Purpose Physical activity (PA) programs for prostate cancer survivors have positive effects on many aspects of health-related quality of life. Translating this research into sustainable community-based settings is necessary to ensure access to programs for survivors. This study examines patient perspectives in the community-based TrueNTH Lifestyle Management (TrueNTH LM) program in Calgary, Canada. Methods Eleven men from programs at civic wellness centers participated in 2 small semistructured focus groups (n = 5 and 6) at the University of Calgary. Motivation for program initiation and adherence, benefits and barriers to participation, and individual satisfaction and feedback on program improvement were discussed. Audio recordings were transcribed and analyzed using thematic methodology guided by a pragmatic philosophy on the patient experience in the program. Results Themes identified included perceived benefits of participating (physical, psychological, and social), facilitators for involvement in the PA program (program design, initial free access, tailored to prostate cancer specific needs, psychosocial environment), and opportunities for improvement and sustainability (exercise as a part of standard care, cost structure, home-based options). Conclusions These findings provide valuable insight into patient perspectives on effective characteristics of prostate cancer and exercise programs. TrueNTH LM has implemented findings, and ensuring needs (benefits and barriers) are addressed for prostate cancer survivors when entering community-based PA programs.

Recent community studies have suggested that low level lead exposure is significantly associated with blood pressure in the general population. This finding is inconsistent with the results of recent occupational studies of lead exposed workers, although the occupational studies contained serious methodological weaknesses. The present study examined the relation between occupational lead exposure and diastolic and systolic blood pressure in randomly selected samples of 270 exposed and 158 non-exposed workers. Four exposure indicators were examined: employment at a lead battery plant v a control plant, current blood lead value, current zinc protoporphyrin value, and time weighted average blood lead value. After controlling for other known risk factors such as age, education, income, cigarette usage, alcohol consumption, and exercise, the associations between exposure and blood pressure were small and non-significant. In the absence of a biologically feasible hypothesis regarding the mechanism by which low level lead exposure would influence blood pressure the present findings challenge the validity of the general population association.The relation between lead exposure and rises in blood pressure has recently received a great deal of attention because of the implication that mortality from cardiovascular and cerebrovascular disease might be reduced by lowering lead values in the environment.'1 Early reports focused on workers in the lead industries and described hypertension and nephritis as frequent manifestations of lead exposure.23 More recently, Dingwall-Fordyce and Lane showed an excess mortality from cerebrovascular disease in lead exposed workers with 25 years of exposure occurring before 1961.4 The excess mortality was greater for workers dying between 1926 and 1950 than for workers dying between 1951 and 1961. With one exception5 studies conducted since the classic research of Dingwall-Fordyce and Lane have confirmed the original findings.6-9 It should be noted that these studies were conducted in plants with extremely high levels of exposure to lead, and the study that failed to find an excess in mortality' was conducted after exposure had been substantially reduced. Because of these extremely high exposures and the almost inevitable nephrotoxicity, the most parsimonious explanation of the excess cardiovascular and cerebrovascular mortality is hypertension secondary to renal disease rather than primary hypertension.Two studies have directly examined the relation

e287 Background: Growing evidence suggests that specific lifestyle practices (e.g., diet and exercise) may delay cancer progression among prostate cancer survivors (PCS) and restore post-treatment quality of life. However, there are limited efforts to translate this knowledge to sustainable behavior change among PCS at a population level. Methods: TrueNTH is an international partnership to develop innovative evidence-based interventions and care models to improve the physical and mental wellbeing of PCS. Within TrueNTH, four countries (U.S.A., Australia, Canada, U.K.) are developing solutions to improve lifestyle practices among PCS. Australia is implementing face-to-face and telehealth delivery of exercise and dietary programs facilitated by a web-based portal. Canada is implementing group-based exercise and yoga programs combined with a web-based portal to deliver exercise, nutrition and stress-reduction resources for PCS and caregivers. The U.K. is implementing a healthy living pharmacy approach to deliver tailored diet and exercise advice and support to men. The U.S. will implement a scalable web-based portal that reaches PCS, providers and partners and provides personalized exercise prescriptions and dietary advice, interactive guidance, and behavioral support via social media, tele-exercise, and face-to-face communities. Results: TrueNTH initiatives are in various phases of a three-year project. Australia has enrolled 30 of 80 men across 2 sites and via telehealth, and demonstrated acceptance of the portal. Canada has enrolled 30+ men in exercise programs and will soon add 4 sites and launch their portal. The UK has evaluated assessment protocols in 2 sites and will soon add a 3rd site and implement the pharmacy-based program. The U.S. is building the portal and supportive tools and will begin a trial in Fall 2016. Conclusions: Each TrueNTH program shares common goals to improve lifestyle practices among PCS. Common metrics across initiatives will allow for a global comparison of implementation approaches and assessment of impact at a population level. TrueNTH will utilize this initiative to create a lifestyle survivorship program that improves the lives of PCS worldwide.

In addition, cognitive function (Montreal Cognitive Assessment (MoCA)) and physical function measures (Grip Strength, Timed Up and Go (TUG) were performed. A patient participant focus group was formed to provide study feedback. Results: From a population frame of 64 incident dialysis patients 43 participants were enrolled (67% response rate), 28% female, mean age 62.1 years (SD 14.4) and 37% with diabetes. 33 out of 43 participants completed the survey at 12 weeks demonstrating nonsignificant trended improvement in items related to shortness of breath, energy, drowsiness, appetite, itching, mobility, cognition, anxiety, bowel health, social relations, physical function, health literacy and sleep quality. There was a non-significant decline in the participants' perceptions of developing coping strategies as measured by the COPE Scale. Study participant focus group members were positive regarding patient participation in this ESKD PROMs study. Conclusions: The majority of PROMs over the first 3 months of dialysis revealed non-significant improvement. Current and further analysis will contribute to the development of a more concise tool to be embedded within standard practice.