title: Fit4Life: a weight loss intervention for children who have survived childhood leukemia.
abstract: BACKGROUND
  Children surviving acute lymphoblastic leukemia (ALL) are at increased risk for overweight and obesity over that of the general population. Whether a generic or tailored approach to weight management is needed for cancer survivors has yet to be tested.
  
  
  METHODS
  Thirty-eight youth 8-18 years with BMI ≥ 85% who had survived ALL were recruited for a randomized clinical trial evaluating a weight management intervention (WMI) tailored for childhood ALL survivors (Fit4Life). Fit4Life recipients received a 4-month web, phone, and text message-delivered WMI tailored for cancer survivorship. Controls received a general WMI delivered via phone and mail. Assessments were performed at baseline and 4 months. Outcome data were analyzed according to assigned treatment condition over time.
  
  
  RESULTS
  Most (80%, (70%, 100%) [median (IQR)]) of the assigned curriculum was received by Fit4Life participants as compared to 50% (40%, 65%) among controls. Fit4Life recipients ≥ 14 years demonstrated less weight gain (P = 0.05) and increased moderate-to-vigorous physical activity (P < 0.01) while all Fit4Life recipients reported reduced negative mood (P < 0.05) over time as compared to control counterparts.
  
  
  CONCLUSIONS
  We demonstrated acceptable feasibility of a WMI tailored for overweight and obese children surviving ALL utilizing a multimodal technology approach. Improved weight, weight-related behavior, and psychological outcomes were demonstrated among Fit4Life intervention as compared to youth receiving a generic WMI. Data from this pilot trial may be used to design a larger trial to determine whether youth of all ages also can derive a benefit from a cancer survivor-tailored WMI and whether short-term outcomes translate into improved long-term outcomes for childhood ALL survivors.
authors.affiliation: Division of Gastroenterology, Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
authors.forename: Jeannie S
authors.initials: JS
authors.lastname: Huang
authors.forename: Lindsay
authors.initials: L
authors.lastname: Dillon
authors.forename: Laura
authors.initials: L
authors.lastname: Terrones
authors.forename: Lynn
authors.initials: L
authors.lastname: Schubert
authors.forename: William
authors.initials: W
authors.lastname: Roberts
authors.forename: Jerry
authors.initials: J
authors.lastname: Finklestein
authors.forename: Maria C
authors.initials: MC
authors.lastname: Swartz
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Norman
authors.forename: Kevin
authors.initials: K
authors.lastname: Patrick
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology / Q000534:rehabilitation*; D011379:Prognosis; D040242:Risk Reduction Behavior; D017741:Survivors / Q000523:psychology*; D015431:Weight Loss
keywords: childhood cancer; leukemia; survivorship; weight management