Healthy Kids after Cancer: A Physical Activity and Nutrition Intervention

癌症后的健康孩子：体育活动和营养干预

基本信息

批准号：
8772910
负责人：
Alicia S Kunin-Batson
金额：
$ 23.23万
依托单位：
HEALTHPARTNERS INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-06-20 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8772910
关键词：
10 year old Accounting Acute Lymphocytic Leukemia Adherence Adult Applications Grants Behavior Benchmarking Biological Biological Markers Body Composition Body Weight Body mass index C-reactive protein Cardiac Child Childhood Childhood Acute Lymphocytic Leukemia Consumption Control Groups Diet Dietary Intervention Dietary intake Disease-Free Survival Eating Effectiveness of Interventions Environmental Risk Factor Exposure to Family Fatigue Fatty acid glycerol esters General Population Goals Health Home environment Hour Inflammation Institution Interleukin-6 Intervention Intervention Studies Intervention Trial Late Effects Leukemia Acute Lymphoblastic Chemotherapy Malignant Childhood Neoplasm Malignant Neoplasms Malondialdehyde Modeling National Institute of Diabetes and Digestive and Kidney Diseases Obesity Outcome Assessment Oxidative Stress Parenting behavior Parents Participant Pattern Peroxidases Physical activity Physical activity scale Physiological Pilot Projects Randomized Randomized Controlled Trials Relative (related person)Reporting Risk Role Sample Size Social Change Stress Survivors Telephone Testing Time Treatment Efficacy Tumor Necrosis Factor-alpha Weight Weight Gain arm base behavior change cancer recurrence cancer therapy chemotherapy childhood cancer survivor cost fast food follow-up fruits and vegetables group intervention improved lifestyle intervention meetings motivational enhancement therapy nutrition oxidized low density lipoprotein prevent programs public health relevance satisfaction stem success sugar sweetened beverage treatment as usual tv watching waist circumference

项目摘要

DESCRIPTION (provided by applicant): Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, accounting for 25% of all childhood malignancies. Treatment of childhood ALL has a high success rate, with long-term event-free survival of >85%. Treatment success, however, has not come without cost. Recognition of long-term health problems related to childhood cancer therapies is growing. Both during and after therapy, children treated for ALL are at risk for fatigue, reduced physical activity, poor dietary intake, and excessive weight gain, which are driven by physiological (chemotherapy-induced) changes and social (home/environmental) factors. Specifically, chemotherapy-related inflammation and oxidative stress contribute to fatigue and weight gain, which are sustained by low levels of physical activity, poor dietary intake, and home environmental factors. Very few randomized controlled trials have been directed towards minimizing the negative impact of cancer treatment on body weight, diet, and activity levels in children after ALL. Previous studies have been predominantly center- based interventions, which are time consuming for families and difficult to replicate in standardized fashion across institutions, resulting in poor attendance and completion rates and small sample sizes. Moreover, most intervention studies have not paired physical activity with nutrition guidance and few have focused on young children. The goals of this pilot study are to evaluate the feasibility, acceptability, and potential efficacy of a parent-targeted, phone-delivered nutrition and physical activity program to prevent unhealthy weight gain among 60 childhood ALL survivors, 3-10 years of age. Unlike previous lifestyle-intervention studies among pediatric cancer survivors, our approach directly engages parents to modify home environmental factors related to physical activity and dietary intake to reduce fatigue, disrupt th cycle of inflammation and oxidative stress, and prevent unhealthy weight gain after chemotherapy. Intervention success in this pilot study will be benchmarked by changes in key weight-related behaviors (physical activity and dietary intake) over the 6- month trial, and initia impact of the intervention on biomarkers of inflammation and oxidative stress, fatigue, and body composition will be examined. The role of potential moderators of adherence, acceptability, and efficacy will also be explored (i.e., parenting stress, perceived child vulnerability). Findings frm this study will be used to inform a broader grant application to evaluate the efficacy of this intervention in a large-scale, multisite trial. As a first step, the proposed study would provide important scientific and practical information regarding the feasibility of delivering this intervention, the attractiveness of such programs to parents of childhood cancer survivors, and the potential effectiveness of the intervention for promoting healthy dietary intake, physical activity patterns and healthy weight, reducing fatigue, and improving biomarkers of inflammation and oxidative stress in children who have completed chemotherapy for ALL.

描述（由申请人提供）：急性淋巴细胞白血病 (ALL) 是最常见的儿童癌症，占所有儿童恶性肿瘤的 25%。儿童 ALL 的治疗成功率很高，长期无事件生存率 >85%。然而，治疗的成功并非没有代价。人们越来越认识到与儿童癌症治疗相关的长期健康问题。在治疗期间和治疗后，接受 ALL 治疗的儿童都面临疲劳、体力活动减少、饮食摄入不良和体重过度增加的风险，这是由生理（化疗引起的）变化和社会（家庭/环境）因素驱动的。具体来说，化疗相关的炎症和氧化应激会导致疲劳和体重增加，而身体活动水平低、饮食摄入不良和家庭环境因素会导致疲劳和体重增加。很少有随机对照试验旨在最大限度地减少癌症治疗对 ALL 后儿童体重、饮食和活动水平的负面影响。以前的研究主要是基于中心的干预措施，这对家庭来说非常耗时，并且难以在各个机构之间以标准化方式复制，导致出勤率和完成率较低以及样本量较小。此外，大多数干预研究并未将身体活动与营养指导结合起来，而且很少关注幼儿。这项试点研究的目标是评估以家长为目标、电话提供的营养和体育活动计划的可行性、可接受性和潜在功效，以防止 60 名 3-10 岁儿童 ALL 幸存者出现不健康的体重增加。与之前针对儿科癌症幸存者的生活方式干预研究不同，我们的方法直接让父母改变与体力活动和饮食摄入相关的家庭环境因素，以减少疲劳，破坏炎症和氧化应激的循环，并防止化疗后不健康的体重增加。本试点研究中的干预措施是否成功，将以 6 个月试验期间与体重相关的关键行为（体力活动和饮食摄入）的变化以及干预措施对炎症和氧化应激、疲劳和身体成分等生物标志物的初始影响为基准。将接受检查。还将探讨依从性、可接受性和有效性的潜在调节因素的作用（即养育压力、感知到的儿童脆弱性）。这项研究的结果将用于为更广泛的拨款申请提供信息，以评估这种干预措施在大规模、多地点试验中的有效性。作为第一步，拟议的研究将提供重要的科学和实用信息，涉及实施这种干预措施的可行性、此类计划对儿童癌症幸存者父母的吸引力，以及干预措施在促进健康饮食摄入、身体活动方面的潜在有效性。模式和健康体重，减少疲劳，并改善已完成 ALL 化疗的儿童的炎症和氧化应激生物标志物。