Development of a functional and psychosocial evaluation toolkit using mixed methodology in a community-based physical activity program for childhood cancer survivors.

PURPOSE: The evidence demonstrating the benefits of exercise and PA in patients and survivors of childhood cancer has been translated into a handful of community-based programs, such as the Pediatric cancer patients and survivors Engaging in Exercise for Recovery Program (PEER). To support the translation of research to practice, the next step in knowledge translation is to evaluate program effectiveness. An evaluation must consider the goals of the PEER program, feedback from key stakeholders, and logistics of this program. Thus, the purpose of this study was to develop an evaluation toolkit with an algorithm for the implementation of the PEER program. METHODS: Semi-structured interviews were conducted with three different groups (stakeholders in pediatric oncology, PEER parents, and PEER participants). The interviews were transcribed and coded by two independent reviewers. RESULTS: Key themes extracted from the interviews were split into physical and psychosocial themes. The most reported psychosocial themes were quality of life (QOL), fatigue/energy levels, fun, and cs; and physical themes included motor skills, physical literacy, and physical activity levels. Tools were compiled into the evaluation based on key themes identified as well as logistics of PEER. An algorithm was developed to tailor the evaluation to participants based on age and mobility. CONCLUSION: To date, this is the first evaluation toolkit and algorithm developed for a specific community-based PA program, the PEER program. The next step in knowledge translation will be to implement the evaluation to assess feasibility and share the evaluation for adoption within other developing programs.

Evaluation Tools for Physical Activity Programs for Childhood Cancer: A Scoping Review.

Research on the benefits of physical activity (PA) in childhood cancer has been translated into a handful of community-based programs. However, to foster further translation, an understanding of how to evaluate participant outcomes would be beneficial to provide feedback to participants and stimulate future research. Such a review would provide a summary of acceptable tools for work in this area. The purpose of this scoping review was to identify the evaluation tools that have been used in PA/exercise studies or programs for childhood cancer. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the review used physical and psychosocial evaluation tools within PA and exercise programs or research for childhood cancer. In addition, studies with measures of health behavior such as PA levels and activities of daily living were included. Tools that assessed physical fitness and physical performance were excluded. Information on the types of evaluation tools used, mean age of participants, and type of cancer was extracted. Psychometric properties of each evaluation tool are reported. The most commonly assessed patient outcomes were motor performance, fatigue, well-being, functional mobility, and quality of life. Less commonly reported patient outcomes were hope, self-efficacy, and self-perception. None of the evaluation tools reported in the PA/exercise and pediatric oncology literature assess physical literacy. This review was the first step in a knowledge translation process, identifying evaluation tools that have been used in PA/exercise programs in childhood cancer survivors, that will guide the development and evaluation of current and future community-based programs.

The role of social support in physical activity for cancer survivors: A systematic review.

OBJECTIVE: Social support is conceptualized and operationalized in many ways, making it challenging to understand what types of support best predict physical activity (PA) in cancer survivors. This review examined associations between social support and PA among cancer survivors. METHODS: Following PRISMA guidelines, we searched eight databases for studies that reported an association between social support and PA among adult cancer survivors. We conducted an appraisal and a narrative synthesis of the findings from quantitative studies. RESULTS: Fifty studies representing 28 366 participants were included. Studies collectively included concepts addressing the presence of relationships, others' PA behavior, perceptions of being supported, and function/quality. Findings were mixed in suggesting a positive or null association with PA. CONCLUSIONS: While results are not definitive, this review takes a step toward mapping the social support literature in PA for cancer survivors. Limitations include the homogeneity of the participants in extant studies, and the secondary focus on testing the effects of social support on outcomes. Future research systematically testing the effects of social support is important for facilitating PA in this population.

Exercise interventions and their effect on masculinity, body image, and personal identity in prostate cancer-A systematic qualitative review.

OBJECTIVE: Men with prostate cancer face various body composition and psychosocial challenges following diagnosis. Movement-based interventions such as exercise may represent novel strategies to improve these important biopsychosocial changes. This systematic qualitative review aimed to examine the various exercise interventions and their effect on male perception of masculinity, body image, and personal identity. METHODS: A systematic search across nine electronic databases was conducted in July 2017 and repeated in August 2018. Eligible studies included qualitative works examining masculinity, body image, or personal identity within an exercise intervention. Thematic content analysis allowed for qualitative synthesis across numerous studies. RESULTS: Six studies met eligibility criteria for inclusion. Four interventions used multimodal aerobic and resistance training, one incorporated aerobic exercise through football practice, and one utilized a home-based aerobic plus yoga program. Exercise was implicated to improve masculinity through creation of a safe community, allowed for refocusing on valued male traits, provided a source of distraction, and offered a means of establishing control over one's illness. Exercise also facilitated a process of self-reflection secondary to changes in physique and helped to re-establish male self-efficacy. CONCLUSIONS: Regardless of prostate cancer stage, treatment status, or prior androgen deprivation therapy exposure, both aerobic or aerobic and resistance training exerted positive effects on perceived feelings of masculinity, body image, and personal identity.

Perceptions of masculinity and body image in men with prostate cancer: the role of exercise.

PURPOSE: The goal of this study was to explore the association between levels of exercise and patterns of masculinity, body image, and quality of life in men undergoing diverse treatment protocols for prostate cancer. METHODS: Fifty men with prostate cancer (aged 42-86) completed self-report measures. Self-reported measures included the following: the Godin Leisure Time Exercise Questionnaire (GLTEQ), Masculine Self-esteem Scale (MSES), Personal Attributes Questionnaire (PAQ), Body Image Scale (BIS), and the Functional Assessment of Cancer Therapy-Prostate (FACT-P). Masculinity, body image, and quality of life scores were compared between men obtaining recommended levels of exercise (aerobic or resistance) and those not obtaining recommended level of exercise. Secondary outcomes included the association between masculinity, body image, and quality of life scores as they relate to exercise levels. RESULTS: There were significantly higher scores of masculinity (p < 0.01), physical well-being (p < 0.05), prostate cancer specific well-being (p < 0.05), and overall quality of life (p < 0.05) in those obtaining at least 150 min of moderate to vigorous aerobic exercise. In the 48% of men who had never received androgen deprivation therapy, significantly higher levels of masculinity, body image, and quality of life were observed in those meeting aerobic guidelines. CONCLUSIONS: Whether treatment includes androgen deprivation or not, men who participate in higher levels of aerobic exercises report higher levels of masculinity, improved body image, and quality of life than those who are inactive. Future longitudinal research is required evaluating exercise level and its effect on masculinity and body image.

Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis.

OBJECTIVE: To conduct a systematic review to evaluate the efficacy of exercise interventions in improving outcomes across domains of functioning and disability in children and adolescents with juvenile idiopathic arthritis (JIA). DATA SOURCES: Seven electronic databases were systematically searched up to November 16, 2016. STUDY SELECTION: Original data, analytic prospective design, physical therapy-led exercise intervention evaluation, children and adolescents with JIA, and assessment of functional, structural, activity, participation, or quality of life outcomes. DATA EXTRACTION: Two authors screened search results, and discrepancies were resolved by consensus. Of 5037 potentially relevant studies, 9 randomized controlled trials and 1 cohort study were included and scored. DATA SYNTHESIS: Study quality (Downs and Black quality assessment tool) and level of evidence (Oxford Centre of Evidence-Based Medicine model) were assessed and meta-analysis conducted where appropriate. Alternatively, a descriptive summary approach was chosen. All randomized controlled trials were moderate-quality intervention studies (level 2b evidence; median Downs and Black score, 20 out of 32; range, 15-27). Interventions included aquatic, strengthening, proprioceptive, aerobic, and Pilates exercises. Pediatric activity capacity (Child Health Assessment Questionnaire) improved with exercise (mean difference, .45; 95% confidence interval, .05-.76). Furthermore, descriptive summaries indicated improved activity capacity, body function and structure (pain and muscle strength), and quality of life outcomes. CONCLUSIONS: Exercise therapy appears to be well tolerated and beneficial across clinically relevant outcomes in patients with JIA. The paucity of high-quality evidence and study heterogeneity limited the ability to provide conclusive, generalizing evidence for the efficacy of exercise therapy and to provide specific recommendations for clinical practice at this time. Future research evaluating exercise program implementation using validated outcomes and detailed adherence and safety assessment is needed to optimize clinical decision pathways in patients with JIA.