The Critical Role of Healthcare Providers in Encouraging Physical Activity in Childhood Cancer Survivors

PURPOSE: Healthcare providers (HCPs) can play an important role in promoting physical activity (PA) in pediatric cancer patients. Therefore, it is critical to identify key aspects of clinical conversations that lead to increased PA promotion to offer personalized care throughout the cancer continuum. We conducted a study aiming 1) to document HCPs' current knowledge when recommending PA to childhood cancer survivors (CCS), 2) to identify themes that emerged from clinical conversations promoting PA, and 3) to document changes over three months in CCS' self-reported PA following clinical conversations promoting PA. METHODS: 20 CCS (8 females and 12 males) participated in audio-recorded clinical conversations. HCPs (3 females and 1 male) were medical oncologists and nurse practitioners. HCPs received a one-time, educational presentation about the benefits of PA. The clinical conversations promoting PA were incorporated into the clinical visit. Conversations were transcribed and a thematic review of the data was conducted to identify emerging themes. At baseline, 1 week and 3 months, CCS completed the original version of the Godin Leisure Time Exercise Questionnaire to self-report their PA level. RESULTS: The mean age of CCS at the time of the conversations was 14.1 ± 2.4 years. The mean age of HCPs was 38.9 ± 4.7 years and had on average 6.8 years of professional experience in pediatric oncology. A total of 6 themes emerged from the clinical conversations: #1: Introduction of PA, #2: PA recommendations, #3: Goal setting, goal progression and goal assessment, #4: Finding solutions and opportunities to engage in PA, #5: Receptiveness about PA, #6: Benefits of PA. At baseline, 75% (N = 15) were identified as 'active', 5% (N = 1) as 'moderately active' and 20% (N = 4) as 'insufficiently active/sedentary'. Following the conversations with their HCPs, CCS were more active, and their PA behavior was maintained at 3-month follow-up where 85% (N = 17) were identified as 'active'. CONCLUSIONS: HCPs can play a pivotal role in championing PA promotion in children and adolescents diagnosed with cancer when they receive additional training. The themes that emerged from this study provide insightful information to refine PA promotion strategies that can be implemented into existing and future clinical PA programs. Supported by: This work was funded by a grant from the Four Diamonds Research Funds obtained by Dr. Kathryn H. Schmitz. Dr. Maxime Caru is supported by the Four Diamonds Research Funds, Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children’s Hospital, Hershey, PA, USA.