KAM: Kids Are Moving
Condition: Children With Cancer; Fatigue; Physical Activity
MeSH terms: Fatigue
Study type: Interventional

Summary: 
      During cancer treatment children are less active than their health peers. This inactivity
      persists into survivorship and can negatively affect health and quality of life. Physical
      activity may also improve fatigue, a prevalent and distressing symptom during treatment.
      Improving health behaviors during treatment can have lifelong benefits for cancer survivors.
      In this study, the effectiveness of the "Kids are Moving" exercise program will be evaluated.
      The exercise program will follow program guidelines set up by the American College of Sports
      Medicine and will be adapted for children with cancer. Children ages 6 to 18 years, who are
      receiving chemotherapy, and their parents, will be coached on how to increase their physical
      activity and will receive an exercise prescription. This will occur as part of the standard
      care they receive from the nurse practitioners during the first six months of their
      outpatient visits. Investigators want to find out if children in the Kids are Moving program
      are more active and have less fatigue. Activity will be measured through patient
      questionnaires about activity and fatigue, and by wearing the FitBit activity tracker and an
      actigraph. Outcomes will be compared to measurements collected from children who received
      usual care before the exercise program started.

      Physical activity is a vital for improving health and quality of life and for providing
      energy for engaging in positive life experiences as children move along the developmental
      continuum to a long and healthy future. Outcomes of the study will provide a foundation for
      larger multi-site clinical trials.
    

Detailed description: 
      During cancer treatment children are significantly less active than their healthy peers. This
      inactivity persists into survivorship, negatively influencing their health and quality of
      life. Physical activity may also improve fatigue, a near-universal and distressing symptom
      during treatment. Improving health behaviors during treatment can have lifelong benefit.

      The goal of this study is to evaluate the effectiveness of the Kids are Moving exercise
      program that is delivered by nurse practitioners (NP's) during outpatient care provided to a
      specific population of children. The study will be conducted at two pediatric cancer
      treatment sites and will translate the American College of Sports Medicine's program,
      Exercise is Medicine into practice. In this quasi-experimental design, children will receive
      the study intervention, which includes exercise coaching and prescription, that is be
      incorporated into the standard care they receive from the nurse practitioners during their
      outpatient visits. Outcomes will be compared to historical control measurements of children
      who received usual care. Study aims are to:

        1. To compare measurements of activity levels of children receiving exercise coaching over
           the first 6 months of cancer treatment as measured by self-report and the FitBit Flex
           tracker

        2. To compare activity levels of children receiving exercise coaching during cancer
           treatment as measured by self-report and the FitBit Flex tracker, to activity levels of
           children in the historical control group receiving usual care during cancer treatment.

        3. To evaluate the influence of activity levels on fatigue experience by children receiving
           cancer treatment

      Children ages 6 to 18, and their parents, will be invited to participate in study
      measurements which will be completed at the 2nd, 4th, and 6th months of cancer treatment.
      Patients will be included if recently diagnosed with cancer (excluding bone tumors and bone
      metastasis), and ambulatory. Validated self-report instruments will be used to measure
      activity and fatigue. Additionally, the FitBit Flex tracker, a device that measures steps/day
      and motion in three dimensions and an actigraph, will be worn by subjects over a 3 day period
      for each measurement point.

      Physical activity is a vital intervention for improving health and quality of life and for
      providing energy for engaging in positive life experiences that advance children along the
      developmental continuum to a long and healthy future. Outcomes of the study will provide a
      foundation for larger multi-site clinical trials.
    

Intervention name(s): Physical activity coaching
Intervention type(s): Other
Intervention description(s): Children and adolescents will receive the study intervention, which includes exercise coaching and prescription, that is be incorporated into the standard care they receive from the nurse practitioners during their outpatient visits.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: children with cancer; fatigue; physical activity