Slater Megan E, Kelly Aaron S, Sadak Karim T, Ross Julie A
Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
J Cancer Surviv. 2016 Feb;10(1):11-20. doi: 10.1007/s11764-015-0447-x. Epub 2015 Mar 26.
Childhood cancer survivors (CCS) are at high risk of treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Previous PA interventions targeting CCS have focused on the domain of leisure-time/recreational PA. Active transportation, another domain of PA, has not been described in CCS. Therefore, this study aimed to identify active transportation behaviors, barriers, and correlates in adult CCS.
We recruited 158 adult CCS and 153 controls matched on age, sex, and neighborhood for a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among matched participants were used.
Adult CCS engaged in similar levels of active transportation as controls (2.72 vs. 2.32 h/week, P = 0.40) despite perceiving greater health-related barriers (1.88 vs. 1.65 (measured on four-point Likert scale), P = 0.01). Marital/relationship status (odds ratio (OR) = 0.30, 95 % confidence interval (CI) = 0.11-0.81), planning/psychosocial barriers (OR = 0.15, 95 % CI = 0.04-0.53), and perceived neighborhood walkability (OR = 2.55, 95 % CI = 1.14-5.66) were correlates of active transportation among adult CCS, while objective neighborhood walkability (OR = 1.03, 95 % CI = 1.01-1.05) was a correlate among controls.
Results suggest adult CCS and controls utilize active transportation at approximately equal levels. Factors other than health, including perceived neighborhood walkability, are related to active transportation behaviors to a greater degree in adult CCS.
Interventions might consider promoting active transportation as a way to incorporate more PA into the daily lives of adult CCS. Such interventions will not be likely successful, however, without existing or improved neighborhood walkability/bikeability.
儿童癌症幸存者（CCS）面临与治疗相关的晚期效应的高风险，包括心血管疾病和糖尿病，而身体活动不足（PA）可能会加剧这些风险。以往针对CCS的PA干预措施主要集中在休闲/娱乐性PA领域。主动出行作为PA的另一个领域，在CCS中尚未有相关描述。因此，本研究旨在确定成年CCS的主动出行行为、障碍及相关因素。
我们招募了158名成年CCS和153名在年龄、性别和社区方面相匹配的对照者，进行了一项关于主动出行行为和认知的调查。使用了考虑匹配参与者之间相关性的线性和逻辑回归模型。
尽管成年CCS感知到更多与健康相关的障碍（1.88对1.65（四分制李克特量表测量），P = 0.01），但其主动出行水平与对照者相似（2.72对2.32小时/周，P = 0.40）。婚姻/关系状况（优势比（OR）= 0.30，95%置信区间（CI）= 0.11 - 0.81）、计划/心理社会障碍（OR = 0.15，95% CI = 0.04 - 0.53）以及感知到的社区步行适宜性（OR = 2.55，95% CI = 1.14 - 5.66）是成年CCS主动出行的相关因素，而客观的社区步行适宜性（OR = 1.03，95% CI = 1.01 - 1.05）是对照者的相关因素。
结果表明成年CCS和对照者的主动出行水平大致相当。在成年CCS中，除健康因素外，包括感知到的社区步行适宜性等其他因素与主动出行行为的关联程度更大。
干预措施可能需要考虑将促进主动出行作为一种将更多PA纳入成年CCS日常生活的方式。然而，如果没有现有的或改善的社区步行适宜性/骑行便利性，此类干预措施不太可能成功。
