Central Obesity and Cancer Prevention for Chinese American Women

Cancer is the leading cause of death in women in the United States (US). Chinese Americans
are the largest ethnic group among Asian Americans. Although the incidence of breast cancer,
the most common cancer in women, has decreased among other U.S racial groups over the last 15
years, Chinese American women in California have experienced a significant increase of
incidence of 1.1% from 1998 to 2013. Studies have found that assimilation stress and obesity
are associated with increased risk for breast cancer in Chinese American women. There are no
existing interventions targeted at breast cancer prevention among premenopausal mothers with
abdominal obesity. Interventions tailored to an individual's cultural, lifestyle and social
support system are needed to reduce obesity and breast cancer risk. A smartphone-based
intervention provides a promising platform for obesity and cancer prevention. The overall
goal of this project is to test the feasibility of an obesity and breast cancer prevention
intervention among Chinese American women in San Francisco. The investigators will adapt the
Healthy Mothers Healthy Children: Technology-Based Intervention to Prevent Obesity to reduce
obesity and breast cancer risk in premenopausal women with abdominal obesity who have
dependent children in San Francisco. The proposed intervention ("Smartphone-Based Cancer and
Obesity Prevention Program for Chinese Women: SCOPP-CW) includes 12 weekly educational
modules and six bi-weekly tailored messages delivered via WeChat, a popular private
communication app used by Chinese and Chinese Americans. The investigators propose to conduct
a pilot randomized control study (RCT) to assess the short-term efficacy of SCOPP-CW on
abdominal obesity, breast cancer knowledge and attitudes, weight-related behaviors (food
intake and physical activity), and metabolic risk (blood pressure, lipid profile, hemoglobin
A1c), which are associated with breast cancer. Thus the investigators propose the following
aims: (1) Aim 1: To estimate the preliminary efficacy of the SCOPP-CW intervention on the
primary outcomes (i.e. waist circumference and breast cancer knowledge and attitudes) and
secondary outcomes (i.e. body mass index, self-efficacy, food intake, physical activity at
baseline, 3 months, and 6 months, and metabolic risk [blood pressure, hemoglobin A1C, and
lipid panel]) at baseline and 6 months.

Aim 2: To assess feasibility by understanding participants' acceptance, barriers to adherence
and recommendations for intervention using focus group interviews. The investigators
anticipate that this intervention will have a significant impact on breast cancer prevention.
The investigators plan to use the proposed pilot study's findings to conduct a larger scale
randomized trial (R01) to test the long-term efficacy of the intervention.

Inclusion Criteria:

- be female

- be at least 18 years old

- have a waist circumference great than 80 cm

- own a smartphone

- be able to read Chinese and speak Mandarin

- be premenopausal

- have a child between the age of 1 and 18 years old.

Exclusion Criteria:

- are pregnant

- gave birth less than 12 months prior to enrollment date

- have a history of breast cancer

- have an acute or life-threatening disease (e.g., renal failure).