Access to Physical Activity Programmes and Cancer Support in Young Adults Living with and Beyond Cancer Through the Lens of Cancer Inequalities

接受癌症诊断的年轻人数量正在增加，估计每年有超过14，600名20多岁和30多岁的人在英国被诊断出来。这个年龄段在文献中的研究，尽管年轻人面临着可能危及生命的诊断的独特需求。癌症护理的发展显著提高了青少年和年轻成年癌症幸存者的生存率，从而使越来越多的人摆脱了癌症。对于年轻的成年癌症幸存者来说，这可能意味着他们生命中的很大一部分时间都是在风险和合并症增加的情况下度过的。因此，被诊断患有癌症的年轻人是人口中的一个弱势亚群体，他们从心理和生理角度来看都面临着一些独特的挑战;他们已经过了青春期，但尚未达到老年人服务的需要。因此，人们认识到，需要为年轻人提供干预措施和循证服务，以促进整个癌症护理过程及以后的身体和心理健康。总部位于英国的癌症慈善机构Trekstock致力于确保20多岁和30多岁的年轻人能够获得必要的，量身定制的支持，以应对癌症诊断的心理社会和身体影响。随着强有力的证据强调身体活动对改善癌症患者心理健康结果的重要性，其提供的一个方面涉及为年轻人提供结构化的身体活动计划。文献中广泛承认，身体活动可以改善多种健康措施，并在整个癌症护理过程中降低残疾风险。有证据表明，患有癌症的年轻人久坐不动的行为可能导致生活质量下降，并在治疗期间增加肿瘤。同样，研究表明，身体活动可以在癌症治疗结束后使个人受益，无论是在情感健康方面还是在癌症治疗的身体后遗症中。然而，尽管有已知的好处，但在癌症诊断期间和之后，这一人群的身体活动水平仍然很低。因此，本研究项目旨在评估和优化Trekstock的体育活动服务提供，特别强调这个年龄组的癌症不平等。从文献中可以明显看出，这一领域的研究主要由女性和白色英国人参与。在这项拟议的研究中，我们的目标是探索这种差异，以确保所有面临癌症的年轻人都能获得量身定制的体力活动支持。首先，将对已发表的灰色文献进行系统审查，以探讨围绕这些不平等现象的知识差距。此外，这项研究将研究癌症患者和癌症患者参与体育活动的障碍和促进因素。建议的研究问题包括：1）哪些不平等影响获得癌症支持计划？2)如何解决在参与体育活动方案方面的这些不平等现象？3)当前体育活动服务存在哪些差距，如何解决？4)为解决患有癌症和癌症以外的年轻人的不平等问题而制定体育活动方案的影响是什么？对于面临类似治疗负担和后遗症的其他人群，本研究旨在推进这一领域的知识，并增加所有面临癌症诊断的年轻人的体育活动计划的可及性。

The number of young adults who receive a cancer diagnosis is increasing, with estimates suggesting more than 14,600 individuals in their 20s and 30s are diagnosed each year in the UK. This age bracket is under researched within the literature, despite the distinct needs of young adults facing a potentially life-threatening diagnosis. Developments in cancer care have markedly improved the survival rates of adolescent and young adult cancer survivors, whereby an increased number of individuals are living beyond cancer. For young adult cancer survivors, this can mean a significant proportion of their life is spent with increased risks and comorbidities. Young adults diagnosed with cancer therefore represent a vulnerable sub-group of the population, who, from both a psychological and physiological perspective face number of unique challenges; having passed puberty, but not yet reached the needs of older adult services. It has therefore been recognised that interventions and evidence-based provisions are needed for young adults, to promote physical and psychosocial wellbeing throughout the cancer care continuum and beyond. UK-based cancer charity, Trekstock, work to ensure young adults in their 20s and 30s living with and beyond cancer have access to essential, tailored support to deal with the psychosocial and physical impact of a cancer diagnosis. With robust evidence highlighting the importance of physical activity to improve psychosocial wellbeing outcomes for individuals living with cancer, one aspect of their provision involves access to structured physical activity programmes for young adults. It is widely acknowledged within the literature that physical activity can improve a multitude of health measures and reduce the risk of disability throughout the cancer care continuum. Evidence suggests high rates of sedentary behaviour in young adults with cancer may result in worse quality of life and increased symptomology during treatment. Similarly, research suggests that physical activity can benefit individuals following the end of cancer treatment, both in terms of emotional wellbeing and in living with the physical after-effects of cancer treatment. However, despite the known benefits, physical activity levels remain low amongst this population group, both during and following a cancer diagnosis. The present research project therefore aims to evaluate and optimise Trekstock's physical activity service provision, with particular emphasis on cancer inequalities in this age group. It is evident from the literature that research in this field is dominated by participants identifying as female and white British. In this proposed study, we aim to explore this disparity with the ambition of ensuring all young adults facing cancer can access tailored physical activity support. Initially, a systematic review of published and grey literature will be undertaken to explore the gap in knowledge surrounding these inequalities. Further, this research will examine the barriers and facilitators to engaging in physical activity experienced by individuals living both with and beyond cancer. Proposed research questions include: 1) What inequalities affect access to cancer support programmes? 2) How can these inequalities in accessing physical activity programmes be addressed? 3) What are the gaps in current physical activity services and how can they be addressed? 4) What is the impact of tailoring physical activity programmes to address inequalities in young people living with and beyond cancer? With implications for other population groups facing a similar treatment burden and after-effects, this research intends to advance knowledge in this field, and increase the accessibility of physical activity programmes for all young adults facing a cancer diagnosis.