New Paper: A digital program to support childhood cancer survivors to become more physically active

This paper was published in the Journal of Medical Internet Research Cancer. Read the full paper here: https://cancer.jmir.org/2022/3/e38367

Background

Nearly 800 children are diagnosed with cancer each year in Australia. Fortunately, improvements in cancer treatments have led to rising survival rates. Whilst >80% of children will survive their disease, many will go on to experience treatment-related late effects, including chronic conditions such as cardiovascular disease or obesity. As survivors’ risk for developing chronic conditions is exacerbated, engaging in healthy behaviours such as regular physical activity is essential.
Many survivors of childhood cancer have also expressed the need for age-appropriate exercise information and report a desire for exercise guidance. However, a major burden for many survivors and families is the barrier of distance and travel, particularly for 45% of the population living in regional or rural areas. A solution of overcoming this burden of distance, is the delivery of health behaviour interventions using distance-delivered technologies.

​About the study

The iBounce pilot study is a digital health intervention designed to educate and engage 8–13-year-old childhood cancer survivors about physical activity and fitness. iBounce uses a slightly modified version of ‘iEngage’, an evidence-based health education program connected to wearable activity trackers that provides children without chronic disease with health knowledge and practical kills to improve their physical activity levels. Lead researcher and accredited exercise physiologist, Dr Lauren Ha, adapted iEngage to create the home-based iBounce intervention by modifying physical activities, educational content, and including a component to engage parents into the program.

Findings

The primary aim of this study was to investigate the feasibility and acceptability of childhood cancer survivors using the iBounce intervention. In total, 30 participants opted in, of whom 27 (90%) completed baseline assessments and 23 (77%) commenced the iBounce program. The opt-in rate was 59% and most survivors (19/23, 83%) completed the intervention. The retention rate (70%) and activity tracker compliance (79%) were high, and there were no intervention-related adverse events.
In terms of acceptability, survivors rated the program as enjoyable (75%) and easy-to-use (86%), but many survivors were not satisfied with the activity tracker (60%) potentially due to the technological issues that occurred.
Preliminary efficacy results showed that the iBounce program significantly improved survivors’ fitness levels after the intervention.
We demonstrated that iBounce is feasible for delivery and acceptable among survivors, despite some technical difficulties. The distance-delivered format provides an opportunity for survivors to engage in health behaviours at home, including families living in regional or rural areas.

Future directions

We will use these pilot findings to evaluate an updated version of iBounce. Dr Lauren Ha is currently conducting focus groups with childhood cancer survivors aged 8-21 years, parents of survivors, and health professionals to explore their priorities of using digital health to improve physical activity levels. If you are interested in contributing to designing and upgrading the iBounce program, please email ibounce@unsw.edu.au with the subject title as: iBounce focus groups. 

Impact

The impact of the iBounce program has been very positive. Kingston, a 10-year old lymphoma survivor was a participant in the iBounce pilot and recalls his improvement over the sessions. Kingston experienced muscle loss and fatigue during his cancer treatment. After completing the iBounce program, his fitness has improved and he is now preparing to play representative soccer in the UK. Read the inspiring story here published by The Sydney Morning Herald.