Web-based Physical Activity Intervention for Children with ALL

被诊断为急性淋巴细胞白血病(ALL)的儿童的五年存活率已超过 90%。不幸的是，治愈并不是没有后果的。所有幸存者患肥胖症、骨质疏松症的风险都很高。 矿物质密度、心肌病、周围神经病和心理社会功能改变。研究是 迫切需要为幸存者提供改善其长期健康状况的工具。因为患有白血病的儿童 很可能采取久坐不动的生活方式，这是因为久坐不动的生活方式 可能会使所有幸存者经历的许多并发症永久化或加剧，便携式和 促进体力活动并影响心脏代谢健康和生物标记物的一般性干预 治疗后第一年的健康可能特别有益。此方案旨在访问 儿童肿瘤学小组(COG)的资源，并补充正在进行的治疗方案。它会抽签的 在组委会现有的基础设施和专业知识的基础上，招募完成后的儿童样本 儿童ALL的治疗。本研究的主要目标是评估以奖励为基础的 在为期六个月的时间里，通过一个面向ALL儿童的互动网站进行身体活动干预 从根治性化疗结束后前三个月的任何时间开始，关于健康、生物标记物 心脏代谢健康、炎症、脂肪因子状态、生活质量和学校出勤率。我们也 计划评估干预对心脏代谢健康标记物的影响是否受变化的影响 在健身方面。为了实现这一目标，我们设计了一项双臂、前瞻性、随机研究，并提供了以下奖励： 基础干预组(N=192)和对照组(N=192)。对照组将接受教育 鼓励体力活动的材料，包括关于共同活动修改的信息 神经肌肉骨骼缺陷(如神经病、虚弱)，以及记录体力活动的活动监测器 级别。干预组将收到相同的教育材料、活动监控器和访问 以奖励为基础的互动网站，旨在激发更多的体力活动。干预组 参赛者将根据体力活动水平获得积分。积分兑换小礼品卡(5美元) 在研究过程中。根据我们的初步研究，儿童/青少年平均将获得8份礼物 扑克牌。个人体力活动水平被上传到网站(确认数据上传 对于控制组参与者，并为干预组配备交互式视频游戏型仪表板 当活动监视器连接到计算机时，参与者)。提供奖励和鼓励 由网站根据干预参与者测量的体力活动水平计算。孩子们最初是 不太活跃的人仍然会获得积分，因为奖励制度是基于个人的基线体力活动。评估 时间点计划在基线、干预后和干预后六个月和一年 完成。

The five year survival rate among children diagnosed with acute lymphoblastic leukemia (ALL) has surpassed 90%. Unfortunately, cure is not without consequences. ALL survivors are at elevated risk for obesity, low bone mineral density, cardiomyopathy, peripheral neuropathy, and altered psychosocial functioning. Research is critically needed to provide survivors with tools to improve their long term health. Because children with leukemia are likely to adopt a sedentary lifestyle that persists long into survivorship, and because a sedentary lifestyle may perpetuate or exacerbate many of the complications experienced by ALL survivors, a portable and generalizable intervention that promotes physical activity and impacts fitness and biomarkers of cardiometabolic health in the first year after treatment may be of particular benefit. This proposal is designed to access the resources of the Children's Oncology Group (COG) and complements ongoing therapeutic protocols. It will draw upon the existing infrastructure and expertise of the COG to recruit a sample of children as they complete treatment for childhood ALL. The primary goals of this study are to evaluate the effects of a rewards-based physical activity intervention, delivered via an interactive website for children with ALL, during a six month period beginning any time during the first three months after the end of curative chemotherapy, on fitness, biomarkers of cardiometabolic health, inflammation, adipokine status, quality of life and school attendance. We also plan to evaluate if the effects of the intervention on markers of cardiometabolic health are mediated by changes in fitness. To achieve this goal we have designed a two-arm, prospective, randomized study with a rewards- based intervention group (N=192) and a control group (N=192). The control group will receive educational materials encouraging physical activity, including information about activity modifications for common neuromusculoskeletal deficits (e.g. neuropathy, weakness), and an activity monitor to record physical activity levels. The intervention group will receive the same educational materials, the activity monitor, and access to a rewards-based interactive website designed to motivate increased levels of physical activity. Intervention group participants will receive points based on physical activity levels. Points are redeemed for small gift cards ($5.00) during the course of the study. Based on our pilot study, the average child/adolescent will earn eight gift cards. Individual physical activity levels are uploaded to the website (with acknowledgement of the data upload for control group participants, and with an interactive video game-type dashboard for intervention group participants when the activity monitor is connected to a computer). Rewards and encouragement are provided by the website based on the intervention participants' measured physical activity levels. Children who are initially less active still earn points as the rewards system is based on individual baseline physical activity. Evaluation time points are planned at baseline, after intervention, and six months and one year after the intervention is completed.