One in every eight women in the United States will have invasive breast cancer at some time during her life. Researchers still don't know what exactly causes this pervasive disease, but they have identified dozens of risk factors that appear to be linked to it--from family history to alcohol consumption.
The leaders of a prevention program called Small Steps Are Easier Together have studied these risk factors and pinpointed one major link that women can actually do something about: obesity. Now they're reaching out to rural communities to help reduce obesity rates and the incidence of breast cancer. The program is part of Cornell's Program on Breast Cancer and Environmental Risk Factors (BCERF) and is funded by the Cooperative State Research, Education, and Extension Service, an agency of the U.S. Department of Agriculture.
"Obesity is the major risk factor that post-menopausal women can modify to reduce their risk of breast cancer," said Carol Devine, a nutrition professor who is leading the program. "A lot of risk factors for breast cancer you can't do anything about, but this is something you can change. It's hard, but you can do it."
When Small Steps launched in 2004, Devine and a team of educators at BCERF sat down to figure out the best way to reduce obesity rates among women in rural communities. Studies show individual weight-loss programs only sustain weight loss in about 10 percent of cases, so they went looking for a different kind of solution.
"We have a population problem, so we wanted to come up with a population solution," Devine said. "We wanted an approach that would impact a lot of people. We came to the conclusion that we would try to help people change their environments, to make it easier for them to be active, and make healthy food choices."
The team also wanted to help women make long-lasting changes and they wanted to encourage community participation, said Mary Maley, Small Step's health educator.
"Small changes are easier for people to sustain, so we wanted to start there," she said. "We also learned that leadership at the local level has a huge impact on whether you can actually implement change."
In its first year, the project team reached out to two rural communities--Hobart and Stamford in Delaware County.
The team interviewed community members and solicited opinions about changes the community could make. "People took pictures of food in vending machines, a farmer's market, a school gymnasium, and a rail trail," Devine said. "Then we would have a conversation about changes they thought they could make. We wanted to help them realize what they had, and to make changes that they could sustain."
For Jeanne Darling, executive director of Cornell Cooperative Extension in Delaware County, the input from local residents was essential.
"The local leadership team really took ownership," Darling said. "More than 500 people came out for the first meeting, and people walked around the world and back together. It was pretty powerful."
Darling is continuing the program locally through a grant she received from the Robinson Broadhurst Foundation. "We're offering opportunities for physical activity and some healthy eating options," she said. …