Staying Strong and Healthy for Androgen Deprivation Therapy for Latino Men

描述(申请人提供)：雄激素剥夺疗法(ADT)越来越多地被用于治疗前列腺癌，包括在新辅助和辅助放射治疗(RT)的情况下，用于手术或放射治疗后的初级治疗后复发，或前列腺癌处于晚期。考虑到前列腺癌是美国男性中最常见的非皮肤癌，这一点变得非常重要。尤其令人担忧的是拉美裔男性，因为拉美裔是美国增长最快的少数群体。拉美裔男性被诊断出患有晚期疾病，这使得他们更有可能接受ADT治疗。研究表明，服用ADT的男性出现血管运动症状、抑郁、疲劳、与健康相关的生活质量(HRQOL)降低、骨密度(BMD)降低、性功能障碍、代谢综合征、脂肪量增加，以及瘦肉量减少、血脂增加和动脉顺应性降低的风险增加，所有这些都使他们患心血管疾病(CVD)、骨质疏松和II型糖尿病的风险更高。拉丁裔更容易患肥胖症、血脂异常、心血管适合度低、高血压和糖尿病。因此，我们建议测试我们的保持强壮和健康计划，以促进拉美裔男性在ADT期间的健康活动和营养。采用混合方法设计，我们的目标是：1.比较75名开始接受ADT的拉丁裔男性和75名开始接受ADT的拉丁裔男性干预前后的BMI、血脂、腰围/臀围和血糖，并随机分配到接受常规护理的75名拉丁裔男性。2.使用SF-12情绪和身体健康子量表比较干预前后的HRQOL，并使用扩展的前列腺癌综合指数(EPIC)在组内和组间比较特定疾病的HRQOL。3.开发并比较接受干预和常规护理的拉丁裔男性的活动和营养选择的解释性模型。4.从参与者的角度评估干预的可接受性和效益。将从几个网站招募拉美裔男性，这些网站主要服务于洛杉矶的拉美裔人口。男性将来到加州大学洛杉矶分校翻译研究中心进行基线、6个月和12个月的测量，并在12个月时进行面试。被分配到干预组的男性将在基线措施后立即接受关于营养和锻炼计划的初步评估和教育。然后，他们将每周接到护士协调员/文化联络小组的12个电话，以提供有针对性的信息，建立单独定制的营养和活动目标，评估目标的成就，并提供支持。我们将对每组中的30名男性进行定性访谈，以从他们的角度评估干预措施，并为与食物和活动选择有关的决策过程制定解释性框架。分析将结合组内比较和扎根的理论技术。

DESCRIPTION (provided by applicant): Androgen deprivation therapy (ADT) is increasingly being used to treat prostate cancer in the neoadjuvant and adjuvant contexts with radiation therapy (RT), for recurrence following primary treatment with surgery or radiation, or when the prostate cancer is at an advanced stage. This becomes highly significant considering that prostate cancer is the most commonly diagnosed no cutaneous cancer in American men. Of particular concern are Latino men, because Latinos are the fastest growing minority in the United States (US). Latino men are diagnosed with later stage disease making them more likely to be treated with ADT. Studies have shown that men on ADT are at increased risk for vasomotor symptoms, depression, fatigue, diminished health- related quality of life (HRQOL), decreased bone mineral density (BMD), sexual dysfunction, metabolic syndrome, increased fat mass, along with decreased lean muscle mass, increased serum lipids, and decreased arterial compliance all of which places them at higher risk for cardiovascular disease (CVD), osteoporosis, and type II diabetes. Latinos more often have obesity, dyslipidemia, low cardiovascular fitness, hypertension, and diabetes. Therefore, we propose to test our Staying Strong and Healthy program to promote healthy activity and nutrition during ADT for Latino men. Using a mixed methods design we aim to: 1. Compare pre- and post-intervention BMI, lipids, waist/hip circumference, and glucose within and between 75 Latino men starting ADT who are randomly assigned to receive the Staying Strong and Healthy intervention and 75 Latino men starting ADT randomly assigned to receive usual care. 2. Compare pre- and post- intervention HRQOL using the SF-12 subscales of emotional and physical well-being and disease-specific HRQOL using the Expanded Prostate Cancer Index Composite (EPIC) within and between groups. 3. Develop and compare explanatory models of Latino men's activity and nutrition choices between those receiving the intervention and those receiving usual care. 4. Evaluate acceptability and benefit of the intervention from perspective of participants. Latino men will be recruited form several sites serving predominantly Latino populations in Los Angeles. Men will come to UCLA Center for Translational Research for baseline, 6 and 12 months measures and interview at 12 months. Men assigned to the intervention group will receive initial assessment and education on nutrition and the exercised program immediately following baseline measures. They will then receive 12 weekly calls from a nurse coordinator/cultural liaison team to deliver focused information, establish individually tailored nutrition and activity goals, assess accomplishments of goals and provide support. We will conduct qualitative interview with 30 men from each group to assess the intervention from their perspective and to develop explanatory frameworks for decision process used relative to food and activity choices. Analysis will combine within and between group comparisons and grounded theory techniques.