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Haponiuk-Skwarlińska J, Gąsior JS, Albrecht K, Łaguna P, Werner B. Determinants of physical activity level in pediatric oncological patients treated with cardiotoxic therapy - a study protocol. BMC Pediatr 2025; 25:355. [PMID: 40320516 PMCID: PMC12051312 DOI: 10.1186/s12887-025-05714-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Accepted: 04/24/2025] [Indexed: 05/08/2025] Open
Abstract
BACKGROUND Childhood cancer and its therapy, especially that involving potentially cardiotoxic cancer treatment, can structurally affect muscle strength and heart function, and therefore may result in lowered physical activity (PA). This study protocol aims to find the significant determinants of PA levels in pediatric oncological patients 1-5 years after heart-toxic chemotherapy and/or radiation of the heart region. METHODS The study group will include children 1-5 years after completing cancer therapy involving cardiotoxicity risk factors. The primary outcome of interest is the PA measured with an ActiGraph GT3X Accelerometer for 14 consecutive days and the assessment of WHO pediatric age-adjusted PA norms achievement. Assessed PA levels will be evaluated according to the possible determinants of PA: disease/treatment related risk factors, treatment complications, possible complications after the treatment, cardiac function with echocardiography including 2D and 3D strain imaging, physical function and muscle strength in ALPHA (Assessing Levels of Physical Activity) health-related fitness test battery and exercise capacity in cardiopulmonary exercise testing. The self-efficacy and motivation to PA, quality of life (QoL), lifestyle, socio-demographic, and anthropogenic factors as well as knowledge about the positive impact of PA will be evaluated with original and validated questionnaires. The PA determinants of the study group will be compared to the results of the control group of children in the same follow-up period (> 1 year < 5 years) after completing cancer therapy without cardiotoxic methods. DISCUSSION The results may contribute to the development of future recommendations on prophylactic and therapeutic approaches, as well as proper lifestyle recommendations for children in long-term follow-up after cardiotoxic cancer therapy. The determinants will be used to develop targeted exercise prescriptions and exercise programs. TRIAL REGISTRATION NCT06256068.
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Affiliation(s)
- Julia Haponiuk-Skwarlińska
- Department of Pediatric Cardiology and General Pediatrics, Doctoral School, Medical University of Warsaw, Żwirki i Wigury 63 A, Warsaw, 02-091, Poland
| | - Jakub S Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Żwirki i Wigury 63 A, Warsaw, 02-091, Poland.
| | - Katarzyna Albrecht
- Department of Pediatrics, Oncology, Hematology and Transplantology, Medical University of Warsaw, Żwirki i Wigury 63 A, Warsaw, 02-091, Poland
| | - Paweł Łaguna
- Department of Pediatrics, Oncology, Hematology and Transplantology, Medical University of Warsaw, Żwirki i Wigury 63 A, Warsaw, 02-091, Poland
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Żwirki i Wigury 63 A, Warsaw, 02-091, Poland
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Mao J, Zhang Y, Qiu X, Wang C, Yang X, Li Q. Barriers and Facilitators to Physical Activity Participation Among Colorectal Cancer Survivors: A Mixed-Method Systematic Review. Semin Oncol Nurs 2025; 41:151811. [PMID: 39894701 DOI: 10.1016/j.soncn.2025.151811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 12/30/2024] [Accepted: 01/12/2025] [Indexed: 02/04/2025]
Abstract
OBJECTIVES Physical activity (PA) is essential in cancer rehabilitation. Worryingly, PA compliance among colorectal cancer (CRC) survivors is relatively poor, and the barriers and facilitators of PA participation in this population are poorly understood. This review aimed to identify the barriers and facilitators of PA participation among CRC survivors and apply the Capability-Opportunity-Motivation-Behavior (COM-B) model to analyze and categorize these factors. METHODS A mixed-method systematic review was conducted using six electronic databases (Embase, Medline, PubMed, Scopus, Web of Science, and Chinese National Knowledge Infrastructure) to conduct literature search. The searches were conducted from the inception of databases till May 2024, and eligible studies were limited to English or Chinese. The mixed methods appraisal tool (MMAT) was utilized to perform quality assessment, and the convergent integrated approach and descriptive analysis were used for data synthesis and analysis. RESULTS This review included 32 studies (seven qualitative, 24 quantitative, and one mixed-method), and no studies were eliminated due to quality. According to the COM-B model, cancer-related symptoms, time constraints, and lack of motivation or interest were the main barriers to PA participation among CRC survivors. The main facilitators of PA participation for CRC survivors included improvement in cancer-related symptoms, enough social support from family and friends, and perceived benefits of PA. CONCLUSIONS This review comprehensively identified the unique barriers and facilitators to PA participation among CRC survivors based on the COM-B model. Future research should consider these barriers and facilitators and develop effective PA interventions to increase PA compliance among CRC survivors.
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Affiliation(s)
- Jiayu Mao
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Yi Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xiaoke Qiu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Can Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xueli Yang
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China.
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Gu Y, Yu J, Li L, Pan L, Ma D, Cui L, Cui C, Guo F. Parents' perceptions of physical activity for their children with cancer: a qualitative meta-synthesis. Front Pediatr 2025; 13:1402516. [PMID: 40224387 PMCID: PMC11985796 DOI: 10.3389/fped.2025.1402516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 03/13/2025] [Indexed: 04/15/2025] Open
Abstract
Background The the number of cases of cancer in children is increasing annually. Physical activity (PA) can enhance the future outcomes and quality of life of children with cancer. However, studies have shown that children with cancer have low levels of PA and that the majority don't adhere to the guidelines' recommendations for physical activity. Objective The aim was to synthesize parents' perceptions of PA for their children with cancer and to explore barriers and facilitators, thereby providing a basis for promoting PA in children with cancer. Methods The PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and three Chinese databases were systematically searched. Qualitative empirical reports from the onset of the corresponding databases until October 2023 were included in the review. Two independent reviewers performed the review, carried out the data extraction process and evaluated the study quality. Findings Six studies in all were included. Parents' perceptions of PA for their children with cancer were synthesized into the following three themes of analysis: (1) barriers to participation in PA; (2) facilitators of participation in PA; and (3) seeking support. Conclusion Our study identified complex factors that influence physical activity participation in children with cancer, and these findings provide a focus for future interventions. Future research should further explore appropriate, targeted exercise intervention programs to promote children's participation in physical activity.
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Affiliation(s)
- Yan Gu
- Department of Cardiovascular Disease Center, The First Hospital of Jilin University, Changchun, China
| | - Jie Yu
- Department of Pediatric Hematology, Children's Medical Center, The First Hospital of Jilin University, Changchun, China
| | - Liangjian Li
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Changchun, China
| | - Liming Pan
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Changchun, China
| | - Dongmei Ma
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Changchun, China
| | - Lin Cui
- Department of Nursing, The First Hospital of Jilin University, Changchun, China
| | - Chunxue Cui
- School of Nursing, Changchun Medical College, Changchun, China
| | - Fang Guo
- Department of Nursing, The First Hospital of Jilin University, Changchun, China
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Flannery MK, Morin J, O’Malley K, Schmidt D, Hoag JA. Team Survivors: Preliminary Analysis of an Innovative Intervention to Promote Physical Activity in Survivors of Childhood Cancer and Hematopoietic Stem Cell Transplant. CHILDREN (BASEL, SWITZERLAND) 2025; 12:399. [PMID: 40310069 PMCID: PMC12025396 DOI: 10.3390/children12040399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2025] [Revised: 03/12/2025] [Accepted: 03/19/2025] [Indexed: 05/02/2025]
Abstract
(1) Background: Inadequate physical activity is an ongoing issue for pediatric survivors of childhood cancer and hematopoietic stem cell transplant (HSCT), increasing their risk for chronic health conditions and decreasing quality of life. Team Survivors is a 12-week program in which survivors train as a group to participate in a community triathlon. Preliminary findings from a quality improvement project of Team Survivors were used to assess its feasibility in influencing survivors' physical activity and quality of life and their family's perception of the program. (2) Methods: Repeated measures t-tests evaluated changes in caregiver-reported exercise self-efficacy and health-related quality of life (HRQoL). These findings were supplemented by a narrative review of qualitative data from caregivers and survivors on their overall experience and satisfaction with the program. (3) Results: All participants successfully completed the triathlon, and families reported satisfaction with the program's logistics (i.e., coordination, coaching, and practice). Neither caregiver-reported exercise self-efficacy nor HRQoL significantly differed between pre- and post-intervention, but notable improvements were reported in all domains of HRQoL. Qualitatively, the perceived benefits reported by caregivers and survivors were multifaceted. Physical benefits included improvements in survivors' physical activity level and endurance. Psychosocially, caregivers and survivors reported greater confidence and motivation for physical activity, improved coping, and increased social engagement and feelings of normalcy. (4) Conclusions: Mixed method results support the feasibility of Team Survivors in positively impacting survivors' ability to engage in physical activity. The multifaceted structure of the program may more broadly impact psychosocial functioning in addition to physical activity. Future studies require a larger sample size to adequately power the analyses.
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Affiliation(s)
| | - Jocelyn Morin
- Children’s Wisconsin, Milwaukee, WI 53226, USA; (J.M.); (D.S.)
| | | | - Debra Schmidt
- Children’s Wisconsin, Milwaukee, WI 53226, USA; (J.M.); (D.S.)
| | - Jennifer A. Hoag
- Children’s Wisconsin, Milwaukee, WI 53226, USA; (J.M.); (D.S.)
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Alamilla RA, Kaushal N, Bigatti SM, Keith NR. Comparing Barriers and Facilitators to Physical ActivityAmong Underrepresented Minorities: Preliminary Outcomes from a Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:234. [PMID: 40003460 PMCID: PMC11855078 DOI: 10.3390/ijerph22020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 01/26/2025] [Accepted: 02/04/2025] [Indexed: 02/27/2025]
Abstract
Physical activity (PA)'s benefits are well established, yet many U.S. adults fail to meet PA guidelines. This is especially true for minorities facing social inequities. This study explored PA's barriers and facilitators among urban Midwestern minorities using a mixed-methods approach framed on the socio-ecological model. A cross-sectional survey was conducted between January and June 2024 among community-dwelling minorities. Participants were grouped as completing low (LLPA) or high (HLPA) weekly leisure-time PA for comparison. Quantitative analysis included MANOVA, follow-up ANOVAs, and calculation of effect sizes. Qualitative data were assessed using inductive thematic analysis. Twenty-nine adults (44.83% Black, 41.37% Latino) participated in the study. The HLPA group (n = 18) reported higher leisure-time PA (p = 0.001, d = 2.21) and total PA (p = 0.02, d = 1.00) compared to the LLPA group (n = 11). LLPA participants faced more personal barriers to PA (p = 0.02, d = -0.92). Common barriers identified in the interviews included a lack of time and financial costs. Facilitators included social support and available PA facilities. Both groups achieved the USPA guidelines through different PA domains. Increasing social support and lowering PA-related costs could enhance participation. Addressing barriers and leveraging existing facilitators are crucial to increasing PA among minorities.
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Affiliation(s)
- Rafael A. Alamilla
- School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN 46202, USA;
| | - Navin Kaushal
- School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN 46202, USA;
| | - Silvia M. Bigatti
- Richard M. Fairbanks School of Public Health, Indiana University Indianapolis, Indianapolis, IN 46202, USA;
| | - NiCole R. Keith
- School of Public Health—Bloomington, Indiana University Bloomington, Bloomington, IN 47405, USA
- Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Regenstrief Institute, Indianapolis, IN 46202, USA
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King-Dowling S, Harris S, Daniel LC, Kwan MYW, Ginsberg JP, Goldmuntz E, Szalda D, Schwartz LA. A pilot study of device-assessed physical activity and ecological momentary assessment among adolescent and young adult survivors of childhood cancer. Ann Behav Med 2025; 59:kaaf002. [PMID: 39898877 DOI: 10.1093/abm/kaaf002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2025] Open
Abstract
BACKGROUND Adolescent and young adult survivors of childhood cancer (AYA) are at risk for treatment-related late effects (eg, heart and lung problems) which may be mitigated by physical activity (PA). To design effective, tailored PA interventions for this population, predictors and benefits of PA behavior need to be measured in real-time. PURPOSE To examine the feasibility and acceptability of ecological momentary assessment (EMA) combined with accelerometry and explore the dynamic associations between PA and real-time physical and psychosocial factors among AYA. METHODS AYA (N = 20, mean age = 18.9 years) recently off cancer treatment participated in a 2-week intensive monitoring protocol in which they completed up to 4 EMA surveys/day assessing current mood, pain, fatigue, arousal, PA intentions and motivation, and social-environmental context, while PA levels were passively monitored using a wrist-worn ActiGraph GT9X accelerometer. Acceptability was measured via self-report. RESULTS EMA and accelerometry were feasible and acceptable (≥70% compliance and study endorsement) for AYA. Multilevel models showed that AYA engaged in more PA when they were away from home, with others, in a better mood, less fatigued, more energetic, and more motivated than their own average levels. Further, when AYA engaged in more PA than their usual levels in the hour before completing an EMA survey, they subsequently reported less fatigue, less pain, more energy, and a more positive mood. CONCLUSIONS EMA and accelerometry are acceptable and feasible among AYA survivors of childhood cancer. This methodology can be utilized for understanding the real-time barriers, facilitators, and benefits of PA behaviors in this at-risk population to design effective, dynamic PA interventions.
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Affiliation(s)
- Sara King-Dowling
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - Sheereen Harris
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G5, Canada
| | - Lauren C Daniel
- Department of Psychology, Rutgers University, Camden, NJ, 08102, United States
| | - Matthew Y W Kwan
- Department of Child and Youth Studies, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Jill P Ginsberg
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, United States
| | - Elizabeth Goldmuntz
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, United States
- Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - Dava Szalda
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, United States
| | - Lisa A Schwartz
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, United States
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Lai B, Chaviano K, Richman JS, Ahmad M, Wright A, Young R, Davis D, Rimmer JH, Madan-Swain A, Chewning JH. Extended Reality Gaming for Exercise and Mindfulness Throughout Pediatric Cancer Rehabilitation: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e64879. [PMID: 39714090 PMCID: PMC11704644 DOI: 10.2196/64879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/16/2024] [Accepted: 09/28/2024] [Indexed: 12/24/2024] Open
Abstract
BACKGROUND Pediatric patients with cancer have limited options to self-manage their health while they are undergoing treatments in the hospital and after they are discharged to their homes. Extended reality (ER) using head-mounted displays has emerged as an immersive method of improving pain and mental health and promoting health-enhancing physical activity among a variety of clinical groups, but there is currently no established protocol for improving both physical and mental health in pediatric cancer rehabilitation. OBJECTIVE This phase I, pilot, feasibility randomized controlled trial aims to investigate the potential effects of a 14-week ER program on physical activity participation and indicators of health among pediatric patients with cancer who undergo bone marrow transplantation. An ancillary aim is to evaluate the feasibility of the program through participant engagement. METHODS This study includes a 2-arm parallel group design with a 1-group crossover (the control group will start the intervention after a waiting period). Overall, 16 pediatric patients with cancer undergoing rehabilitation (aged ≥8 years) at a children's hospital will be randomly allocated into one of two groups: (1) an immediate start group that undergoes an ER program in the hospital until discharge and then for 8 weeks at home (total duration of approximately 14 weeks), and (2) a waitlist control group that undergoes usual care in the hospital and for 8 weeks at home, before receiving the 8-week home ER program. The program will include active video gaming with rhythmic music exercises as well as mindfulness-based practices using a high-quality app. Home-based programming will include behavioral coaching calls. Physical activity will be measured daily through step counts using a tri-axial accelerometer. Health outcomes will be measured across time and include global health, measured by the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health Scale Short Form 7+2, and lung function, measured by a forced expiratory volume using a peak flow meter. Feasibility will be evaluated through participant engagement metrics, such as enrollment, dropout, adverse events, and attendance rates. Descriptive statistics will be obtained for all study variables. Outcomes will be modeled using mixed modeling procedures, and changes in means will be estimated with CIs. RESULTS The study was funded in February 2024. Recruitment procedures started on June 27, 2024. All data are anticipated to be collected by February 2026. Full trial results are anticipated to be analyzed and submitted for publication by March 2026. The study's anticipated end date is March 31, 2026. CONCLUSIONS This trial tests an accessible remote program for improving both physical and mental health among pediatric patients with cancer. The knowledge obtained from this study will inform the development of a larger trial. TRIAL REGISTRATION ClinicalTrials.gov NCT06298357; https://clinicaltrials.gov/study/NCT06298357. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/64879.
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Affiliation(s)
- Byron Lai
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kelli Chaviano
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Joshua S Richman
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mahmoud Ahmad
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ashley Wright
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Raven Young
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Drew Davis
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James H Rimmer
- Dean's Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, United States
| | - Avi Madan-Swain
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Joseph H Chewning
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
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Dong Y, Ban Y, Zhong T, Guo Y, Tang D, Yu R, Liu K. Individualized Physical Activity Prescriptions for Children and Adolescents With Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Cancer Nurs 2024:00002820-990000000-00331. [PMID: 39704539 DOI: 10.1097/ncc.0000000000001412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2024]
Abstract
BACKGROUND For improved health outcomes, children and adolescents with cancer must maintain physical activity. Individualized physical activity prescription is an effective way to promote physical activity in this group. OBJECTIVE We reviewed and meta-analyzed evidence on the effectiveness of individualized physical activity prescriptions for improving physical activity and other health outcomes among children and adolescents with cancer. METHODS Seven databases were searched from inception up to January 2024 for randomized controlled trials. Two researchers independently extracted data and assessed the quality of studies using the Risk-of-Bias tool. Data were pooled into Review Manager 5.3 for data synthesis and subgroup analyses. RESULTS Seventeen randomized controlled trials were included. The systematic review summarized the characteristics of recent interventions. Meta-analyses showed that although individualized physical activity prescriptions had no overall effect on physical activity (n = 8 studies), anthropometry and body composition (n = 5), functional capacity (n = 3), quality of life (n = 8), fatigue (n = 3), and self-efficacy (n = 5), they improved cardiovascular fitness (n = 8, P = .02) and muscle strength (n = 8, P = .04). Subgroup analyses showed that studies providing 6-month interventions (P = .003) or such interventions combined with motivational interviewing (P = .002) reported significantly increased physical activity in patients. CONCLUSIONS Individualized physical activity prescriptions appear to improve cardiovascular fitness and muscle strength in children and adolescents with cancer. IMPLICATIONS FOR PRACTICE High-quality studies providing long-duration interventions and motivational interviewing are needed for optimal physical activity programs for children and adolescents with cancer. The application of electronic devices should increase the types of physical activities for this group to further improve health outcomes.
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Affiliation(s)
- Yijie Dong
- Author Affiliations: School of Nursing, Sun Yat-sen University, Guangzhou, China (Mrs Dong, Mrs Ban, Mrs Guo, and Dr Liu); Pediatric Hematology Department, Sun Yat-sen Memorial Hospital, Guangzhou, China (Mrs Zhong, Mrs Tang, and Mrs Yu)
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Bruneau C, Perrin C, Bertrand A, Mongondry R, Marec-Berard P, Fervers B, Pérol O. Determinants of physical activity commitment in adolescents and young adults with cancer: sociological protocol for a hospital-based mixed methods study (ETAPE-AJA). BMJ Open 2024; 14:e081195. [PMID: 39327053 PMCID: PMC11429357 DOI: 10.1136/bmjopen-2023-081195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 08/15/2024] [Indexed: 09/28/2024] Open
Abstract
INTRODUCTION Adolescents and young adults (AYA) with cancer undergo physical transformations due to disease and treatments occurring alongside puberty and adolescence. Although physical activity is recommended for its benefits, its practice among AYA with cancer remains insufficient. The aim of the Éducation Thérapeutique et Activité Physique: Engagement des Adolescents et Jeunes Adultes atteints de cancer study is to identify the evolution of AYA with cancer medical knowledge and powers (power to act, to express oneself) over life and cancer care, and their role in commitment in adapted physical activity (APA) and therapeutic patient education during and after oncological treatments. METHODS AND ANALYSIS This prospective mixed methods monocentre study will be conducted in a French comprehensive cancer centre. Observations will be conducted two times a week during medical consultations, APA interventions and therapeutic education sessions for AYA with cancer. Semidirective interviews will involve 70 participants, including AYA with cancer aged 15-25, health professionals, APA teachers and parents. Quantitative data will be collected on AYA's social characteristics and participation in physical activity intervention and therapeutic education sessions. A correspondence factor analysis will supplement inductive analysis of ethnographic qualitative data, involving patient coresearchers. The results will help to improve the understanding of AYAs' medical knowledge and powers, their commitment in physical activity and to develop strategies to increase their participation. ETHICS AND DISSEMINATION This study complies with reference methodology MR004 of the French National Data Protection Authority and was registered by the Data Protection Officer of the Leon Berard Cancer Center on the activity registry of the institution (Ref. N°R201-004-259; 5 July 2022). Ethics approval has been obtained from the Centre Léon Bérard ethics board (Ref. N°2022-006; 20 July 2022). Oral informed consent will be obtained from all participants before data collection. The results of this study will be published in peer-reviewed scientific journals, national and international conferences.
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Affiliation(s)
- Charlotte Bruneau
- Laboratoire L-VIS (STAPS), Université Claude Bernard Lyon 1, Villeurbanne, Rhône, France
| | - Claire Perrin
- Laboratoire L-VIS (STAPS), Université Claude Bernard Lyon 1, Villeurbanne, Rhône, France
| | - Amandine Bertrand
- Dispositif Adolescents Jeunes Adultes atteints de Cancer (DAJAC), IHOPe, Lyon, Rhône-Alpes, France
| | - Rodolf Mongondry
- Department of Cancer and Environment, Léon Bérard Cancer Centre, Lyon, Rhône-Alpes, France
| | - Perrine Marec-Berard
- Dispositif Adolescents Jeunes Adultes atteints de Cancer (DAJAC), IHOPe, Lyon, Rhône-Alpes, France
| | - Béatrice Fervers
- Department of Cancer and Environment, Léon Bérard Cancer Centre, Lyon, Rhône-Alpes, France
- EA4129 ‘Santé, Individu, Société’, University Lyon 1, Lyon, France
| | - Olivia Pérol
- Department of Cancer and Environment, Léon Bérard Cancer Centre, Lyon, Rhône-Alpes, France
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Stub T, Mathisen M, Thorsen L, Kiserud CE, Lie HC. Experiences Using Nonpharmacological Interventions for Chronic Fatigue: A Focus Group Study of Long-Term Survivors of Young Adult Cancers With Fatigue. Cancer Rep (Hoboken) 2024; 7:e2139. [PMID: 39233646 PMCID: PMC11375328 DOI: 10.1002/cnr2.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/18/2024] [Accepted: 06/30/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Cancer-related fatigue is a common and distressing late effect of cancer that can persist for decades after treatment completion. Although negatively affecting survivors' quality of life, few, if any, efficacious interventions for persistent, or chronic, fatigue exist. AIMS To inform future interventions, we explored how long-term, young adult cancer survivors (YACSs) with chronic fatigue live with, and manage their fatigue over time, including their experiences with nonpharmacological interventions (NPIs) for chronic fatigue. METHODS AND RESULTS We conducted a qualitative focus group study with 15 YACSs (13 women) with chronic fatigue, on average 7.3 years post-diagnosis. The YACS were identified and recruited through a nationwide health survey of cancer survivors (the NOR-CAYACS study). Systematic content analysis was used to identify recurrent themes. Analysis revealed five themes: (1) manifestation of fatigue, detailing chronic fatigue experiences; (2) impact on daily life, highlighting the necessity to balance rest and activity, affecting relationships; (3) NPIs, where walks in nature were notably beneficial; (4) barriers to fatigue management, including energy deficits, treatment-related bodily changes, and self-care prioritization challenges; (5) facilitators to fatigue management, emphasizing the need for regular breaks, self-care practices, and the importance of fatigue management education. CONCLUSION This study offers novel insights into the lived experiences of YACSs with chronic fatigue, a subject scarcely examined in prior research. Our findings highlight the significant impact of chronic fatigue and the individualized strategies YACSs use to cope. The research emphasizes the need for personalized interventions to support chronic fatigue management, marking a critical step forward in addressing this often-overlooked issue in survivorship care. Future research should focus on tailored approaches to improve YACSs' quality of life.
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Affiliation(s)
- Trine Stub
- NAFKAM-Norway's National Research Center in Complementary and Alternative Medicine, Faculty of Health Science, Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Marleen Mathisen
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences in Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lene Thorsen
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Hanne C Lie
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences in Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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11
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Thomas E, Di Bartolo L, Galioto M, Seminara D, Pusa S, Baxter R, Ortega-Gómez S, Jiménez-Pavón D, Vasilopoulou M, Vantarakis A, Tavares P, Campos MJ, Thaller P, Thaller J, Papakonstantinou S, Kirkar M, Vivirito S, Glorioso F, Iannitto E, Lo Mauro M, Bianco A. Experiences, behaviours, and perspectives of young cancer survivors on physical activity. Heliyon 2024; 10:e35732. [PMID: 39170495 PMCID: PMC11336842 DOI: 10.1016/j.heliyon.2024.e35732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/16/2024] [Accepted: 08/02/2024] [Indexed: 08/23/2024] Open
Abstract
This narrative review aimed to identify young cancer survivors' behaviours, experiences, and perspectives concerning physical activity, and identify useful strategies for promoting a healthy lifestyle. A manual search on the following databases was conducted: PubMed, Scopus, and Web of Science. The search was conducted between June 1, 2023, and April 12, 2024. Articles published from database inception up to April 12, 2024, were retrieved. Articles published in any language were considered. Perspectives including ideas, perceived barriers, and facilitators have been identified. Young cancer survivors seem to engage in physical activity as a useful coping strategy to regain normality and keep healthy after the cancer diagnosis. Although emotional and social support seems fundamental to increase participation, several other factors, including physical limitations, fatigue, sex, cancer type, and socio-economic status can influence physical activity participation. For those engaged in physical activity, the preferred activities are walking, biking, going to the gym, and exercising at home, while the least preferred are exercising at the hospital or boot camp-based exercises. Yoga is more frequently chosen by those still under treatment. Young cancer survivors appear to have unique needs different from those of adult cancer survivors. Mode of treatment delivery, increased awareness concerning the effects of physical activity, including families and friends, connecting survivors, and providing social support together with increasing motivation are key strategies for the promotion of physical activity in young cancer survivors. Fitness and healthcare professionals should consider these aspects to increase young cancer survivors' involvement in physical activities.
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Affiliation(s)
- Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Luca Di Bartolo
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Marina Galioto
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Domiziana Seminara
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Susanna Pusa
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Sonia Ortega-Gómez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - Maria Vasilopoulou
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Apostolos Vantarakis
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Paula Tavares
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Maria João Campos
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Petra Thaller
- Department of Health Consulting, Research and Science, Outdoor Against Cancer, Munich, Germany
| | - Joshua Thaller
- Department of Health Consulting, Research and Science, Outdoor Against Cancer, Munich, Germany
| | | | | | | | - Francesca Glorioso
- Lega Italiana per la Lotta contro i Tumori (LILT Palermo), Palermo, Italy
| | - Ennio Iannitto
- Lega Italiana per la Lotta contro i Tumori (LILT Palermo), Palermo, Italy
| | - Mario Lo Mauro
- Medical Oncology Unit, Ospedale Buccheri-La Ferla Fatebenefratelli, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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12
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Smith-Turchyn J, Mukherjee SD. Factors Influencing the Decision of Individuals with Breast Cancer to Join an Exercise Oncology Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:244-252. [PMID: 38418705 DOI: 10.1007/s13187-024-02403-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
Exercise has been found to have numerous benefits for individuals with cancer undergoing treatment. The primary objective of this study was to explore factors that influence the decision to join an exercise trial for individuals with a current diagnosis of breast cancer. A theory-informed survey was administered exploring factors (i.e., attitudes, subjective norms, perceived behavioral control) that influenced participants' decision to join the "NEXT-BRCA" exercise trial. Eligible participants included self-reported females over 18 years, diagnosed with stage 1-3 breast cancer undergoing treatment and cleared for exercise by their oncologist. Survey questions were analyzed using descriptive statistics and exploratory analysis was performed to determine if associations existed between personal characteristics (age, physical activity level, co-morbid conditions) and cancer characteristics (treatment received). Seventy-four participants completed the survey. Most participants (85% of respondents) were interested in increasing their level of physical activity. The most common attitudes contributing to participant's decision to participate in the trial included feelings that exercise was beneficial for improving physical (91%) and mental health (89%). Advice from the treating oncologist was ranked as the most important factor influencing their decision to join the trial (73%). Respondents hoped to gain exercise knowledge through educational materials (72%) and a structured exercise program (70%). Findings explore why individuals with breast cancer participate in exercise trials during treatment. This knowledge will enhance recruitment of future studies using similar interventions and assist clinicians to maximize education regarding exercise and access to exercise programs for individuals with breast cancer in the future.
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Affiliation(s)
- Jenna Smith-Turchyn
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Rm 436, Hamilton, ON, L8S 1C7, Canada.
| | - Som D Mukherjee
- Department of Oncology, McMaster University, 1200 Main Street West, Hamilton, ON, L8N 35, Canada
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13
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Valle CG, Heiling HM, Deal AM, Diamond MA, Hales DP, Nezami BT, Rini CM, Pinto BM, LaRose JG, Tate DF. Examining sociodemographic and health-related characteristics as moderators of an mHealth intervention on physical activity outcomes in young adult cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01577-4. [PMID: 38607515 PMCID: PMC11470108 DOI: 10.1007/s11764-024-01577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE This study explored whether sociodemographic and health-related characteristics moderated mHealth PA intervention effects on total and moderate-to-vigorous physical activity (MVPA) at 6 months, relative to a self-help condition among young adult cancer survivors (YACS). METHODS We conducted exploratory secondary analyses of data from a randomized controlled trial among 280 YACS. All participants received digital tools; intervention participants also received lessons, adaptive goals, tailored feedback, text messages, and Facebook prompts. Potential moderators were assessed in baseline questionnaires. PA was measured at baseline and 6 months with accelerometers. Linear model repeated measures analyses examined within- and between-group PA changes stratified by levels of potential moderator variables. RESULTS Over 6 months, the intervention produced MVPA increases that were ≥ 30 min/week compared with the self-help among participants who were males (28.1 vs. -7.7, p = .0243), identified with racial/ethnic minority groups (35.2 vs. -8.0, p = .0006), had baseline BMI of 25-30 (25.4 vs. -7.2, p = .0034), or stage III/IV cancer diagnosis (26.0 vs. -6.8, p = .0041). Intervention participants who were ages 26-35, college graduates, married/living with a partner, had a solid tumor, or no baseline comorbidities had modest MVPA increases over 6 months compared to the self-help (ps = .0163-.0492). Baseline characteristics did not moderate intervention effects on total PA. CONCLUSIONS The mHealth intervention was more effective than a self-help group at improving MVPA among subgroups of YACS defined by characteristics (sex, race, BMI, cancer stage) that may be useful for tailoring PA interventions. IMPLICATIONS FOR CANCER SURVIVORS These potential moderators can guide future optimization of PA interventions for YACS. CLINICALTRIALS GOV IDENTIFIER NCT03569605.
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Affiliation(s)
- Carmina G Valle
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hillary M Heiling
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Molly A Diamond
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Derek P Hales
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine M Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Deborah F Tate
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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14
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Hoover RL, Xu J, Conklin JL, Nichols HB, Smitherman A, Valle CG, Schwartz T, Mayer DK, Hirschey R. Physical Activity Intervention Characteristics and Effects on Behavioral and Health-Related Outcomes Among Adolescents and Young Adults Living with and Beyond Cancer: A Systematic Review. J Adolesc Young Adult Oncol 2024; 13:55-79. [PMID: 37682344 PMCID: PMC10877394 DOI: 10.1089/jayao.2023.0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
Participation in physical activity (PA) during and after cancer treatment is safe and beneficial in the adolescent and young adult (AYA) cancer population. PA can positively impact health-related outcomes; however, participation remains low. This systematic review aims to describe PA intervention characteristics and outcomes in AYA survivors of cancer (AYASCa). This review followed Preferred Reporting Index for Systematic Reviews and Meta Analyses (PRISMA) guidelines and was registered with Prospero (CRD42022365661). PubMed, CINAHL, and Scopus databases were searched for randomized control trials (RCTs) and pre/post-test studies without a control group through December 31, 2022. Data included: participant demographics, PA intervention characteristics, and health-related outcomes. Studies were assessed using the National Institute of Health Critical Appraisal Tools, and findings were synthesized to identify common characteristics of PA interventions and outcomes. Twenty-three studies were included: 15 RCTs and 8 pre/post-test studies. Heterogeneity existed across design, sample demographics, intervention timing, and observed outcomes. The most common characteristics of PA interventions were supervision of PA, wearable device use, tailored/individualized PA prescriptions, and goal setting. PA interventions positively affected health-related outcomes, with 21 studies reporting statistically significant findings. Implementing personalized PA prescriptions, utilizing wearable devices, and incorporating goal setting as characteristics in PA interventions hold potential benefits for AYASCa, leading to improved outcomes. Still, additional research is needed to explore interventions that utilize these PA characteristics and determine which ones are most effective for AYASCa. By further investigating and identifying optimal PA characteristics, interventions can be better tailored to meet this population's specific needs and preferences, ultimately enhancing their overall well-being and recovery.
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Affiliation(s)
- Rebecca L. Hoover
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jingle Xu
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jamie L. Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hazel B. Nichols
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Andrew Smitherman
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Pediatric Hematology/Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carmina G. Valle
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Todd Schwartz
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Deborah K. Mayer
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
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15
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Gentile A, Ficarra S, Ortega-Gómez S, Jiménez-Pavón D, Asimakopoulou Z, Vantarakis A, Tavares P, Vaz V, Thaller J, Papakonstantinou S, Kirkar M, Glorioso F, Galioto M, Lo Mauro M, Bianco A. Choose the healthy way! Physical activity as a tool to improve mental health in young cancer survivors. Acta Oncol 2023; 62:1589-1591. [PMID: 37837211 DOI: 10.1080/0284186x.2023.2270154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Ambra Gentile
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Sonia Ortega-Gómez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - Zoi Asimakopoulou
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Apostolos Vantarakis
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Paula Tavares
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Vasco Vaz
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Joshua Thaller
- Department of Health Consulting, Research and Science, Outdoor Against Cancer, Munich, Germany
| | | | - Musa Kirkar
- Centro Internazionale per la Promozione dell'educazione e lo Sviluppo (CEIPES), Palermo, Italy
| | - Francesca Glorioso
- Lega Italiana per la lotta Contro i Tumori (LILT Palermo), Palermo, Italy
| | - Marina Galioto
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Mario Lo Mauro
- Medical Oncology Unit, Ospedale Buccheri-La Ferla Fatebenefratelli, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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16
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Buro AW, Sauls R, Stern M, Carson TL. A qualitative study of stress experiences, health behaviors, and intervention preferences in young adult cancer survivors. Support Care Cancer 2023; 31:295. [PMID: 37093353 PMCID: PMC10123481 DOI: 10.1007/s00520-023-07756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To inform behavioral intervention development, this study examined experiences and unmet needs related to stress, diet, and physical activity in young adult (YA) cancer survivors. METHODS Twenty-three semi-structured interviews were conducted with a purposive sample of YA cancer survivors (n = 12 aged 18-29 years; n = 11 aged 30-39 years; 57% racial or ethnic minority) between May and July 2022 via Zoom. Data were analyzed using a coding reliability approach to thematic analysis. RESULTS Stressor-related themes included health and health care, economic stability, social and community context, and balancing responsibilities. Transition to independent adulthood was discussed among younger participants (18-29 years). Coping-related themes included letting go, keeping anchored in faith, and distraction. Older participants (30-39 years) reported more diverse coping strategies. Routine and consistency and the impact of stress were themes aligning with health behaviors. Control was a cross-cutting theme regarding stressors, coping, and health behaviors. Themes related to intervention preferences included individualized approach, expert-based content, peer support, integrative self-care, and manageability. Younger participants preferred multiple intervention formats (e.g., website, tracking logs). CONCLUSIONS Findings highlighted unmet needs regarding social and environmental stressors in YA cancer survivors and a preference for individualized, expert-based content and peer support in stress management-enhanced behavioral interventions. Such interventions may be tailored for specific age groups to account for differences in stress experiences and intervention preferences.
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Affiliation(s)
- Acadia W Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
| | - Rachel Sauls
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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