Authors: William H.C. Li PhD RN, Oi K. Joyce Chung PhD RN and Tan Cheung
Background: Sustainability is an important consideration in the potential implementation of an innovation in clinical practice. There is evidence that adventure-based training intervention can be effective in in enhancing the self-efficacy and quality of life among childhood cancer survivors. Nevertheless, it is uncertain whether such effects could be sustained over time, up to 12 or 18 months.Objective: To examine the sustainability, feasibility and acceptability of an adventure-based training and health education program in changing the exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors. Methods: A randomized controlled trial, two-group pretest and repeated post-test, between-subjects design was conducted to 69 childhood cancer survivors (9- to 16-year-olds). Participants in the experimental group joined a 4-day integrated adventure-based training and health education program. Control group participants received the same amount of time and attention as the experimental group but not in such a way as to have any specific effect on the outcome measures. Participants’ exercise behavior changes, levels of physical activity, self-efficacy, and quality of life were assessed at the time of recruitment, 3, 6, and 9, 12 and 18 months after starting the intervention. Results: From baseline to 18 months after the intervention, the experimental group reported statistically significant differences in the stages of change in physical activity, and higher levels of physical activity, self-efficacy, and quality of life than the control group. The results of process evaluation revealed that the program was both feasible and acceptable to participants. Conclusions: The program was found to have substantial effects on enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors over at least 18 months. Healthcare professionals should consider adopting such programs to promote the regular physical activity among childhood cancer survivors.
Keywords: adventure-based training; childhood cancer survivors; Chinese; physical activity self-efficacy; quality of life