Web-Based Intervention Increases Physical Activity and QoL in Adolescent Cancer Survivors

Adolescent survivors of childhood cancer showed greater gains in physical activity with motivational web intervention than controls

Moderate to vigorous physical activity (MVPA) fitness, as well as neurocognitive and health-related quality of life (HRQoL) outcomes were significantly improved over 24 weeks in adolescent survivors of childhood cancer using a web-delivered, interactive, rewards-based physical activity intervention compared to adolescent survivors who received just an activity monitor and educational material. Lead author Carrie R Howell of St. Jude Children's Research Hospital in Memphis, USA reported these findings on 16 February at the 2018 Cancer Survivorship Symposium in Orlando, USA. 

The study ( NCT01778127) recruited survivors of childhood cancer who were not currently undergoing treatment for cancer and were aged 11 or more but less than 15 years. The subjects were physically active for less than 60 minutes a day and were randomised 2:1 to intervention or to a control group. The intervention group received educational materials, an activity monitor, plus access to an interactive website designed to motivate increased physical activity via rewards, such as t-shirts, stickers, and gift cards, whereas the control group received only the activity monitor and educational materials. 

The investigators monitored both groups’ physical activity, fitness, neurocognitive, and HRQoL outcomes at baseline and after 24-weeks. The mean changes in outcomes between the groups were compared using paired t-tests. 

The mean [standard deviation] age of the subjects was 12.7 [± 1.1], the majority (80%) were white, and 55.1% were female. 

The intervention group increased physical activity over 24 weeks while the control group showed a decrease in activity levels 

The majority of subjects finished the 24-week course. Overall 78 of the 97 survivors enrolled completed the study; of these 53 were in the intervention group and 25 were in the control group. 

The MVPA increased over time in the intervention group while the MVPA actually decreased in the control group; the mean change per week in MVPA was 4.7 minutes [± 119.9] in the intervention group compared to a decrease of mean -24.3 [±89.7] minutes in the control group (p = 0.30). 

Other physical parameters that increased in the intervention group compared to the controls were a mean change in hand grip strength (p = 0.01), the number of daily sit-ups (p < 0.01), and push-ups (p < 0.01). 

Increased activity resulted in improved overall outcomes in survivors of childhood cancer 

The increase in physical activity over time was reflected in improved neurocognitive measures and HRQoL outcomes in the intervention group, whereas no change in scores was observed in the controls. 

Increases in the intervention versus the control subjects included verbal executive function p < 0.01, physical function (p = 0.01), and overall HRQoL (p = 0.01). 

Conclusions

The findings indicate that this web-based motivational intervention increased both the motivation to exercise and MVPA in adolescent survivors of childhood cancer. The increased MVPA had corresponding positive effects on fitness, as well as, neurocognitive and HRQoL outcomes compared to control subjects. 

Disclosure

No external funding was disclosed.

Reference

Howell CR, Krull KR, Partin R, et al. Randomized web-based physical activity intervention in adolescent survivors of childhood cancer. Abstract presented at 2018 Cancer Survivorship Symposium, 16-17 February, Orlando, USA.