The Avon Foundation for Women has awarded City of Hope researcher Katherine Henderson, Ph.D., a two-year, $300,000 grant to create the Health of Women (HOW) study, an innovative and expansive online research investigation.

The HOW study, which opened in December 2009, is enlisting recruits from the new Love/Avon Army of Women, a nationwide movement to end breast cancer through research. The Army of Women aims to recruit more than 1 million women of all ages and ethnicities — those who have breast cancer and those who do not — into its Web-based legion.

Katherine Henderson and Leslie Bernstein study women’s health. (Photo by p.cunningham)

Created by breast cancer expert Susan Love, M.D., the Love/Avon Army of Women should provide an invaluable database that can be used for decades to come to recruit women into studies such as the HOW study, said Henderson, assistant research professor in the Department of Population Sciences’ Division of Cancer Etiology and principal investigator for HOW.

Once women enroll in the HOW study, they will fill out an ongoing series of Internet-based surveys covering a variety of questions about lifestyle, family history and other factors. Researchers will look for relationships to important questions about women’s health.

“In the short term, we aim to critically examine important cohort [group] characteristics and show that new technology can be used to create an exceptional scientific resource,” said Henderson. “In the long term, the cohort will be a powerful tool for investigating the still-unanswered questions related to breast cancer.

“The Army of Women is a phenomenon that is expected to recruit a million women. That resource gives us enormous flexibility in learning how to design scientific, analytic studies like the HOW cohort, which will enable us to study the interplay of genetics and physical activity in determining a woman’s risk for breast cancer.”

City of Hope’s Leslie Bernstein, Ph.D., professor and director of the Division of Cancer Etiology, is mentoring Henderson through the process of designing and launching the HOW study.

“Cohort studies are the most valuable form of study in epidemiology, but they are extremely costly and very difficult to manage,” said Bernstein. “The new effort uses technology that is economical and permits us to capture behavior and lifestyle changes that impact women’s risk of cancer in real time.”

In 1995, Bernstein and colleagues began the seminal National Cancer Institute-funded California Teachers Study, which has followed 133,500 current and former educators, comparing those who developed cancer to those who did not. The study has yielded significant findings during the past 14 years, but researchers have found that responses to questionnaires mailed to participants have dwindled to about 67 percent.

Bernstein and Henderson are intrigued by the idea of creating a cohort study using the Internet.

“We are constantly seeking new studies to address current questions. We want to ask new questions of women all the time — but to do that in a standard cohort study like the California Teachers Study costs at least $150,000 just for the mailing of materials,” Bernstein explained. “Through HOW, we just create an online questionnaire, participants respond, and we will have preliminary data available within weeks.”

Bernstein expects the online tools will lower costs, simplify data management and improve communication with study participants.

“Our future cohort members joined the Love/Avon Army of Women because they wanted to participate in research to enhance progress toward eliminating breast cancer. This means they should be engaged, willing to fully participate and easy to follow to determine their ongoing health,” said Bernstein. “They are the perfect group to recruit into our new cohort study.”

The HOW study promises to explore medical topics beyond breast cancer research, covering women’s health conditions such as endometriosis and uterine fibroids.

“Cohorts also can provide information for us on all types of cancer, as well as on diabetes, heart disease and stroke,” added Bernstein.

For more information about the Love/Avon Army of Women, visit www.armyofwomen.org.