Community-based Lifestyle Intervention Research Articles

More than Just a Number: Perspectives from Black Male Participants on Community-Based Interventions and Clinical Trials to Address Cardiovascular Health Disparities.

Black Americans remain significantly underrepresented and understudied in research. Community-based interventions have been increasingly recognized as an effective model for reckoning with clinical trial participation challenges amongst underrepresented groups, yet a paucity of studies implement this approach. The present study sought to gain insight into Black male participants' perception of clinical trials before and after participating in a community-based team lifestyle intervention in the United States. Black Impact, a 24-week community-based lifestyle intervention, applied the American Heart Association's Life's Simple 7 (LS7) framework to assess changes in the cardiovascular health of seventy-four Black male participants partaking in weekly team-based physical activities and LS7-themed education and having their social needs addressed. A subset of twenty participants completed an exit survey via one of three semi-structured focus groups aimed at understanding the feasibility of interventions, including their perceptions of participating in clinical trials. Data were transcribed verbatim and analyzed using a content analysis, which involved systematically identifying, coding, categorizing, and interpreting the primary patterns of the data. The participants reported a positive change in their perceptions of clinical trials based on their experience with a community-based lifestyle intervention. Three prominent themes regarding their perceptions of clinical trials prior to the intervention were as follows: (1) History of medical abuse; (2) Lack of diversity amongst research teams and participants; and (3) A positive experience with racially concordant research teams. Three themes noted to influence changes in their perception of clinical trials based on their participation in Black Impact were as follows: (1) Building trust with the research team; (2) Increasing awareness about clinical trials; and (3) Motivating participation through community engagement efforts. Improved perceptions of participating in clinical trials were achieved after participation in a community-based intervention. This intervention may provide a framework by which to facilitate clinical trial participation among Black men, which must be made a priority so that Black men are "more than just a number" and no longer "receiving the short end of the stick".

Physical activity and sleep changes among children during the COVID-19 pandemic

Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann–Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data were collected from 94 children (aged 5–17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1655 steps. Sleep onset and wake time were delayed by about an hour and 45 min, respectively, while sleep duration decreased by over 12 min as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. Trial Registration: Clinical trial registration: NCT03339440

Effectiveness of a community-based multicomponent lifestyle intervention (the ADA programme) to improve the quality of life of French breast cancer survivors: protocol for a pragmatic cluster randomised trial and embedded qualitative study

IntroductionBreast cancer survivors (BCSs) are often faced with multiple mental and physical sequelae and are at increased risk of emotional distress, degraded health-related quality of life (HRQoL), chronic pain and...

Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program

BackgroundPoor mental health is a leading cause of morbidity and mortality among Black men in the United States. Efforts to improve mental health among Black men have been hampered by a lack of access and utilization of mental health services. Physical activity and social networks have been shown to improve mental health. Thus, we examined the effect of a community team-based physical activity, health education and social needs intervention among Black men on mental health over 24 weeks.MethodsBlack adult males (n = 74) from a large Midwestern city participated in Black Impact, a 24-week community-based lifestyle change program adapted from the Diabetes Prevention Program and American Heart Association’s (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA’s Life’s Simple 7 (LS7) framework. Measures of mental health including the Center for Epidemiological Studies Depression Scale (CES-D), Patient Health Questionnaire 2-question depression screener (PHQ-2), and Perceived Stress Scale-10 (PSS-10) were completed at baseline, 12 and 24 weeks. The change in mental health scores from baseline to 12 and 24 weeks were evaluated using linear mixed-effects models adjusting for age, education, and income. The change in cardiovascular health scores, defined as objective metrics of LS7 (LS5 [blood pressure, total cholesterol, fasting glucose, body mass index and smoking]), by baseline mental health were evaluated using linear mixed-effects models with an interaction term (time*baseline mental health variable) and a random intercept for each participant.ResultsAmong 71 Black men (mean age 51, 85% employed) at 24 weeks, CES-D scores decreased from 10.54 to 7.90 (-2.64, 95%CI:-4.74, -0.55), PHQ-2 decreased from 1.04 to 0.63 (-0.41, 95%CI: -0.75, -0.07), and PSS-10 decreased from 14.62 to 12.91 (-1.71, 95%CI: -3.53, 0.12). A 1-unit higher CES-D at baseline was associated with less improvement in LS5 scores by -0.04 (95%CI: -0.076, -0.005) and − 0.032 (95%CI:-0.067, 0.003) units at week 12 and 24, respectively, with similar findings for PSS.ConclusionsThe Black Impact community-based lifestyle program has the potential to reduce depressive symptoms and stress in Black men. There is a dire need for larger, randomized studies to test the impact of Black Impact on mental health in Black men to advance health equity.Trial RegistrationRetrospectively Registered, ClinicalTrials.gov Identifier: NCT04787978.

Common Study Designs of Nutrition Clinical Trials: Review of the Basic Elements and the Pros and Cons

Introduction: Nutrition Clinical Trials (NCTs) are pivotal in establishing causal links between nutritional interventions and chronic diseases. This review comprehensively examines prevalent clinical trial designs, emphasizing their strengths and limitations. The goal is to provide insights into the selection and optimization of these designs for dietary intervention studies.
 Methods: Various study designs in NCTs are explored, including quasi-experimental designs, double-blind randomized placebo-controlled trials for nutrient/functional foods supplementation, community-based lifestyle interventions, pragmatic nutrition interventions, and field trial projects. The characteristics, advantages, and challenges of each design are discussed. Real examples are presented to illustrate how these designs can be tailored and optimized for dietary intervention studies.
 Results: Parallel randomized clinical trials are acknowledged as the gold standard, despite requiring substantial sample sizes and having inherent limitations. Cross-over NCTs emerge as valuable for assessing temporary treatment effects while mitigating potential confounders and interpatient variability. However, they may not be suitable for acute diseases and progressive disorders, and attrition rates can be higher. Multi-arm randomized designs offer increased study power with a lower sample size but necessitate more intricate design, analysis, and result reporting.
 Conclusion: In conclusion, each study design in NCTs comes with its set of strengths and limitations. The selection of an appropriate design should consider determinants and common considerations to provide robust evidence for establishing cause-and-effect associations or assessing the safety and efficacy of food products in nutrition research. This comprehensive understanding aids researchers in making informed choices when planning and conducting nutrition clinical trials.

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.

A co-designed, community-based intensive health behavior intervention promotes participation and engagement in youth with risk factors for type 2 diabetes.

Obesity among youth (children and adolescents) is associated with increased risk for youth-onset type 2 diabetes. Lifestyle change can delay or prevent the development of type 2 diabetes, yet real-world implementation of health behavior recommendations is challenging. We previously engaged youth with risk factors for type 2 diabetes, their caregivers, and professionals in a human-centered design study to co-design a lifestyle change program. Here we report the outcomes for this 16-week co-designed lifestyle change program for youth at risk for T2D and their caregivers. This single-arm family-based cohort study included youth aged 7-18 years, with BMI ≥85th percentile (overweight or obese) and at least one additional risk factor for type 2 diabetes, and their caregivers. Clinical (BMI, HbA1c), self-reported physical activity, and quality of life outcomes were evaluated at baseline (B), post-intervention (M4), and 1 year (M12) following the intervention. Seventy-eight youth (mean age 12.4 ± 2.7y, 67% female, 37.8% white) and 65 caregivers were included in the data analysis. Youth baseline BMI z-scores (2.26 ± 0.47) and HbA1c (5.3 ± 0.3) were unchanged at follow up time points [BMI z-scores M4 (2.25 ± 0.52), M12 (2.16 ± 0.58), p-value 0.46], [HbA1c M4 (5.3 ± 0.3), M12 (5.2 ± 0.3), p-value (0.04)]. Youth reported increased physical activity at M4 (p = 0.004), but not at M12. Youth quality of life scores increased at M12 (p=0.01). Families who attended at least one session (n=41) attended an average of 9 out of 16 sessions, and 37 percent of families attended 13 or more sessions. A co-designed, community-based lifestyle intervention promotes increased physical activity, improved quality of life, maintenance of BMI z-scores and HbA1c, and engagement in youth with risk factors for T2D.

An Innovative Approach to Promote Weight Loss Among Mexican Immigrants: A Pilot Study.

Mexican Americans are among the highest risk groups for obesity and its associated health consequences, including diabetes, heart disease, and cancer.154 overweight/obese Mexican Americans recruited from the Mexican Consulate in New York City were enrolled in COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), a 12-week Spanish-language lifestyle intervention that included a dietary counseling session, weight-loss resources, and thrice-weekly text messages. Participants' weight (primary outcome); dietary intake, physical activity, and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention.Of the 109 who completed follow-up, 28% lost ≥ 5% of their baseline body weight. Post-intervention, participants consumed more fruit and less soda, sweet pastries, fried foods and red meat; increased physical activity; and evidenced greater nutrition knowledge.A community-based lifestyle intervention with automated components such as text messaging may be a scalable, cost-effective approach to address overweight/obesity among underserved populations.

Effects Of A Community-based Lifestyle Intervention On Body Composition And Strength Among Breast Cancer Survivors

Effects Of A Community-based Lifestyle Intervention On Body Composition And Strength Among Breast Cancer Survivors

Community-based lifestyle intervention for diabetes (Co-LID study) management in rural Nepal: study protocol for a clustered randomized controlled trial

BackgroundType 2 diabetes mellitus (T2DM) has increased globally; with a disproportionate burden in South and Southeast Asian countries, including Nepal. There is an urgent need for clinically and cost-effective culturally adapted T2DM management programs. In this study, we aim to assess the effectiveness of community based culturally appropriate lifestyle intervention in improving the management and care of people with T2DM.MethodsWe will conduct a cluster randomized control trial to evaluate the effectiveness of community based culturally appropriate lifestyle intervention in improving T2DM outcomes. The trial will be conducted in 30 randomly selected healthcare facilities from two purposively selected districts (Kavrepalanchowk and Nuwakot districts) of Bagmati province, Nepal. The selected healthcare facilities are being randomized into 15 interventions (n = 15) and usual care (n = 15) groups. Those in the intervention will receive group-based 12 an hour-long fortnightly session delivered over 6 months period. The intervention package includes 12 planned modules related to diabetes care, ongoing support, supervision and monitoring, follow-up from the trained community health workers, and educational materials on diabetes self-management. The participants in the usual care groups will receive pictorial brochure on diabetes management and they will continue receiving the usual care available from the local health facilities. The primary outcome is HbA1c level, and the secondary outcomes include quality of life, health care utilization, and practice of self-care behaviour, depression, oral health quality of life, and economic assessment of the intervention. Two points measurements will be collected by the trained research assistants at baseline and at the end of the intervention.DiscussionThis study will provide tested approaches for culturally adapting T2DM interventions in the Nepalese context. The findings will also have practice and policy implications for T2DM prevention and management in Nepal.Trial registrationAustralia and New Zealand Clinical Trial Registry (ACTRN12621000531819). Registered on May 6, 2021.

567-P: Impact of Diabetes Prevention Education Program on Diabetes Knowledge among Adults with Prediabetes—A Cluster Randomized Controlled Trial in Nepal

Background: Diabetes knowledge is important for diabetes prevention but has been less studied among people with prediabetes. This study aimed to assess the impact of a community-based lifestyle intervention program called Diabetes Prevention Education Program (DiPEP) on diabetes knowledge among adults with prediabetes in Nepal. Method: This study is a part of a two-arm open cluster randomized controlled trial conducted from October 2019-September 2021 in two urban areas of Nepal. Participants of the intervention arm received four 1-hour weekly education sessions, follow-up for the next 5 months, diabetes prevention education brochure, exercise calendar and daily food logbook. The control arm received an education brochure at baseline and 1-hour education session after endline data collection. The change in diabetes knowledge was assessed using Nepali validated 24-items Diabetes Knowledge Questionnaire (DKQ), with higher score representing better disease knowledge. Linear mixed model was used to analyze the impact of the DiPEP on diabetes knowledge score with intent-to-treat approach. Results: A total of 291 participants were recruited in the trial with mean age of 50.3±7.6 years and 67% were female. Only 290 participants had baseline DKQ (158 intervention, 132 control), out of these 258 completed the endline DKQ (139 intervention, 119 control). At baseline, mean DKQ score was 9.2 (SD 5.2) in intervention and 10.6 (SD 4.8) in control arm. After the intervention, mean change in the score between intervention and control group was 0.4 (95% CI -1.0-1.7) among those with good compliance to DiPEP. The results did not change from main analysis for those who attended ≥3 of all 4 sessions. Conclusion: Diabetes knowledge did not improve significantly after the intervention among the participants. Regular and frequent engagement of participants might help to improve diabetes knowledge among the individuals. Disclosure P.Shakya: None. A.Shrestha: None. B.M.Karmacharya: None. A.Shrestha: None. M.Bajracharya: None. B.E.Kulseng: None. E.Skovlund: None. A.Sen: None. Funding Norwegian University of Science and Technology, Department of Public Health and Nursing (81850087)

Addressing non-medical health-related social needs through a community-based lifestyle intervention during the COVID-19 pandemic: The Black Impact program.

Non-medical health-related social needs (social needs) are major contributors to worse health outcomes and may have an adverse impact on cardiovascular risk factors and cardiovascular disease. The present study evaluated the effect of a closed-loop community-based pathway in reducing social needs among Black men in a lifestyle change program. Black men (n = 70) from a large Midwestern city participated in Black Impact, a 24-week community-based team lifestyle change single-arm pilot trial adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Participants were screened using the Centers for Medicare and Medicaid Services (CMS) Accountable Health Communities Health-Related Social Needs Screening Tool. Participants with affirmative responses were referred to a community hub pathway to address social needs. The primary outcome for this analysis is change in social needs based on the CMS social needs survey at 12 and 24 weeks using mixed effect logistic regressions with random intercepts for each participant. Change in a LS7 score (range 0-14) from baseline to 12 and 24 weeks was evaluated using a linear mixed-effects model stratified by baseline social needs. Among 70 participants, the mean age of participants was 52 ±10.5 years. The men were sociodemographically diverse, with annual income ranging from <$20,000 (6%) to ≥$75,000 (23%). Forty-three percent had a college degree or higher level of education, 73% had private insurance, and 84% were employed. At baseline 57% of participants had at least one social need. Over 12 and 24 weeks, this was reduced to 37% (OR 0.33, 95%CI: 0.13, 0.85) and 44% (OR 0.50, 95%CI: 0.21, 1.16), respectively. There was no association of baseline social needs status with baseline LS7 score, and LS7 score improved over 12 and 24 weeks among men with and without social needs, with no evidence of a differential effect. The Black Impact lifestyle change single-arm pilot program showed that a referral to a closed-loop community-based hub reduced social needs in Black men. We found no association of social needs with baseline or change in LS7 scores. Further evaluation of community-based strategies to advance the attainment of LS7 and address social needs among Black men in larger trials is warranted.

Identifying behavioural barriers and facilitators to engaging men in a community-based lifestyle intervention to improve physical and mental health and well-being

BackgroundThere are few community-based lifestyle interventions designed to target physical and mental health of men. We conducted a qualitative focus group study with men to explore their perceived barriers and facilitators to uptake and engagement with interventions designed to improve their physical and mental health and wellbeing.MethodsA volunteer sampling approach (advertisements posted on a premier league football club’s social media) was used to recruit men aged 28 to 65 years who were interested in improving their physical and/or mental health and wellbeing. Focus group discussions were conducted at a local premier league football club to 1) explore men’s perceived barriers and facilitators to uptake of community-based interventions; 2) identify health issues considered important to address; 3) obtain participant views on how to best engage men in community-based interventions; and 4) use the findings to inform the development of a multibehavioural complex community-based intervention (called ‘The 12th Man’).ResultsSix focus group discussions were conducted (duration 27 to 57 min) involving 25 participants (median age 41 years, IQR = 21 years). Thematic analyses generated seven themes: ‘Lifestyle behaviours for both mental health and physical health’; ‘work pressures are barriers to engaging with lifestyle behaviour change’; previous injuries are barriers to engagement in physical activity and exercise’; personal and peer group relationships impact on lifestyle behaviour change’; relationships between body image and self-confidence on mastery of skills for physical activity and exercise’; building motivation and personalised goal setting’; and ‘credible individuals increase uptake and continued engagement with lifestyle behaviour change’.ConclusionsFindings suggest that a multibehavioural community-based lifestyle intervention designed for men should promote parity of esteem between physical and mental health. It should also acknowledge individual needs and preferences, emotions in the context of goal setting and planning, and be delivered by a knowledgeable and credible professional. The findings will inform the development of a multibehavioural complex community-based intervention (‘The 12th Man’).

Quality of life: concepts, needs, psychometric measurement, factors associated and treatment responsiveness in depression disorder

Quality of life (QOL) is a multifaceted concept that warrants attention, especially in depression disorder. This review aimed to summarize the empirical evidence regarding concepts, needs, psychometric measurement, factors associated, and treatment responsiveness in depression disorder. The narrative review was conducted based on studies published in English databases from the last three decades to 2022 on the evidence from extensive electronic databases using PubMed, SCOPUS, PsychINFO, ScienceDirect, SpringerLink, and Google Scholar. The significant findings from books, journals and grey literature were also included. Based on relevant and significant facts the concepts were developed and evidence-based narrations were made under each concept to understand QOL in depression disorder. This review found a significant association between poorer QOL with the severity of depression and, its association with age of respondents, the intensity of the depressive symptoms, lower education, subjective perception of health, lower socio-economical status, and social support. The review signifies the needs and psychometric instruments of QOL in patients with depressive disorder. The review revealed that psychoeducation, multimodal and community-based lifestyle intervention, self-awareness and body-mind-spirit interventions, CBT, group therapy and mental health promotion intervention improved the QOL in depression disorder. The study concluded that QOL is a patient-centric approach, and should be involved as the standard measure of evaluating care outcomes, satisfaction, and cost-effectiveness through the incorporation of the various treatment approaches in clinical practice. Despite being an essential component QOL is received relatively little attention in depression disorder by clinicians and mental health professionals.

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.

Virtual Community Engagement for Retention of Black Men in Clinical Research.

Black American men have worse cardiovascular health compared with their White counterparts, yet are highly underrepresented in clinical trials. In 2020, Black men were recruited to participate in Black Impact, a community-based lifestyle intervention to increase cardiovascular health. Due to the research pause during the Coronavirus Disease (COVID-19) pandemic, a virtual community engagement (VCE) process was co-designed with community stakeholders and evaluated for its effect on retention for the clinical trial. VCE via weekly virtual video conference sessions occurred for 9 weeks as a run-in phase prior to in-person research activities. Data collected during sessions included attendance, anecdotes on acceptability, and topical requests for subsequent weeks. Content analysis was performed on scribe notes from sessions to ascertain themes describing the implementation and participant perceptions of the VCE. Descriptive statistics were used to analyze quantitative data. The VCE provided opportunities to co-create a safe atmosphere in small groups, discuss mental health, foster trust, capitalize on the power of spirituality, and establish a brotherhood. Following the VCE run-in phase, 74 of 100 participants remained engaged for participation in the Black Impact study. The VCE described provides a framework that can be used to retain Black men during study delays or disruptions through fostering engagement and building community among participants and researchers.

Abstract 9442: Increasing Patient Activation Among Black American Men in a Community-Based Lifestyle Intervention Pilot: Black Impact

Introduction: Life’s simple 7 (LS7) is a seven-metric framework from which cardiovascular health can be measured. Black Americans have the lowest attainment of LS7 among all communities. This may be in part related to patient activation or “having the capability and the willingness to take on the role of managing one’s own health and health care”. Patients with lower patient activation scores on the Patient Activation Measure tool (PAM) are more likely to develop and suffer from chronic diseases like hypertension and stroke. Black Americans report lower patient activation as compared to Non-Hispanic Whites, and lower medication adherence. Here, we discuss changes in patient activation during a 24-week community-based, lifestyle intervention focused on improving cardiovascular health in Black American men. Methods: We recruited 74 Black men with less than 4 of 7 LS7 metrics in the “ideal” range to participate in Black Impact, a community-based lifestyle intervention adapted from the AHA’s Check, Change, Control Program and Diabetes Prevention Program. Participants met weekly in groups of 8-25 for 24 weeks, completing group-based physical activities and health education sessions. Biometric screenings and self-report surveys (including the PAM 10-item questionnaire) were administered at baseline, 12, and 24 weeks. Changes in PAM scores at 12 and 24 weeks were calculated using a linear mixed-effects model with random intercepts. Results: The mean baseline PAM score of participants, when adjusted for age, education, and income, was 64.68 (95% CI: 60.51, 68.85). At week 12, the PAM score increased by an average of 4.36 (95% CI: 1.09, 7.63; p = 0.01). At week 24, the increase from baseline was 8.22 (95% CI: 5.06, 11.38; p &lt; 0.001). Increases in PAM were non-significantly associated with increases in LS7 over the 24 weeks (p= 0.346) Conclusions: In Black Impact, PAM scores increased substantially at 12 and 24 weeks. The 8-point PAM increase at 24 weeks is equivalent to a 16% reduction in the likelihood of hospitalizations and a 16% increase in medication adherence. These findings suggest community-based lifestyle interventions focused on increasing cardiovascular health may be a key strategy in advancing equity in patient activation.

IMPROVING THE PERFORMANCE OF COMMUNITY HEALTH WORKERS IN A BEHAVIORAL LIFESTYLE INTERVENTION FOR OLDER ADULTS

Abstract Community health workers (CHWs) play essential roles in implementing community-based behavioral lifestyle interventions. This qualitative analysis aimed to explore what program factors and CHW characteristics would help improve CHW performance in the Mobility and Vitality Lifestyle Program (MOVE UP), a community-based behavioral weight-management intervention for improving mobility among overweight or obese older adults. The MOVE UP program was implemented from January 2015 to June 2019 at 23 community-based sites in Pittsburgh, Pennsylvania. Trained and supported CHWs delivered 32 group sessions over 13 months. We collected data from semi-structured interviews with 21 CHWs and 14 community key informants (community site directors or coordinators); seven focus group discussions with participants from 9 sites, and 124 pieces of graduation advice provided by MOVE UP graduates for future participants; onsite CHW performance observation at 18 sites, and 124 meeting memos of support phone calls with CHWs. Interviews and focus groups were audio-recorded and transcribed verbatim. All data were thematically analyzed in a deductive approach, using the CHW generic logic model. Emerging themes were: Trained CHWs still require onsite support by experienced CHWs or training staff to deliver the first session; Participants need a Q&amp;A session by specialists to address their questions beyond CHWs’ knowledge; Desirable CHW characteristics could increase CHWs’ relation and accessibility to participants, such as the same age group, similar weight loss experience, and living or working in the same community. These findings provide important insight as to recruiting and supporting CHWs in a community-based behavioral lifestyle intervention for older adults.

The Role of Social Support in Cardiovascular Clinical Trial Participation among Black Men: Black Impact.

Background: Attainment of the American Heart Association’s Life’s Simple 7 (LS7) metrics reduces cardiovascular disease (CVD) risk; yet, Black Americans have the lowest LS7 attainment among all communities, the highest rate of CVD mortality, and low clinical trial participation. Social support is positively correlated with chronic disease self-management. Here, we describe the role of social support in a single-arm pilot clinical trial of a community-based lifestyle intervention among Black American men. Methods: The 24-week intervention featured weekly team-based physical activity and LS7-themed education. Seventy-four Black men participated in the intervention; twenty agreed to participate in exit surveys via one of three semi-structured focus groups. Data were transcribed verbatim and analyzed using content analysis framed by House’s social support framework. Results: Participants reported support from both peers and health coaches. The sub-themes of social support among peers were: (1) acknowledgement, understanding, and validation, (2) inspiration, (3) sense of community, (4) fear of disappointing fellow participants, and (5) group synergy. The sub-themes of social support from the health coaches and study team staff included: (1) contemplation of current health status, (2) racial concordance of health coaches and study team staff, (3) investment of the research team, (4) incentives, (5) access to healthcare providers, and (6) the COVID-19 pandemic. Emotional support was the most frequently discussed theme. Conclusions: Social support, especially emotional support, from peers and health coaches was a driver of clinical trial participation among participants. The intervention created a positive social environment and decreased medical mistrust. This intervention may provide a framework by which to facilitate clinical trial participation among Black men.

Comprehending Nutrition and Lifestyle Behaviors of People with Metabolic Syndrome: A Focus Group Study

Demographically and socio-culturally appropriate care is critical for empowering people with metabolic syndrome (MetS) to self-manage their condition. This focus group study aimed to explore the understanding of nutrition and lifestyle behaviors (NLBs) of Malaysians with MetS. Adults with MetS (N = 21) participated in four focus groups at a university’s research clinic in Malaysia. A thematic framework analysis approach was applied to the focus group data using an initial coding framework developed from the Health Belief Model. Six main themes were identified on perceived motivations, barriers, and threats toward healthy NLBs. Motivations to adopt healthy NLBs were body image, personal experience of adverse complications, and family and social support. The perception that healthcare is a business model, the idea that changes in NLBs are difficult and expensive, and cultural influence on food intake were identified as barriers to healthy NLBs. Inadequate knowledge of MetS was identified as a subtheme in this study. Health education and health promotion activities that aim to modify the NLBs of people with MetS should consider the community’s perception of motivation and barriers to change. Addressing these aspects in the development of programs can potentially increase program adoption and adherence, ensuring the success of community-based lifestyle interventions.