TY - JOUR
T1 - Perceived barriers and facilitators to physical activity in childhood cancer survivors and their parents
T2 - A large-scale interview study from the International PACCS Study
AU - Larsen, Elna Hamilton
AU - Mellblom, Anneli Viktoria
AU - Larsen, Marie Hamilton
AU - Ruud, Ellen
AU - Thorsen, Lene
AU - Petersen, Natasha Nybro
AU - Larsen, Hanne Baekgaard
AU - Fridh, Martin Kaj
AU - Lie, Hanne Cathrine
N1 - © 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.
PY - 2023/1
Y1 - 2023/1
N2 - BACKGROUND: Physical activity (PA) may reduce risks of late effects in childhood cancer survivors, yet many have low activity levels. Using the WHO's International Classification of Functioning, Disability, and Health for Children and Youths (ICF-CY) as a conceptual framework, we aimed to identify perceived barriers and facilitators to PA in young survivors and their parents.DESIGN/METHODS: We conducted individual, semi-structured interviews with 63 survivors, aged 9-18 years, ≥1-year off treatment, and 68 parents, recruited from three pediatric oncology departments in Norway and Denmark. Interviews were analyzed inductively using thematic analysis to identify barriers and facilitators to PA, which were mapped onto the ICF-CY model components; body function/structures, activities, participation, and environmental and personal factors.RESULTS: Two-thirds of the survivors described how treatment-related impairments of bodily functions (e.g., fatigue, physical weakness, reduced lung capacity) caused physical limitations, reducing opportunities to participate in PA, especially team sports and school physical education. This resulted in a perceived ability gap between survivors and peers, reducing motivation for PA. These PA barriers were moderated by environmental factors that facilitated or further hindered PA participation (family, peer, and school support). Similarily, personal factors also facilitated (acceptance, motivation, goal setting) or hindered (anxiety, low motivation, and lack of trust) PA participation.CONCLUSION: Treatment-related long-term or late effects represented significant barriers to PA as their functional consequences reduced survivors' capacities and capabilities to be active. Environmental and personal factors acting as facilitators or further barriers to PA were identified. Applying the ICF-CY framework in clinical practice could help to enable PA participation.
AB - BACKGROUND: Physical activity (PA) may reduce risks of late effects in childhood cancer survivors, yet many have low activity levels. Using the WHO's International Classification of Functioning, Disability, and Health for Children and Youths (ICF-CY) as a conceptual framework, we aimed to identify perceived barriers and facilitators to PA in young survivors and their parents.DESIGN/METHODS: We conducted individual, semi-structured interviews with 63 survivors, aged 9-18 years, ≥1-year off treatment, and 68 parents, recruited from three pediatric oncology departments in Norway and Denmark. Interviews were analyzed inductively using thematic analysis to identify barriers and facilitators to PA, which were mapped onto the ICF-CY model components; body function/structures, activities, participation, and environmental and personal factors.RESULTS: Two-thirds of the survivors described how treatment-related impairments of bodily functions (e.g., fatigue, physical weakness, reduced lung capacity) caused physical limitations, reducing opportunities to participate in PA, especially team sports and school physical education. This resulted in a perceived ability gap between survivors and peers, reducing motivation for PA. These PA barriers were moderated by environmental factors that facilitated or further hindered PA participation (family, peer, and school support). Similarily, personal factors also facilitated (acceptance, motivation, goal setting) or hindered (anxiety, low motivation, and lack of trust) PA participation.CONCLUSION: Treatment-related long-term or late effects represented significant barriers to PA as their functional consequences reduced survivors' capacities and capabilities to be active. Environmental and personal factors acting as facilitators or further barriers to PA were identified. Applying the ICF-CY framework in clinical practice could help to enable PA participation.
KW - Adolescent
KW - Cancer Survivors
KW - Child
KW - Exercise
KW - Humans
KW - Neoplasms/therapy
KW - Parents
KW - Qualitative Research
KW - ICF model
KW - barriers and facilitators
KW - childhood cancer survivor
KW - physical activity
KW - late effects
UR - http://www.scopus.com/inward/record.url?scp=85139823386&partnerID=8YFLogxK
U2 - 10.1002/pbc.30056
DO - 10.1002/pbc.30056
M3 - Journal article
C2 - 36251019
SN - 1545-5009
VL - 70
JO - Pediatric Blood & Cancer
JF - Pediatric Blood & Cancer
IS - 1
M1 - e30056
ER -