Men Moving Forward: A Lifestyle Intervention for African American Prostate Cancer Survivors

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Prostate cancer (PC) is the most commonly diagnosed cancer among men, with highest incidence and lowest survival observed among African-Americans (AA). Comorbidity burden is higher among AA PC survivors, which is important given they are more likely to die of comorbid conditions than of PC itself. Additionally, AA PC survivors report poorer quality of life (QOL) relative to Non-Hispanic white (NHW) survivors. Many factors drive these differences among which body composition and health behaviors are important, yet modifiable contributors. In response, mandated survivorship care now includes a focus on healthy lifestyles. Additionally, the American Cancer Society put forth nutrition and physical activity guidelines to help all cancer survivors achieve optimal health and QOL. Unfortunately, many survivors are not aware of these guidelines and studies suggest that AA PC survivors are more likely than NHW survivors to be non-adherent. The combined effects of poor diet and physical inactivity often result in adverse body composition (i.e, high adiposity, low lean mass) leading to hormonal changes, along with increased sytemic inflammation and insulin resistance which are theorized to promote carcinogenesis and chronic diseases. Although, lifestyle interventions report beneficial results for PC survivors, the inclusion of AA men is critically limited. No large intervention study to date has targeted AA PC survivors either through recruitment or by tailoring the intervention to meet their needs. We propose a randomized trial with 200 AA prostate cancer survivors to examine the efficacy of Men Moving Forward, a six-month community-based lifestyle intervention rooted in the evidence-based Moving Forward lifestyle intervention originally developed with AA breast cancer survivors, and then adapted in collaboration with AA PC survivors. Men Moving Forward supports PC survivors in adopting physical activity and eating patterns that will improve their body composition, bolster QOL and reduce risk for comorbidities and, potentially, PC recurrence. Study outcomes include body composition (adiposity, lean mass), behavior (diet, physical activity), and quality of life. We will also explore biomarkers of general health (blood pressure, lipids) and tumor progression (inflammation, insulin resistance and hormones). This study is novel in its focus on AA PC survivors, measurement of body composition and exploration of relevant biomarkers. Addtionally, the study is being conducted in partnership with the Milwaukee Public Recreation system which increases the potential for program sustainability. We have assembled a highly qualified, multidisciplinary study team, leveraging our resources and previous intervention strategies that integrate social support and technology to promote intervention participation and adherence.