Implementing a behavioral physical activity program in children and adolescent survivors of childhood cancer: a pilot randomized controlled trial

• Published in: Journal of behavioral medicine Vol. 47; no. 5; pp. 792 - 803
• Main Authors: Caru, Maxime, Dandekar, Smita, Gordon, Brett, Conroy, David E., Barb, Emily D., Doerksen, Shawna E., Smink, Gayle M., McKeone, Daniel J., Shah, Nidhi B., Greiner, Robert J., Schramm, Joseph W., Rao, Pooja, McGregor, Lisa, Schmitz, Kathryn H.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2024; Springer Nature B.V
• Subjects: Adolescent; Behavior change; Behavior Therapy - methods; Cancer; Cancer Survivors - psychology; Cancer therapies; Child; Childhood; Children; Clinical research; Clinical trials; Critical incidents; Exercise - psychology; Exercise Therapy - methods; Family Medicine; Feasibility; Feasibility Studies; Female; Functional impairment; General Practice; Health Psychology; Humans; Intervention; Male; Medicine; Medicine & Public Health; Neoplasms - psychology; Neoplasms - therapy; Oncology; Patient Reported Outcome Measures; Pediatrics; Physical ability; Physical activity; Physical training; Pilot Projects; Survivor; Pediatric oncology; Supportive care; Exercise; Survivorship; Health behavior
• ISSN: 0160-7715; 1573-3521; 1573-3521
• DOI: 10.1007/s10865-024-00497-z

Purpose
We aimed to document the acceptability (enrollment rate) and feasibility (phone call delivery rate) of implementing a behavioral PA intervention over 12 weeks, in addition to documenting its effects on patient-reported outcomes and physical functioning. This study also describes the costs of carrying out a behavioral PA intervention. A total of 40 participants were randomized in a 1:1 ratio. The tailored behavioral PA intervention was developed based on the most recent PA guidelines in pediatric oncology and on the COM-B framework to enact PA behavior changes. The prescription (frequency, intensity, time and type (FITT)) was adjusted each week during the weekly support calls. The control group did not receive the intervention. 26 males and 14 females (13.6 years old on average and 2.9 years post-cancer treatment on average) participated in our study. The acceptability rate was 90.9% and the feasibility rate was > 85%. We found that 85% improved PA frequency, 80% improved PA intensity, 100% improved PA time, and 50.0% achieved the recommended PA guidelines. No adverse events were reported over the duration of the intervention. Physical function improved with longer 6-minute walk distances in the intervention group (465.8 ± 74.5 m) than in the control group (398.7 ± 92.9 m) (
p
 = 0.016). PROs scores for all participants were within the limits of the normal range. The estimated cost per participant of carrying out this intervention was USD $126.57. Our 12-week behavioral PA intervention, based on the COM-B framework, was found to be acceptable, feasible and safe in childhood cancer survivors. This study is an important step in the right direction to make exercise standard practice in pediatric oncology.
Clinical trial registration
NCT04947709.