Adventure-based training to promote physical activity, reduce fatigue, and enhance quality of life among Hong Kong Chinese childhood cancer survivors: A phase 3 randomised controlled trial

Abstract

Introduction and Project Objectives: Despite evidence that regular physical activity can attenuate cancer-related fatigue, many childhood cancer survivors are reluctant to engage in regular physical activity. Although adventure-based training may be effective in promoting physical activity among childhood cancer survivors, large-scale or robust evidence of its effectiveness is scarce. In addition, it is unclear if adventure-based training can help attenuate cancer-related fatigue. This study examined the effectiveness of an adventure-based training programme in promoting physical activity, reducing fatigue, and enhancing self-efficacy and quality of life (QoL) among Hong Kong Chinese childhood cancer survivors. Methods: We conducted a prospective, phase 3 randomised controlled trial. Hong Kong Chinese childhood cancer survivors aged 9-16 years were recruited via an outpatient clinic, the Children's Cancer Foundation, and the Sunshine Group. The primary outcome was fatigue. Secondary outcomes were physical activity levels, self-efficacy, hand grip strength, and QoL, which were assessed at baseline, and 3, 6, 9, and 12 months after starting the intervention. Intention-to-treat analysis was used. The study is closed and was registered at ClinicalTrial.gov (NCT02703935). Results: Between Jan 6, 2014, and June 8, 2015, we randomly assigned 222 eligible childhood cancer survivors to either the experimental group (n=117) to receive a 4-day adventure-based training programme or the control group (n=105) to receive placebo intervention. The experimental group reported statistically significantly lower levels of cancer-related fatigue, higher levels of self-efficacy and physical activity, greater rightand left-hand grip strength, and better QoL than the control group. Conclusions: This study provides evidence that adventure-based training is effective in promoting physical activity, reducing cancerrelated fatigue, and enhancing self-efficacy and QoL among Hong Kong Chinese childhood cancer survivors. Project Number: 11121461