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The Influence of Breast Cancer Risk and Risk Perception on Lifestyle Behaviors Among Women With a Family History: A Mixed Method Approach

35 Years
74 Years
Not Enrolling
Breast Neoplasms

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Trial Information

The Influence of Breast Cancer Risk and Risk Perception on Lifestyle Behaviors Among Women With a Family History: A Mixed Method Approach

Lifestyle behaviors among women with a family history of breast cancer are likely to be
influenced by a number of factors, including both objective risk factors and subjective
risk, or perceived risk. The aims of this mixed method study are twofold and will be
explored through both quantitative (i.e. secondary survey data) and qualitative data (i.e.
personal in-depth interviews) derived from the Sister Study, a large epidemiologic study
being conducted through the National Institute of Environmental Health Sciences, which is
addressing risk factors for breast cancer in sisters of women who have had breast cancer.
The quantitative aims include an exploration of lifestyle behaviors and behavioral
differences between White and African American women, as well as an exploration of the
relationships between lifestyle behaviors (i.e. varying levels of objective risk based on
Gail model risk scores, medical risk-reducing factors (i.e. use of Tamoxifen or Raloxifene
and/or prophylactic surgery), as well as additional factors that may be contributors to
perceived risk. This aim will be addressed using data that have already been collected as
part of the baseline activities for the Sister Study. The primary qualitative aim is to
gain a better understanding about perceived risk and the relationship between perceived risk
and lifestyle behaviors in both White and African American women with a family history of
breast cancer. This aim requires the collection of new data through in-person interviews
with between 28 and 40 women, depending on how many interviews are required to achieve "data

The mixed method approach will be based on a "complementarity" model, which emphasizes the
use of two different methods to address different aspects of the research problem. Results
from both methods will become integrated into the discussion of the findings and it is
expected that this approach will enrich the study and allow for elaboration of the
quantitative results. The secondary data analysis will be derived from approximately 10,000
women, initially enrolled in the Sister Study, who are between the ages of 35 and 74 and
have had at least one sister affected by breast cancer. Women for the qualitative
interviews will be recruited from a cohort of Sister Study participants residing within
North Carolina and will include equal numbers of both White and African American women. It
is expected that 28 women will be needed for qualitative data saturation (i.e. no new
information comes forth) to occur.

The primary outcome measures for the quantitative component of the study are dietary fat
intake, fruit and vegetable consumption, alcohol use and physical activity, which will all
be measured categorically. Physical activities will first be converted into MET (metabolic
equivalent) values and then MET values will be summed across all activities before
categorizing into quartiles or quintiles. Qualitative data will be analyzed through content
analysis, which will involve the identification of common themes or ideas expressed in
response to questions from a semi-structured interview guide developed specifically to
address the aims of the study.

Inclusion Criteria


Data from the first 20,000 women enrolled in the Sister Study will be utilized for the
quantitative analysis.

Participants for the qualitative study will include women living in North Carolina who
reside within a three and a half hour driving distance from the researcher.


The only exclusion criteria for the selection of data from women in the Sister Study are
as follows:

1. women will be excluded if they were adopted because a complete family history is
unlikely to be known;

2. women will be excluded if they have had prior history of cancer, with the exception
of non-melanoma skin cancer;

3. women from racial/ethnic groups classified as "other" will also be excluded.

The same exclusion criteria described above will also apply for the qualitative study.

Type of Study:


Study Design:

Time Perspective: Prospective


United States: Federal Government

Study ID:




Start Date:

October 2006

Completion Date:

October 2008

Related Keywords:

  • Breast Neoplasms
  • Objective Risk
  • Gail Model
  • Subjective Risk
  • Medical Risk-Reducing Strategies
  • Physical Activity, Diet, Alcohol Use
  • Breast Cancer Risk
  • Breast Neoplasms
  • Neoplasms



NIEHS, Research Triangle ParkResearch Triangle Park, North Carolina  27709