Open pilot of a culturally responsive, cognitive-behavioral intervention (PROWESS) for Black and Latino men receiving androgen deprivation therapy for prostate cancer.

Abstract

e17009 Background: Black and Latino men face disproportionately higher risks prostate cancer (PC) and PC-related mortality compared to White men. Moreover, Black and Latino men taking androgen deprivation therapy (ADT) for PC report relatively lower quality of life (QOL), partially due to ADT side effects. While physical activity ameliorates ADT side effects and improves QOL, few interventions exist to increase physical activity and help manage ADT side effects for these groups. The aim of this study was to develop and refine a culturally-responsive, cognitive-behavioral intervention, PROWESS (PROstate cancer Wearables Exercise and Structured Supports) to increase physical activity, manage ADT side effects, and improve QOL for Black and Latino men with PC on ADT. Methods: We conducted a single-arm open pilot trial (n=16) of a cognitive-behavioral intervention for English- or Spanish-speaking Black and Latino men with PC on ADT to explore the intervention's feasibility and participants' satisfaction. Participants attended a once-weekly, six-session telehealth intervention led by a psychologist to enhance physical activity, symptom management, and QOL in groups of 3-5 men. They completed online questionnaires, including the Client Satisfaction Questionnaire-3 (CSQ-3, Range: 4-12), post-intervention and an optional exit interview. Participants received a Fitbit for the duration of the program to set physical activity goals and monitor progress. Results: We enrolled 16 of 33 approached patients (48.5%). Of 16 enrolled patients (median age=70.0 years; 84.6% Black, 23.1% Latino), 13 (81.3%) participated in the intervention. Three groups were conducted in English, and one was conducted in Spanish. Twelve out of 13 participants (92.3%) attended at least 4 sessions, and 6 (46.2%) attended all 6 sessions. Twelve out of 13 participants (92.3%) completed post-intervention surveys. Participants found the intervention acceptable, as indicated by high median CSQ-3 scores (11.0, Inter-Quartile Range 10.5-12.0). Out of 12 participants who agreed to use a Fitbit, 9 (75.0%) wore their Fitbit at least once, and 3 (25.0%) wore the Fitbit all 12 weeks. Exit interview data showed high satisfaction with the group format, especially the opportunity to meet other men from similar backgrounds going through PC treatment. Participants noted gaining knowledge and skills regarding side effect management and coping. They did not, however, find the Fitbit or focus on increasing physical activity as helpful as the other intervention targets. Conclusions: The high proportion of intervention completion and satisfaction with PROWESS supports further testing of the intervention in a randomized trial. Exit interview data highlight the importance of social connection, coping skills, and side effect management for improving QOL for Black and Latino men on ADT. Clinical trial information: NCT05755490 .