Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Teachers College, Columbia University.
Pediatr Blood Cancer. 2018 Sep;65(9):e27243. doi: 10.1002/pbc.27243. Epub 2018 May 24.
Survivors of childhood cancer are at increased risk of lifestyle influenced health issues. We sought to understand the association between stages of change (SOC) and psychosocial variables related to modifiable health behaviors: physical activity (PA), dietary fat intake, and intake of fruits and vegetables among adolescents and young adults at different phases of cancer therapy.
We conducted an exploratory cross-sectional survey of adolescents and young adults currently being treated for cancer or who are survivors of childhood cancer. We evaluated SOC and several psychosocial variables using the previously validated Patient-Centered Assessment and Counseling for Exercise (PACE+): Physical Activity and Diet Surveys for Adolescents tool. Current dietary behaviors were evaluated with 24 hr diet recall.
One hundred and eighteen patients participated in the survey. SOC did not vary by phase of treatment. Ethnicity and body mass index were strongly associated with SOC for PA, but not for dietary behaviors. There was a significant association between SOC and self-efficacy, knowledge of strategies, and family or friend support for PA, dietary fat, and fruits and vegetables. Higher self-efficacy and family support were significant variables impacting SOC and participants' reported intake of fruits and vegetables servings.
We demonstrate that SOC for the investigated behaviors did not change based on phase of treatment, supporting the initiation of lifestyle interventions early on in treatment. We identify several psychosocial variables that may act as important targets for future lifestyle interventions aimed to improve dietary and exercise behaviors in adolescents and young adults with cancer and survivors.
儿童癌症幸存者面临着更多受生活方式影响的健康问题的风险。我们试图了解与可改变的健康行为相关的心理社会变量之间的变化阶段(SOC)的关联:青少年和癌症治疗不同阶段的年轻人的体力活动(PA),脂肪摄入量和水果和蔬菜摄入量。
我们对目前正在接受癌症治疗或儿童癌症幸存者的青少年和年轻人进行了探索性横断面调查。我们使用先前验证的以患者为中心的运动评估和咨询(PACE +)评估 SOC 和几个心理社会变量:青少年的体力活动和饮食调查工具。使用 24 小时饮食回忆评估当前的饮食行为。
有 118 名患者参加了调查。SOC 不因治疗阶段而异。种族和体重指数与 PA 的 SOC 密切相关,但与饮食行为无关。SOC 与自我效能,策略知识以及对 PA,脂肪和水果和蔬菜的家庭或朋友支持之间存在显着关联。更高的自我效能和家庭支持是影响 SOC 以及参与者报告的水果和蔬菜摄入量的重要变量。
我们证明,针对所调查行为的 SOC 并未因治疗阶段而改变,这支持在治疗早期开始生活方式干预。我们确定了一些心理社会变量,这些变量可能是未来针对癌症青少年和年轻人的生活方式干预的重要目标,以改善饮食和运动行为和幸存者。