Instructions provided by Movember:
Expression of Interest Outline is captured in a 2 page letter (references separate)
a. Organisation/Project Lead: Provide a brief description of the applicant
organisation and project lead, including organisation size (# of employees) and
relationship to the community represented in the application. If applicable, briefly
describe other partners that would be part of the Project.
b. Target Audience: Identify the primary audience for this project and provide a
description of how the project directly benefits your target population. If
possible, describe the overall population size as well as the size of your sample
c. Assessment of Need: Provide a brief description of the primary purpose of the
project and the need or gap you are seeking to address. If available, include
baseline data with initial metrics, or a project starting point that includes a gap
analysis or relevant patient-level data that informs the stated objectives.
d. Goals & Objectives: Briefly state the overall goal of the project, including a description of how the goal aligns with the focus of this RFP project. List the overall objective(s) you plan to meet with your research project. Describe the outcomes that you expect to achieve by carrying out the project.
e. Funding Amount: Provide the total funding requested. A Full Budget is not
required for the EOI. Note that the final amount requested can be adjusted in a full
proposal submission. Please refer to eligible and ineligible costs when building a
f. Additional Information: If relevant, please provide any additional information
regarding the importance of the project that the assessment panel should
Organization/Project Lead: The Prostate Cancer Patient Empowerment Program (PC-PEP) is led by Dr. Gabriela Ilie, a Prostate Cancer Quality of Life Research Scientist, and Dr. Rob Rutledge, an Oncologist treating prostate cancer, both as Associate Professors at Dalhousie University’s Faculty of Medicine. A dedicated team of professionals and site leads in eight Canadian provinces, work collectively to enhance the quality of life for men with prostate cancer. Dr. Ilie and her team have a track record of service, representation, and collaboration with underserved communities, and bolstered by PC-PEP’s integration into Nova Scotia’s Cancer Programs standard of care.
Target Audience: PC-PEP primarily serves men diagnosed with prostate cancer in underserved communities, including those in rural and remote areas, Indigenous communities, African/Caribbean-Canadian communities, and sexual-orientation minority groups. The program directly supports their mental and physical well-being, with a focus on individuals from these communities. Collaborations with various minority groups are actively underway.
Assessment of Need: This proposal stems from the multi-phase development, testing, and global implementation of PC-PEP, a comprehensive six-month daily health-promotion program led by a prostate cancer quality of life expert and an oncologist. The program caters to men at any prostate cancer stage, offering daily emails and 3-5-minute PEP videos over six months, promoting exercise, home-based strength training via video, Kegel exercises, relaxation techniques, dietary guidance with weekly cooking videos, and relationship advice. It employs a ‘Buddy’ and mentor system, along with monthly videoconferences to ensure an interactive and organic program. Educational videos help men navigate the healthcare system effectively, aiming to complement, not compete with, local or national programs. For further details, visit PCPEP.org. A published randomized trial involving 128 men scheduled for surgery or curative-intent radiotherapy showed clinically significant improvements in participants’ mental health at six and twelve months, compared to a wait-list controlled group that received standard care. The intervention group showed benefits such as weight loss, improved quality of life (QOL), enhanced urinary symptoms, and reduced healthcare utilization, potentially leading to cost savings. The phase 4 implementation trial has expanded to include all stages of prostate cancer and has enrolled 300+ men to date, representing individuals from all Canadian provinces and four countries, including the underserved communities mentioned earlier.
Our Team has learned that to establish Prostate Cancer Communities of Empowerment, it is vital to: (1) recruit men from each minority group who have prostate cancer; (2) Customize the program to meet each group’s unique needs, including group-specific monthly videoconferences and a buddy system; (3) evaluate the program and gather feedback from participants; (4) modify the program based on the received feedback; and (5) provide the modified program to a second cohort for evaluation, each step presenting an opportunity to build Communities of Empowerment.
Creating accrual systems involves engaging both current and new minority group patients (Research Citizens) and inviting key partners, such as community leaders, healthcare professionals, support and advocacy groups, non-profits, government entities, researchers, and funders to join the team. Our focus will be on testing and adjusting the intervention for each minority group, with a robust multimedia accrual campaign to raise awareness of men’s health at all levels, fostering an empowerment culture in each community.
The program evaluation is comprehensive, including weekly compliance reports and open-ended questions regarding culturally inappropriate programming. The six-month end-of-program evaluation covers quantitative assessment and incorporates open-ended questions and videotaped exit interviews for qualitative assessment. Extensive demographic and QOL data collected from each minority group will be compared with data from the 350+ men who completed the program in the current phase 4 trial.
The PC-PEP program addresses the critical need to enhance the health and quality of life for men diagnosed with prostate cancer in underserved communities, focusing on bridging existing gaps in care and support.
Goals & Objectives:
Overall Goal: The project aims to improve the short and long-term mental and physical health of men diagnosed with prostate cancer in underserved communities across Canada, empowering men in rural/remote Canada, the African/Caribbean–Canadian community, indigenous communities, and sexual-orientation minorities.
- Empowerment and Support: Empower men from underserved communities through the PC-PEP program, enhancing their mental and physical health.
- Cultural Sensitivity: Tailor the program to meet the unique needs of each minority group, ensuring cultural appropriateness.
- Program Evaluation: Conduct a comprehensive evaluation of the PC-PEP program’s impact on health outcomes, with a focus on sub-groups experiencing poor physical and mental health.
- Modification and Improvement: Modify the program based on participant feedback, ensuring its effectiveness and cultural sensitivity.
- Community Building: Build Communities of Empowerment by uniting key partners, stakeholders, and program participants to collaboratively address disparities and improve health outcomes within each community.
The research question for this implementation trial revolves around identifying which men benefit most and least from the intervention, considering the Context and Mechanisms involved, with the intention of adapting the program to address sub-groups with continued poor physical and mental health Outcomes. Other areas of interest include changes in health-related behavior, the cost-effectiveness of the program, and its sustainability. Stakeholder meetings will help identify the barriers and enablers to recruiting more men from underserved communities, assess advertising materials, and enhance accessibility to the online program for those with limited financial means. The final phase of this project involves accruing men to the modified program, comparing the outcomes and evaluation of men undergoing the modified program with the initial cohort of men who underwent the unmodified program. Additionally, reasons for non-participation will be documented.
Funding Amount: The project seeks a total funding of $500,000 to cover expenses related to program administration, personnel, research, evaluation, and outreach efforts.
Notes used to craft EOI ie. Project Steps
Building Communities of Empowerment for Men from Diverse Backgrounds through The Prostate Cancer Patient Empowerment Program (PC-PEP)
The goal of the PC-PEP Communities of Empowerment is to improve the short and long term mental and physical health of men diagnosed with prostate cancer (PC) who live in rural/remote Canada, are part of the African/Caribbean–Canadian community, are indigenous, and/or who self-identify as a sexual-orientation minority.
This proposal arose out of the multi-phase development, testing, and international implementation of PC-PEP, a comprehensive home-based six-month daily health-promotion program designed and run by an Oncologist and Psychology Professor–Scientist. Men with any stage of prostate cancer receive a daily email and 3-5-minute PEP video for six months teaching and encouraging them to exercise, do home-based strength-training via video, do Kegels, practice a relaxation technique using biofeedback, along with offering daily dietary advice with weekly cooking videos, and relationship teaching and exercises. A ‘Buddy’ (calling co-participants) and mentor system along with monthly videoconferences keep the program ‘organic’ and interactive. The program also includes educational videos teaching men how to get the best care from the medical system, and the monthly videoconferences reinforce health advocacy behaviours and attitudes. PCPEP is not meant to be competitive with any other local or nationally based programming, but instead reminds men to tap into available resources. Visit PCPEP.org to learn more.
The published PCPEP randomized trial of 128 men scheduled for surgery or curative-intent radiotherapy showed clinically significant improvement in the mental health of the men undergoing the program at six and twelve months compared with a wait-list controlled group offered standard of care treatment. Men in the intervention group lost more weight, had better quality of life (QOL), reported better urinary symptoms, and required less health care in follow up, (representing an absolute cost savings, publications pending) compared with the control group. The phase 4 implementation trial capturing extensive demographic and QOL data at 0, 6, 12 and 24 months of follow up and expanded to all stages of prostate cancer has accrued 350 men to date including men from all Canadian province.s, four countries, and the four underserviced communities listed above.
To build Communities of Empowerment it will be necessary to a) accrue men with PC from each minority group, b) administer the program for the men, and offer group-specific monthly videoconferences and buddy system c) evaluate the program and garner participant feedback, d) modify the program, e) Offer the modified program to a second cohort and evaluate the program. Each of these steps provides an opportunity to build Communities of Empowerment.
Creating accrual systems will include inviting key partners (community leaders, health care professionals, support and advocacy groups, other not-for-profits, government, researchers, funders etc) to join the team with a focus of testing and modifying the intervention in each minority group. Generated and strong multi-media accrual campaign will raise the awareness of men’s health at all levels and reinforces an empowerment culture in each community.
Evaluation of the program is multi-faceted. Men on the program complete a weekly compliance which will include an open-ended question allowing them to comment on culturally inappropriate programming. The six-month (end of program) evaluation includes quantitative assessment of all aspects of the programming and open-ended questions, as well as videotaped exit interviews for qualitative evaluation. The extensive demographic and QOL online survey data collected in each minority group will be compared with the exact same measures captured in the 350+ men who have already completed the program as part of the current phase 4 trial. This implementations trial’s research question can be summarized as ‘which men benefit most and least from the intervention’. – with the intention of identifying sub-groups who continue to suffer poor physical and mental health outcomes, and modifying the program accordingly. Other outcomes of interest include changes in health-related behaviour, the cost-effectiveness of the program, and others.
Modification of the program will occur in three of the four minority groups. The fourth group, men living in rural/remote Canada, have already provided their very positive feedback in three stakeholder conferences organized in Halifax, as well as in the n=40 recorded exit interviews (qualitative analysis completed). For the other three groups, modifications of the program would be driven by the evaluation and feedback as outlined in the previous paragraph. Bringing Community of Empowerment members for each group together in a face-to-face conference would be critical to further understanding and working towards modifying the program for each group. For instance, it may be necessary to create videos featuring people from the minority community in the program content. The stakeholder meeting would also help outline the barriers and enablers to accruing more men from the underserviced communities, including assessing advertising materials, and ways to make this online program more accessible to those with limited financial means.
Accruing men to the modified program: The last phase of this project is to repeat administration and evaluation of the modified program. The outcomes/evaluation of men going through the modified program would be compared against the first cohort of men undergoing the unmodified program. In addition, we would capture the reasons why men who were offered the program decided not to participate.
Our team have already established members in each of the Communities of Empowerment and continue to build momentum. Our Lead has tested and established a community of men who attend the monthly videoconferences from rural/remote Canada. The program is being integrated into the standard of care in Nova Scotia via the support of the provincial Cancer Care Program. The ‘men with other men’ group (sexual orientation minority group) has a national lead who is actively accruing men to the phase 4 trial, and co-leads their own monthly videoconference. We have accrued and have worked with leads of African-Nova-Scotian groups. Though indigenous men have completed our program, we will need to re-approach leads in the indigenous health community. However, we have site PIs currently accruing patients in Saskatoon, Edmonton, and will open sites in other centres with larger indigenous populations like Thunder Bay.
This Communities of Empowerment project builds on a successful research program which has translated the health-promotion science into a unique and powerful medium of improving the health and well-being of men affected by prostate cancer. It fills a critical gap in a health care system (which focuses on illness and physical care) by engaging the patient, family and the larger community in improving their health. Men participating in the program learn how to advocate for themselves within and beyond the medical system, and bring the healthy lifestyle habits back into their communities. The Communities of Empowerment raise the awareness and advocate for these underserviced communities and provide health-care system administrators ways to improve the health and well-being of entire communities.
CHAT GPT modification of the notes (highly used by some colleagues, perhaps better than a human; so we included as reference)
We are writing to express our strong interest in the Prostate Cancer Health Equity Initiative and would like to submit a proposal titled “Building Communities of Empowerment for Men from Diverse Backgrounds through The Prostate Cancer Patient Empowerment Program (PC-PEP)”. The goal of this program is to improve the short and long-term mental and physical health of men diagnosed with prostate cancer who belong to all of the Priority Populations; men who live in rural/remote Canada, are part of the African/Caribbean–Canadian community, are indigenous, and/or who self-identify as a sexual-orientation minority.
Our proposal is based on the successful development and implementation of PCPEP, a comprehensive home-based six-month daily health-promotion program for men with prostate cancer. The program includes daily emails and videos, and prescribes exercise and strength training routines, kegels, relaxation techniques, dietary advice, relationship teaching and educational resources. It incorporates a buddy/mentor system and monthly videoconferences to create an interactive and supportive environment. We have conducted and published a randomized trial of 128 men scheduled for surgery or curative-intent radiotherapy, which showed clinically significant improvements in mental health, weight loss, quality of life, urinary symptoms, and reduced healthcare utilization compared to a control group. The ongoing phase 4 implementation trial has accrued 300+ men from various international locations, including men from all Canadian provinces and the aforementioned Priority Populations. Visit PCPEP.org to learn more.
To build Communities of Empowerment, we plan to target each Priority group and focus on recruiting men with prostate cancer from these populations. We will engage key partners, including community leaders, healthcare professionals, support and advocacy groups, and other stakeholders, to maximize accrual of an initial cohort of men. A comprehensive multimedia accrual campaign will raise awareness and promote an empowerment culture within each community.
The program will be evaluated through various methods, including weekly program compliance assessments, quantitative evaluations of program outcomes, qualitative feedback through open-ended questions and exit interviews, and comparison with our existing and ongoing phase 4 trial participants. These evaluations will help us identify sub-groups within each Priority Population who benefit most and least from the program, as well as to assess changes in health-related behaviors and cost-effectiveness.
Modifications to the program will be made (and tested on a second cohort) based on participant feedback and evaluation results. We will organize face-to-face stakeholder meetings for each minority group to further understand their specific needs, barriers, and enablers. This collaborative approach will ensure that the program is tailored to the unique cultural and contextual factors of each community, potentially including the production of culturally relevant program content.
We have already established connections with leads in each of the Communities of Empowerment and our team is actively working towards building momentum and expanding our reach. We are collaborating with national and local stakeholders and have already integrated the program into the standard of care in Nova Scotia Cancer Care Program.
This Communities of Empowerment project is an extension of our successful research program, which has already demonstrated the power of community and health-promotion techniques in improving the well-being of men affected by prostate cancer. By engaging patients, families, and communities, our program goes beyond the traditional focus on illness / physical treatment to empower individuals to improve their health, and to advocate for changes to improve the health and well-being of entire communities.
Thank you for considering this Expression of Interest. We are deeply passionate about addressing the disparities in prostate cancer outcomes among all four Priority Populations and believe that our proposal has the potential to make a significant impact. We would be honored to be chosen to submit a Full Proposal, and we eagerly await the opportunity to further showcase the potential of our project.
References for this grant application
RCT – EU Paper
Ilie, G., Rendon, R., Mason, R., MacDonald, C., Kucharczyk, M. J., Patil, N., Bowes, D., Bailly, G., Bell, D., Lawen, J., Ha, M., Wilke, D., Massaro, P., Zahavich, J., Kephart, G., & Rutledge, R. D. H. (2023). A Comprehensive 6-mo Prostate Cancer Patient Empowerment Program Decreases Psychological Distress Among Men Undergoing Curative Prostate Cancer Treatment: A Randomized Clinical Trial. European urology, 83(6), 561–570. https://doi-org.ezproxy.library.dal.ca/10.1016/j.eururo.2023.02.009
- PC-PEP, a comprehensive home-based intervention to address the educational, physical, and psychosocial needs of prostate cancer patients, delivered early following diagnosis significantly prevented the burden of psychological distress in men undergoing curative prostate cancer treatment compared with standard of care, or late (6 mo later) intervention.
Ilie G., Mason R., Bell D., Bailly G., Rendon R.A., Mann R., Lawen J.G., Bowes D., Wilke D., Patil N., et al. Development and initial evaluation of a multifaceted intervention to improve mental health and quality of life among prostate cancer survivors. Int. J. Ment. Health Addict. 2020;18:1067–1080. doi: 10.1007/s11469-019-00108-y.
- Participation in an initial 28-day PC-PEP intervention resulted in significant improvement in psychological distress and physical health in men diagnosed with prostate cancer, with very good to excellent compliance with all five components of PC-PEP being observed.
This is one of the publications from the PRO Survey Study:
Ilie, G., White, J., Mason, R., Rendon, R., Bailly, G., Lawen, J., Bowes, D., Patil, N., Wilke, D., MacDonald, C., Rutledge, R., & Bell, D. (2020). Current Mental Distress Among Men With a History of Radical Prostatectomy and Related Adverse Correlates. American journal of men’s health, 14(5), 1557988320957535. https://doi.org/10.1177/1557988320957535
- In a sample of 136 prostate cancer patients from the Maritime provinces of Canada who underwent radical proctectomy, 16.2% screened positive for mental distress. Severity of urinary problems was associated with increased distress (OR = 4.79, 95% CI [1.04, 22.03]) and increased age OR = 0.87, 95% CI [0.78, 0.97]), better relationships satisfaction (OR = 0.14, 95% CI [0.3, .077]), and current medication for anxiety and/or depression (OR = 0.09, 95% CI [0.02, 0.62]) were protective factors.
The pcpep.org website has many more references on the various stages of the program.