SALSA - Study of Active Lifestyle Activation

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PROJECT SUMMARY The proposed supplemental funding request is in response to PA 20-272, and to support R01 CA263144 (SALSA: Study of Active LifeStyle Activation; NCT05075759; funding period 2021-2026). SALSA is a remotely conducted 12-month randomized controlled trial testing a multi-faceted approach at improving physical activity and diet quality in long-term survivors of childhood cancer at an increased risk of early cardiovascular (CV) disease. The primary outcomes of the trial are reductions in sedentary time and improvements in diet quality after 12 months. Secondary outcomes include other CV risk factors such as changes in blood pressure and weight, and the measurement of various blood biomarkers known to be associated with CV disease (e.g., lipid profile, insulin resistance, general inflammation, and adipokines). Collectively, many of these CV risk factors may contribute to the phenotype of accelerated aging and premature frailty, which is now increasingly recognized among cancer survivors, including survivors of childhood cancer. The proposed supplement seeks to enhance our understanding of the accelerated aging phenotype in survivors of childhood cancer. Specifically, we propose to approach SALSA participants who have completed the 12-month intervention with: 1) more in-depth phenotyping of physical function (via remote methods) beyond the actigraphy data collected by the parent trial, and 2) collect additional biomarkers known to be associated with accelerated aging in cancer survivors. Leveraging SALSA’s randomized trial design, we will also explore differences by study arms (i.e., control group; clinician-led goal-setting; mHealth-based goal setting), and among those participants (irrespective of study arm) who have better lifestyle profiles while adjusting for history of cardiotoxic cancer treatment exposures. While the limited nature of this supplement may preclude our ability to identify statistically significant differences between groups, it will provide important preliminary data demonstrating feasibility of assessing physical function using remote methods, and data on potentially detectable differences that may inform the design of future interventions that seek to target specific functional outcomes and other biomarkers of frailty and accelerated aging.