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

前列腺癌(PC)是男性中最常见的癌症，发病率最高，最低 在非裔美国人(AA)中观察到的存活率。AA PC幸存者的共病负担更高， 这一点很重要，因为他们更有可能死于并存的疾病，而不是PC本身。此外，AA PC幸存者报告说，与非西班牙裔白人(NHW)幸存者相比，他们的生活质量(QOL)较差。很多因素 推动这些差异，其中身体成分和健康行为是重要的，但可以修改 贡献者。作为回应，强制生存护理现在包括对健康生活方式的关注。另外， 美国癌症协会提出营养和体力活动指南，以帮助所有癌症幸存者 实现最佳健康和生活质量。不幸的是，许多幸存者并不知道这些指南和研究 表明AA PC幸存者比NHW幸存者更有可能是非依从者。综合效应 饮食不良和缺乏体力活动往往会导致身体成分不良(即高脂肪、低瘦体重) 导致荷尔蒙变化，伴随着增加的系统性炎症和胰岛素抵抗，这是 理论上是为了促进癌症发生和慢性疾病。尽管，生活方式干预报告是有益的 结果对于PC幸存者来说，AA男性的纳入是非常有限的。到目前为止还没有大规模的干预研究 以再生障碍性贫血幸存者为目标，通过招募或根据他们的需求量身定做干预措施。我们 建议对200名AA前列腺癌幸存者进行随机试验，以检验男性搬家的疗效 Forward，一项为期六个月的社区生活方式干预，植根于循证推进 生活方式干预最初是与AA乳腺癌幸存者一起开发的，后来在合作中进行了调整 与AA PC幸存者一起。男性继续支持PC幸存者进行体育锻炼和进食 这些模式将改善他们的身体成分，提高生活质量，降低合并疾病的风险， 可能是PC复发。研究结果包括身体成分(肥胖、瘦体重)、行为(饮食、 体力活动)和生活质量。我们还将探索一般健康的生物标记物(血压、血脂) 和肿瘤进展(炎症、胰岛素抵抗和激素)。这项研究的重点是AA，这是很新颖的 PC幸存者、身体成分测量和相关生物标记物的探索。此外， 这项研究正在与密尔沃基公共娱乐系统合作进行，该系统增加了 可持续发展的潜力。我们已经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，将社会支持和技术相结合，以 促进干预参与和坚持。

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.