Together stronger: A family-centered lifestyle intervention for Black prostate cancer survivors and their caregivers

The burden of prostate cancer (PCa) is disproportionately high among Black men, who experience poor health outcomes. Black PCa survivors report lower self-perceived health, reduced quality of life, and a greater prevalence of chronic conditions. This substantial burden of comorbidity among Black PCa survivors is particularly concerning, as PCa survivors are more likely to die of these competing conditions than of PCa itself. Among the various factors contributing to the elevated survivorship burden in Black PCa survivors, lifestyle behaviors such as physical activity and healthy eating are of paramount importance, as these behaviors are modifiable. However, Black PCa survivors are less likely to be physically active and less likely to meet the national dietary guidelines. Furthermore, Black PCa survivors have had limited participation in lifestyle interventions. Thus, interventions that effectively promote these lifestyle behaviors among Black PCa survivors are urgently needed. In developing such interventions, it is important to consider the impact of family caregivers, as they play pivotal roles in supporting Black PCa survivors. However, there has been a notable absence of family-centered lifestyle interventions for Black PCa survivors. With this rationale, we have developed a lifestyle intervention for Black PCa survivors and their family caregivers that addresses physical activity and healthy eating. In a 2-arm, pilot feasibility randomized controlled trial (RCT), survivor-caregiver dyads were assigned to either an intervention or a usual-care control group. Results demonstrated recruitment feasibility and showed promise in improving moderate-to-vigorous physical activity, overall diet quality, and physical functioning (6-minute-walk test; 6MWT) in both PCa survivors and their caregivers. However, it remains unknown whether the family-centered approach is superior to an individual approach (i.e., survivor only) in improving and maintaining healthy lifestyle behaviors and health outcomes. Therefore, we propose a 3-arm efficacy RCT to compare the effects of a family-centered intervention, a survivor-only intervention, and a health education control group. The outcomes will include moderate-to-vigorous physical activity and overall diet quality (primary) and 6MWT, quality of life, and family health climate (secondary). We will also evaluate theory-based mediators and moderators of the family-centered intervention. The knowledge gained from this RCT will advance the science of behavioral medicine, and ultimately, improve the health of Black PCa survivors and their family caregivers by lowering morbidity and mortality among Black PCa survivors, as well as reducing cancer risk among caregivers.