Background Estimating advanced breast cancer risk in women undergoing annual or biennial mammography could identify women who may benefit from less or more intensive screening. We developed an actionable model to predict cumulative six-year advanced cancer (prognostic pathologic stage II or higher) risk according to screening interval. Methods We included 931,186 women aged 40-74 years in the Breast Cancer Surveillance Consortium undergoing 2,542,382 annual (prior mammogram within 11-18 months) or 752,049 biennial (prior within 19-30 months) screening mammograms. The prediction model includes age, race/ethnicity, body mass index, breast density, family history of breast cancer, and prior breast biopsy subdivided by menopausal status and screening interval. We used 5-fold cross-validation to internally validate model performance. We defined >95th percentile as high-risk (>0.658%), >75th to <95th percentile as intermediate risk (0.380-0.658%), and <75th percentile as low to average risk (<0.380%). Results Obesity, high breast density, and proliferative disease with atypia were strongly associated with advanced cancer. The model is well-calibrated and has an area under the receiver operating characteristics curve of 0.682 (95%CI 0.670-0.694). Based on women’s predicted advanced cancer risk under annual and biennial screening, 69.1% had low or average risk regardless of screening interval, 12.4% intermediate risk with biennial screening and average risk with annual screening, and 17.4% intermediate or high-risk regardless of screening interval. Conclusion Most women have low or average advanced cancer risk and can undergo biennial screening. Intermediate risk women may consider annual screening and high-risk women supplemental imaging in addition to annual screening.

Given the role of physical activity (PA) and good nutrition to delay the onset and progression of most chronic conditions, effective interventions are needed to influence lifestyle behaviors of community-dwelling populations. The purpose of this study is to examine the effectiveness of Texercise Select to improve health indicators, PA, and dietary behaviors, and confidence to engage in healthful behaviors. Texercise Select, a 12-week exercise program, was delivered. Baseline and 12-week follow-up assessments were collected from 220 participants with baseline data who were aged 45 years and older for this non-randomized one-group pre-post design trial. Linear mixed models were fitted for continuous outcome variables and GEE models with logit link function for binary outcome variables. Significant improvements (P < 0.05) were seen in physical activity scores (d = 0.64 for aerobic activity), weekly fruit/vegetable consumption (d = 0.31), daily water consumption (d = 0.29), as well as PA- and nutrition-related confidence (d =0.38 and 0.21, respectively) and social support (d =0.45). Programs rooted in best practices show promise for positively impacting large numbers of participants and becoming sustainably embedded in communities over time.

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Tai Chi: Moving for Better Balance (TCMBB) is an evidence-based fall prevention exercise program being disseminated in selected communities through state injury prevention programs. This study: (1) describes the personal characteristics of TCMBB participants; (2) quantifies participants’ functional and self-reported health status at enrollment; and (3) measures changes in participants’ functional and self-reported health status post-intervention. There were 421 participants enrolled in 36 TCMBB programs delivered in Colorado, New York, and Oregon. Of the 209 participants who completed both baseline enrollment and post-intervention surveys, the average age of participants was 75.3 (SD ± 8.2) years. Most participants were female (81.3%), non-Hispanic (96.1%), White (94.1%), and described themselves as in excellent or very good health (52.2%). Paired t-test and general estimating equation models assessed changes over the 3-month program period. Pre- and post-assessment self-reported surveys and objective functional data [Timed Up and Go (TUG) test] were collected. On average, TUG test scores decreased (p < 0.001) for all participants; however, the decrease was most noticeable among high-risk participants (mean decreased from 18.5 to 15.7 s). The adjusted odds ratio of reporting feeling confident that a participant could keep themselves from falling was five times greater after completing the program. TCMBB, which addresses gait and balance problems, can be an effective way to reduce falls among the older adult population. By helping older adults maintain their functional abilities, TCMBB can help community-dwelling older adults continue to live independently.