African American Cancer Survivors Research Articles

Sleep health and quality of life in the Detroit Research on Cancer Survivors cohort.

Sleep disturbances represent a modifiable target to improve quality of life and longer-term outcomes in cancer survivors. However, the association between sleep health and overall quality of life in African American cancer survivors has been poorly assessed, a population at increased risk for morbidity and mortality. Seven hundred and eighteen Detroit Research on Cancer Survivors (ROCS) cohort participants completed a supplemental sleep survey at the time of enrollment, which included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI). Linear and logistic regression was used to evaluate the association between sleep and mental health, while block regression models were used to estimate the contribution of clustered factors to Health-Related Quality of Life (HRQOL). Nearly 60% of the cohort reported symptoms indicative of poor sleep quality on the PSQI, 15% reported excessive daytime sleepiness on the ESS, and 12% reported moderate to severe insomnia on the ISI. Survivors with elevated ISI scores reported FACT-G scores that were 17 points lower than those without symptoms of insomnia (95% CI: - 13.1, - 21.2). Poor sleep health accounted for the largest proportion of variability in FACT-G scores (R2 = 0.27) and change in R2 value (0.18) when compared to comorbidities, health behaviors, cancer-related factors, and demographics. Overall sleep health was significantly associated with poorer HRQOL and variability in FACT-G scores. Additional studies investigating a causal relationship between sleep and HRQOL are needed to determine whether sleep quality could affect disparities in cancer outcomes. Addressing sleep quality in cancer survivors may improve long-term health and HRQOL.

Equipping Faith-Based Communities for Cancer Support Ministry: A Pilot Study of Cancer Support Training for Members of African-American Churches in the USA.

Church-academic partnerships focused on cancer, generally target cancer screening and prevention, with few focusing explicitly on cancer survivors. With the population of cancer survivors steadily increasing, highlighting the value of faith-based cancer support ministry is paramount. However, many churches may not have the resources to integrate relevant cancer support ministry and may need to identify ways to reach cancer survivors. We piloted cancer support training to help church members to start a cancer support ministry with African-American churches in Milwaukee, WI. We sought to measure the feasibility of a two-day training workshop to build the capacity of churches through recruiting and training church members on how to foster social support and to disseminate cancer information and resources throughout their churches. Our study was guided by the social networks and social support framework, which we applied to cancer survivorship. Our study supports the feasibility of engaging churches in a virtual training to support the development of cancer support ministries to address the needs of African-American cancer survivors. Based on our recruitment success, workshop attendance, evaluation and retention, our results suggest that a two-day workshop was successful in facilitating the initiation of cancer support ministries within African-American churches.

Examining the role of social relationships on health and health behaviors in African American men with prostate cancer: a qualitative analysis.

Cancer survivor cohort studies document the positive impact of health behaviors on cancer survivorship by influencing quality of life, comorbidity burden, and cancer recurrence. Social networks can be instrumental in supporting health behavior changes. This study used qualitative interviews to explore how social networks may impact health and health behaviors of African American Prostate Cancer Survivors (AAPCS) enrolled in Men Moving Forward (MMF), a lifestyle intervention designed with and for AAPCS. Specifically, we sought to understand how different relationships within social networks influence health and health behaviors, and to identify potential mechanisms for this influence. Eighteen men who completed the MMF intervention participated in a semi-structured interview which explored social connections, health and health behaviors, stress, and the cancer experience. Interviews were recorded and transcribed, and thematic analysis was performed by two coders. Participants described robust social networks of friends and family. Four distinct yet overlapping themes were identified that described how relationships influence health and health behaviors among AAPCS: (1) provision of knowledge, (2) health and behavior history, (3) encouragement and support, and (4) shared behavior. These results provide initial insight into the types of relationships that influence health, and the intersecting and multifaceted mechanisms through which this influence occurs.

African American and Hispanic Cancer Survivors' and Caregivers' Experiences in Nebraska.

Racial and ethnic minority populations experience poorer cancer outcomes compared to non-Hispanic White populations, but qualitative studies have typically focused on single subpopulations. We explored experiences, perceptions, and attitudes toward cancer care services across the care continuum from screening through treatment among African American and Hispanic residents of Nebraska to identify unique needs for education, community outreach, and quality improvement.We conducted four focus groups (N = 19), April-August 2021 with people who were aged 30 or older and who self-identified as African American or Hispanic and as cancer survivors or caregivers. Sessions followed a structured facilitation guide, were audio recorded and transcribed, and were analyzed with a directed content analysis approach.Historical, cultural, and socioeconomic factors often led to delayed cancer care, such as general disuse of healthcare until symptoms were severe due to mistrust and cost of missing work. Obstacles to care included financial barriers, transportation, lack of support groups, and language-appropriate services (for Hispanic groups). Knowledge of cancer and cancer prevention varied widely; we identified a need for better community education about cancer within the urban Hispanic community. Participants had positive experiences and a sense of hope from the cancer care team.African American and Hispanic participants shared many similar perspectives about cancer care. Our results are being used in collaboration with national and regional cancer support organizations to expand their reach in communities of color, but structural and cultural barriers still need to be addressed.

Abstract A021: Prevalence of metabolic syndrome and its association with physical activity in African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program

Abstract Background: Black/African American (Bl/AA) men have the highest death rate from Prostate Cancer(PC) compared to any other race/ethnicity. PC is also the second leading cause of death in this population. Men Moving Forward (MMF) is the first community-based lifestyle intervention developed with and for African American Prostate Cancer Survivors (AAPCS). This study assesses the prevalence of Metabolic Syndrome(MetS) in MMF cohort at baseline and explores the association between physical activity (PA) and MetS. MetS is implicated as a possible risk factor for the progression of PC and is a well-established risk factor for Cardiovascular (CV) disease, the most common cause of death among PC survivors cured of their cancers. MetS is defined as having three or more risk factors: waist circumference > 40-inches, blood pressure (BP) > 130/80 mmHg, fasting blood glucose >100 mg/dl, HDL level <40mg/dl and triglyceride level > 150 mg/dl. Notably, physical inactivity is a known risk for MetS, CV disease and PC. Methods: MMF is a 16-week group-based lifestyle intervention, led by local health coaches. To be eligible, men must have a BMI > 23 kg/m2, completed treatment or on active surveillance, and non-adherent to ACS nutrition OR PA guidelines. Men complete surveys, physical assessments, and blood draws at baseline, post-intervention, and 12-months. Baseline waist circumference, resting BP measurement, fasting glucose level, HDL level, and triglyceride level were examined. PA was measured using the Godin Leisure-Time Exercise scale with scores stratified into three activity levels: insufficiently active (< 14 ), moderately active(14-23), and active(> 24). The association between PA and MetS was assessed using Chi-square test of independence. Results: 117 AAPCS were enrolled at baseline, with 98 having complete PA and MetS data. These participants had a mean age of 66.21 ± 7.378. Top comorbidities include hypertension (71%), obesity (51%), diabetes (31%), and hypercholesterolemia (48%). 36.27% of participants had MetS at baseline, higher than the prevalence observed in NHANES for Bl/AA men without cancer (16.7%). Many had risk factors for MetS: 27% had BP >130/80 mmHg, 65% had fasting glucose levels > 100mg/dl, 27% had HDL level <40 mg/dl, 17% had triglyceride levels > 150 mg/dl and 73% had waist circumference > 101.6cm(40 inches). When assessing physical activity at baseline 39% were active, 28% were moderately active and 33% were insufficiently active. 41% of those with MetS were insufficiently active. PA and MetS were not significantly associated X2(2, N = 98) = 0.370, P = 0.833. However, among MetS components, PA was significantly associated with high BP, X2(2, N = 108) = 10.51, P = 0.0052. Conclusion: Data reflects the value of supporting AAPCS in lifestyle changes to increase PA and to improve the burden of CV disease and PC recurrence risk. Few efforts have addressed lifestyle among AAPCS, despite high PC prevalence. Future reports will examine other factors associated with MetS and prostate cancer such as dietary intake and body composition. Citation Format: Meheret B. Gebreegziabher, Patricia Sheean, Paula Papanek, Alexis Vistcky, Awoyinka Iwalola, Anjishnu Banerjee, Toni Uhrich, Margaret Tovar, Miracle Powell, Sandra Contreras, Kathleen O'Connell, Melinda Stolley. Prevalence of metabolic syndrome and its association with physical activity in African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A021.

Abstract A106: Examining the role of social connection on allostatic load and quality of life in African American prostate cancer survivors

Abstract Background. Racial disparities in prostate cancer (PC) survivorship persist despite clinical advancements. Chronic stress may contribute to these disparities, with allostatic load (AL) considered a measure of such stress. Associations between AL and survivorship outcomes such as quality of life (QoL) are documented, yet less is known about factors influencing these relationships. Social connections (SC) (e.g., social networks, social support) are associated with improved QoL in survivors, yet which aspects of SC and which pathways linking SC to QoL remain unclear. Additionally, little is known about the SC of African American PC survivors (AAPCS) and how these relate to QOL, stress, and AL. This study explores the relationship between SC, stress (perceived and AL) and QOL in in 48 AAPCS enrolled in Men Moving Forward, a randomized trial to improve body composition through lifestyle change. Methods. At baseline, participants completed surveys including: the Cohen Social Network Index assessing 3 aspects of social networks: network size (# of ties with regular contact), diversity (# of roles with regular contact) and embeddedness (# of domains with 4 or more regular contacts); Patient-Reported Outcomes Measurement Information System (PROMIS) measures of social support (companionship, emotional and informational support); the perceived stress scale, and PROMIS measures of physical function, anxiety, depression, fatigue, sleep disturbance, social function, and pain intensity. The latter were used to generate summative physical (PQOL) and mental (MQOL) health standardized T-scores (U.S. population mean=50, SD=10). AL scores used 15 criterion reflecting neuroendocrine, cardiovascular, immune, and metabolic systems. Each criterion was assigned a score of 0 or 1: 1 if in the high-risk range based on clinical guidelines. An index score was generated by summing high-risk indicators. Pearson correlations were used to explore the relationship between aspects of SC and QOL and SC and stress variables. Results. The average AL score was 5.8 (SD ± 2.3) of a maximum 15. No significant correlations were found between any SC domains and AL. However, negative associations were identified between network size (r=-.313, p=0.030), emotional support (r=-.319, p = 0.027), companionship (r=-.313, p=0.030) and perceived stress. A positive association was found between loneliness and perceived stress (r=.521, p<0.000). MQOL was positively related to network size (r=.364, p=0.011), emotional support (r=.366, p=0.011), and companionship (r=.288, p=0.047). Loneliness was negatively associated with MQOL (r=-.626, p<0.000) and PQOL (r=-.407, p=0.006). Conclusions. These findings suggest SC has a positive impact on survivorship in AAPCS, and that structural and functional aspects of SC may be involved. Currently, limited resources are available for PC survivors, and even fewer are tailored for AAPCS. Future efforts to improve survivorship for AAPCS should consider assessing social networks and access to social support when initiating survivorship care. Citation Format: Iwalola A. Awoyinka, Kathryn Flynn, Deepak Kilari, Kathryn Bylow, Jennifer Knight, Jamila Kwarteng, Anjishnu Banerjee, Kirsten M. Beyer, Staci Young, Patricia Sheean, Paula Papanek, Melinda Stolley. Examining the role of social connection on allostatic load and quality of life in African American prostate cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A106.

Abstract B146: Development of PRANA: Portal for Research, Analysis and traiNing of breAthing

Abstract Cancer survivorship is a challenging path involving symptoms that afflict both the physical and emotional aspects of life. Cancer survivors are increasingly adopting to newer tools that could be potentially beneficial in symptom relief. One such approach is yogic breathing, a set of breathing practices from the yoga tradition and can be a powerful tool to address both the mind and the body. Breathing regulation is a common technique in several cultures and practices and known to improve wellbeing. While mind-body practices are common among cancer patients, African American cancer patients have low accessibility to these tools although they are open to adopt these lifestyle practices. Our previous studies have shown salivary biomarker changes, and emotional improvement such as reduced stress in response to breathing exercises. We use these breathing exercises in a lodging facility (Hope Lodge) for cancer patients and caregivers during the treatment period. To improve the treatment delivery for remote learning in a culturally acceptable manner we are creating a web portal (named PRANA, meaning vital energy; and an acronym for Portal for Research, Analysis, and traiNing of breAthing) that will house several breathing exercises that would allow participants to choose depending upon their current state of mind and body. The Prana portal will be useful in delivering breathing exercises to patients from remote areas and places where yogic breathing is not provided commonly. We have created the alpha version of the animation characters, exercise scripts, and voiceover. Their cultural suitability is analyzed within the research group and by working with the Participant Engagement Groups (PEGS) through the South Carolina Clinical and Translational Research Institute. These animations will be constructed into a web portal for beta testing and will be available to present at this AACR meeting. Owing to the tailored nature of the practice, this tool will be acceptable by a large proportion of African American cancer survivors. Additionally, the portal would be a resource for researchers that are interested in studying individual breathing exercises. Citation Format: Sundaravadivel Balasubramanian, Crystal Nixon, Katharine R. Sterba, Graham W. Warren. Development of PRANA: Portal for Research, Analysis and traiNing of breAthing [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B146.

Housing instability and psychological distress in African American cancer survivors: findings from the Detroit Research on Cancer Survivors study.

As health care systems seek to screen for and address housing instability in patient populations, robust evidence linking unstable housing to patient-reported outcomes is needed. Housing instability may increase psychological distress in cancer survivors, potentially more so among African American cancer survivors who are also likely to experience disproportionate burden of housing instability. The purpose of this analysis was to estimate associations between housing instability and psychological distress in African Americans diagnosed with cancer. We included survey responses from 2875 African American cancer survivors in the Detroit Research on Cancer Survivors (ROCS) study. We examined how housing instability at enrollment, using an item adapted from the Health Leads Screening Toolkit, related to psychological distress at enrollment, using Patient Reported Outcomes Measurement System (PROMIS) 4-item anxiety and depression short forms. Linear regression models adjusted for sociodemographic factors were used to estimate associations overall and stratified by stage at diagnosis. Approximately 12% of participants reported being unstably housed. Housing instability was associated with significant differences in PROMIS scores for both anxiety (difference: 6.79; 95% CI: 5.57-8.01) and depression (difference: 6.16; 95% CI: 4.99-7.34). We did not find meaningful differences stratifying by disease stage. Housing instability was experienced by over a tenth of this cohort of African American cancer survivors and was related to statistically and clinically meaningful differences in psychological distress even following adjustment for sociodemographics. These findings provide evidence supporting screening of housing instability in cancer survivors, especially those from medically underserved populations.

Use of electronic cigarettes among African American cancer survivors.

The use of electronic cigarettes (e-cigarettes) is increasing rapidly in the United States, although the negative health outcomes associated with these products are still unknown. Emerging research has examined the use of e-cigarettes in the cancer survivor population as a whole, yet none has focused on e-cigarette use in the African American (AA) cancer survivor population. The authors used data from the Detroit Research on Cancer Survivors cohort study, comprised of AA adult cancer survivors. Logistic regression models were used to evaluate factors potentially associated with e-cigarette ever use and current use. Of 4443 cancer survivors who completed a baseline interview, 8.3% (n=370) reported ever using e-cigarettes, and 16.5% (n=61) of those reporting ever use also reported current use of e-cigarettes. Ever users and current users were on average younger than those who did not use e-cigarettes (57.5vs. 61.2years; p<.001). Current cigarette smokers were >20 times more likely (odds ratio, 20.75; 95% confidence interval, 12.84-33.55) and former smokers were almost 10 times more likely (odds ratio, 9.50; 95% confidence interval, 6.03-14.97) to have ever used e-cigarettes than never-smokers. Preliminary data suggested that ever use of e-cigarettes is associated with later stage at diagnosis for breast and colorectal cancers. As the use of e-cigarettes increases in the general population, it is important to continue to monitor their use in cancer survivors and to gain more insight as it pertains to the AA cancer survivor population. Elucidation of the factors associated with e-cigarette use in this population may help inform comprehensive cancer survivorship recommendations and interventions.

Sleep health and quality of life in African American cancer survivors: The Detroit ROCS Cohort.

10556 Background: Sleep disturbances are particularly prevalent among cancer survivors, likely attributed in part to anxiety over prognosis, treatment, and associated financial concerns. We know little about prevalence, patterns and predictors of poor sleep health in African American (AA) cancer survivors. Sleep problems may contribute in part to the observed disparities in outcomes in this high-risk population and represents a modifiable target to improve quality of life and longer-term health problems. Methods: The Detroit Research on Cancer Survivors (ROCS) study is a large cohort of AA cancer survivors diagnosed with female breast, prostate, colorectal, endometrial, lung or any other early onset cancer on or after 01/01/2013 in Metropolitan Detroit. We have enrolled 5,073 survivors into the study, each completing a baseline survey with annual follow-up to update medical history, health related quality of life (QoL), and other prognostic factors. In 2021, a supplemental sleep survey was administered to all eligible survivors. The current investigation analyzes sleep, QoL (measured using the Functional Assessment of Cancer Therapy - General (FACT-G) survey), and relevant health behavior data from 716 survivors who completed the sleep survey. Sleep health was measured using the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). Block regression was used to estimate the contribution of clustered factors to QoL. Five blocks were evaluated: sleep health, demographics, cancer characteristics, comorbidities, and health behaviors. Results: Nearly 60% of AA cancer survivors in the study reported symptoms indicative of poor sleep quality (PSQI score 6-21) with 17% reporting excessive daytime sleepiness (ESS score 11-24) and 11% reporting moderate to severe insomnia (ISI score ≥ 15). Sleep disturbances and poor quality of sleep were associated with clinically meaningful declines in QoL, where survivors with ISI scores in the clinical range reported adjusted FACT-G scores 19 points lower than those with ISI score below the clinical range (95% CI -14.7, -22.6). Sleep health accounted for the largest proportion of variability in FACT-G scores (R2= 0.28) and accounted for an additional 19% of the variance over and above the other 4 blocks. Finally, AA survivors reporting regular physical activity also reported better sleep quality in all 3 sleep scales (p &lt; 0.001). Conclusions: A substantial proportion of AA cancer survivors reported poor sleep quality which impacted their QoL. Understanding the determinants of sleep health in this population will lead to the development of interventions aimed at improving quality of life and downstream health consequences in AA cancer survivors.

Beyond the treatment: The role of race, sex, and education in health trajectories between cancer survivors and noncancer older adults

Introduction: The number of older, long-term cancer survivors is increasing. However, little is known about how cancer and aging affect the health trajectories of older adults differently. In addition, the impact of race, sex, and education on the processes of aging and the cancer experience needs further investigation. The current study aims to address this knowledge gap by combining two National Cancer Institute (NIC)-funded longitudinal studies conducted in Cleveland from 1998 to 2010.Materials and Methods: The unique cross-sequential design facilitates a comparison between the health changes in long-term (five years +) older cancer survivors (breast, prostate, and colorectal cancer) and demographically matched older adults without a history of cancer in the same geographic area within the same period. The study also captured comprehensive information on how socioeconomic status interacts with cancer and aging over time. General linear models were employed in the data analysis.Results: The findings showed that early cancer experience did not affect long-term cancer survivors' health status in later life. Conversely, comorbidities, being an African American, being female, and having education less than a college degree significantly decreased the health trajectory in later life for all older adults. Moreover, compared to other groups, older African American cancer survivors reported a dramatic decrease in self-reported health after controlling for other conditions.Discussion: Study findings can inform public policy and social services to offer comprehensive treatment plans and help individuals overcome their diseases and lead longer and healthier lives.

African American Women Breast Cancer Survivors: Coping with the COVID-19 Pandemic.

African American women breast cancer survivors are among those with the greater burden of cancer. Breast cancer is the second leading cause of death among black women, and this death rate is 40% higher than that of white women. The COVID-19 pandemic increased the burden of morbidity and mortality among this population of cancer survivors. In this report, we explore the ways in which the COVID-19 pandemic was a source of stress for African American women breast cancer survivors and their subsequent responses to these stressors. This is a qualitative descriptive study with content analysis of data from the narratives of 18 African American breast cancer survivors. Participants were interviewed via phone and video conferencing platform and asked questions related to their experiences with the COVID-19 pandemic. The findings suggest stressors associated with (1) potential COVID-19 spreaders in their immediate environments; (2) closures and restricted access to social- and faith-based activities; (3) televised news broadcasts of COVID-19; and (4) disruptions to planned cancer prevention and control healthcare. Three categories emerged that captured the ways in which these women responded to stressors during the early phase of this pandemic: (1) seeking control in their social environments; (2) following the rules; and (3) seeking support from God, family, and friends. These findings can be used to better support breast cancer patients during the early phases of a pandemic.

Recruiting African American Prostate Cancer Survivors for a Population-based Biobank Study.

Prostate cancer affects African American men disproportionately compared with men of other racial/ethnic groups. To identify biological bases for this health disparity, we sought to create a state-wide biobank of African American prostate cancer survivors in Florida. African American men diagnosed with prostate cancer between 2013 and 2017 and living in Florida at diagnosis were identified through the State of Florida's cancer registry. Individuals were approached via mail and telephone, assessed for eligibility, and asked for informed consent. χ2 and t tests were conducted to identify differences between eligible and reachable individuals (i.e., had valid contact information) versus consented participants. Of the 5,960 eligible and reachable individuals, 3,904 were eligible and contacted at least once, and 578 consented [overall consent rate = 10% (578/5,960); adjusted consent rate = 15% (578/3,904)]. Statistically significant (Ps < 0.05) but small differences in demographic and clinical variables were observed. Consented participants were less likely to be older than 64 (35% vs. 41%) and less likely to have received radiotherapy (36% vs. 41%) and hormone therapy (16% vs. 21%), but more likely to have regional prostate cancer (13% vs. 11%) and have undergone surgery (44% vs. 39%). Consented participants did not differ from reachable individuals on other demographic and clinical factors (Ps > 0.05). Recruiting African American prostate cancer survivors to biobanking research through a cancer registry is feasible. However, the consent rate was low, and existing challenges limit consent and participation. Strategies for overcoming barriers to informed consent and increasing participation in biospecimen research are needed to address cancer disparities.

Association between major discrimination and deficit accumulation in African American cancer survivors: The Detroit Research on Cancer Survivors Study.

Discrimination can adversely affect health and accelerate aging, but little is known about these relationships in cancer survivors. This study examines associations of discrimination and aging among self-identified African American survivors. A population-based sample of 2232 survivors 20-79years old at diagnosis were enrolled within 5 years of breast (n=787), colorectal (n=227), lung (n=223), or prostate (n=995) cancer between 2017 and 2022. Surveys were completed post-active therapy. A deficit accumulation index measured aging-related disease and function (score range, 0-1, where <0.20 is robust, 0.20 to <0.35 is pre-frail, and 0.35+ is frail; 0.06 is a large clinically meaningful difference). The discrimination scale assessed ever experiencing major discrimination and seven types of events (score, 0-7). Linear regression tested the association of discrimination and deficit accumulation, controlling for age, time from diagnosis, cancer type, stage and therapy, and sociodemographic variables. Survivors were an average of 62years old (SD, 9.6), 63.2% reported ever experiencing major discrimination, with an average of 2.4 (SD, 1.7) types of discrimination events. Only 24.4% had deficit accumulation scores considered robust (mean score, 0.30 [SD, 0.13]). Among those who reported ever experiencing major discrimination, survivors with four to seven types of discrimination events (vs. 0-1) had a large, clinically meaningful increase in adjusted deficits (0.062, p<.001) and this pattern was consistent across cancer types. African American cancer survivors have high deficit accumulated index scores, and experiences of major discrimination were positively associated with these deficits. Future studies are needed to understand the intersectionality between aging, discrimination, and cancer survivorship among diverse populations.

Chemotherapy-induced peripheral neuropathy in the detroit research on cancer survivors (ROCS) cohort.

Improved life expectancy has increased the likelihood for long-term complications from chemotherapy among cancer survivors. One burdensome complication is chemotherapy-induced peripheral neuropathy (CIPN). We evaluated rates of CIPN outcomes in the Detroit Research on Cancer Survivorship (ROCS) cohort. The population included 1,034 African American (AA) survivors who received chemotherapy for breast, colorectal, lung or prostate cancer. CIPN prevalence was based on initial occurrence of worsening of self-reported pain, numbness or tingling after chemotherapy. Current CIPN included symptoms still present at the time of the survey, and persistent CIPN symptoms were present 12 or more months post-chemotherapy. CIPN severity was ranked as mild, moderate or severe. Logistic regression was utilized to evaluate sociodemographic and clinical factors associated with the various categories of CIPN. CIPN prevalence was 68%, with 53% current and 52% persistent. The symptom severity distribution based on prevalent CIPN included 32.2% mild, 30.8% moderate, and 36.9% severe. Factors associated with prevalent CIPN (odds ratio, 95% confidence interval) included primary cancer site (breast: 3.88, 2.02-7.46); and (colorectal: 5.37, 2.69-10.73), lower risk for older age at diagnosis (0.66, 0.53-0.83) and divorced/separated marital status (2.13, 1.42-3.21). Current CIPN was in addition, associated with more advanced stage disease trend (1.34, 1.08-1.66) and greater number of co-morbid medical conditions trend (1.23, 1.09-1.40), as was persistent CIPN. Severity of prevalent CIPN was associated with history of arthritis (1.55, 1.06-2.26) and severity of persistent CIPN with higher BMI (1.58, 1.07-2.35). CIPN is a common and persistent complication in AA cancer survivors. Further research is needed to improve our understanding of CIPN predictors in all groups of cancer survivors.

Barriers and facilitators to the engagement of physical activity among Black and African American cancer survivors during and after treatments.

To identify physical activity (PA) barriers and facilitators among Black and African American (Black/AA) cancer survivors that should be considered in future PA intervention development for this population. A community advisory board (CAB) of Black/AA cancer survivors and patient advocates guided in-depth qualitative interviews (n = 19) that were completed via telephone using a semi-structured interview guide. Interviews were transcribed verbatim, and data were analyzed using directed content analysis to detail a report of PA barriers and facilitators during and after cancer treatment. The CAB reviewed and interpreted these barriers and facilitators to identify the final results. Survivors (n = 19) of nine different types of cancer completed interviews. PA barriers during cancer treatments included physical and psychological suffering. PA barriers after cancer treatments included social and environmental constraints (e.g., lack of access needed for PA, safety concerns, and competing priorities). PA facilitators both during and after cancer treatments included family support, faith, and support from other survivors. PA facilitators during treatment also included feeling better after doing PA, setting realistic and flexible goals, and gaining a sense of control of one's health by striving for PA goals. To increase PA among Black/AA cancer survivors, PA interventions are needed that address structural barriers, include the role of faith, leverage family support, highlight the psychological benefits of PA, and use goal setting.

Abstract B032: Diet quality and physical activity of African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program

Abstract Background: In the United States, approximately 41,600 new cases of prostate cancer will be diagnosed in Black/African American men in 2022. Lifestyle can impact cancer survivorship, including recurrence risk, comorbidity burden and quality of life. The American Cancer Society has set physical activity and nutrition guidelines for cancer survivors that include plant-based eating and regular physical activity and strength training. However, many cancer survivors are unaware of these guidelines, and they often face challenges in adopting such behaviors. Men Moving Forward (MMF) is among the first community-based lifestyle intervention developed with and for African American Prostate Cancer Survivors (AAPCS). This study examines the diet and physical activity patterns of MMF participants at baseline. Methods: MMF is a 16-week group-based lifestyle intervention, led by local health coaches. Men complete surveys and physical assessments at baseline, post-intervention and at a 12-month follow-up. The VioScreen Food Frequency Questionnaire (FFQ) was used to obtain dietary intake and diet quality scores for participants at baseline. The Healthy Eating Index-2015 (HEI-2015) is used to assess adherence to the Dietary Guidelines for Americans (DGA) 2015-2020. Baseline HEI-2015 scores of men in the Multiethnic Cohort Study (MEC) were used to provide a population-based comparison. We also examined how many men received an HEI-2015 total score &amp;gt;80, reflecting an ideal diet for reducing premature death and chronic disease risk. Physical activity was measured using the Godin Leisure-Time Exercise Questionnaire (Godin) with an item added to query on frequency of strength training. Results: At baseline of MMF, 80 AAPCS completed the FFQ and 83 AAPCS completed the Godin. MMF participants had a mean age of 66.4 ± 6.86, 49.4% were married/living with a partner, and had varying incomes and education levels. Top comorbidities include hypertension (71%), obesity (51%), diabetes (31%), and hypercholesterolemia (48%). MMF participants had lower total HEI-2015 scores than MEC study men with average scores of 60.3 ± 11.0 and 65.6 ± 10.3, respectively. About half of the HEI-2015 component scores were similar between MMF and MEC participants. However, MMF participants reported 1 or more points higher component scores for “dairy” and “refined grains”, and 1 or more points lower scores for “seafood &amp; plant proteins”, “fatty acids”, “sodium”, and “saturated fats” than their MEC counterparts. Although AAPCS in MMF reported similar HEI-2015 scores to typical American men, only 3 of the 80 AABCS at baseline reported HEI-2015 scores &amp;gt;80, highlighting a need for diet quality improvement. At baseline, 40% of participants were considered active and 33% reported strength training at least twice weekly. Conclusion: Data reflect the value of supporting AAPCS in lifestyle changes to improve dietary quality, physical activity and strength training. Few efforts have addressed lifestyle among AAPCS, despite high prostate cancer burden. Future reports will examine the efficacy of MMF. Citation Format: Margaret Y. Tovar, Patricia Sheean, Paula Papanek, Alexis Visotcky, Lola Awoyinka, Anjishnu Banerjee, Kathryn Bylow, Deepak Kilari, Kathryn Flynn, Toni Uhrich, Sophia Aboagye, Sandra Contreras, Kathleen Jensik, Melinda Stolley. Diet quality and physical activity of African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B032.

Abstract B064: The role of peer support in the survivorship experience of African American prostate cancer survivors

Abstract Background: The link between social connections and health behaviors in the general population has been well documented. However, information on how social connections may impact African American prostate cancer survivors (AAPCS) is limited. This study uses qualitative interviews to explore how social connections may impact the health and health behaviors of AAPCS enrolled in Men Moving Forward (MMF), a lifestyle intervention designed for and by AAPCS. Specifically, we sought to understand how different aspects of the social network may impact health or health behaviors and identify opportunities to leverage social connections to improve the survivorship of AAPCS. Methods: Men completing the MMF program were invited to participate in the qualitative interview. A semi-structured interview guide exploring social networks, health and health behaviors, and cancer survivorship was developed and revised in consult with the MMF community advisory board. Interviews were scheduled at the convenience of participants and held via zoom or at a study site location of the participants choosing. Interviews were audio recorded, transcribed verbatim, and coded by two coders using MAXQDA software. A grounded theory approach to coding was taken, with initial line-by-line coding done using an open coding approach, followed by axial coding to thematically organize codes. Results: To date, 14 of 20 interviews have been completed and some preliminary findings are included here. Early findings have identified themes around the importance of peer support and shared experiences and sharing of stories across the survivorship continuum. Within this theme, the following sub-themes were identified: 1) Connecting with other survivors helped with acceptance and isolation following diagnosis. 2) Feedback, advice, and information sharing felt more credible and valued when coming from someone who understood what they had been through. 3) Shared experience helped men feel understood and able to share without fear of judgement. 4) Telling their story to others offered a way to confront stigma around prostate cancer and offer support to men in their communities. This sharing also offered comfort to the survivors. Conclusions: Peer support and shared experience offer an opportunity to provide support and education to AAPCS. Currently, peer support resources for men are limited, and even fewer offer culturally tailored support or programming. Enhancing efforts to create and activate social connections between survivors may offer additional an opportunity to improve survivorship outcomes in AAPCS. Citation Format: Iwalola Awoyinka, Margaret Tovar, Staci A. Young, Melinda R. Stolley. The role of peer support in the survivorship experience of African American prostate cancer survivors [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B064.

Abstract A034: Health-related quality of life among African American prostate cancer survivors enrolled in a lifestyle intervention program

Abstract Background: Prostate cancer (PC) is the most diagnosed non-skin cancer among men in the United States, with African American (AA) men experiencing the highest incidence of all racial/ethnic groups. Screening and treatment advances for PC have resulted in men living years beyond their diagnosis; however, side effects of PC treatments can impact health-related quality of life (QoL). African American PC survivors (AAPCS) may be at increased risk of experiencing lower QoL. Lifestyle interventions show potential for improving QoL through changes in health behavior and symptom improvement, yet few have focused on AAPCS. This study explores QoL of AAPCS enrolled in Men Moving Forward (MMF), a randomized trial to improve body composition through lifestyle change. Methods: Baseline data from 83 AAPCS enrolled in MMF were used in analysis. Participants completed Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests for physical function, anxiety, depression, fatigue, sleep disturbance, social function, and pain intensity. Standardized T scores (U.S. general population mean = 50, SD =10) were generated for all domains except pain intensity (0-10), and summary scores for physical and mental health were generated. A higher score reflects more of a construct being measured. Thus, for symptoms, scores above the mean are worse, while for functioning domains, scores below the mean are worse. Summary scores for physical and mental QoL were also calculated. Questionnaires related to physical activity, self-efficacy, perceived stress, social support, and resilience were also collected. We compare sample means to published norms of U.S. PC survivors, considering a difference of 3 points (1/3 SD) as clinically meaningful. Multiple linear regression analyses were used to examine factors associated with physical and mental health summary scores. Results: AAPCS scores were similar to the U.S. PCS means for depression (45.6 vs 45.4), fatigue (47.9 vs 47.3), sleep disturbance (48.4 vs 48.2), and physical function (50.4 vs 50.2). AAPCS scores were worse than the U.S. PCS means for anxiety (49.4 vs 45.9) and social participation (51.2 vs 55.1). The average mental health summary score for AAPCS was better than the U.S. general population (53.4 vs 50), while the physical health summary score was similar (51.4 vs 50). Perceived stress (p&amp;lt;0.000) was negatively associated with mental health. Comorbidities (p=0.002) were negatively associated with physical health, while physical activity (p=0.034) was positively associated with physical health. Conclusions: Our sample of AAPCS was similar to U.S. PCS except for worse anxiety and social function. We also found that factors that could be impacted by a lifestyle intervention were associated with physical and mental health. Future work will examine additional correlates and explore the impact of the MMF lifestyle intervention on changes in QoL. Citation Format: Iwalola Awoyinka, Kathryn E. Flynn, Anjishnu Banerjee, Alexis Visotcky, Sophia Aboagye, Margaret Tovar, Deepak Kilari, Kathryn A. Bylow, Paula Papanek, Patricia M. Sheean, Melinda R. Stolley. Health-related quality of life among African American prostate cancer survivors enrolled in a lifestyle intervention program [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A034.

Abstract B022: Adaption of a cancer prevention wellness program for Hispanic community members

Abstract Background. Cancer is the second leading cause of death in Wisconsin with higher mortality rates observed for Black/African American (B/AA) and Hispanic/Latino (H/L) communities. However, programs tailored to the interests of communities most impacted by cancer AND made available to the general population are lacking. In this project, we adapted the Moving Forward program for African American cancer survivors which included a program workbook, in-person education/supervised exercise classes and text messaging. We targeted two adaptations to inform a cancer prevention program available to the public through a public recreation system: 1) tailoring to include non-cancer affected individuals and 2) extending to meet the needs of the H/L community. Methods. This project was facilitated through partnerships between an academic cancer center, the Milwaukee public recreation system (MKE Rec) and the WI Department of Health and Human Services. We also engaged a community advisory board (CAB). Our approach comprised focus groups, surveys collected at community events, and an After-Action Review of a 4-week program pilot (2 groups, English or Spanish language). Translation was conducted using a forward/back translation process with workbook review by individuals from different Spanish language backgrounds. Our CAB contributed to the development and review of all study procedures and materials. Results: 42 H/L community members participated through two focus groups (1 English language, [N=4]), 1 Spanish language (N=6)], 16 surveys, and 16 pilot participants (N=9 Spanish language, N=7 English language). Adaptations targeted program content and materials, as well as program implementation/sustainability within MKE Rec. Program adaptations included: 1) integrating information on basic cancer biology; 2) explaining associations between cancer, lifestyle and other risk factors; 3) adding cancer screening information; 4) including cooking demonstrations and recipes with culturally relevant tips; 5) updating workbook images and content to reflect the diversity of local communities; and 6) addressing comorbidity risk. Key adaptations related to conducting and sustaining within a public recreation system included: 1) creating a standardized instructor training and manual; 2) dividing the program into two 8-week sessions to meet the public recreation system program calendar; 3) eliminating the text message component; 4) providing the program workbook and classes in English and Spanish; and 5) integrating different exercise approaches to meet needs/interests of different age groups, genders, and different fitness levels. The adapted program, Total Wellness/Bienestar Total, is now offered as the first ever Spanish language wellness class within MKE Rec. Conclusions: Community-academic partnerships and ongoing community engagement led to meaningful adaptations to a cancer prevention and lifestyle program. These efforts leverage a public resource and can impact disparities by making widely available cancer prevention and lifestyle support. Citation Format: Jamila Kwarteng, Laura Pinsoneault, Anakaren Manriquez Prado, Sophia Aboagye, Alexis Visotcky, Erica Wasserman, Derek Donlevy, Patricia Sheenan, Margaret Tovar, Kathleen Jensik, Regina Vidaver, Melinda Stolley, Sandra Contreras. Adaption of a cancer prevention wellness program for Hispanic community members [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B022.