title: Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers.
abstract: BACKGROUND
  Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U.S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities.
  
  
  METHODS
  The proposed study will evaluate the efficacy of an evidence-based and theoretically-driven Motivation And Problem Solving (MAPS) intervention, adapted and culturally-tailored for reducing cancer risk related to smoking, poor diet, and physical inactivity among high-risk Mexican-origin smokers who are overweight/obese (n = 400). Participants will be randomly assigned to one of two groups: Health Education (HE) or MAPS (HE + up to 18 MAPS counseling calls over 18 months). Primary outcomes are smoking status, servings of fruits and vegetables, and both self-reported and objectively measured physical activity. Outcome assessments will occur at baseline, 6 months, 12 months, and 18 months.
  
  
  CONCLUSIONS
  The current study will contribute to a very limited evidence base on multiple risk factor intervention studies on Mexican-origin individuals and has the potential to inform both future research and practice related to reducing cancer risk disparities. An effective program targeting multiple cancer risk behaviors modeled after chronic care programs has the potential to make a large public health impact because of the dearth of evidence-based interventions for Latinos and the extended period of support that is provided in such a program.
  
  
  BACKGROUND
  National Institutes of Health Clinical Trials Registry # NCT01504919.
authors.affiliation: School of Social Work, The University of Texas at Austin, Austin, TX, USA.
authors.forename: Yessenia
authors.initials: Y
authors.lastname: Castro
authors.forename: Karen
authors.initials: K
authors.lastname: Basen-Engquist
authors.forename: Maria E
authors.initials: ME
authors.lastname: Fernandez
authors.forename: Larkin L
authors.initials: LL
authors.lastname: Strong
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Eakin
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.forename: Yisheng
authors.initials: Y
authors.lastname: Li
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
mesh_terms: D054521:Cultural Competency; D004032:Diet / Q000208:ethnology*; D037001:Directive Counseling / Q000379:methods; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007802:Language; D017058:Mexican Americans / Q000523:psychology*; D009369:Neoplasms / Q000208:ethnology* / Q000517:prevention & control; D050177:Overweight / Q000208:ethnology; D015397:Program Evaluation; D012107:Research Design; D012307:Risk Factors; D012309:Risk-Taking; D057185:Sedentary Behavior / Q000208:ethnology*; D012907:Smoking / Q000208:ethnology*; D013689:Telephone; D013781:Texas