Effectiveness of an integrated adventure-based training and health education program in promoting physical activity among childhood cancer survivors

Abstract

BACKGROUND: Research indicates that regular physical activity enhances the physical and psychological well-being of childhood cancer survivors. Nevertheless, there is growing concern about declining levels of physical activity in childhood cancer survivors. This study aimed to examine the effectiveness of an integrated adventure-based training and health education program in promoting changes in exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of Hong Kong Chinese childhood cancer survivors. METHOD: A randomized controlled trial, two-group pretest and repeated post-test, betweensubjects design was conducted to 71 childhood cancer survivors (9–16-year olds). Participants in the experimental group joined a four-day integrated adventure-based training and health education program. Control group participants received the same amount of time and attention as the experimental group, but not in such a way as to have any specific effect on the outcome measures. Participants’ exercise behavior changes, levels of physical activity, self-efficacy and quality of life were assessed at the time of recruitment, 3, 6, and 9 months after starting the intervention. RESULTS: Participants in the experimental group reported statistically significant difference in physical activity stages of change (p < 0.001), higher levels of physical activity (p < 0.001) and self-efficacy (p = 0.04) than those in the control group. Besides, there were statistically significant mean differences (p < 0.001) in physical activity levels ( 2.6), self-efficacy ( 2.0) and quality of life ( 4.3) of participants in the experimental group from baseline to 9 months after starting the intervention. CONCLUSIONS: The integrated adventure-based training and health education program was found to be effective in promoting physical activity among childhood cancer survivors. RESEARCH IMPLICATIONS: This study did not measure physiological changes in the participants, although previous research has indicated that engaging in physical activity may help to ameliorate adverse treatment-related effects such as fatigue and decreased muscle strength and endurance. Therefore, it is recommended that future longitudinal studies be conducted to monitor the level of physical activity and physical activity behavior of childhood cancer survivors, and to detect any physiological changes that occur over an extended period of time. CLINICAL IMPLICATIONS: (1) To advocate the idea of having regular physical activity in childhood cancer survivors, and (2) To implement the integrated adventure-based training and education program to those survivors without engaging in regular physical activity, and (3) Healthcare professionals should go beyond their normal roles by building partnerships with schools and communities to promote the adoption and maintenance of regular physical activity among childhood cancer survivors using a multi-disciplinary approach. ACKNOWLEDGEMENT OF FUNDING: None.