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Ha L, Wakefield CE, Fardell J, Cohn RJ, Simar D, Signorelli C, Mizrahi D. Parent perceptions of their child's and their own physical activity after treatment for childhood cancer. Support Care Cancer 2022; 30:8947-8957. [PMID: 35909162 PMCID: PMC9340709 DOI: 10.1007/s00520-022-07288-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/14/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Parents are important facilitators of physical activity for children, yet little is known about the perceptions of parents of childhood cancer survivors. We investigated parent perceptions of their own and their child's physical activity levels after cancer treatment and examined associations with clinical, demographic, and psychosocial factors. METHODS We conducted a cross-sectional survey among 125 parents and 125 survivors. Parents reported on the perceived importance of their child being physically active and concerns regarding exercising after cancer treatment. RESULTS Parents and survivors self-reported median (range) of 127.5 (0-1260) and 220 (0-1470) min/week of moderate-to-vigorous physical activity. Most parents (n = 109, 98%) believed that physical activity was highly important for their child. Some parents (n = 19, 17%) reported concerns, most commonly regarding exercise safety (n = 7, 22%). Parents were more likely to perceive that their child should increase physical activity if their child was an adolescent and had high body fat percentage. CONCLUSIONS Physical activity levels varied widely among survivors, reflecting factors including parents' lifestyles, limited understanding of exercise benefits and perceptions of risk. Given survivors' insufficient physical activity levels and sedentary behaviour among families, embedding physical activity promotion into health systems and follow-up support could benefit the entire family unit.
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Affiliation(s)
- Lauren Ha
- School of Health Sciences, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia.
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Joanna Fardell
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - David Simar
- School of Health Sciences, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - David Mizrahi
- Prince of Wales Clinical School, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
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Ha L, Mizrahi D, Cohn RJ, Simar D, Wakefield CE, Signorelli C. Accuracy of perceived physical activity and fitness levels among childhood cancer survivors. Pediatr Blood Cancer 2021; 68:e29134. [PMID: 34133073 DOI: 10.1002/pbc.29134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/11/2021] [Accepted: 05/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood cancer survivors do not engage in sufficient physical activity and have low fitness levels. Perceived physical activity and fitness levels may influence survivors' engagement in health behaviours. We aimed to investigate survivors' perceptions of physical activity and fitness levels and identify how accurate their perceptions were. We further explored survivors' attitudes toward physical activity, including perceived importance and desire to increase activity levels. PROCEDURE We recruited 116 childhood cancer survivors (8-18 years) and assessed their perceived physical activity levels using a questionnaire and the Godin's Leisure Score Index. Accuracy of their perceptions was established by comparing their perceived physical activity levels with the recommended guidelines. Survivors reported their perceived fitness levels using the International Fitness Scale. We compared survivors' perceptions with their performance on the 6-minute walk test using weighted Cohen's kappa to determine interrater agreement between perceived and objectively measured fitness. RESULTS Most survivors did not meet the physical activity guidelines (<420 min/week). One-third incorrectly perceived whether their self-reported physical activity levels were appropriate (84% underestimated, while 16% overestimated). Survivors had average fitness and were inaccurate at perceiving their fitness level. Survivors highly valued the importance of being able to do physical activity, and 89% reported a desire to increase their physical activity. CONCLUSIONS Our results reveal that many survivors are not accurate when perceiving their physical activity and fitness levels. Emphasising the need for objective fitness assessments, and patient education in clinical practice may support survivors to accurately perceive their physical activity and fitness levels, thus improving health behaviours.
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Affiliation(s)
- Lauren Ha
- School of Health Sciences, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - David Mizrahi
- Prince of Wales Clinical School, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Richard J Cohn
- Behavioural Sciences Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - David Simar
- School of Health Sciences, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- Behavioural Sciences Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Christina Signorelli
- Behavioural Sciences Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
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Mizrahi D, Wakefield CE, Simar D, Ha L, McBride J, Field P, Cohn RJ, Fardell JE. Barriers and enablers to physical activity and aerobic fitness deficits among childhood cancer survivors. Pediatr Blood Cancer 2020; 67:e28339. [PMID: 32386117 DOI: 10.1002/pbc.28339] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Physical activity and aerobic fitness are modifiable risk factors for cardiovascular disease (CVD) after childhood cancer. How survivors engage in physical activity remains unclear, potentially increasing CVD risk. We assessed survivors' physical activity levels, barriers and enablers, fitness, and identified predictors of fitness and physical activity stage of change. METHODS Childhood cancer survivors (CCS; 8-18 years old) ≥1 year post-treatment were assessed for aerobic fitness (6-min walk test), used to extrapolate VO2max , and body composition (InBody 570). Survivors self-reported physical activity to determine stage of change (Patient-Centered Assessment and Counselling for Exercise). Physical activity and fitness were compared with guidelines and CVD-risk cut-points (VO2max < 42 mL/kg/min: males; VO2max < 35 mL/kg/min: females). Multiple regression and mediator-moderator analysis were used to identify fitness predictors and stage of change. RESULTS One hundred two survivors (12.8 ± 3.3 years) participated (46% acute lymphoblastic leukaemia). Forty percent of males (VO2max = 43.3 ± 6.3 mL/kg/min) and 28% of females (VO2max = 36.5 ± 5.9 mL/kg/min) were in the CVD-risk category, while 25% met physical activity guidelines. Most prevalent physical activity barriers were fatigue (52%), preferring television instead of exercise (38%), and lacking time (34%). Predictive factors for reduced fitness included being older, female, higher waist-to-height ratio, higher screen time, and moderated by lower physical activity (r2 = 0.91, P < .001). Survivors with higher physical activity stage of change were male, lower body fat percentage, lower screen time, and lived with both parents (r = 0.42, P = .003). CONCLUSION Aerobic fitness and physical activity of CCS is low compared with population norms, potentially increasing CVD risk. Addressing physical activity barriers and enablers, including reducing screen time, could promote regular physical activity, reducing CVD risk.
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Affiliation(s)
- David Mizrahi
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - David Simar
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia
| | - Lauren Ha
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - James McBride
- Respiratory Medicine, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Penelope Field
- Respiratory Medicine, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Richard J Cohn
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Joanna E Fardell
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
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