2018 SURVIVORSHIP: Web-Based Interventions Help Adolescents Stay Physically Active After Cancer Treatment


Key Points

  • Time spent performing moderate-to-vigorous physical activity increased by an average of 4.7 minutes per week in the web-based intervention group, and decreased by an average of 24.3 minutes per week in the control group.
  • Participants in the intervention group also experienced improvements in hand-grip strength, number of push-ups and sit-ups completed, verbal fluency, and health-related quality of life.
  • Online tools may be effective in motivating young cancer survivors to stay active following cancer treatment.

Survivors of childhood cancer are at increased risk for obesity and metabolic syndrome, which can lead to other serious health conditions, including heart disease, stroke, and diabetes. However, engaging in regular physical activity may help remediate these health issues in young survivors. A randomized study by Howell et al evaluating the efficacy of a web-delivered, interactive, rewards-based physical activity intervention aimed at increasing physical activity among young cancer survivors has found that the intervention increased physical activity by nearly 5 minutes per week. Conversely, physical activity decreased by more than 24 minutes in the control group.

Improving the motivation to exercise may have positive effects on fitness, cognition, and health-related quality of life, according to the study findings. The study (Abstract 102) will be presented at the Cancer Survivorship Symposium: Advancing Care and Research on February 16–17, 2018, in Orlando, Florida.

Study Methodology

Researchers from St. Jude Children’s Research Hospital in Memphis, Tennessee, and Yale School of Medicine in New Haven, Connecticut, randomly assigned 97 survivors between the ages of 11 and 15 who were no longer receiving cancer treatment and were physically active less than 60 minutes a day to a web-based physical activity intervention or to a control group. The study was open to adolescents with any type of cancer and about 25% of the participants had acute lymphoblastic leukemia (ALL).

Both groups received an educational handout with information about the importance of physical activity and examples of activities, along with a wearable activity monitor. The intervention group also had access to an interactive, age-appropriate website designed to motivate increased physical activity via rewards, such as t-shirts, stickers, and gift cards.

At the beginning and at the end of the study, participants visited St. Jude for an assessment of their physical fitness, including strength, flexibility, and endurance, and neurocognitive measures, such as attention and memory, as well as their health-related quality of life, assessed using the Pediatric Quality of Life Inventory questionnaire.

Study Findings

A total of 78 participants, 53 in the intervention group and 25 in the control group, completed the 24-week program. The mean age was 12.7, 80% were white, and 55.1% were female.

The intervention group increased their moderate-to-vigorous physical activity over time (mean change in weekly moderate-to-vigorous physical activity = 4.7 minutes; SD = 119.9), while the control group steadily decreased their weekly moderate-to-vigorous physical activity (-24.3 minutes; SD = 89.7; P = .30). In the intervention group, mean change in hand grip strength (P = .01), number of sit-ups (P < .01) and push-ups (P < .01), neurocognitive measures (eg, verbal executive function, P < .01), and health-related quality of life outcomes (eg, overall health-related quality of life, P = .01; physical function, P = .01) improved over time; no change was observed in the control group.

Impact of the Physical Activity on Young Cancer Survivors

“Increasing physical activity may have positive effects on fitness, cognition, and quality of life in adolescent survivors of pediatric cancers,” said Carrie R. Howell, PhD, a clinical research scientist at St. Jude Children’s Research Hospital and lead author of this study, during an ASCO press briefing highlighting the study. “We are currently testing this intervention in a larger group of survivors. We have initiated a Children’s Oncology Group-wide trial to test this intervention in a group of leukemia survivors from ages 8 to 15 years.”

“[This study provides] more evidence of the many different types of benefits that are derived from increasing physical activity and also this is a reminder that we may need to be creative in how we motivate or engage people,” said ASCO expert Timothy Gilligan, MD, MSc, FASCO, moderator of ASCO’s press briefing. “So, this is an interesting study of a new tool to do that.”

This study was funded by the National Cancer Institute, the American Lebanese Syrian Associated Charities, and HopeLab.

Melissa M. Hudson, MD, FASCO, reported a consulting or advisory role with Coleman Supportive Oncology Initiative for Children with Cancer, Oncology Research Information Exchange Network, Pfizer, and Princess Máxima Center. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.