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

摘要/摘要 化疗期间和化疗后的并存疾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，与欧洲和美国的同行相比。这包括下降 在心肺健康与心脏毒性作用相结合的情况下，少数族裔癌症患者患癌症的风险更高 心血管疾病。尽管运动训练对癌症患者有好处，但 在弱势群体和种族/少数民族群体中，癌症临床试验的参与率很低，可能 由于障碍更大，获得运动训练的机会更少。因此，对新的可获得性和成本的需求- 针对西班牙裔和黑人社区的有效家庭锻炼干预，以更好地了解 体力活动干预至关重要。我们提出了一项试点随机试验来检验16周的效果 对久坐、超重或肥胖的西班牙裔和黑人的监督和非监督运动干预 为治疗乳腺癌、结直肠癌和前列腺癌而接受化疗的癌症患者。这 提案将解决以下目标：1)审查这些发明是否会增加每天的分钟数 每周进行锻炼；2)评估发明对心血管危险因素的影响；3)确定 这些发明对患者报告的结果和身体功能的影响。我们假设两者都是 运动组每周每天运动的分钟数将显著增加， 与对照组相比，心血管疾病风险、生活质量和身体功能得到改善。这 研究是创新的，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 对接受化疗的少数族裔人群采用新的、可实现的干预措施的第一项研究，c) 整合新的生理变量进行干预。我们的建议解决了这一优先重点 通过设计和实施针对 服务不足、研究不足、弱势群体--接受化疗的西班牙裔和黑人患者。这个 Dieli-Conwright博士(DFCI)和严博士(UMB)将结合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，以成功执行这一项目。此次合作是 由UMB-DF/HCC伙伴关系与NCI CPACHE支持的资源唯一地成为可能。 这项研究的发现将产生关于运动干预效果的新知识，并提供 指导改善这一服务不足的弱势群体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.