Meghan B Skiba

Interests

Research

cancer prevention and control, nutrition, exercise, aging, lifestyle medicine, energetics, bioactives, interventions, community-based participatory research, epidemiology

Teaching

research methods, theory, integrative health, service learning

Courses

Scholarly Contributions

Journals/Publications

• Hawley, N., Green, J., Ahlich, E., Hauff, C., Hermer, J., Skiba, M. B., James, D. L., & Nash, S. H. (2024). Patient perspectives of weight stigma across the cancer continuum: A scoping review. Cancer medicine.
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  Weight stigma has been defined as the social devaluation and denigration of individuals because of their weight. The purpose of this scoping systematic review was to assess and understand patient experiences with weight stigma in the cancer care setting.
• Reynolds, L. M., Houston, D. K., Skiba, M. B., Whitsel, E. A., Stewart, J. D., Li, Y., Zannas, A. S., Assimes, T. L., Horvath, S., Bhatti, P., Baccarelli, A. A., Tooze, J. A., & Vitolins, M. Z. (2024). Diet Quality and Epigenetic Aging in the Women's Health Initiative. Journal of the Academy of Nutrition and Dietetics.
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  Higher diet quality scores are associated with a lower risk for many chronic diseases and all-cause mortality; however, it is unclear if diet quality is associated with aging biology.
• Wang, F., Skiba, M. B., Follis, S., Liu, N., Bidulescu, A., Mitra, A. K., Mouton, C. P., Qi, L., & Luo, J. (2024). Allostatic load and risk of invasive breast cancer among postmenopausal women in the U.S. Preventive medicine, 178, 107817.
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  Allostatic load can reflect the body's response to chronic stress. However, little is known about the association between allostatic load and risk of breast cancer in postmenopausal women. This study used a large prospective cohort in the United States to examine the relationship between allostatic load and invasive breast cancer risk, and to evaluate the relationship by racial and ethnic identity and breast cancer subtypes.
• Kung, C. P., Skiba, M. B., Crosby, E. J., Gorzelitz, J., Kennedy, M. A., Kerr, B. A., Li, Y. R., Nash, S., Potiaumpai, M., Kleckner, A. S., James, D. L., Coleman, M. F., Fairman, C. M., Galván, G. C., Garcia, D. O., Gordon, M. J., His, M., Hornbuckle, L. M., Kim, S. Y., , Kim, T. H., et al. (2023). Key takeaways for knowledge expansion of early-career scientists conducting Transdisciplinary Research in Energetics and Cancer (TREC): a report from the TREC Training Workshop 2022. Journal of the National Cancer Institute. Monographs, 2023(61), 149-157.
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  The overall goal of the annual Transdisciplinary Research in Energetics and Cancer (TREC) Training Workshop is to provide transdisciplinary training for scientists in energetics and cancer and clinical care. The 2022 Workshop included 27 early-to-mid career investigators (trainees) pursuing diverse TREC research areas in basic, clinical, and population sciences. The 2022 trainees participated in a gallery walk, an interactive qualitative program evaluation method, to summarize key takeaways related to program objectives. Writing groups were formed and collaborated on this summary of the 5 key takeaways from the TREC Workshop. The 2022 TREC Workshop provided a targeted and unique networking opportunity that facilitated meaningful collaborative work addressing research and clinical needs in energetics and cancer. This report summarizes the 2022 TREC Workshop's key takeaways and future directions for innovative transdisciplinary energetics and cancer research.
• Skiba, M. B., Wells, S. J., Brick, R., Tanner, L., Rock, K., Marchese, V., Khalil, N., Raches, D., Thomas, K., Krause, K. J., & Swartz, M. C. (2023). A Systematic Review of Telehealth-Based Pediatric Cancer Rehabilitation Interventions on Disability. Telemedicine journal and e-health : the official journal of the American Telemedicine Association.
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  Telehealth is an emerging method which may overcome barriers to rehabilitation access for pediatric cancer survivors (aged ≤19 years). This systematic review aimed to examine telehealth-based rehabilitation interventions aimed at preventing, maintaining, or improving disability in pediatric cancer survivors. We performed systematic searches in Ovid MEDLINE, Ovid EMBASE, Cochrane Library, SCOPUS, Web of Science, and CINAHL Plus between 1994 and 2022. Eligible studies included telehealth-based interventions assessing disability outcomes in pediatric cancers. Database searches identified 4,040 records. Nine unique interventions met the eligibility criteria. Telehealth delivery methods included telephone (n = 6), email (n = 3), mobile health applications (n = 3), social media (n = 3), videoconferencing (n = 2), text messaging (n = 2), active video gaming (n = 2), and websites (n = 2). Interventions focused on physical activity (n = 8) or self-management (n = 1). Outcomes assessing disability varied (n = 6). Three studies reported statistically and clinically significant results. Narrative synthesis of findings was constructed based on the Picker's principles for patient-centered care: (1) values, preferences, and needs; (2) involve family and friends; (3) coordination of care; (4) provide social support; (5) holistic well-being; and (6) information and communication. Telehealth-based rehabilitation interventions for pediatric cancer survivors is an emerging research area with potential to improve disability outcomes. Adequately powered trials with consistency in disability outcome measures are warranted. Additional research is needed to determine the effectiveness and best practices for telehealth-based pediatric cancer rehabilitation.
• Thomson, C. A., Crane, T. E., Miller, A., Gold, M. A., Powell, M., Bixel, K., Van Le, L., DiSilvestro, P., Ratner, E., Lele, S., Guntupalli, S., Huh, W., Robertson, S. E., Modesitt, S., Casey, A. C., Basen-Engquist, K., Skiba, M., Walker, J., Kachnic, L., & Alberts, D. S. (2023). Lifestyle intervention in ovarian cancer enhanced survival (LIVES) study (NRG/GOG0225): Recruitment, retention and baseline characteristics of a randomized trial of diet and physical activity in ovarian cancer survivors. Gynecologic oncology, 170, 11-18.
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  The Lifestyle Intervention for oVarian cancer Enhanced Survival (LIVES) is a national study of a combined diet and physical activity intervention for stage II-IV ovarian cancer survival, an under-represented cancer in lifestyle behavioral intervention research. Here, we present the data on recruitment, retention, and baseline demographic, clinical and lifestyle behavior characteristics of the LIVES study participants.
• Werts, S. J., Lopez-Pentecost, M., Skiba, M. B., Vogel, R., Enriquez, T., Garcia, L., Ingram, M., & Thomson, C. A. (2023). Conducting photovoice with binational cancer survivors to identify behavior change intervention preferences. Progress in Community Health Partnerships: Research, Education, and Action, 17(4).
• Donzella, S. M., Lind, K. E., Skiba, M. B., Farland, L. V., Thomson, C. A., Werts, S. J., Bell, M. L., LeBlanc, E., Weitlauf, J. C., Hery, C. M., Naughton, M. J., Mortimer, J., & Crane, T. E. (2022). The relationship between sleep and weight change among women diagnosed with breast cancer participating in the Women's Health Initiative. Breast cancer research and treatment, 192(2), 423-433.
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  Short and long sleep duration and poor sleep quality are risk factors for weight gain and cancer mortality. The purpose of this study is to investigate the relationship between sleep and weight change among postmenopausal breast cancer survivors.
• McElfresh, J. J., Skiba, M. B., Segrin, C. G., Badger, T. A., Crane, T. E., Crist, J. D., & Thomson, C. A. (2022). Interventions for Loneliness Among Adult Cancer Survivors: A Systematic Review and Meta-Analysis. Journal of psychosocial oncology, 39(4), 509-533.
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  Loneliness is common after cancer, contributing to poor outcomes. Interventions to modify loneliness are needed. This systematic review describes the current literature regarding loneliness interventions in cancer survivors. Databases including: Ovid/MEDLINE; The Cochrane Central Register of Controlled Trials (CENTRAL); Elsevier/Embase; Clarivate/Web of Science (Core Collection), EBSCO/PsycINFO, EBSCO/CINAHL were used to perform a systematic review of literature using PRISMA guidelines. Second, risk of bias, meta-analysis and a narrative synthesis approach was completed to synthesize findings from multiple studies. Six thousand five hundred three studies were initially evaluated; eight studies met inclusion criteria. Findings indicate a paucity of interventions, generally of lower quality. Interventions were feasible and acceptable; those interventions with cultural modifications were more likely to demonstrate effectiveness. There are limited interventions addressing loneliness in cancer survivors. Development and testing of culturally-relevant programs are warranted. Current studies suggest the psychosocial symptom of loneliness is modifiable among adult cancer survivors. Few interventions have been tested and shown to be effectiveness in cancer survivors in the U.S. and none have been tailored for older adult survivors, by patient gender/sex and few for specific race/ethnic groups. Results from this systematic review: a narrative synthesis and meta-analysis can inform future interventions targeting loneliness in this growing, yet vulnerable, adult cancer survivor population.
• Morrill, K. E., Robles-Morales, R., Lopez-Pentecost, M., Martínez Portilla, R. J., Saleh, A. A., Skiba, M. B., Riall, T. S., Austin, J. D., Hirschey, R., Jacobs, E. T., Spotleson, L., & Hanna, T. P. (2022). Factors associated with cancer treatment delay: a protocol for a systematic review and meta-analysis. BMJ open, 12(6), e061121.
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  Treatment delays are significantly associated with increased mortality risk among adult cancer patients; however, factors associated with these delays have not been robustly evaluated. This review and meta-analysis will evaluate factors associated with treatment delays among patients with five common cancers.
• Skiba, M. B., Dieckmann, N. F., Lyons, K. S., & Winters-Stone, K. M. (2022). Associations between perceptions of relationship quality and markers of inflammation and insulin resistance among couples coping with cancer. Journal of cancer survivorship : research and practice.
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  Among married couples living with breast and prostate cancer, positive perceptions of relationship quality by both survivors and their spouses were associated with lower inflammation or insulin resistance in their partner. Our data support evidence that health within couples is both interdependent and transactional and suggests that one member's perception of the relationship is associated with biologic changes in one's partner, leading to better physical health of the couple. These findings may provide a biologic underpinning to observations of an inverse relationship between relational satisfaction and overall mortality and underscore the need for a dyadic approach to health.
• Skiba, M. B., Harker, G., Guidarelli, C., El-Gohary, M., Horak, F., Roeland, E. J., Silbermann, R., Hayes-Lattin, B., & Winters-Stone, K. (2022). Using Wearable Inertial Sensors to Assess Mobility of Patients With Hematologic Cancer and Associations With Chemotherapy-Related Symptoms Before Autologous Hematopoietic Stem Cell Transplant: Cross-sectional Study. JMIR cancer, 8(4), e39271.
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  Wearable sensors could be a simple way to quantify and characterize mobility in patients with hematologic cancer scheduled to receive autologous hematopoietic stem cell transplant (autoHSCT) and how they may be related to common treatment-related symptoms and side effects of induction chemotherapy.
• Skiba, M. B., Lopez-Pentecost, M., Werts, S. J., Ingram, M., Vogel, R. M., Enriquez, T., Garcia, L., & Thomson, C. A. (2022). Health Promotion Among Mexican-Origin Survivors of Breast Cancer and Caregivers Living in the United States-Mexico Border Region: Qualitative Analysis From the Vida Plena Study. JMIR cancer, 8(1), e33083.
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  Hispanic survivors of cancer experience increased cancer burden. Lifestyle behaviors, including diet and physical activity, may reduce the cancer burden. There is limited knowledge about the posttreatment lifestyle experiences of Hispanic survivors of cancer living on the United States-Mexico border.
• Martinez, J. A., Skiba, M. B., Chow, H. S., Chew, W. M., Saboda, K., Lance, P., Ellis, N. A., & Jacobs, E. T. (2021). A Protective Role for Arachidonic Acid Metabolites against Advanced Colorectal Adenoma in a Phase III Trial of Selenium. Nutrients, 13(11).
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  Oxylipins derived from arachidonic acid (ARA) have been implicated in the development of colorectal adenomas and colorectal cancer. The primary purpose of this work was to determine the relationship between plasma levels of oxylipins and colorectal adenoma characteristics at study entry, as well as with the development of a new adenoma during follow-up within a Phase III adenoma prevention clinical trial with selenium (Sel). Secondarily, we sought to determine whether the selenium intervention influenced plasma oxylipin levels. Four oxylipins were quantified in stored plasma samples from a subset of Sel study subjects ( = 256) at baseline and at 12-months. There were significantly lower odds of an advanced adenoma at baseline with higher prostaglandin E (PGE), with an OR (95% CI) of 0.55 (0.33-0.92), and with 5-hydroxyeicosatetraenoic acid (5-HETE) ((0.53 (0.33-0.94)); and of a large adenoma with higher PGE ((0.52 (0.31-0.87)). In contrast, no associations were observed between any oxylipin and the development of a new adenoma during follow-up. Selenium supplementation was associated with a significantly smaller increase in 5-HETE after 12 months compared to the placebo, though no other results were statistically significant. The ARA-derived oxylipins may have a role in the progression of non-advanced adenoma to advanced, but not with the development of a new adenoma.
• Skiba, M. B., Jacobs, E. T., Crane, T. E., Kopp, L. M., & Thomson, C. A. (2021). Relationship Between Individual Health Beliefs and Fruit and Vegetable Intake and Physical Activity Among Cancer Survivors: Results from the Health Information National Trends Survey. Journal of adolescent and young adult oncology.
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  The aim of this study was to describe diet and physical activity (PA) behaviors and health beliefs among cancer survivors and identify potential differences between adolescent and young adult (AYA) and adult/older cancer survivors. Cancer survivors ( = 1864) participating in the Health Information National Trends Survey (HINTS) provided responses regarding diet and PA and selected health beliefs related to general health and cancer (self-efficacy, attitudinal belief, normative belief, risk belief, intention, and self-regulation). Health belief associations with diet and PA were assessed using adjusted logistic regression models, and multiple linear regression was used for a computed Modified American Cancer Society Adherence score (0-10, higher score indicates higher adherence to recommendations); age at diagnosis was evaluated as a potential effect modifier. Health behaviors between AYA and adult/older were not significantly different; a greater percent of AYA met fruit and resistance PA recommendations. Higher health self-efficacy was associated with meeting aerobic PA recommendations (odds ratio [OR]: 1.71; confidence interval [95% CI]: 1.13-2.60;  = 0.01). Higher intention was inversely related to meeting vegetable recommendation (OR: 0.58; 95% CI: 0.35-0.97;  = 0.04). Self-regulation was associated with higher odds of meeting each recommendation. Self-efficacy and self-regulation were associated with greater adherence ( = 0.52 ± 0.16,  = 0.001;  = 1.21 ± 0.24,  
• Winters-Stone, K. M., Lyons, K. S., Beer, T. M., Skiba, M. B., & Hung, A. (2021). A pilot feasibility study of Exercising Together© during radiation therapy for prostate cancer: a dyadic approach for patients and spouses. Pilot and feasibility studies, 7(1), 216.
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  Prostate cancer can negatively impact the health of patients and their spouse, particularly early on in the cancer trajectory.
• Crane, T. E., Miller, A., Skiba, M. B., Donzella, S., & Thomson, C. A. (2020). Association of chronotype and pain at baseline in ovarian cancer survivors participating in a lifestyle intervention (NRG/GOG 0225).. Journal of Clinical Oncology, 38(15_suppl), 6018-6018. doi:10.1200/jco.2020.38.15_suppl.6018
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  6018Background: Chronotype is defined as an individual’s propensity to sleep at a specific time in a 24-hour cycle with late chronotype associated with poorer health outcomes including cancer. Chro...
• Crane, T. E., Skiba, M. B., Miller, A., Garcia, D. O., & Thomson, C. A. (2020). Development and Evaluation of an Accelerometer-Based Protocol for Measuring Physical Activity Levels in Cancer Survivors: Development and Usability Study. JMIR mHealth and uHealth, 8(9), e18491.
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  The collection of self-reported physical activity using validated questionnaires has known bias and measurement error.
• Jacobs, E. T., Foote, J. A., Kohler, L. N., Skiba, M. B., & Thomson, C. A. (2020). Re-examination of dairy as a single commodity in US dietary guidance. Nutrition reviews, 78(3), 225-234.
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  Dairy products have been a key component of dietary guidance in the United States for more than 100 years. In light of major advances in the understanding of dietary intake and metabolism, the aim of this review was to examine whether dairy should remain a single commodity in federal guidance. Considerations include recognizing that a substantial proportion of the world's adult population (65%-70%) exhibits lactase nonpersistence, a reduced ability to metabolize lactose to glucose and galactose. Shifts in the US population, including a greater proportion of African Americans and Asians, are of key importance because several studies have shown a markedly higher prevalence of lactase nonpersistence and, consequently, a lower dairy intake among these groups. While cow's milk alternatives are available, families who use them will pay up to an additional $1400 per year compared with those who are able to consume dairy products. Dietary guidance also contains downstream effects for government assistance, such as the US Department of Agriculture's National School Lunch Program and School Breakfast Program. For reasons like these, Canada has recently removed dairy as a separate food group in national dietary guidance. The results of the present review suggest that consideration of this modification when developing population-level guidelines in the United States is warranted.
• Skiba, M. B. (2020). 0414 Chronotype and Sleep Among Ovarian Cancer Survivors Participating in a Lifestyle Intervention. Sleep, 43(Supplement_1), A158-A159. doi:10.1093/sleep/zsaa056.411
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  Abstract Introduction Chronotype is defined as an individual’s propensity to sleep at a specific time in a 24-hour cycle with late chronotype associated with poorer health outcomes including cancer. The role of chronotype on lifestyle behaviors remains relatively undefined in ovarian cancer. The Lifestyle Intervention for oVarian cancer Enhanced Survival study is testing whether 1205 women randomized to a diet and physical activity intervention for 24-months will have longer progression-free survival versus attention control. Here we determine the frequency and predictors of late versus early and mid chronotypes in disease-free ovarian cancer survivors. Methods 894 ovarian cancer survivors with baseline measures were included in analyses. Chronotypes were determined using self-reported time to bed (early- < 9 pm; mid- ≥ 9 pm - ≤12 am; late- >12 am) captured through the Pittsburgh Sleep Quality Index. Demographic, diet and physical activity data were captured with validated questionnaires and BMI measured in clinic. Descriptive statistics and logistic regression, adjusted for smoking status and race, were performed. Results 12.4% of women were late chronotype with significant differences between chronotypes observed for race, smoking history, sleep duration, and physical activity (p < 0.05). Late chronotype reported fewer hours of sleep per night (6.54 ± 1.51hrs) compared to mid (7.10± 1.31hrs) and early (7.74 ± 1.30hrs) chronotype. Blacks had higher odds of being late chronotype, OR 4.28 (95% CI 2.16-8.46). Late chronotype were more likely to report a history of smoking and lower recreational activity and had a higher mean BMI of 29.1± 6.0 kg/m2 compared to mid and early chronotype 27.8± 6.2 kg/m2 and 27.4± 5.4kg/m2, respectively. No significant differences were observed for sleep or diet quality, age, education or employment status. Conclusion Results of this analysis are consistent with other community-based population studies with regard to chronotype and race. Ovarian cancer is aggressive and late chronotype are more likely to have other risk factors that elevate risk of recurrence (obesity, tobacco use and inactivity. Six-month data are being analyzed by treatment arm and will provide important insights as to the role of sleep phase and lifestyle behaviors in this vulnerable population. Support NCT00719303; NCI R01CA186700-01A1
• Skiba, M. B., Hopkins, L. L., Hopkins, A. L., Billheimer, D., & Funk, J. L. (2020). Nonvitamin, Nonmineral Dietary Supplement Use in Individuals with Rheumatoid Arthritis. The Journal of nutrition, 150(9), 2451-2459.
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  Over-the-counter, natural product-based (nonvitamin, nonmineral) dietary supplement (NVNM DS) use is common in adults with rheumatoid arthritis (RA), a group at risk for drug-DS interactions, due to polypharmacy, but this use is underreported to health care providers. Recent dramatic changes in US sales of specific NVNM DS suggest that the prevalence and types of NVNM DS used in RA populations may also have shifted.
• Skiba, M. B., McElfresh, J. J., Howe, C. L., Crane, T. E., Kopp, L. M., Jacobs, E. T., & Thomson, C. A. (2020). Dietary Interventions for Adult Survivors of Adolescent and Young Adult Cancers: A Systematic Review and Narrative Synthesis. Journal of adolescent and young adult oncology, 9(3), 315-327.
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  Adolescent and young adult (AYA) cancer survivors, here defined as individuals diagnosed with cancer between 15 and 39 years of age, are at high risk for adverse late-term metabolic effects of treatment through adulthood. Diet is a modifiable lifestyle behavior that may improve metabolic health outcomes in AYA cancer survivors. However, the details of dietary interventions for this unique population remain largely undescribed. In this systematic review, we aim to synthesize the results of dietary interventions for adult AYA cancer survivors. Seven databases and clinical trial registries were searched in March 2019 for interventions targeting dietary behaviors in AYA cancer survivors (PROPSERO systematic review number: CRD42019126376). Descriptive statistics and a narrative synthesis were completed to detail intervention participants and components. After full text review of 233 studies, four studies met all inclusion criteria. All studies were heterogeneous for participant age, cancer type, and duration, and were designed for feasibility and preliminary efficacy. Included studies followed different dietary guidance; however, each resulted in a significant change on a primary outcome of either dietary quality or body composition. Three of the four studies included a theoretical framework, where self-efficacy was a central construct. Counseling, in person, telephone, or electronic, provided behavioral support. Results of this systematic review suggest high potential to change dietary behaviors in AYA, but interventions remain limited. AYA cancer survivors demonstrate unique physiological and psychosocial needs, and future interventions designed to address this care gap should be targeted for this population with consideration of social support, delivery mode, and individual tailoring.
• DeSalvo, J. C., Skiba, M. B., Howe, C. L., Haiber, K. E., & Funk, J. L. (2019). Natural Product Dietary Supplement Use by Individuals With Rheumatoid Arthritis: A Scoping Review. Arthritis care & research, 71(6), 787-797.
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  Natural product dietary supplements (NDS), defined as non-mineral, non-vitamin, ingested, natural product-derived, substances, are the most frequently used complementary and alternative medicine modality in the US, with musculoskeletal disease being the most frequent reason for their use. Because NDS usage is frequently unreported, and patients with RA may be at higher risk for NDS-related side effects due the underlying nature of the disease and frequent use of complex pharmaceutical regimens, a scoping review of the literature was undertaken to examine population-based patterns of NDS use for RA self-management.
• Skiba, M. B., Kohler, L. N., Crane, T. E., Jacobs, E. T., Shadyab, A. H., Kato, I., Snetselaar, L., Qi, L., & Thomson, C. A. (2019). The Association between Prebiotic Fiber Supplement Use and Colorectal Cancer Risk and Mortality in the Women's Health Initiative. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 28(11), 1884-1890.
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  Fiber-based prebiotic supplements are marketed for maintaining bowel health and promoting beneficial gut bacteria. However, the association between prebiotic supplement use and colorectal cancer risk and mortality is unknown.
• Skiba, M. B., Luis, P. B., Alfafara, C., Billheimer, D., Schneider, C., & Funk, J. L. (2018). Curcuminoid Content and Safety-Related Markers of Quality of Turmeric Dietary Supplements Sold in an Urban Retail Marketplace in the United States. Molecular nutrition & food research, e1800143.
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  Turmeric is a top selling dietary supplement (DS) in the United States with rapidly expanding usage. Therefore, turmeric DS formulations available for sale in an urban US retail marketplace are analyzed, and point of sale information is related to measures of quality relevant to safety.
• Thomson, C. A., Chow, H. H., Wertheim, B. C., Roe, D. J., Stopeck, A., Maskarinec, G., Altbach, M., Chalasani, P., Huang, C., Strom, M. B., Galons, J. P., & Thompson, P. A. (2017). A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. Breast cancer research and treatment, 165(1), 97-107.
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  Diindolylmethane (DIM), a bioactive metabolite of indole-3-carbinol found in cruciferous vegetables, has proposed cancer chemoprevention activity in the breast. There is limited evidence of clinically relevant activity of DIM or long-term safety data of its regular use. A randomized, double-blind, placebo-controlled trial was conducted to determine the activity and safety of combined use of BioResponse DIM® (BR-DIM) with tamoxifen.
• Thomson, C. A., Ho, E., & Strom, M. B. (2016). Chemopreventive properties of 3,3'-diindolylmethane in breast cancer: evidence from experimental and human studies. Nutrition reviews, 74(7), 432-43.
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  Diet is a modifiable factor associated with the risk of several cancers, with convincing evidence showing a link between diet and breast cancer. The role of bioactive compounds of food origin, including those found in cruciferous vegetables, is an active area of research in cancer chemoprevention. This review focuses on 3,3'-diindolylmethane (DIM), the major bioactive indole in crucifers. Research of the cancer-preventive activity of DIM has yielded basic mechanistic, animal, and human trial data. Further, this body of evidence is largely supported by observational studies. Bioactive DIM has demonstrated chemopreventive activity in all stages of breast cancer carcinogenesis. This review describes current evidence related to the metabolism and mechanisms of DIM involved in the prevention of breast cancer. Importantly, this review also focuses on current evidence from human observational and intervention trials that have contributed to a greater understanding of exposure estimates that will inform recommendations for DIM intake.

Presentations

• Skiba, M. B. (2023, February). Culturally specific dyadic physical activity promotion: tailoring evidence-based interventions for Hispanic prostate cancer survivors and their caregivers. Prostate Cancer Innovative Working Group Data ClubUniversity of Arizona Cancer Center.
• Skiba, M. B. (2023, May). Living Harmoniously with Your Environment to Prevent Skin Cancer. Healthy Skin Seminar. University of Arizona Cancer Center: Skin Cancer Institute.
• Skiba, M. B. (2023, September). The Essential Nutrients for Healthy Aging. Innovations in Healthy Aging Lecture Series. University of Arizona: University of Health Sciences Innovation in Healthy Aging.
• Skiba, M. B., & Krupnik, C. (2023, April). Association of Technology Access and Perceived Health in Southern Arizona: A Geographic Information Systems Analysis. Society of Behavioral Medicine 44th Annual Meeting. Phoenix, AZ: Society of Behavioral Medicine.
• Skiba, M. B., Krupnik, C., Felion, C. M., & Lind, K. E. (2023, April). Community Connectedness Classification and Cancer Incidence in Southern Arizona. Western Institute of Nursing. Tucson, AZ: Western Institute of Nursing.
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  Symposia Presentation as part of "Social Determinants of Healthy and Symptom Burden Among Cancer Survivors and Caregivers across the Lifespan"
• Skiba, M. B. (2022, December). The role of community and technology to advance health equity in Southern Arizona. Cancer Prevention and Control Seminar SeriesUniversity of Arizona Cancer Center.
• Wood, K. C., Marshall, T. F., Sleight, A. G., Kendig, T., Jones, J. M., Wechsler, S. B., Skiba, M. B., Brick, R., Flores, A. M., & Pergolotti, M. (2022, November). Functional outcome measurement in cancer rehabilitation: lessons learned from the Research and Outcomes Task Force. American Congress of Rehabilitative Medicine Annual Meeting. Chicago, IL: American Congress of Rehabilitative Medicine.