Right after Cancer, Textual content Messages Up Work out and Cut down Late Results
Sending a text with a quick motivational intervention (MI) to mother and father of childhood cancer survivors considerably increased their child’s physical action level compared with command individuals and also reduced therapy-associated late consequences.
The results arrive from a randomized demo of 161 small children (median age, 12.4 many years) who had recovered after leukemia, lymphoma, or brain tumors.
“Physical action is effective in avoiding and attenuating several adverse late effects adhering to pediatric cancer and treatment options, [but] most little ones who endure most cancers do not take part in adequate physical exercise to get hold of these health positive aspects,” say the scientists, led by Ankie Tan Cheng, PhD, the Chinese College of Hong Kong, Hong Kong, China.
“To our know-how, [this study] was the first randomized medical demo to use short MI to encourage mom and dad to persuade their youngsters surviving most cancers to interact in regular bodily exercise,” they comment.
The intervention “was effective in marketing regular bodily action in young children who survived most cancers,” they report. It “can be integrated into pediatric survivorship care to attenuate most cancers- and therapy-similar adverse effects and boost QOL [quality of life] amongst the vulnerable pediatric oncology populace,” they conclude.
The examine was posted on the net June 14 in JAMA Network Open.
Intervention vs Controls
A total of 161 kids amongst 9 and 16 years of age who experienced survived cancer ended up randomly assigned together with their mother and father to the intervention group or the handle team.
The key outcome was the kid’s physical action stages at 12-month abide by-up, measured by the Chinese College of Hong Kong: Physical Action Ranking for Little ones and Youth score.
The intervention team underwent a 10-moment overall health information session delivered by a nurse at the time of recruitment into the study. “The session highlighted the distinct wellness advantages of frequent physical action for the kids,” the authors make clear. “And during every conversation, mom and dad were being requested whether they experienced inspired their little one to complete normal actual physical activity in the earlier 7 days,” they incorporate.
The temporary intervention was shipped to mothers and fathers ordinarily not less than as soon as a 7 days and not a lot more than a few instances a week for the duration of the very first 6 months, after which nominal messaging was shipped to parents till analyze endpoint at 12 months.
In contrast to the control team, the intervention group confirmed noticeably increased increments in physical exercise stages at 3, 6, and 12 months following study enrollment (P < .001 for all time endpoints). "Moderate to vigorous PA [physical activity] levels among participants in the intervention group increased by 72.8% compared with 6.3% in controls during the 12-month study period," the team notes.
Secondary endpoints of the trial included treatment-relate late effects. Cancer-related fatigue was significantly reduced (P = .003), and peak expiratory flow rate was significantly improved (P < .001). There were also improvements in left-hand grip strength (P = .04), right-hand grip strength (P = .02), and QOL (P = .04), although these did not reach statistical significance.
The intervention may have been effective because it simply alleviated parental concerns and misconceptions about their child’s engagement in physical activity, the authors comment. They also note that family involvement is important in Chinese culture, in which children are encouraged to follow parental instructions and advice.
“The use of this technology enables direct, real-time, continuing professional counselling and support for parents: the rapid delivery of instant messaging provided a means of 2-way communication that was flexible, efficient and time-saving,” Cheung and colleagues conclude.
Family Involvement Is Key
Family involvement is a key aspect of this study, comment Katie Devine, PhD, MPH, and Gary Kwok, PhD, both from the Rutgers Cancer Institute of New Jersey, New Brunswick, in an accompanying editorial.
“An important highlight of this intervention is the direct parent[al] involvement in the intervention,” the editorialists write.
The intervention may help address specific concerns that parents might have about their children exercising, such as worrying about overtaxing their child and misconceptions about how exercise might make their child tired, rather than alleviating fatigue. “While there are barriers to implementing physical activity and exercise interventions with families following a cancer diagnosis, targeting the family unit may increase the chance of successful outcomes,” the editorialists state.
Indeed, studies have shown that family support is a key factor in promoting physical activity among children and adolescents in the general population as well as among childhood cancer survivors, the editorialist comment.
Furthermore, “instant messaging allows brief conversions to occur in parents’ everyday life settings, offering support at times when needed, while minimizing participant burden,” they add.
Limitations of the study include the potential for bias because physical activity was self-reported, although objective measures are difficult to collect and analyze. “The study suggested the utility of targeting parents to improve children’s physical activity and the acceptability of using an instant messaging application to deliver personalized messages over time,” Devine and Kwok comment.
“Future work should consider strategies for promoting family support for physical activity in different intervention contexts and measuring the pathways through which interventions improve outcomes,” they suggest.
The authors and editorialists have disclosed no relevant financial relationships.
JAMA Netw Open. Published online June 14, 2022. Full text, Editorial
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