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

男人向前迈进：对非裔美国前列腺癌​​幸存者的生活方式干预

• 批准号: 10457264
• 负责人: Melinda R Stolley
• 金额: $ 62.62万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10457264
• 关键词: Address; Adherence; Adopted; African American; African American population; American Cancer Society; Behavior; Behavioral; Biological; Biological Markers; Blood Pressure; Body Composition; Breast Cancer survivor; C-Peptide; C-reactive protein; Cancer Survivor; Cancer Survivorship; Caring; Chronic Disease; Climacteric; Collaborations; Communities; Diet; Eating; Estradiol; Exhibits; Guidelines; Health; Health behavior; Hormonal Change; Hormones; Incidence; Inflammation; Insulin Resistance; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Intake; Intervention; Intervention Studies; Leptin; Lipids; Location; Malignant Neoplasms; Malignant neoplasm of prostate; Mass Behavior; Measurement; Nonmetastatic; Not Hispanic or Latino; Obesity; Outcome; Outcome Study; Patient Outcomes Assessments; Pattern; Physical Function; Physical activity; Plant Roots; Processed Meats; Program Sustainability; Quality of life; Randomized; Recreation; Reporting; Resources; Risk; Sex Functioning; Sex Hormone-Binding Globulin; Social isolation; Social support; Survivors; System; Technology; Testosterone; Thinness; Time; Underrepresented Populations; Unhealthy Diet; Work; adiponectin; arm; base; blood lipid; cancer diagnosis; cancer recurrence; carcinogenesis; comorbidity; efficacy evaluation; evidence base; fasting glucose; fruits and vegetables; healthy lifestyle; improved; interest; intervention effect; intervention program; lean body mass; lifestyle intervention; men; mortality; multidisciplinary; novel; nutrition; physical inactivity; post intervention; program dissemination; programs; prostate cancer progression; prostate cancer survivors; randomized trial; recruit; response; strength training; survivorship; tumor progression

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.

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）中观察到生存。 AA PC幸​​存者的合并症负担更高， 这很重要，因为它们比PC本身更有可能死于合并症。另外，AA PC幸存者报告说，相对于非西班牙裔白人（NHW）幸存者，生活质量较差（QOL）。许多因素 驱动这些差异，其中身体成分和健康行为很重要，但可修改 贡献者。作为回应，现在有规定的生存护理包括关注健康的生活方式。此外， 美国癌症协会提出了营养和体育锻炼指南，以帮助所有癌症幸存者 实现最佳健康和质量。不幸的是，许多幸存者不知道这些准则和研究 表明，与NHW幸存者相比，AA PC幸​​存者更有可能是非依从者。综合效果 饮食不良和身体不活跃通常会导致身体不良的组成（即高肥胖，低瘦质量） 导致荷尔蒙变化，以及肿瘤炎症和胰岛素抵抗增加的增加 理论上促进致癌和慢性疾病。虽然，生活方式干预报告有益 PC幸存者的结果是，AA男性的包含受到严重限制。迄今为止没有大型干预研究 通过招聘或调整干预措施来满足他们的需求，对AA PC幸​​存者进行了针对性的AA PC幸​​存者。我们 提出了一项与200个AA前列腺癌幸存者的随机试验，以检查男性的疗效 Forward是一个六个月的基于社区的生活方式干预措施，植根于循证的前进 最初由AA乳腺癌幸存者开发的生活方式干预措施，然后改编成合作 与AA PC幸​​存者。前进的男性支持PC幸存者在采取体育锻炼和进食方面 将改善其身体成分，增强QOL并降低合并症的风险的模式 可能是PC复发。研究结果包括身体成分（肥胖，瘦质量），行为（饮食， 体育活动）和生活质量。我们还将探索一般健康的生物标志物（血压，脂质） 和肿瘤进展（炎症，胰岛素抵抗和激素）。这项研究是新颖的，重点是AA PC幸存者，人体组成的测量以及相关生物标志物的探索。另外， 研究正在与密尔沃基公共休闲系统合作进行，该系统增加了 计划可持续性的潜力。我们组建了一个高素质的多学科学习团队， 利用我们的资源和以前的干预策略，将社会支持和技术整合到 促进干预参与和依从性。