
The BCERF website was totally revamped. There were 30,685 page views during 2004; between January and September 2005 there were 112,667 fact sheet downloads (412 daily). Dr Warren was interviewed by two radio shows (KUTR-AM820, 10,000 listeners and CJOB, 1 million listeners) and served as an expert for articles in Scientific American (circ. 638,000) and Womens Health Advisor (circ. 38,000). Research was presented at the USDA Priester Conference and American Public Health Assoc. annual meeting. Presentations were given to the public (70 participants) and to professionals (565). Key findings of the rural community needs assessment were: 1) Overweight was seen as a health problem but there is comfort about being overweight. 2) Attitudes about responsibility for overweight varied; seen as up to the individual, as well as a community concern. 3) Structural and social environmental hurdles to healthy eating existed; 72% of respondents shopped out of town for affordable
healthy foods. Healthy foods were seen as lacking in worksites (77%), restaurants (58%) and community events (50%). 4) A good environment for physical activity exists with 10 miles of sidewalks, 19 miles of walking trails and 26 acres of parks. Respondents found them well maintained (> 70%) and convenient (76%). 5) Respondents (40-74%) had safety concerns about traffic, snowmobiles, and dogs. 6) Life pressures, social norms and long winters kept people from using facilities. 7) Community leaders supported these efforts; 81% felt they had a stake in addressing healthy eating and physical activity.
Publications
- Warren, B.S. and Devine, C.M. (2004). Smoking and breast cancer risk. In: Smoking Concerns Sourcebook, First Edition. K. Bellenir, ed. (Detroit, Omnigraphics), pp195-202.
- Warren, B.S. and Devine, C.M. (2004). Family History, Inheritance and Breast Cancer Risk. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp133-145.
- Warren, B.S. and Devine, C.M. (2004). Hormone Treatments and Breast Cancer Risk. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp145-152.
- Warren, B.S. and Devine, C.M. (2004). Phytoestrogens and Breast Cancer Risk. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp231-238.
- Warren, B.S. and Devine, C.M. (2004). Breast cancer in Women from Different Ethnic Groups. In: Breast Cancer Sourcebook, Second Edition. S.J. Judd, ed. (Detroit, Omnigraphics), pp133-145.
- Clark, H.A. and Snedeker, S. M. (2005) Critical Evaluation of the Cancer Risk of Dibromochloropropane (DBCP), J Environ Sci Health C-Environ Carcinog Ecotoxicol Rev,23(2):215-60.
- Clark, H.A. and Snedeker, S. M. (2006) (Accepted) Orchratoxin A; Its cancer risk and potential for exposure, Journal of Toxicology and Environmental Health, Part B: Critical Reviews, accepted for publication.
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