title: Sustainability of an Integrated Adventure-Based Training and Health Education Program to Enhance Quality of Life Among Chinese Childhood Cancer Survivors: A Randomized Controlled Trial.
abstract: BACKGROUND
  Physical activity is of paramount importance to enhance the quality of life of childhood cancer survivors.
  
  
  OBJECTIVE
  The objectives of this study were to examine the sustainability, feasibility, and acceptability of an adventure-based training and health education program in changing the exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors.
  
  
  METHODS
  A follow-up study (12 and 18 months) of a previous study was conducted. Participants in the experimental group (n = 33) joined a 4-day integrated adventure-based training and health education program. The control group (n = 36) received the standard medical care. Changes in exercise behavior, levels of physical activity, self-efficacy, and quality of life were assessed from the time of recruitment, and at 12 and 18 months after starting the intervention. Process evaluation was conducted to determine whether the program was feasible and acceptable to participants.
  
  
  RESULTS
  From baseline to 18 months after the intervention, the experimental group reported statistically significant differences in the stages of change in physical activity and higher levels of physical activity, self-efficacy, and quality of life than did the control group. The results of process evaluation revealed that the program was both feasible and acceptable to participants.
  
  
  CONCLUSIONS
  The program was found to have substantial effects on enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors over at least 18 months.
  
  
  CONCLUSIONS
  Healthcare professionals should consider adopting such programs to promote the regular physical activity among childhood cancer survivors.
authors.affiliation: Author Affiliations: School of Nursing, Lee Ka Shing Faculty of Medicine, the University of Hong Kong (Drs Li and Chung and Ms Ho); and Paediatric Oncology Unit, Queen Mary Hospital, Hong Kong (Ms Chiu); Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore (Prof Lopez).
authors.forename: Oi Kwan Joyce
authors.initials: OK
authors.lastname: Chung
authors.forename: Ho Cheung William
authors.initials: HC
authors.lastname: Li
authors.forename: Sau Ying
authors.initials: SY
authors.lastname: Chiu
authors.forename: Ka Yan
authors.initials: KY
authors.lastname: Ho
authors.forename: Violeta
authors.initials: V
authors.lastname: Lopez
mesh_terms: D002648:Child; D015444:Exercise / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006723:Hong Kong; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D011788:Quality of Life; D020377:Self Efficacy; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data