Mobile Health Fitness Program for Adolescent and Young Adult Childhood Cancer Survivors

Not Applicable

Completed

Conditions: Survivorship
Fatigue

Interventions: Behavioral: Exercise Intervention
Behavioral: Internet-Based Intervention
Device: Monitoring Device
Other: Quality-of-Life Assessment

Registration Number: NCT02688192

Lead Sponsor: Rutgers, The State University of New Jersey

Brief Summary: This clinical trial studies a mobile health fitness program for adolescent and young adult childhood cancer survivors. Adolescent and young adult childhood cancer survivors are at risk to have negative late effects from treatment and to develop chronic health conditions. A sedentary lifestyle may increase the risk of cardiovascular disease, osteoporosis, and early mortality. Physical activity reduces the risk for cardiovascular disease and early mortality, improves cardiorespiratory fitness, muscular fitness, bone health, and body composition, and it is also positively associated with quality of life. Programs and technologies that promote physical activity are important because health behaviors adopted by adolescent and young adult childhood cancer survivors are likely to continue into adulthood. A mobile health fitness application may motivate adolescent and young adult childhood cancer survivors to engage and maintain physical activity.

Detailed Description: PRIMARY OBJECTIVES:

I. Evaluate the feasibility of the technology-enhanced (electronic accelerometer + app + 8 weekly group sessions) fitness program in a pilot randomized clinical trial.

SECONDARY OBJECTIVES:

I. Determine the effectiveness of the technology-enhanced fitness program on participants' cardiorespiratory fitness and muscular fitness.

II. Examine the effects of the program on secondary outcomes of health related quality of life (HRQOL) and fatigue.

OUTLINE:

Participants are randomized to 1 of 2 arms.

ARM I (Intervention): Participants attend 8 group meetings weekly, wear an electronic accelerometer, engage in private social support messaging within the app and Facebook private groups, and then use the mobile app for 4 weeks without in-person groups.

ARM II (WAITLIST CONTROL \[WLC\]): After the 6 month assessment, participants receive the FitSurvivor intervention as in arm I.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 49

Inclusion Criteria

Any diagnosis of cancer prior to age 21
Off treatment for at least 6 months
For patients < 18 years, parents must give informed consent and patient must give assent; patients >= 18 must give informed consent

Exclusion Criteria

Any medical contraindication to exercise according to a physician or physician's designee
Non-English speaking
Current physical activity level exceeding Centers for Disease Control and Prevention (CDC) guidelines for activity (60 min of moderate-vigorous exercise/day for 5+ days/week (wk) including 3+ days of vigorous intensity activities and muscle-strengthening exercises on 3+ days/wk and bone strengthening exercises on 3+ days/wk for children < 18 and 150 min of moderate vigorous exercise or 75 min of vigorous exercise/wk and 2+ days of muscle strengthening activities for adults >= 18); the CDC guidelines are used to determine exercise prescription in our intervention; individuals already exceeding the guidelines would be unlikely to benefit from participating
Significant developmental delay per patient, parent, or physician report
Pregnant (per patient report); if participant becomes pregnant during the course of the study, she will be removed from further participation

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm I (Intervention)	Internet-Based Intervention	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation 4. Participate in a fitness program which includes: * 8 group meetings of 90 minutes weekly * Behavioral internet based intervention engage in private social support messaging within the app and Facebook private groups and mobile app
Arm I (Intervention)	Quality-of-Life Assessment	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation 4. Participate in a fitness program which includes: * 8 group meetings of 90 minutes weekly * Behavioral internet based intervention engage in private social support messaging within the app and Facebook private groups and mobile app
Arm II (Waitlist Control [WLC])	Quality-of-Life Assessment	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation After waiting 6 months they will begin the fitness program as described in Arm I
Arm II (Waitlist Control [WLC])	Internet-Based Intervention	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation After waiting 6 months they will begin the fitness program as described in Arm I
Arm I (Intervention)	Exercise Intervention	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation 4. Participate in a fitness program which includes: * 8 group meetings of 90 minutes weekly * Behavioral internet based intervention engage in private social support messaging within the app and Facebook private groups and mobile app
Arm II (Waitlist Control [WLC])	Monitoring Device	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation After waiting 6 months they will begin the fitness program as described in Arm I
Arm I (Intervention)	Monitoring Device	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation 4. Participate in a fitness program which includes: * 8 group meetings of 90 minutes weekly * Behavioral internet based intervention engage in private social support messaging within the app and Facebook private groups and mobile app
Arm II (Waitlist Control [WLC])	Exercise Intervention	Assessment including 1. Wear an electronic accelerometer 2. Quality of life assessment 3. Physical fitness evaluation After waiting 6 months they will begin the fitness program as described in Arm I

Primary Outcome Measures

Name	Time	Method
Feasibility of the Technology-enhanced Fitness Program	Baseline	Feasibility will be evaluated by the number of participants who enroll and complete baseline assessment for the randomized trial. In total, 354 participants were mailed letters; 68 were contacted/screened, of which 56 were eligible and 49 enrolled (88% of those screened eligible, 14% of total potentially eligible pool).

Secondary Outcome Measures

Name	Time	Method
Health Related Quality of Life (HRQL) Measured Using the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale	Baseline to post-intervention (3 months)	The PedsQL Generic Core Scale is a well-validated measure of HRQOL with physical, emotional, social, and cognitive functioning domains. The PedsQL Generic Core yields two summary scores - Physical Summary and Psychosocial Summary. Scores are transformed on a 0-100 scale, with higher scores indicating better functioning.
Fatigue Measured Using the PedsQL Multidimensional Fatigue Scale	Baseline to post-intervention (3 months)	Fatigue measured using the PedsQL Multidimensional Fatigue Scale. The PedsQL Multidimensional Fatigue Scale yields three subscales: general, sleep/rest, and cognitive fatigue. Scores are transformed on a 0-100 scale, with higher scores indicating better functioning.
Feasibility - Retention	Baseline to post-intervention (3 months)	Percentage of participants who compete the 3 month assessment
Change in Cardiorespiratory Fitness Measured Using Submaximal Treadmill Test	Baseline to post-intervention (3 months)	Cardiorespiratory fitness was measured via submaximal treadmill testing using a modified Bruce protocol. This standardized graded treadmill test adds two warm-up stages, with the first performed at a 1.7 mph and 0% grade and the second at 1.7 mph and 5% grade. Participants performed the graded exercise test until they reached 85% of their age-predicted maximum heart rate, which was measured using a chest-worn Polar heart rate monitor. Estimated VO2 max was calculated for each participant using the multi-stage model and American College of Sports Medicine metabolic equations.
Feasibility - Engagement With the App	Duration of the FitSurvivor intervention (12 weeks)	Engagement with the app was measured by 1) number of in-app exercises completed; 2) points earned (more active = more points); 3) achievements unlocked; and 4) number of likes and comments posted within the social feed. These are count data. Achievements unlocked has possible range of 0 to 20. Number of in-app exercises completed, points earned, and number of likes and comments posted within the social feed have a possible lower limit of 0 and no upper limit; higher numbers indicate more instances of each. The full range of participant data are: number of in-app exercises completed = 0-44; points earned = 0-1,195; number of achievements unlocked = 1-20; number of likes/comments posted = 0-8.
Change in Muscle Strength/Endurance Measured Using 10-repetition Maximum Strength Tests (Upper and Lower Body)	Baseline to post-intervention (3 months)	Lower and upper body muscular strength/endurance were measured via 10-repetition maximum (10-RM) tests following National Strength and Conditioning Association guidelines (leg press machine for lower body and barbell bench press for upper body). Weight was increased until participants executed 10 repetitions in good form for both exercises. Estimates of 1-RM leg and bench press were made using a linear prediction equation. Higher scores indicate greater muscular strength/endurance.

Trial Locations

Locations (2): Hackensack University Medical Center
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Hackensack, New Jersey, United States
Rutgers Cancer Institute of New Jersey
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New Brunswick, New Jersey, United States