Mendoza Jason A, Baker K Scott, Moreno Megan A, Whitlock Kathryn, Abbey-Lambertz Mark, Waite Alan, Colburn Trina, Chow Eric J
Department of Pediatrics, University of Washington, Seattle, Washington.
Seattle Children's Research Institute, Seattle, Washington.
Pediatr Blood Cancer. 2017 Dec;64(12). doi: 10.1002/pbc.26660. Epub 2017 Jun 15.
Physical activity (PA) may be important for preventing chronic diseases for adolescent and young adult (AYA) childhood cancer survivors. Randomized controlled trials (RCTs) of PA interventions for AYA survivors are sparse, but necessary to determine effective programs for increasing PA among this population. Thus, we conducted a pilot RCT, testing the feasibility of a mobile health (mHealth) intervention to promote PA among AYA survivors.
We recruited 14- to 18-year-olds who were ≥1-year post cancer therapy from Seattle Children's Hospital. The 10-week intervention consisted of a wearable PA-tracking device (Fitbit Flex) and a peer-based virtual support group (Facebook group). Research staff helped set step goals and awarded badges weekly. Controls received usual care. Baseline assessments occurred before randomization and follow-up assessments occurred during weeks 8-10 of the intervention period. Feasibility criteria are defined below. Qualitative interviews assessed acceptability. Exploratory outcomes included PA, quality of life, and motivation for PA.
All feasibility criteria were met: we recruited 60 survivors, intervention participants wore the Fitbit on the majority (71.5%) of intervention days, and ≥90% of all participants completed questionnaires. Qualitative data confirmed intervention acceptability. Exploratory analyses found no significant adjusted group differences for change in moderate-to-vigorous PA (4.4 vs. 5.0 min/day; P = 0.92) or sedentary time (-4.5 vs. 1.0 min/day; P = 0.73), comparing intervention subjects to controls. Some modest differences were found for select subscales of quality of life and motivation for PA.
This mHealth PA intervention was feasible and acceptable to AYA childhood cancer survivors and warrants a fully powered RCT.
身体活动(PA)对于预防青少年和青年期(AYA)儿童癌症幸存者的慢性病可能很重要。针对AYA幸存者的PA干预随机对照试验(RCT)很少,但对于确定增加该人群PA的有效方案是必要的。因此,我们进行了一项试点RCT,测试移动健康(mHealth)干预在促进AYA幸存者PA方面的可行性。
我们从西雅图儿童医院招募了癌症治疗后≥1年的14至18岁青少年。为期10周的干预包括一个可穿戴的PA追踪设备(Fitbit Flex)和一个基于同伴的虚拟支持小组(Facebook群组)。研究人员帮助设定步数目标并每周颁发徽章。对照组接受常规护理。在随机分组前进行基线评估,在干预期的第8至10周进行随访评估。可行性标准如下定义。定性访谈评估了可接受性。探索性结果包括PA、生活质量和PA动机。
所有可行性标准均得到满足:我们招募了60名幸存者,干预参与者在大多数(71.5%)干预日佩戴了Fitbit,并且所有参与者中≥90%完成了问卷调查。定性数据证实了干预的可接受性。探索性分析发现,将干预组与对照组进行比较时,中度至剧烈PA的变化(4.4对5.0分钟/天;P = 0.92)或久坐时间(-4.5对1.0分钟/天;P = 0.73)没有显著的调整后组间差异。在生活质量和PA动机的某些特定子量表上发现了一些适度差异。
这种mHealth PA干预对AYA儿童癌症幸存者是可行且可接受的,值得进行一项充分有力的RCT。