Testing Homebased ExeRcise Strategies to Improve Exercise Participation and CardioVascular Health in UndersErved Minority Patients with Cancer Undergoing Chemotherapy, the THRIVE Study

总结/摘要 化疗期间和化疗后，共病风险和生活方式行为存在显著差异 在西班牙裔和黑人癌症患者中，与欧美同行相比。其中包括下降 在心肺健康与心脏毒性效应配对，使少数癌症患者的风险更高， 心血管疾病尽管运动训练对癌症患者有好处， 在弱势群体和种族/少数民族群体中，参与临床癌症试验的人数很少， 由于更大的障碍和更少的运动训练。因此，需要新的可访问和成本- 针对西班牙裔和黑人社区的有效的家庭锻炼干预，以更好地了解 身体活动干预至关重要。我们建议进行一项试点随机试验，以检查16周的效果， 对久坐、超重或肥胖的西班牙裔和黑人进行有监督和无监督的运动干预 接受化疗以治疗乳腺癌、结肠直肠癌和前列腺癌的癌症患者。这 建议将针对以下目标：1）研究发明是否会增加每天的分钟数 每周进行的锻炼; 2）评估本发明对心血管危险因素的影响; 3）确定 本发明对患者报告的结果和身体功能的影响。我们假设 锻炼组每周的日常锻炼分钟数将显著增加， 与对照组相比，心血管疾病风险、生活质量和身体功能改善。这 这项研究具有创新性，因为a）我们将在高需求、研究不足的人群中进行研究，B）这是 第一项针对接受化疗的少数人群采用新型和可实现的干预措施的研究，c） 整合新的生理变量进行干预。我们的建议涉及这一优先重点， 通过设计和实施一项运动干预， 服务不足、研究不足的弱势人群-接受化疗的西班牙裔和黑人患者。的 联合PI博士Dieli-Conwright（DFCI）和Yan（UMB）将汇集他们在运动科学方面的专业知识， 癌症存活率和心血管生理学来成功执行这个项目。开展此种合作 UMB-DF/HCC合作伙伴关系在NCI CPACHE支持的资源下独特地使其成为可能。 这项研究的结果将产生关于运动干预效果的新知识，并提供 指导提高这一服务不足、易受伤害人群的质量和治疗耐受性， 癌症患者。

SUMMARY/ABSTRACT Profound disparities exist in comorbid disease risk and lifestyle behaviors during and following chemotherapy in Hispanic and Black cancer patients, compared with European American counterparts. This includes declines in cardiorespiratory fitness paired with cardiotoxic effects, placing minority cancer patients at a higher risk for cardiovascular disease. Despite the beneficial effect of exercise training for cancer patients, rates of participation in clinical cancer trials are low among disadvantaged and racial/ethnic minority groups, possibly due to greater barriers and less access to exercise training. Therefore, the need for novel accessible and cost- effective home-based exercise intervention aimed at the Hispanic and Black communities to better understand physical activity interventions is crucial. We propose a pilot randomized trial to examine the effect of 16-week supervised and unsupervised exercise interventions in sedentary, overweight or obese Hispanic and Black cancer patients undergoing chemotherapy for the treatment of breast, colorectal, and prostate cancer. This proposal will address the following aims: 1) examine whether the inventions will increase daily minutes of exercise performed per week; 2) assess the effect of the inventions on cardiovascular risk factors; 3) determine the effect of the inventions on patient-reported outcomes and physical function. We hypothesize that both exercise groups will experience a significant increase in minutes of daily exercise per week, reductions in cardiovascular disease risk, improved quality of life, and physical function when compared to Controls. This study is innovative because a) we will conduct the study in high-need, understudied population, b) this is the first study to employ a novel and achievable intervention for a minority population receiving chemotherapy, c) integration of novel physiological variables for the intervention. Our proposal addresses the priority focus of this funding opportunity announcement through the design and implementation of an exercise intervention for an underserved, understudied, vulnerable population- Hispanic and Black patients receiving chemotherapy. The Co-PIs Drs. Dieli-Conwright (DFCI) and Yan (UMB) will bring together their expertise in exercise science, cancer survivorship, and cardiovascular physiology to successfully execute this project. This collaboration is uniquely made possible by the UMB-DF/HCC Partnership with the resources supported by the NCI CPACHE. Findings from this study will generate new knowledge about the effects of exercise intervention and provide guidance towards improving the quality and treatment tolerability in this population of underserved, vulnerable patients with cancer.