Implementation Of A Behavioral Physical Activity Program In Childhood Cancer Survivors: A Randomized Controlled Trial

PURPOSE: Children and adolescents diagnosed with cancer are living longer and physical activity (PA) can enhance their physical and mental health. Studies have emphasized the critical need to understand the most effective strategy to implement PA in pediatric oncology. Therefore, we aimed to document the acceptability and feasibility of implementing a 12-week behavioral PA intervention and to show its effects on patient-reported outcomes and physical functioning. This study also describes the costs of carrying out the intervention. METHODS: 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) was adjusted each week during the weekly support calls to maximize participants' success in reaching their goals. The control group did not receive the intervention. RESULTS: A total of 26 males and 14 females (13.6 ± 2.3 years old and 2.9 ± 1.4 years post-treatment) 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 at the 12-week follow-up. 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) at 12-week follow-up (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 behavioral PA intervention was $126.57. CONCLUSIONS: Our 12-week behavioral PA intervention 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. Four Diamonds Research Funds, Pennsylvania State Health Children's Hospital, obtained by Dr. Schmitz.