Parent and Health Care Provider Perceptions for Development of a Web-Based Weight Management Program for Survivors of Pediatric Acute Lymphoblastic Leukemia: A Mixed Methods Study

Folta, Sara C.; Chang, Winnie; Hill, Rachel; Kelly, Michael J.; Meagher, Susan M.; Bowman, W. Paul; Zhang, Fang Fang

doi:10.2196/cancer.6680

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…The initial curriculum was developed based on the “4-Health” program, a childhood obesity prevention program in rural settings by the US Department of Agriculture (USDA) [26]. The adaption of the curriculum was directly informed by qualitative research that identified targeted nutrition and physical activity needs and specific barriers for childhood ALL survivors [27]. Grounded in theoretical models (e.g., social cognitive and self-determination theories) [28,29], the intervention sessions incorporated core behavioral change strategies including increasing knowledge, setting behavior goals, self-monitoring, problem solving, and positive reinforcement [30].…”

Section: Methodsmentioning

confidence: 99%

Early Lifestyle Intervention for Obesity Prevention in Pediatric Survivors of Acute Lymphoblastic Leukemia

Zhang

Kelly

et al. 2019

Nutrients

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Patients with pediatric acute lymphoblastic leukemia (ALL) experience rapid weight gain during treatment and increases in weight are maintained throughout treatment and beyond. Without prompt interventions, altered dietary and physical activity behaviors may become difficult to reverse, contributing to obesity risk long-term. Fifteen children, aged 3–9 years, diagnosed with pediatric ALL who were on maintenance therapy or within two years of treatment completion (mean BMI percentile: 70.4th) and one parent from each family, were enrolled into a 12-week lifestyle intervention delivered remotely through web-based sessions and phone calls with a lifestyle coach. Outcomes were assessed at baseline and end of the intervention. Thirteen of the 15 enrolled families (86.7%) completed the intervention. Parents reduced the “pressure to eat” feeding practice (change in mean score: −0.60, 95% CI: −1.12 to −0.07; p-value = 0.03) post intervention. Children increased the consumption of milk (0.54 serving/d, 0.02 to 1.07; p-value = 0.04) and percent of calories from protein (2.54%, 0.22 to 4.87%; p-value = 0.04) and reduced the consumption of potatoes (−0.16 serving/d, -0.30 to −0.03; p-value = 0.02). No significant changes were observed for children’s levels of physical activity, BMI, or waist circumference. Results from this pilot support the feasibility and preliminary efficacy of early lifestyle intervention among pediatric ALL survivors.

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Section: Methodsmentioning

confidence: 99%

Early Lifestyle Intervention for Obesity Prevention in Pediatric Survivors of Acute Lymphoblastic Leukemia

Zhang

Kelly

et al. 2019

Nutrients

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“…To understand the feasibility of initiating lifestyle interventions early in cancer care, we conducted a mixed-methods study, including 4 focus groups with 20 health care providers (e.g., oncology dietitians, nurses, oncologists and social workers) and surveyed 46 parents of childhood ALL survivors (mean age = 6.5 years old, 61% on-treatment) to evaluate their perceptions of weight management in childhood ALL survivors. 46 About 76% of the parents indicated that they would like to help their child maintain a healthy weight and the most preferred time (47%) to participate in lifestyle interventions was within 3 months after starting maintenance chemotherapy. Health care providers also considered the maintenance phase an appropriate time to introduce lifestyle modification largely because the treatment is less intense and the patients’ family has had time to adapt to the diagnosis of childhood cancer.…”

Section: Early Lifestyle Interventions In Childhood Cancer Survivorsmentioning

confidence: 99%

Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors

2017

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Purpose of review Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care. Recent findings Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Summary Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible.

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“…It has been proposed that the emotional impact of childhood cancer diagnosis and the acute treatment phase have been identified as barriers to implementing such an early intervention [ 30 , 64 , 65 ]. Accordingly, in our study, the worsening of the medical condition was one of the main reasons for exclusion from the intervention.…”

Section: Discussionmentioning

confidence: 99%

Early Nutritional Intervention to Promote Healthy Eating Habits in Pediatric Oncology: A Feasibility Study

et al. 2022

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This study aims to describe the feasibility of a nutritional intervention that promotes healthy eating habits early after cancer pediatric diagnosis in patients and their parents. Participants were recruited 4 to 12 weeks after cancer diagnosis as part of the VIE study. The one-year nutritional intervention included an initial evaluation and 6 follow-up visits every 2 months with a registered dietician. The feasibility assessment included rates of retention, participation, attendance, completion of study measures, and participants’ engagement. A preliminary evaluation of the intervention's impact on the participants’ dietary intakes was conducted. A total of 62 participants were included in the study (51.6% male, mean age = 8.5 years, mean time since diagnosis = 13.2 weeks). The retention and attendance rates were 72.6% and 71.3%, respectively. Attendance to follow-up visits declined over time, from 83.9% to 48.9%. A majority of participants had high participation (50.8%) and high engagement (56.4%). Measures of body-mass-index or weight-for-length ratio and dietary 24-h recalls were the procedures with the highest completion rates. Participants with refractory disease or relapse were less likely to complete the intervention. Post-intervention, participants (n = 21) had a lower sodium intake compared to the initial evaluation. These results suggest that a nutritional intervention that involves patients and parents early after a pediatric cancer diagnosis is feasible.

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Parent and Health Care Provider Perceptions for Development of a Web-Based Weight Management Program for Survivors of Pediatric Acute Lymphoblastic Leukemia: A Mixed Methods Study

Cited by 8 publications

References 24 publications

Early Lifestyle Intervention for Obesity Prevention in Pediatric Survivors of Acute Lymphoblastic Leukemia

Early Lifestyle Intervention for Obesity Prevention in Pediatric Survivors of Acute Lymphoblastic Leukemia

Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors

Early Nutritional Intervention to Promote Healthy Eating Habits in Pediatric Oncology: A Feasibility Study

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