Testicular cancer survivors (TCS) experience more than 7 times the risk of coronary artery disease compared to the general population, and risk of cardiovascular (CV) disease presents a greater threat to their long-term health than recurrence of testicular cancer (TC). Although the etiology of this risk is poorly understood, intermediate markers of CV outcomes which are elevated in TCS, such as hypercholesterolemia and increased body mass, are likely moderated in part by health behaviors (HB; e.g., physical activity, smoking, and dietary habits), as in other populations. Our data suggest that although TCS exposed to cisplatin-based chemotherapy (CBCT) have increased risk for CV disease, even CBCT-na?ve TCS are at increased risk as assessed by Framingham scores and indices of subclinical arthrosclerosis, both of which are influenced by HBs. However, little is known about the determinants of HBs in this population, which is unfortunate, as these represent modifiable mediators of CV risk. Understanding predictors of HBs is a first step in reducing CV risk. Social cognitive theory (SCT) has demonstrated high predictive power for understanding HBs positing that cognitive, environmental, and behavioral factors interact to determine HBs. Using SCT for intervention development is not straightforward, however, as assessment tools need to capture population-specific factors. Our overarching goal is to describe modifiable determinates of HBs among TCS so that interventions can be undertaken to assist TCSs in improving HBs. The current study has two specific aims: Development of population-specific measures of SCT constructs that allow for prediction of HBs related to CV risk; and 2) assessment of the relationship of SCT constructs to HBs and risk status in a diverse sample of TCS. The ultimate goal is development of interventions to improve the long-term CV risk of TCS. This research progresses through two phases. First, TCS attending the Abramson Cancer Institute's Living Well After Cancer program will be assessed to provide item content for population-specific measures of SCT constructs. This is a well-suited sample as complete medical data are available to allow linkage of SCT constructs to CV risk. Second, a large, registry-derived sample of TCS will be assessed through self-report to allow for validation of the SCT measures and description of modifiable predictors of HBs and CV risk. Testicular cancer survivors (TCS) experience more than 7 times the risk of coronary artery disease compared to the general population, and risk of cardiovascular (CV) disease presents a greater threat to their long-term health than recurrence of testicular cancer (TC). CV outcomes are likely moderated in part by health behaviors (physical activity, smoking, and dietary habits),but little is known about the determinants of HBs in this population. Our overarching goal is to describe modifiable determinates of HBs among TCS so that interventions can be undertaken to assist TCS's in improving HBs. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page Continuation Format Page ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Small Research Grants (R03)
Project #
5R03CA124217-02
Application #
7477097
Study Section
Special Emphasis Panel (ZCA1-SRRB-D (J1))
Program Officer
Alfano, Catherine M
Project Start
2007-08-01
Project End
2011-07-31
Budget Start
2008-08-01
Budget End
2011-07-31
Support Year
2
Fiscal Year
2008
Total Cost
$78,750
Indirect Cost
Name
University of Pennsylvania
Department
Psychiatry
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104