A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

BMC Public Health

Research

Heléne Dahlqvist¹  Mats Jong¹  Miek C. Jong²  Lars Beckman³  E. Anne Lown⁴  Winnie Schats⁵ 

[1] Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70, Sundsvall, Sweden;Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70, Sundsvall, Sweden;The Arctic University of Norway, National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, Hansine Hansens Veg 18, 9019, Tromsø, Norway;Department of Oncology, Sundsvall Hospital, 85186, Sundsvall, Sweden;Department of Social & Behavioral Sciences, University of California San Francisco, Box 0612, 490 Illinois Street, SBS, 94143, San Francisco, CA, USA;Scientific Information Service, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands;

关键词: Childhood cancer;    Health promotion;    Nature;    Nature-connectedness;    Oncology;    Quality of life;   

DOI  :  10.1186/s12889-023-16408-x

 received in 2022-12-08, accepted in 2023-07-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe majority of childhood, Adolescent and Young Adult (AYA) cancer survivors suffers from long-lasting health issues following cancer treatment. It is therefore critical to explore effective health promotion strategies to address their needs. Exposure to nature is a promising approach to support the needs of young cancer survivors. This study investigated whether it is feasible to conduct a randomized controlled trial (RCT) of a wilderness program for childhood and AYA cancer survivors.MethodsEligible participants were aged 16–39 years, had a cancer diagnosis, and met minimal criteria. Seventy-one individuals expressed interest and 59 were randomized to either a wilderness or a holiday program. The wilderness program involved an 8-day expedition including backpacking, sea kayaking, gorge climbing, camping, bush-craft skills, and mindfulness-practices. It was followed by a 4-day basecamp after 3 months. The comparison was an 8-day holiday program at a Spa-hotel followed by a 4-day holiday program at the same hotel after 3 months. Primary outcome was study feasibility and safety.ResultsUltimately, 19 AYAs participated in the wilderness and 23 in the holiday program. All completed the study at one-year follow-up. Participants were mostly female (70%) and represented diverse cancers. Clinical characteristics were similar between study arms excepting greater age at cancer diagnosis in the wilderness program (age 19.1 vs. 12.5; p = 0.024). Program adherence and data completeness was high (> 90%) in both arms. Adverse Effects (AEs) in the wilderness vs. the holiday program were similar (Relative Risk: 1.0, 95% Confidence Interval 0.8–1.3). The most frequent AE was tiredness, all were mild to moderate in severity, and serious AEs were not reported. Nature connectedness significantly increased over time in the wilderness program participants, but not in the holiday program (p < 0.001). No differences were found between the two study arms regarding quality of life, self-esteem, or self-efficacy.ConclusionIt is feasible to conduct a RCT and a supervised wilderness adventure is equally safe for childhood and AYA cancer survivors as a holiday program. This pilot study lays the foundation for a larger RCT to investigate the effectiveness of wilderness programs on the health of young cancer survivors.Trial registration date and number18/02/2021, NCT04761042 (clinicaltrials.gov).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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