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

男人向前迈进：对非裔美国前列腺癌​​幸存者的生活方式干预

• 批准号: 10208814
• 负责人: Melinda R Stolley
• 金额: $ 63.58万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208814
• 关键词: Address; Adherence; Adopted; African American; American Cancer Society; Behavior; Behavioral; Biological; Biological Markers; Blood Pressure; Body Composition; Breast Cancer survivor; C-Peptide; C-reactive protein; Cancer Survivor; Cancer Survivorship; Caring; Chronic Disease; Climacteric; Collaborations; Communities; Diet; Eating; Estradiol; Exhibits; Guidelines; Health; Health behavior; Hormonal Change; Hormones; Incidence; Inflammation; Insulin Resistance; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Intake; Intervention; Intervention Studies; Leptin; Lipids; Location; Malignant Neoplasms; Malignant neoplasm of prostate; Mass Behavior; Measurement; Nonmetastatic; Not Hispanic or Latino; Obesity; Outcome; Outcome Study; Patient Outcomes Assessments; Pattern; Physical Function; Physical activity; Plant Roots; Processed Meats; Program Sustainability; Quality of life; Randomized; Recreation; Reporting; Resources; Risk; Sex Functioning; Sex Hormone-Binding Globulin; Social isolation; Social support; Survivors; System; Technology; Testosterone; Thinness; Time; Underrepresented Populations; Unhealthy Diet; Work; adiponectin; arm; base; blood lipid; cancer diagnosis; cancer recurrence; carcinogenesis; comorbidity; efficacy evaluation; evidence base; fasting glucose; fruits and vegetables; healthy lifestyle; improved; interest; intervention effect; intervention program; lean body mass; lifestyle intervention; men; mortality; multidisciplinary; novel; nutrition; physical inactivity; post intervention; program dissemination; programs; prostate cancer progression; prostate cancer survivors; randomized trial; recruit; response; strength training; survivorship; tumor progression

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.

前列腺癌（PC）是男性中最常见的癌症，发病率最高， 在非裔美国人（AA）中观察到的存活率。AA PC幸存者的合并症负担更高， 这一点很重要，因为他们更有可能死于合并症而不是PC本身。此外，AA 与非西班牙裔白色（NHW）幸存者相比，PC幸存者报告的生活质量（QOL）较差。许多因素 驱动这些差异，其中身体成分和健康行为是重要的，但可以改变 贡献者。作为回应，强制性生存护理现在包括关注健康的生活方式。此外，本发明还 美国癌症协会提出了营养和身体活动指南，以帮助所有癌症幸存者， 实现最佳的健康和QOL。不幸的是，许多幸存者并不知道这些指导方针和研究 表明AA PC幸存者比NHW幸存者更有可能是非依从性的。的综合影响 不良的饮食习惯和缺乏运动往往会导致不良的身体成分（即高脂肪，低瘦体重） 导致激素变化，沿着增加的全身炎症和胰岛素抵抗， 理论上是促进癌症和慢性疾病的。尽管生活方式干预报告说 PC幸存者的结果，AA男性的纳入是非常有限的。到目前为止，还没有大型干预研究 通过招募或定制干预措施以满足其需求，有针对性地帮助AA PC幸存者。我们 我建议对200名AA前列腺癌幸存者进行一项随机试验，以检查男性运动的疗效 前进，一个为期六个月的基于社区的生活方式干预，植根于循证的前进 生活方式干预最初是与AA乳腺癌幸存者一起开发的，然后在合作中进行了调整 AA PC幸存者Men Moving Forward支持PC幸存者采取体力活动和饮食 改善他们的身体组成，提高QOL和降低合并症风险的模式， 可能会导致PC复发。研究结果包括身体成分（肥胖，瘦体重），行为（饮食， 身体活动）和生活质量。我们还将探索一般健康的生物标志物（血压，血脂） 和肿瘤进展（炎症、胰岛素抵抗和激素）。这项研究是新颖的，其重点是AA PC幸存者，身体成分的测量和相关生物标志物的探索。此外， 这项研究是与密尔沃基公共娱乐系统合作进行的， 计划的可持续性。我们组建了一支高素质的多学科研究团队， 利用我们的资源和以前的干预战略，整合社会支持和技术， 促进干预参与和坚持。