||1R03CA270475-01 Interpret this number
||H. Lee Moffitt Cancer Ctr & Res Inst
||The Coach Study: a Framework for Individualized Coaching in Young Adult Cancer Survivors to Encourage Healthy Behaviors
When a young adult (YA) is diagnosed with cancer, normal growth and development is disrupted, heightening
nutritional needs in a vulnerable population. YA Hispanic and African Americans survivors are particularly
vulnerable as they are more likely to have a higher body mass index (BMI) pre-treatment, further increasing the
risk of late effects of cancer and comorbidities. Following treatment, YA survivors report worse quality of life
(QOL) and greater symptomatology, including fatigue, constipation, frailty, low muscle mass, slow walking speed,
and weakness similar to adults aged 65 and older. As a result of treatment, changes in body weight and
limitations in physical movement are a major concern in 30-60% of survivors. While a number of lifestyle
interventions have been published, only two published YA cancer survivor studies have incorporated a diet and
PA bundled health behavior approach. Each study followed different dietary guidelines and both studies were
conducted in YA breast cancer survivors who may have different needs as a result of treatment and gender
differences. There is a lack of understanding of YA from racial/ethnic minority backgrounds as the
aforementioned studies did not include Hispanic survivors and recruited only a small handful of African American
survivors, an important gap we plan to address in this application. Thus, healthy lifestyle interventions
encompassing diet and physical activity (PA) to prevent obesity-related late effects are warranted. The goal of
the current study is to take a sequential mixed methods approach addressing this knowledge gap to gain
essential quantitative and qualitative information that will serve as the framework for our next steps; a healthy
lifestyle intervention for YA cancer survivors that are diverse in terms of race, ethnicity, gender, cancer diagnosis,
time since diagnosis, and treatment. In Aim 1, we will recruit a diverse sample of YA cancer survivors currently
between 20-30 years of age to obtain objective and subjective lifestyle behavior data on current diet quality, PA,
and quality of life. For Aim 2, we will recruit a subset of Aim 1 survivors to participate in phenomenological based
semi-structured interviews guided by the Social Cognitive Theory to (a) explore sociocultural, environmental,
and individual factors associated with lifestyle behaviors; (b) explore awareness of ACS guidelines, current
practices, and essential intervention modules (e.g., integrating cultural foods and preferences) to inform
intervention content and modality. There is an urgent need to develop health behavior interventions for YA cancer
survivors that are effective and easily disseminated. Successful completion of this study will provide the
information needed to create and enhance the framework for our proposed intervention “COACH: Individualized
COaching in young Adult Cancer survivors to encourage Healthy behaviors” in terms of format and module
content, with desirable patient-level preferences for sociocultural and environmental factors. The intervention
framework created at the end of the study will be easily modified to best suit an individual’s background, taking
into consideration their worldview, increasing the potential to be widely disseminated and effective.
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