title: Effectiveness of an integrated adventure-based training and health education program in promoting regular physical activity among childhood cancer survivors.
abstract: BACKGROUND
  There is growing concern about declining levels of physical activity in childhood cancer survivors. This study aimed to examine the effectiveness of an integrated adventure-based training and health education program in promoting changes in exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of Hong Kong Chinese childhood cancer survivors.
  
  
  METHODS
  A randomized controlled trial, two-group pretest and repeated post-test, between-subjects design was conducted to 71 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 months after starting the intervention.
  
  
  RESULTS
  Participants in the experimental group reported statistically significant differences in physical activity stages of change (p < 0.001), higher levels of physical activity (p < 0.001) and self-efficacy (p = 0.04) than those in the control group. Besides, there were statistically significant mean differences (p < 0.001) in physical activity levels (-2.6), self-efficacy (-2.0), and quality of life (-4.3) of participants in the experimental group from baseline to 9 months after starting the intervention.
  
  
  CONCLUSIONS
  The integrated adventure-based training and health education program was found to be
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: H C William
authors.initials: HC
authors.lastname: Li
authors.forename: Oi Kwan Joyce
authors.initials: OK
authors.lastname: Chung
authors.forename: Ka Yan
authors.initials: KY
authors.lastname: Ho
authors.forename: Sau Ying
authors.initials: SY
authors.lastname: Chiu
authors.forename: Violeta
authors.initials: V
authors.lastname: Lopez
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015444:Exercise / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009369:Neoplasms / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome
keywords: Chinese; adventure-based training; childhood cancer; pediatric oncology; physical activity; self-efficacy