One in every eight women in the United States will have invasive breast cancer at some time during her life. One risk factor that women can do something about is obesity.

Cornell's prevention program -- Small Steps Are Easier Together -- reaches out to rural communities and workplaces to get that message out.

"Obesity and physical activity are two major risk factors that postmenopausal women can modify to reduce their risk of breast cancer," said nutrition professor Carol Devine, who leads the program, which is part of Cornell's Program on Breast Cancer and Environmental Risk Factors (BCERF). "A lot of risk factors for breast cancer you can't do anything about, but this is something you can change. It's hard, but you can do it."

Launched in 2004, the program takes into account that individual weight-loss programs only sustain weight loss in about 10 percent of cases.

"We wanted an approach that would impact a lot of people," Devine said. "We came to the conclusion that we would try to help people change their environments, to make it easier for them to be active and make healthy food choices."

The program also focuses on helping women make long-lasting changes and encouraging community and worksite participation.

"Small changes are easier for people to sustain, so we wanted to start there," said Mary Maley, Small Step's health educator. "We also learned that leadership at the local level has a huge impact on whether you can actually implement change."

In its first year, the project team worked with women in two rural communities in Delaware County to identify the kinds of changes they could make.

"More than 500 people came out for the first meeting," said Jeanne Darling, executive director of Cornell Cooperative Extension (CCE) in Delaware County, who is continuing the program locally with a grant from the Robinson Broadhurst Foundation. Components include opportunities for physical activity, healthy eating options, a student-walking group and youth gardening projects with weekly nutrition and physical activity workshops on the horizon.

Darling noted that the program has been successful in encouraging people to walk more, but finding ways to support healthy eating has been more difficult. Since then, the team started to work in 10 workplaces in rural areas last year.

At each site, they created walking teams, drew maps with walking routes and handed out pedometers. Some work sites also replaced soda with non-caloric beverages in vending machines, encouraged fruit in lieu of other snacks and asked cafeterias to reduce serving sizes.

Last year, the goal was to have 20 percent of participants increase their daily walking steps by 2,000 steps, and they exceeded that goal at every work site.

"There are more healthy food choices available at these work sites, but we haven't been able to quantify if people are forgoing the less healthy choices as well," Darling said.

This year, they expanded the program to five more work sites and plan to measure diet changes more carefully. And they hope to find new ways to encourage employees to join in. Their overall goal is to help communities and workplaces develop skills to sustain a healthy environment without intervention.

"In the long run, we hope they don't need us at all," Devine said.

The program is funded by the Cooperative State Research, Education and Extension Service of the U.S. Department of Agriculture.

Sheri Hall is assistant director of communications at the College of Human Ecology.