A scoping review to map the concept, content, and outcome of wilderness programs for childhood cancer survivors

Abstract

Objectives Systematic mapping of the concept, content, and outcome of wilderness programs for childhood cancer survivors. Design Scoping review. Search strategy Searches were performed in 13 databases and the grey literature. Included studies describe participation of childhood cancer survivors in wilderness programs where the role of nature had a contextual and therapeutic premise. At least two authors independently performed screening, data extraction and analysis. Results Database searches yielded 1848 articles, of which 15 met the inclusion criteria. The majority of programs (73%) employed adventure therapy. Five activity categories were identified as components of wilderness programs: challenge/risk, free time/leisure, experiential learning, physical activity and psychotherapeutic activities. A majority of the participating childhood cancer survivors were female, white, aged 8–40 years, with a wide range of cancer diagnoses. Reported outcomes included increased social involvement, self-esteem, self-confidence, self-efficacy, social support, and physical activity. Key gaps identified included the absence of randomized controlled trials (RCTs), lack of studies on long-term effects, lack of information on the multicultural aspects of programs, and missing information on engagement in nature activities after the program ended. Conclusions This scoping review guides childhood cancer survivors, their families, practitioners, clinicians and researchers in the development and optimization of wilderness programs for childhood cancer survivors. In addition, it informs the utilization of these programs, and identifies gaps in the evidence base of wilderness programs. It is recommended that future study reporting on wilderness programs include more detail and explicitly address the role of nature in the program. Performing RCTs on wilderness programs is challenging, as they occur in real-life contexts in which participants cannot be blinded. Creative solutions in the design of pragmatic trials and mixed method studies are thus needed for further investigation of the effectiveness and safety of wilderness programs in childhood cancer survivors.

Protocol of a mixed-method randomised controlled pilot study evaluating a wilderness programme for adolescent and young adult cancer survivors: the WAYA study

“…18 19 The majority of nature-based programmes that specifically address the needs of childhood and AYA cancer survivors can be categorised under the umbrella term of adventure programmes. 20 A previous observational study involving a 6-day outdoor adventure programme demonstrated improved body image, selfcompassion, self-esteem and decreased depression and alienation in young adult cancer survivors compared with a wait-list control. 21 Another observational study reported that a 1-week outdoor adventure camp significantly enhanced physical activity and reduced sedentary behaviour of young adult cancer survivors compared with wait-list controls up to 3 months after camp.…”

“…A recently published systematic scoping review that mapped the concept, content and outcome of wilderness programmes for childhood cancer survivors concluded that high-quality studies with appropriate comparison groups are needed to further build the evidence base for these programmes. 20 Therefore, the present study is initiated to examine the feasibility of performing a randomised clinical trial (RCT) of a wilderness programme that is specifically developed to benefit the health of AYAs that are diagnosed with cancer during childhood, adolescence or young adulthood. A holiday programme is chosen as a comparison to control for other possible effective factors such as attention, group support and getting out of their regular environment.…”

“…The wilderness programme for adolescent and young adults (WAYA) cancer survivors is developed based on the results of a previous study. 20 It aims to increase Open access physical activity, self-esteem, self-efficacy, self-care, personal growth and supportive relationships of participants. Nature has a central role in the WAYA, grounded in the ecosophy theory of Naess, 26 wherein the health and well-being of the natural world is intrinsically interwoven in a bi-directional fashion with the health and well-being of humans.…”

Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

“…The results were then followed by an analysis of the text words (title, abstract, or authors keywords) of the retrieved articles, and of the index terms (subject heading words) used to describe the articles. An earlier review was also examined for words for the search concepts of wilderness-related therapies [27], followed by discussions and comments from all team members.…”

Oxytocin Reactivity during a Wilderness Program without Parents in Adolescents

“…One way to nurture independence in adolescents is to provide proper encouragement and reinforcement to explore the world on their own and take responsibility for their decisions in a safe setting [ 8 ]. Wilderness programs adopt this approach and immerse participants to experience mental, physical, emotional, and spiritual challenges, such as survival challenges and long-term parental separation, in a safe and supportive outdoor environment [ 9 , 10 ]. A review of the solo wilderness programs reported that participants gain greater sense of independence by being free from manipulation and domination from others [ 11 ].…”