ABSTRACT
The number of men living with and beyond a prostate cancer (PCa) diagnosis exceeds 3.3 million and is
rapidly increasing in the United States. An estimated 30% of PCa survivors develop comorbid conditions (e.g.,
hypertension, heart diseases, and stroke). Comorbidity is the leading cause of mortality for PCa survivors,
surpassing mortality caused by PCa itself. A healthy diet protects survivors from comorbidities and improves
PCa survival outcomes, yet few PCa survivors adhere to a healthy diet. Moreover, PCa is often considered a
“couple’s disease,” as in both survivors and their partners perceive the threats of PCa to their health and life,
which may, in turn, increase their receptivity to adopting a healthy diet. Within an intimate relationship, it is
likely that one’s diet is influenced by both self-perceived and partner-perceived threats. However, these
interdependent relationships have not been examined among PCa survivor and partner dyads. Furthermore,
the connection of perceived threats to diet may be influence by factors at dyadic (e.g., relationship quality) and
neighborhood (e.g., area deprivation index and food access) levels. In addition, after PCa survivors and
partners perceive the threats of PCa, little is known about how they communicate and collaborate to adopt a
healthy diet. To address these knowledge gaps, we propose a multi-method study to investigate the process
through which PCa survivors and partners adopt and maintain a healthy diet during the PCa trajectory.
Adopting the Actor-Partner Interdependence Model as the analytic model, in Aim 1 we will examine the
interdependent relationships between perceived threats and diets and their changes over time. We will use
data from 280 dyads of PCa survivors and partners in the Prostate Cancer Education & Resources for Couples
(PERC) study (1R01NR016990-01A1). We will also assess how these relationships are moderated by dyadic
relationship and neighborhood conditions. For Aim 2 we will recruit 20 dyads of PCa survivors and partners at
the University of North Carolina Medical Center and conduct dyadic interviews supplemented with one-to-one
interviews to determine how they communicate and collaborate to adopt and maintain a healthy diet. This
study aligns with the research lenses of prevention and health promotion, social determinants of health, and
health equity in NINR’s 2022-2026 strategic plan. This proposed study, combined with the training plans for
career development, serves as my initial step towards becoming an independent behavioral and nurse scientist
to develop and test couple-based behavioral interventions for cancer survivors and partners.
