Psychosocial interventions to increase physical activity in young people living with and beyond cancer: a systematic review
Objectives: Despite significant evidence for the psychological and physical health benefits of physical activity for children and young people living with and beyond cancer, many still do not meet the recommended levels of physical activity (PA). Little is currently known about which behaviour change techniques and intervention components successfully promote PA for children and young people in this population. Design: A systematic review was conducted to identify primary papers describing physical activity interventions for children and young people living with and beyond cancer. Methods: Using Bronfenbrenner's ecological theory as a framework, we explored the key intervention components across domains known to predict PA for young cancer survivors (Gilliam et al., 2011). Results: Intervention components in the 14 review studies included: 1) behavioural (including goals and planning; Instruction on how to perform the behaviour, self-monitoring, credible source, information about the consequences, behavioural rehearsal, habit formation, feedback on behaviour, verbal persuasion about capability, graded tasks, biofeedback , 2) cognitive-emotional (targeting attitude, perceived behavioural control, intentions, resilience and achievement) 3) socio-cultural (family and peer support for PA), 4) environmental (providing access to resources, environmental restructuring, safety), 5) demographic, (ages 4-19) and 6) medical (provision of tailored exercise depending on age and cancer stage). Conclusions: Promising interventions for improving physical activity participation and adherence during and beyond cancer treatment for young people integrate psychosocial (behavioural, cognitive-emotional, social), environmental and medical intervention components. Our conceptual model can be used to inform the development of empirically-supported clinical interventions, as well as guiding future research objectives and priorities.