Promoting Weight-Loss in African American Cancer Survivors in the Deep South

描述（由申请人提供）：三种与肥胖相关的癌症（乳腺癌、前列腺癌、结直肠癌）占每年癌症诊断的1/3以上，2009年造成112，520人死亡。尽管近年来在早期发现和治疗方面取得了显着进展，但生活在南方腹地的非洲裔美国人的癌症负担更大。亚拉巴马（AL）的非裔美国人与肥胖相关的癌症死亡率超过了白色人的国家和州死亡率，也超过了非裔美国人的国家死亡率。超重和肥胖是美国76%的非裔美国人的特征，与多种癌症有关。虽然减少多余的体重对癌症预防和生存都有好处，但实现和保持体重减轻是由个人，社会背景和环境因素复杂化的。在一般人群中，非裔美国人减肥的成功率往往低于他们的白色同行。提到的障碍包括缺乏社会支持和环境挑战（例如，健康的平价食品供应有限，获得安全和方便的体育活动机会的机会有限）。多层次（个人，人际关系，环境/政策）的方法已经显示出在实现和维持减肥的承诺，然而，据我们所知，有没有发表的研究多层次减肥干预非洲裔美国人癌症幸存者。拟议的三组群集设计将招收450名超重的非洲裔美国人（225名癌症幸存者及其225名家庭成员）居住在AL的9个农村社区。社区将被随机分配接受基于证据和文化适应的减肥干预（第1组），一个基于证据和文化适应的减肥干预加上社区战略，以支持减肥（组2），或没有干预（组3）。该研究旨在回答研究问题：除了基于证据的减肥计划之外，基于证据的社区策略是否会导致居住在南方腹地农村社区的超重癌症幸存者（及其家庭成员）的体重减轻？该研究的独特元素包括其基于社区的参与式研究（CBPR）方法;关注减肥成功的社会和环境障碍，使用社区健康顾问提供计划内容，以及目标县长期参与成功的学术-社区合作伙伴关系，寻求消除癌症差异。

DESCRIPTION (provided by applicant): Three obesity-related cancers (breast, prostate, colorectal) account for over 1/3 of cancer diagnoses annually and caused 112,520 deaths in 2009. Despite notable progress in early detection and treatment in recent years, African Americans living in the Deep South experience greater cancer burden. Obesity-related cancer death rates for African Americans in Alabama (AL) exceed national and state rates for their white counterparts, as well as national rates among African Americans. Overweight and obesity, which characterizes 76% of African Americans in the US, are implicated in multiple cancers. While reducing excess weight is beneficial in both cancer prevention and survivorship, achieving and maintaining weight loss is complicated by individual, socio-contextual and environmental factors. In the general population, African Americans are often less successful with weight loss than their white counterparts. Cited barriers include lack of social support and environmental challenges (e.g., limited availability of healthy affordable food and access to safe and convenient opportunities for physical activity). Multilevel (individual, interpersonal, environment/policy) approaches have shown promise in achieving and sustaining weight loss; however, to our knowledge, there are no published studies of multilevel weight-loss interventions for African American cancer survivors. The proposed three-group cluster design will enroll 450 overweight African Americans (225 cancer survivors and their 225 family members) residing in 9 rural communities in AL. Communities will be randomly assigned to receive either an evidence-based and culturally-adapted weight loss intervention (Group 1), an evidence-based and culturally-adapted weight loss intervention plus community strategies to support weight loss (Group 2), or no intervention (Group 3). The study seeks to answer the research question: Do evidence-based community strategies supporting weight loss in addition to an evidence-based weight loss program result in greater weight loss among overweight cancer survivors (and their family members) residing in rural communities in the Deep South? Unique elements of the study include its community-based participatory research (CBPR) approach; focus on social and environmental barriers to weight loss success, use of community health advisors to deliver program content, and long-term involvement of targeted counties in a successful academic-community partnership seeking to eliminate cancer disparities.