Potential Implementation of an Adventure-Based Training Intervention in Clinical Practice to Enhance the Self-Efficacy and Quality of Life Among Childhood Cancer Survivors

Abstract

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.