BACKGROUND:Research assessing the effects of behavioral interventions on the home food environment is limited. OBJECTIVES:This study aimed to assess the efficacy of Athletes for Life (AFL), a 10-wk family- and community-based diet improvement and physical activity promotion intervention, on home availability of fruit, vegetables, and sugar-containing foods. METHODS:Dyads of 1 adult parent and 1 child from 131 households (96% Hispanic) were randomly assigned to AFL (n = 64) or a wait-list control group (n = 67). AFL included behavioral modification strategies for increasing fruit and vegetable consumption and reducing sugar intake, with modifying home food availability as a strategy for diet improvement. Trained research assistants assessed home availability of vegetables, fruits, low- and high-sugar breakfast cereals (separately), prepared desserts, candy, low-sugar beverages, and sugar-sweetened beverages with a modified version of the home food inventory. Intervention effects (i.e., between-group differences in change) were examined using mixed-effects Poisson regression via condition (control vs. intervention) × time (preintervention vs. postintervention) interaction terms, adjusting for study cohort, household size, and number of days since last shopping trip. RESULTS:Intervention households demonstrated significant improvements, compared with control households, in the number of vegetables available (8.39-10.38 for intervention; 8.69-8.55 for control; P < 0.01); number of vegetables, excluding potatoes (7.70-9.65 for intervention; 7.92-7.83 for control; P < 0.01); and number of prepared desserts available (from 2.85 to 1.75 for intervention; from 2.42 to 2.52 for control; P < 0.01). No other outcomes of interest were statistically significant. CONCLUSIONS:Encouraging changes toward a healthier home food environment as part of the AFL intervention resulted in participants increasing the number of vegetables and reducing the number of prepared desserts available in the home. How promoting a healthy home food environment leads to diet change warrants further investigation. This trial was registered at clinicaltrials.gov as NCT03761589.

Promoting fitness may be a viable and acceptable approach for chronic disease prevention. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of a behavioral and fitness-oriented intervention called "Athletes for Life Program" (AFL) implemented in a community center. AFL was a pre-post, 6-week program. Latino families (n = 24) participated in weekly 90-minute physical activity (PA) and nutrition sessions. Measures included fitness, accelerometer-measured PA, body mass index (BMI), and self-report survey. Feasibility and acceptability were evaluated via post-intervention interviews. Intervention effects were tested using paired samples t-test and qualitative data via thematic analysis. Most parents were female (96%) and Latino (79%), while children were male (57%) and Latino (83%). Retention and attendance rates were 75% and 67% for parents and 81% and 70.8% for children. Children improved muscular endurance, speed, and cardiovascular endurance (P < 0.01), with no change in habitual Moderate-to-Vigorous Physical Activity (MVPA). There were significant reductions in children's consumption of soda (2.0 ± 1.4 vs 1.6 ± 1.2, P < 0.01), fruit-flavored drinks (2.0 ± 1.5 vs 1.1 ± 1.3, P = .01), and eating cake/pastries (1.48 ± 1.1 vs 1.0 ± 0.8, P = .05). Families expressed interest in continuing to participate in AFL. AFL is a promising family-based fitness-focused program to improve health among Latinos.

Background:Early cancer diagnosis improves survival and quality of life, yet disparities in stage at diagnosis persist. This study evaluates demographic, clinical, insurance, and neighborhood-level socioeconomic factors associated with late-stage cancer diagnosis within an academic health system. Methods:We conducted a retrospective cohort study of 27,064 adults diagnosed with breast, colorectal, or lung and bronchus cancer between 2015 and 2025 in the University of California Health System. Late-stage disease was defined as AJCC stage III/IV. Multivariable logistic regression examined associations between late-stage diagnosis and patient characteristics, insurance status, comorbidity burden, and neighborhood socioeconomic measures, including the Area Deprivation Index (ADI), Social Vulnerability Index (SVI), and Healthy Places Index (HPI). Results:17.6% of patients were diagnosed at a late stage. Cancer type was the strongest predictor, with lung (aOR ≈ 13-14) and colorectal cancer (aOR ≈ 8) associated with higher odds of late-stage diagnosis compared with breast cancer. Residence in medium and high ADI tertiles and Medicaid insurance (OR = 1.16; 95% CI: 1.06-1.28) were associated with higher odds of late-stage diagnosis, while Veterans Affairs coverage was associated with lower odds (OR = 0.76; 95% CI: 0.58-1.01). SVI was not associated with stage at diagnosis, whereas higher HPI scores were modestly protective. Conclusion:Late-stage cancer diagnosis is driven primarily by cancer type and insurance status, with additional contributions from neighborhood disadvantage.

BACKGROUND:COVID-19 has disproportionately affected minority groups, including Latinos. Since the development of COVID-19 vaccines, effective implementation faced challenges due to multiple factors, necessitating multi-level and multi-sector approaches. This study describes the Vaccine Promotion Program (VPP), a multi-level intervention to increase COVID-19 vaccine uptake among Latinos in clinical and community settings. METHODS:VPP is a double-blind, pragmatic, 12-month cluster-randomized trial in collaboration with a large Federally Qualified Health Center (FQHC) in San Diego, CA. Ten clinics will be randomized to a Multilevel Intervention involving activities at the interpersonal, clinic, and community levels (VPP) or Standard Clinical Practice (SCP) (n = 5 clinics, respectively). Patients in VPP clinics will receive tailored clinic-originated messages about COVID-19 vaccination and motivational interviews (MI) (15-30-min telephone/telehealth encounters) from Health Educators (HE) to encourage COVID-19 vaccination. HEs will send emails and/or text message-based information to encourage vaccination. The community-level intervention involves targeted and tailored activities to promote COVID-19 vaccine uptake in neighborhoods surrounding the five VPP clinics. A cohort of 200 patients will be enrolled to participate in comprehensive surveys and follow-up for 24 months to assess longer-term outcomes. The primary outcome (COVID-19 aggregated vaccination rates) will be compared at baseline, 6, and 12 months between VPP and SCP clinics and neighborhoods, respectively. DISCUSSION:VPP directly addresses the most prominent COVID-19 vaccination barriers, including health literacy, community trust, and vaccine access, through a multi-level approach in collaboration with an FQHC. This approach has the potential to be an effective and scalable public health approach to vaccination among underserved communities.

IntroductionDespite strong evidence linking adverse childhood experiences (ACEs) to poor health, current healthcare interventions lack robust empirical support, underscoring the need for a new framework to build child resilience across healthcare, policy, community, and family systems.ObjectivesTo introduce and provide preliminary empirical evidence supporting the Circles of Resilience (CoR) model by examining whether social connections and vital conditions buffer pathways linking ACEs, maternal anxiety, and child self-regulation in a Federally Qualified Health Center (FQHC) serving Latino families.MethodsWe conducted a cross-sectional study using parent-reported data collected from 2021–2023 at an FQHC in San Diego, California (N = 156 Latino mother–child dyads). Measures included ACEs, maternal anxiety, child self-regulation, and protective factors: (1) social connections and (2) vital conditions (housing, food security, transportation, community resources). Structural equation modeling examined interrelationships among ACEs, maternal anxiety, and child self-regulation, including whether maternal anxiety mediated pathways and whether familial protective factors moderated associations.ResultsHigher ACEs were associated with worse child self-regulation (β = 7.44, p < 0.001). There was an indirect association between ACEs and child self-regulation via maternal anxiety (indirect β = 2.48, p = 0.006; ACEs → anxiety β = 0.67, p = 0.007; anxiety → self-regulation β = 3.72, p < 0.001). Vital conditions were significantly associated with child self-regulation (β = −1.81, SE = 0.92, p = 0.049), whereas social connections were not (β = 2.08, SE = 1.87, p = 0.266). Higher social connections weakened the ACEs–maternal anxiety association (interaction β = −0.70, p = 0.005), while the buffering effect of vital conditions was not significant (β = −0.61, p = 0.078).ConclusionFindings provide preliminary support for CoR model pathways. Higher ACEs were associated with poorer child self-regulation, partially mediated by maternal anxiety. Vital conditions were directly associated with child self-regulation, whereas parental social connections were not. However, social connections significantly buffered the ACEs–maternal anxiety association, suggesting a protective effect on caregiver stress. The buffering effect of vital conditions was not significant. If replicated longitudinally, findings may clarify distinct mechanisms through which contextual resources shape resilience in children exposed to early adversity.

INTRODUCTION:This study explored factors associated with sugar-sweetened beverage (SSB) and water consumption among adults in a small community in rural Mexico. METHODS:We conducted a cross-sectional survey using door-to-door sampling in an unincorporated community. Measures included self-reported consumption of beverages, personal preference, behavioral, and social environmental factors. Hierarchical multivariate linear regression models tested associations between social environmental factors and beverage consumption. RESULTS:Participants (n = 89) reported consuming high amounts of sugar-sweetened beverages, averaging 29.9 oz (884.2 mL) per day. Daily water intake was approximately 33.9 oz (1002.5 mL) per day. Personal preference (β = 1.58; 95% CI 1.20, 2.04), behavioral (β = 1.38; 95% CI 1.10, 1.74), and social environmental factors (β = 1.38; 95% CI 1.02, 1.86) were associated with greater daily consumption of SSBs. CONCLUSIONS:Adults reported consuming high amounts of SSBs and low amounts of water. These behaviors correlated with personal preference, behavioral, and social environmental factors. A multidimensional approach that considers personal, behavioral, and social environmental factors could reduce SSB consumption and improve health outcomes in rural Mexican communities.

Training programs designed to increase participation of underrepresented students in cancer-related careers rarely include structured community engagement components. We describe the design and pilot of the Field Experience in Cancer Outreach and Engagement (FECOE), a program developed as part of the CREATE Partnership (Cancer Research and Education to Advance HealTh Excellence), a National Cancer Institute-funded grant to San Diego State University (SDSU) and University of California San Diego (UCSD). Scholars were situated within the UCSD Moores Cancer Center Community Outreach and Engagement (COE) component and completed 20 h of field and product-development activities from May-August 2025. A focus group was conducted at the conclusion of the program. Three SDSU Undergraduate Scholars and one UCSD Medical Student Scholar completed the pilot. Scholars reported gaining skills in health communication, community engagement, and cultural humility. Scholars described the experience as "connected" and "eye-opening," and reported gains in career clarity. Feedback included improving tracking of hours, event preparation, and networking. The pilot FECOE demonstrates the feasibility of embedding a community outreach field experience within a cancer research training program. The COE-embedded model offers a scalable, sustainable approach that benefits Scholars and the host institution's outreach mission. Lessons learned will inform refinements for future iterations.

Parents play a critical role in supporting their children’s physical activity (PA) and sedentary behavior (SB). However, less is known about parents’ support for child PA and SB in underserved populations. In this study, we examined the associations between parent and child total PA (TPA), SB, and moderators of these associations in a primarily Hispanic/Latino sample. This cross-sectional study used baseline data from 68 parent–child dyads who participated in a two-group randomized controlled trial. TPA and SB were measured for seven consecutive days using GeneActiv wrist-worn accelerometers. Multivariable linear regression was used to evaluate the parent–child TPA and SB associations [betas (ß) and 95

BACKGROUND:Obesity is highly prevalent among Hispanic and Latino adults and is an established risk factor for 13 cancers; however, studies focused on Hispanic and Latino adults are limited. We examined 6 anthropometric measures in association with incidence of obesity-related cancers among Hispanic and Latino adults, overall and by sex, age, and heritage. METHODS:We included 16 415 Hispanic and Latino adults from the Hispanic Community Health Study/Study of Latinos. Baseline (2008-2011) anthropometric measures included body mass index (BMI), waist circumference, waist-to-height ratio, waist-to-hip ratio, fat mass index, and percent body fat. The incidence of 13 obesity-related cancers was ascertained through linkages with 4 state cancer registries (n = 330 incident obesity-related cancer diagnosed over a mean follow-up of 10.7 years). Survey-weighted Cox models estimated covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between each anthropometric measure and latent class analysis-derived groups and obesity-related cancer risk. RESULTS:Hazard ratios were elevated among adults with the highest levels of anthropometric measures and more so among women than among men. For example, a BMI of at least 30 (vs <25) kg/m2 was associated with an adjusted hazard ratio of 1.42 (95% CI = 0.88 to 2.30) overall and adjusted hazard ratios of 2.22 (95% CI = 1.18 to 4.16) in women and 0.46 (95% CI = 0.20 to 1.02) in men. Adjusted hazard ratios also varied by Hispanic and Latino heritage. For example, a 1-standard deviation increase in BMI was associated with a 63% (HR = 1.63, 95% CI = 1.10 to 2.41) increase in obesity-related cancer risk among South American adults but not among Central American adults (HR = 1.03, 95% CI = 0.53 to 2.00). CONCLUSIONS:Multiple anthropometric measures were positively associated with obesity-related cancer risk, particularly among women. Efforts to reduce obesity may be important for cancer prevention in Hispanic and Latino adults.

BACKGROUND:The influence of physical activity (PA) and sedentary behavior (SB) on survival to late age with intact mobility is unclear. This study investigated associations between accelerometer-measured daily PA, SB, and survival to age 90 birthyear with and without intact mobility in the Women's Health Accelerometry Collaboration (WHAC). METHODS:Postmenopausal US women aged 78-89 years without mobility disability were followed for an average of 6.1 years. At age 90 birthyear, participants were categorized as: (1) surviving with intact mobility, (2) surviving with mobility disability, or (3) deceased. Participants wore an accelerometer on the hip for up to 7 days at baseline from 2011 to 2015. Covariate-adjusted multinomial logistic regression models estimated odds ratios (ORs) of PA (light, moderate-to-vigorous [MVPA], total, steps) and SB (sitting time, mean sitting bout duration) with survival outcomes relative to dying. RESULTS:Among 2656 women (mean baseline age 83.1 years), 62.8% survived with intact mobility, 22.3% with mobility disability, and 15.0% died. Compared to dying before age 90, the OR (95% confidence intervals [CI]) for every 1-SD increment in accelerometer variables and survival with intact mobility were 1.36 (1.20, 1.54) for light PA, 1.69 (1.47, 1.96) for MVPA, 1.51 (1.33, 1.71) for total PA, 1.75 (1.51, 2.03) for steps, 0.70 (0.61, 0.80) for sitting time, and 0.79 (0.70, 0.89) for sitting bouts. Similar, weaker trends were present for mobility disability. CONCLUSIONS:These findings corroborate the potential role of increasing physical activity in preserving physical functioning as an important element of healthy longevity.

321 Background: H/L pts with PCa are at an increased risk of developing ADT-related side effects. Diet and exercise can improve PCa-related outcomes, including reducing ADT-related toxicities. However, little is known about individual perspectives on factors impacting engagement in health-promoting behaviors among H/L men with PCa. Methods: We developed a survey to examine sociodemographic characteristics, exercise/dietary habits, motivation for change, and barriers to participate in lifestyle interventions. We surveyed pts with PCa who self-identified as H/L ethnicity, treated at UCSD, and who were either previously or currently on ADT at the time of the survey. Questionnaires were administered in Spanish or English, either in person or by telephone, using interpreter services based on pt preference. Results: Between April and August 2024, 61 pts (median age 66 years) completed the survey with an 88% response rate. Most pts were of Mexican descent (85%), born outside the U.S. (72%), had public health insurance (51%), resided in disadvantaged neighborhoods (54%) based on the Area Deprivation Index, from H/L ethnic enclaves (64%), and were primarily Spanish speakers (51%), with 36% reporting no English proficiency. About half (49%) reported household financial distress, yet 92% felt supported by their community or family during PCa diagnosis. At the time of the survey, 85% of pts were on ADT, 68% had distant metastasis, and 69% had undergone local therapy. Most had a BMI ≥ 30 kg/m2 (52%), diabetes (51%), and 66% had a history of coronary artery disease or a high-risk atherosclerotic cardiovascular disease score of ≥ 20%. Most pts (51%) reported limited dietary monitoring and 71% reported less than 50 min/week of moderate-intensity exercise, with 41% not engaging in any moderate exercise. However, most expressed motivation to initiate lifestyle changes (91% exercise; 83% diet) and 82% showed interest in joining a community lifestyle intervention program. Pts identified participation incentives including family involvement (73%), other H/L participants (77%), Spanish-speaking staff (86% among Spanish speakers), and a driving distance of less than 5 miles. Conclusions: We report that H/L pts with PCa on ADT have substantial cardiometabolic risk factors. While engagement in health-promoting activities was limited, patients expressed motivation to improve health-promoting practices, with actionable incentives to enhance participation, underscoring the need for tailored intervention to mitigate ADT toxicity in this pt population. These findings will inform the design of an interventional study that examines the impact of a combined group exercise and nutrition counseling intervention on physical fitness and cardiovascular health among H/L men with PCa on ADT.

BACKGROUND:COVID-19 has disproportionately affected underserved communities, such as Latinos living in the U.S. Promotoras (Community Health Workers) may be effective at delivering tailored and culturally relevant strategies to prevent household spread and the burden of SARS-CoV-2 among Latinos and other minority groups. PURPOSE:To develop, implement, and test the clinic-based promotora-led COVID-19 Prevention Program (CPP) to reduce transmission of SARS-CoV-2 in 256 Latino households and the community. DESIGN:CPP is a two-group randomized controlled trial designed to test the immediate, mid-term, and long-term effectiveness of the promotora-led intervention, as well as test its effectiveness on short- and long-term behavioral, mental, and physical health outcomes. The primary outcome is household infection rate assessed at 6 weeks and 6-, 12-, and 24-months based on a binary indicator (yes vs. no) of evidence of a new infection via antigen, real-time reverse transcriptase-polymerase chain reaction (RT-PCR), or antibody SARS-CoV-2 test results within household members. Patients in the intervention group will receive enhanced standard-of-care, including tailored, real-time text messaging and virtual counseling, delivered by promotoras. Patients in the control group will receive the clinical standard of care. Analyses will test for household-level group differences in new infections related to an identified index case. DISCUSSION:Preventing household spread of SARS-CoV-2 is an important strategy to reduce the overall burden of SARS-CoV-2 among Latinos. The CPP is a scalable and tailored approach that has the potential to serve as a model to address future respiratory disease outbreaks, especially among uninsured, low-income, and medically underserved communities. TRIAL REGISTRATION:Clinicaltrials.gov Identifier NCT05697068 (1/20/2023).

Latino children are disproportionally affected by overweight and obesity (OW/OB). Family-based behavioral treatment (FBT) is the most empirically supported treatment for children with OW/OB and traditionally includes a child and a caregiver. Very few FBT programs have been tested among Latino families, and to date, outcomes are inconsistent and/or show small effects. Familismo is a core value in Latino culture highlighting the importance of family functioning over any individual members, and it is possible that by adapting the treatment and including other family members, FBT outcomes could be enhanced for Latino families. Randomized trials show that parent-only FBT programs (PBT) are similarly effective to FBT and can be easier to disseminate and cost less. The current trial is a two-arm randomized controlled trial comparing the effect of a telehealth PBT program tailored to Latino families (PBT-LC) with a health education (HE) comparator on the child's weight over the 18 months of the study. We randomized 167 Latino families with a child with OW/OB to either six-months of telehealth PBT-LC or HE treatment delivered to the parent and additional caregiver in English or Spanish with 12-months of follow-up. This ongoing study may provide a translatable evidence-based cost-effective program tailored for Latino families with a child with OW/OB. Clinical trials # NCT05437406.

Rural, indigenous populations in Mexico face barriers to accessing sexual and reproductive health (SRH) resources and services. Given the lack of information to inform educational materials tailored to the needs of these indigenous communities, we aimed to: (a) quantitatively characterise the SRH awareness and practices among adolescents and adults in a rural, mostly indigenous community in northern Mexico and (b) qualitatively assess community perspectives on an educational pamphlet with SRH information (e.g. contraceptive options). Quantitative data collection occurred in November 2018 and April 2019 using convenience sampling in a community clinic and random sampling for community households. Qualitative data collection occurred in November 2019 via individual interviews and focus group discussions to assess community perspectives about an SRH educational pamphlet developed from quantitative data. Participants in the quantitative phase of our study (n = 217) were a median age of 30 years, 71% were female, and those with children reported having a median of three (range = 1-11). SRH knowledge was low, as were self-reported efforts to obtain contraceptives or testing for HIV/STIs. Most believed that children should learn about SRH by age 10-15 years, and 94% felt that parents should deliver such education. Participants had low knowledge about SRH but high motivation to educate children and adolescents on these topics, indicating potential for SRH campaigns in this community. Health education materials were well-received in the qualitative phase of our study (n = 17 from individual interviews; n = 22 from focus group discussions), and raised interest among community members in learning more about these topics.

Purpose: Physical activity (PA) and sedentary behavior (SB) are modifiable factors associated with improved body composition (BC) and lower morbidity risk in breast cancer survivors. The COVID-19 pandemic disrupted activity patterns worldwide, but data on post-pandemic habits among Latin American survivors remain scarce. This study examined PA and SB levels and explored whether their relationship with BC varies based on cancer history status. Methods: In this cross-sectional study, 120 Mexican women (60 breast cancer survivors and 60 women without cancer history) reported PA and SB using validated questionnaires. BC indicators were assessed using dual-energy X-ray absorptiometry. Correlation analysis and multivariable linear regression were performed, adjusting for pertinent confounders. Results: The mean age was 52.5 ± 9.3 years. Overall, 57% were physically inactive, and the average sitting time was 4.8 ± 2.8 hours per day. PA levels were negatively correlated with total body fat percentage (TBFP) (rho = − 0.26), fat mass index (rho = − 0.20), waist circumference (rho = − 0.20), and android fat mass (rho = − 0.20) (all p < 0.05). SB was not associated with BC. After adjustment, PA level remained independently inversely associated with TBFP (p < 0.05), and cancer history status did not modify this relationship. Conclusions: Physical inactivity persists post-pandemic among Mexican women, including breast cancer survivors. PA is associated with healthier BC, independent of cancer history status. Implications for Cancer Survivors: Increasing PA through structured, culturally tailored support integrated into survivorship care may improve body composition and mitigate long-term health risks among post-pandemic breast cancer survivors.

The Healing Experiences of Adversity Among Latinos (HEALthy4You; H4Y) study was a multi-sector partnership between an academic research institution, a Federally Qualified Health Center (FQHC), and a multi-sector collective impact coalition focused on childhood obesity prevention. The goal of HEALthy4You was to develop community-centered and culturally appropriate precision interventions within FQHCs for Latino families to address predictors of adverse child experiences and treat childhood obesity. A multidisciplinary and multi-sector research, clinical, and community team (N = 29) was formed in September 2020 to co-design the study, which launched in June 2022. The team utilized a co-creation approach combined with the Exploration, Preparation, Implementation, and Sustainment framework to facilitate a collaborative design process. We conducted an internal and retrospective process evaluation in March 2023 to identify antecedents and situational factors associated with project formation, with a focus on understanding tensions and challenges with a broad partnership structure. We outline the team's co-creation process and describe internal challenges and pitfalls that emerged when developing the project. We sought to better understand the impact of differing perspectives, priorities, and goals between disciplines, sectors, and roles; differing approaches to evidence and evidence production; and team strategies to mitigate and manage competing pressures and priorities. This case report describes lessons learned, intending to share insights to support future development of best practices in project, partner, and team formation between researchers, clinicians, and community members. More specifically, these lessons could help inform community-led research endeavors between academic institutions, FQHCs, and community-based organizations (CBOs).

BACKGROUND:Data on prospective associations of accelerometer-measured physical activity, sedentary behavior, and mortality among cancer survivors are lacking. Our study examined accelerometer-measured daily physical activity (including light, moderate to vigorous, total, and steps), sedentary behavior (sitting time and mean bout duration), and mortality among cancer survivors in the Women's Health Accelerometry Collaboration. METHODS:Postmenopausal women in the Collaboration who reported a cancer diagnosis at least 1 year prior to wearing an ActiGraph GT3X+ device on the hip for at least 4 of 7 days from 2011 to 2015 were included. Outcomes included all-cause, cancer-related, and cardiovascular disease (CVD)-related mortality. Covariate-adjusted Cox regression estimated hazard ratios (HRs) and 95% CIs for each physical activity and sedentary behavior measure in association with mortality. RESULTS:Overall, 2479 cancer survivors (mean [SD] age, 74.2 [6.7] years) were followed up for 8.3 years. For all-cause mortality (n = 594 cases), every 78.1 minutes per day in light physical activity, 96.5 minutes per day in total physical activity, 102.2 minutes per day in sitting time, and 4.8 minutes in a sitting bout duration had hazard ratios of 0.92 (95% CI = 0.84 to 1.01), 0.89 (95% CI = 0.80 to 0.98), 1.12 (95% CI = 1.02 to 1.24), and 1.04 (95% CI = 0.96 to 1.12), respectively. Linear associations for cancer mortality (n = 168) and CVD mortality (n = 109) were not statistically significant, except for steps (hazard ratio per 2469 steps/d = 0.66, 95% CI = 0.45 to 0.96) and sitting time (hazard ratio = 1.30, 95% CI = 1.02 to 1.67) for CVD mortality. Nonlinear associations showed benefits of moderate to vigorous physical activity (for all-cause and CVD mortality) and steps (all-cause mortality only) maximized at approximately 60 minutes per day and 5000-6000 steps per day, respectively. CONCLUSIONS:Among postmenopausal cancer survivors, higher physical activity and lower sedentary behavior was associated with reduced hazards of all-cause and CVD mortality.

Background Targeting cardiovascular fitness (CVF), rather than weight loss, may be a more acceptable and feasible outcome among Latinos. Purpose The purpose of this study was to test the short-term efficacy of Athletes for Life (AFL), a fitness- and lifestyle-focused behavioral intervention to improve CVF and performance among Latino families. Methods Latino parent-child dyads (n = 137) were randomized to either AFL program or a waitlist control condition. AFL consisted of 24 group family-based, nutrition and sport/fitness oriented 90-minute sessions (twice-weekly). Measures included 1-mile run/walk time, three-minute step test, accelerometer-measured physical activity, body mass index (BMI), waist circumference, DEXA-measured % body fat, cardiometabolic risk biomarkers, and sociodemographic characteristics. Group differences at post-intervention were tested using ANCOVA analyses adjusting for outcome values at baseline and demographic variables. Results Parents were primarily female (93%), aged 38.3 ± 6.9 years, and 96% Latino and children were 8.8 ± 1.7 years old and 58% female. Intervention participants showed significantly faster adjusted post-intervention 1-mile run/walk times compared to control group participants (difference of −76.6 seconds P < 0.01 and −44 seconds P = 0.04, respectively). Parents also showed a significantly higher adjusted relative VO 2 max (ml/kg/min) compared to control group parents (43.91, SE = 0.41 vs 42.93, SE = 0.44, respectively, P < 0.01). There were no significant post-intervention group differences on physical activity, BMI, waist circumference, % body fat or cardiometabolic biomarkers P > 0.05. Conclusions The AFL program successfully improved aerobic performance among underserved Latino families with no observable changes in adiposity. These results support that fitness may be a more viable and acceptable outcome among Latino families than weight loss.