Exploring Social Ecological Determinants of Physical Activity Among Adult Survivors of Childhood Cancer.

Purpose: Adult survivors of childhood cancer (ASCCs) are at high risk for cardiovascular disease from chemotherapy- and radiation therapy-related cardiotoxicity. Physical activity (PA) can reduce this risk, but the majority of ASCCs do not engage in sufficient PA. The purpose of this study was to identify barriers, facilitators, and resources for PA among ASCCs using the ecological model of physical activity (EMPA) as a theoretical framework. Methods: A concept elicitation survey was distributed independently to ASCCs (diagnosed with cancer before the age of 18, and currently 18-39 years old) and parents/legal guardians of an ASCC. The survey consisted of open-ended questions asking about barriers, facilitators, and resources for PA. Content analysis of open-ended questions categorized responses into levels of the EMPA and identified key themes. Results: Seventeen ASCCs and eight parents of ASCCs completed the survey. The majority of barriers, facilitators, and resources reported were at the individual and microsystem level of the EMPA. Six themes emerged, suggesting that ASCC's PA was related to proximity/access, social support, equipment, time/schedule, finances, and health-related barriers. Conclusion: This is the first study to examine barriers, facilitators, and resources of PA among ASCCs using the EMPA. Findings from this study provide a multilevel perspective on the influences of PA among ASCCs, and can be used for future, in-depth qualitative studies and quantitative survey development, and as a foundational step toward supportive efforts in increasing PA among ASCCs.

Weight-Dependent Disparities in Adolescent Girls: The Impact of a Brief Pilot Intervention on Exercise and Healthy Eater Identity.

Adolescent girls report low participation in healthy behaviors (e.g., nutritious eating and exercise), and are disproportionately affected by obesity. Short-term interventions, such as behavioral summer camps, may positively influence psychological underpinnings of healthy behavior, particularly exercise identity (EI) and healthy eater identity (HEI). The present study investigates disparities and changes in identity and subsequent health behavior in two cohorts of adolescent girls following a brief, multicomponent intervention. A sample of normal-weight adolescent girls from a health promotion camp and an elevated body mass index (BMI) sample from an obesity treatment camp participated in the study. Both camps ran one-week in duration and delivered comparable intervention components. All families were given access to the same eight-week eHealth program post-camp. Significant EI and HEI role-identity disparities between the health promotion and obesity treatment cohorts were apparent at baseline. Following the one-week camp intervention, EI and HEI scores increased in both groups. At follow-up, the treatment group had increased EI and HEI role-identities in such that the groups no longer significantly differed. Positive changes in health behaviors were experienced in each group. This pilot study demonstrates that EI and HEI differ between normal-weight and obese adolescent girls and weight-dependent identity disparities may be mitigated following brief, multicomponent interventions.

In-school versus out-of-school sedentary behavior patterns in U.S. children.

BACKGROUND: This study contributes to the literature by using accelerometers to describe sedentary behavior (SB) patterns in US children. The purpose of this study was to examine SB patterns in fifth-graders by specifically focusing on in-school versus out-of-school SB patterns to identify when (during the school day or outside of the school day) interventions should take place in order to decrease SB in children. METHODS: Data were collected from 206 fifth-graders (9-11 years old) in the Cherry Creek School District in metro Denver, Colorado (USA) during the spring of the 2010-2011 school year and fall of the 2011-2012 school year. Children wore Actical accelerometers continuously over an eight-day period. Data were analyzed using Wilcoxon rank tests, paired samples t-tests, and independent samples t-tests. Awake time was 6 AM-11 PM. We compared the percent of time spent in SB before school, during school, at recess/lunch and after school, as well as differences between boys and girls, and between children from low and high socioeconomic status schools. Children were classified as 'non-sedentary' or 'sedentary' if they participated in <360 min or ≥360 min per day of SB, respectively and were classified as 'inactive' or 'active' if they participated in <60 min or ≥ 60 min per day of MVPA, respectively. Cross-tabs were used (and Fisher's exact test) to identify the proportion of children in the following categories: 1) non-sedentary/inactive; 2) sedentary/inactive; 3) non-sedentary/active; and 4) sedentary/active. Statistical significance was set at p < 0.05. RESULTS: All children (boys and girls and children from low and high socioeconomic status schools) participated in significantly more SB outside of school hours versus during school hours and on weekend days compared to weekdays (p < 0.001). Girls participated in significantly more SB than boys during weekdays (p = 0.015). The majority of children (65.3 %) were classified as sedentary/active. CONCLUSIONS: Given that children appear to be more sedentary during the weekend, where more opportunities to be physically active with the whole family can easily be implemented, future interventions should focus on time periods outside of school hours in order to decrease sedentary behavior and increase light physical activity in particular.