Prospectively examining physical activity in young adult survivors of childhood cancer and healthy controls

Abstract

Background This study compares young adult survivors of childhood cancer (YASCC) and young adults without a history of serious illness/injury on physical activity levels and examines psychological predictors of physical activity in survivors over a two month period. Procedure YASCC participants (n = 117) and healthy controls (n = 148), ages 18–30, recruited during cancer survivorship clinic or primary care clinics completed self-report measures of physical activity, health problems, psychological distress, and health beliefs (Health Perceptions, Satisfaction with Healthcare, Cognitive Competence, Autonomy). Survivorship providers completed ratings of health problems and treatment intensity for survivors. Results Survivors had significantly lower levels of physical activity than controls. Family income, survivor-reported health problems and less positive health beliefs were associated with lower rates of physical activity. Provider-reported survivor health problems and ratings of cancer treatment intensity were not related to survivor physical activity. Less positive survivor beliefs about their cognitive competence predicted survivor physical activity two months later after accounting for other pertinent demographic, medical and psychological variables. Conclusions YASCC were significantly less active than healthy controls. YASCC with more self-identified health problems and negative beliefs about their cognitive competence were less physically active. Beliefs about their health and cognitive competencies may be viable areas for assessment and intervention in order to promote increased engagement in physical activity.

Strategies to promote regular exercise in adolescent and young adult cancer survivors

“…In support of this, medical provider-reported survivor health problems and ratings of cancer treatment intensity were not related to survivor physical activity, but rather survivor-reported negative beliefs about their cognitive capacity (eg, I do not learn new things as easily as other people) predicted lower physical activity 2 months later. 52 This finding supports the role of cognitions in exercise engagement as documented in other studies with AYA survivors as well as the importance of implementing exercise regimens early in cancer diagnosis. 53,54 It is likely that disruptions in the developmental trajectory such as the formation of self-efficacy, perceived health competencies and health beliefs, and perceived behavioral control interact with natural maturation, leading to significantly lower levels of exercise during this critical period of physical and psychological development.…”

“…52 Valle et al reported similar findings, demonstrating that social support mediated the relations between AYA survivor participation in an exercise intervention and increases in moderate-tovigorous exercise. 41 Incorporating peer support for AYAs may lead to greater exercise engagement through direct peer encouragement for AYA engagement in exercise, ongoing accountability related to exercise goals, and support for continued engagement in an active lifestyle.…”

“…[48][49][50][51] This decline appears to be steeper for AYA survivors as research indicates that AYA survivors report significantly lower levels of physical activity compared to healthy peers without a history of serious illness or injury. 52 It is possible that AYA survivors are impacted doubly, with age and illness experience both playing a role. In support of this, medical provider-reported survivor health problems and ratings of cancer treatment intensity were not related to survivor physical activity, but rather survivor-reported negative beliefs about their cognitive capacity (eg, I do not learn new things as easily as other people) predicted lower physical activity 2 months later.…”

Barriers and Facilitators of Healthy Diet and Exercise Among Adolescent and Young Adult Cancer Survivors: Implications for Behavioral Interventions

“…37,38 However, for AYA survivors with suboptimal adherence to recommended health behaviors, supportive care services could be tailored to their needs and address their unique challenges and barriers to accessing such services (e.g., time limitations due to raising young children, financial challenges after cancer treatment, and starting one's career). [39][40][41][42] The current study of AYA cancer survivors and their supporters identified a number of barriers to and facilitators of healthy lifestyle behaviors that could be useful when designing AYA-specific health interventions. Consistent with the hypotheses, these barriers and facilitators occurred on multiple levels ranging from survivors to their family members, peers, and healthcare providers, and included social factors, survivors' outcome expectancies, and self-efficacy.…”

Treatment, Behavioral, and Psychosocial Components of Cardiovascular Disease Risk Among Survivors of Childhood and Young Adult Cancer

“…Compared to healthy controls, survivors reported participating in moderate to vigorous physical activity 2.1 fewer times per week ( P =0.02). 48 In a Hawaiian cohort, Wada et al found that 44% of survivors <18 years old and 29% of survivors ≥18 years old failed to meet national guidelines for time spent in physical activity. 43 Lastly, in a study of 74 survivors of AYA cancers, Murnane et al found a significant reduction in average minutes spent in physical activity after treatment, compared to prediagnosis (219 versus 148, P <0.0005).…”