PRO-Health – A prostate cancer specific healthy eating and exercise program

This is a 12-week pilot randomised controlled trial to evaluate the feasibility, acceptability and preliminary efficacy of PRO-Health: a multifactorial online platform that provides individualised educational material on (i) prostate cancer and treatment side effects and (ii) nutrition and exercise behaviour change multimedia to support remotely delivered nutrition and exercise video-consultation from a dietitian and exercise physiologist. The program will specifically target men with prostate cancer treated with androgen deprivation therapy. Participants will be randomised (1:1 ratio) to the usual care group or the PRO-Health intervention after baseline testing. Those receiving the PRO-Health intervention will receive the following combined nutrition and exercise intervention in parallel. Nutrition Participants will receive 4x individualised nutrition consultations with an accredited practising dietitian delivered via video-consultation using Zoom Video Communications ™. Consultations will be scheduled at Baseline, Week 2, 4 and 8. The initial consultation will be 60-minutes with review consultations being 45-mins. At each consultation the dietitian will follow a standardised medical nutrition therapy protocol where the initial assessment will: •Assess current clinical symptoms, treatment side effects, weight history, and social history. •Review dietary intake using a standardised 24-hr dietary recall. •Create a personalised dietary plan to meet dietary targets: (i) protein (1.2-1.5g/kg/day); (ii) calculate energy requirements with restrictions of 500-1000 kJ/day; (iii) general healthy eating for cardiovascular health. Recommendations are derived from the American Society of Clinical Oncology (ASCO) Exercise, Nutrition and Weight management during cancer treatment guidelines and the American Cancer Society (ASC) nutrition and physical activity guidelines for cancer survivors. •Following the Coventry, Aberdeen & London - Refined (CALO-RE) behaviour change taxonomy framework PRO-Health includes nutrition education material, a personalised dietary plan, and recipes to support dietary behaviour change. •Review consultations will follow the same structure but also evaluate adherence (24-hr recall, session attendance) to dietary goals and progressively change dietary intake where needed. Exercise The exercise component of this intervention will consist of 4x individualised exercise consultation with an exercise physiologist using Zoom Video Communications ™. Consultations will be scheduled at Baseline, Week 1 (optional check-in), 2, 4 and 8. The initial consultation will be 90-minutes with review consultations being 60-mins. Exercise equipment (resistance band and yoga mat) will be couriered to participants in advance. The consultation structure will follow: •Assess and evaluate any contraindications to exercise (including past medical history) and environment for safe exercise. •Explanation of exercise technique and form with demonstrations of exercise performed by the participants. •The exercise prescription will contain 3 sessions/week of combined (1) aerobic exercise (moderate intensity: 50-70% HRmax) lasting 30-mins walking/cycling (including a warm-up and cool-down) and (2) resistance-band training lasting 40-mins at a moderate intensity aiming for 2-3 sets of 8-12 repetitions of 6-8 exercises targeting major muscle groups (i.e., banded chest press, bent over row, squat, lunge). •Following the CALO-RE behaviour change taxonomy framework PRO-Health includes exercise education material and videos of the exercises with written description. To monitor adherence to the exercise program after each exercise session participants will be asked to rate their rating of perceived exertion, level of pain, enjoyment, and completion of the exercise session through PRO-Health. •Review consultations will follow the same structure but also modify the exercise prescript where needed. After 12-weeks participants in the intervention group will be asked to participate in a semi-structured interview. Guided by the Consolidated Framework for Implementation Research, the interviews will explore participants experiences of the study procedure, intervention components, education material, self-efficacy and future alterations required for PRO-Health. The first 12 participants that opt-in to the interview will be interviewed. Interviews will be conducted by PI Baguley.