A breast cancer diagnosis for some can be a devastating experience, followed by a long treatment plan that often involves major surgery and extensive recovery. Weight loss and long-term holistic wellness plans tailored for survivors often aren’t readily available—particularly for historically marginalized U.S. populations—because medical oncology teams tend to focus on treating the cancer itself.
Enter Associate Professor Misty Hawkins, Ph.D. in the Department of Health & Wellness Design and Shelley Johns, Psy.D. from the IU School of Medicine, who have partnered with Jennifer McChristian, M.S.W., D.S.W., L.C.S.W., assistant dean for diversity affairs at IU Indianapolis School of Social Work to create THRIVE NOW, a three-phase research program to develop healthy weight and wellness programs for Black breast cancer survivors.
In fall 2023 the project proposal, “Testing Health Related Interventions: Voices of Equity Needed to Overcome Weight Bias in Obesity-Cancer Care (THRIVE NOW)” was awarded a year-long grant of $100,000—an investment from the IU Simon Comprehensive Cancer Center and IU School of Public Health-Bloomington (SPH-B). A cohort of 10 interdisciplinary experts led by Drs. Hawkins and Johns that included SPH-B doctoral student Kelsey Sinclair; faculty members Maresa Murray, Ph.D. and Evan Jordan, Ph.D.; IU School of Medicine breast oncologist Tarah Ballinger, MD; multimorbidity scientist Kristen Allen Watts, Ph.D., and partnerships with Regenstrief Institute, Walther Cancer Foundation, and Pink4Ever supported the THRIVE NOW study.
“The first phase involved sending a survey to breast cancer survivors of any weight, shape, size and race as we wanted to learn from everybody,” says Dr. Hawkins. “We then asked a group of five Black breast cancer survivors to help us design a preliminary treatment program.”
The program was launched last summer with 12 survivors meeting once a week over the course of eight weeks. The results? An amazing 95 percent of the group attended each session, 75 percent lost or maintained weight, and 58 percent gained or maintained muscle mass. More information about the co-design approach can be found in the team’s recently published report.
But the program is about far more than weight loss—it also addresses sleep, rest, stress levels, and nourishment. The women also engaged in formal mindfulness practices of breath awareness, body scan, and compassion meditations, in addition to the informal practice of mindful eating, which Dr. Johns describes as slowing down to savor each bite in pursuit of a healthier relationship with food.
Dr. McChristian, who is also the CEO and founder of The Crest Counseling, Coaching and Consulting Services, was approached to be a critical collaborator for this study due to her extensive experience with providing accessible, culturally responsive, person-centered mental health care.
“I realized that my life and professional journey perfectly aligned with the purpose and goals of THRIVE NOW,” says Dr. McChristian. “I have had the privilege to walk alongside cancer patients as a navigator, engage with women on their healing journey as a licensed clinical social worker, and live in my authentic authority as a Black woman. I was excited and humbled by this opportunity.”
Dr. Johns says for the last 25 years she has been responsible for the care and wellbeing of breast cancer survivors as a clinical health psychologist at IU School of Medicine, and many have shown high interest in achieving and maintaining a healthy weight to reduce the risk of cancer recurrence.
“Our team felt a deep commitment to filling this critical gap by partnering with Black breast cancer survivors to develop a culturally appealing healthy lifestyle program to support them in achieving their health goals,” says Dr. Johns. “The eight-session program was the highlight of 2024 for me…these remarkable women dedicated time amid their busy lives to come together each week to support each other on their wellness journeys, and every session was a beautiful mix of authentic and often tender sharing, coupled with enthusiastically celebrating successes and encouraging each other during challenging times.”
Emotional wellbeing was also a critical component of the sessions. For many of the participants, sitting in stillness and tuning into their feelings was an experience they had never been given permission to do, according to Dr. McChristian.
“They experienced some anxiety around these new emotions,” shared Dr. McChristian. “This insight—and skills learned throughout the program—helped them to shift their perspectives of their weight loss journey, ultimately leading to a lifelong pursuit of holistic healing.”
Despite only having a year to develop such a critical project with so many moving parts, the team was up for the challenge.
“We have a proven record with rapid recruitment and the efficient conduct of complex cancer survivorship trials, so THRIVE’s tight timeline was manageable for our team,” says Dr. Johns. “The greatest challenge for me was only having time for four sessions with our wise and thoughtful co-designers.”
Dr. McChristian says the firm deadline enabled the team to “build stronger relationships due to the closeness with one another through multiple weekly meetings.”
The next chapter for THRIVE NOW is to pursue a National Institutes of Health Planning Grant (R34) that will be submitted at the end of this February, with Dr. Hawkins and Dr. Johns as multiple principal investigators with advisory input from patients, providers, and other key study experts and partners.
“THRIVE NOW provided an opportunity for us to take a few committed steps toward ensuring that Black breast cancer survivors have a fair and just opportunity to be as healthy as possible. We are just getting started!” says Dr. Johns.
For more inspiring stories about SPH-B students, faculty, and staff, visit go.iu.edu/48bx.