Enhancing exercise motivation in young adults with lymphoma: A self–determination theory–guided intervention
Notice bibliographique
Résumé
Background: Despite the rapidly emerging evidence on the contributions of physical activity to improving cancer-related health outcomes, adherence to physical activity guidelines among young adults (YAs) with lymphoma remains suboptimal. Lack of motivation is a frequently reported psychological barrier to physical activity engagement in this population. This warrants the development of interventions that can enhance exercise motivation and physical activity levels sufficient to improve cancer outcomes. Guided by the self-determination theory (SDT), a macro-theory of human motivation, the virtual exercise intervention named Lymfit (a 12-week individualized exercise program supplemented with bi-weekly kinesiologist support and activity tracking) was developed to enhance exercise motivation among YAs diagnosed with lymphoma. In this doctoral thesis, a conceptual analysis was first conducted to explore the concept of “health promotion motivation” in the context of cancer survivorship. Then, a comprehensive review was conducted to evaluate the methodological considerations in exercise intervention research, particularly focusing on control group designs in randomized controlled trials (RCTs). The findings of these two works informed the refinement of the preliminary version of Lymfit and the design of its pilot RCT.Objectives: To conduct a pilot RCT to evaluate the feasibility, acceptability and preliminary effects of Lymfit on four self-reported study outcomes: psychological need satisfaction, exercise motivation, physical activity level, and health-related quality of life among YAs with lymphoma.Methods: A two-armed pilot RCT was conducted. Study participants were recruited from two university-affiliated hospitals in Montréal, Canada. Consented patients were randomly assigned one-to-one, with stratification by chemotherapy status, into the intervention or a wait-list control group. Feasibility was assessed by a set of predetermined a-priori benchmarks. Acceptability was assessed using a 10-item questionnaire collected at the post-intervention. Preliminary effects were assessed using validated questionnaires collected at baseline before randomization, and post-intervention on four self-reported study outcomes. Analysis of covariance models were used to compare post-intervention group differences for the study outcomes between the two groups. For each outcome, an effect size of at least 0.2 was set as the benchmark. Additionally, the minimal important change was calculated for quality of life domains, with a threshold of four T-score points changes to be considered meaningful. Results: 41 patients were screened for eligibility; 26 (63.4%) were enrolled in the study and were randomized into the two study groups (intervention group n = 13, wait-list control group n = 13). All a-priori feasibility benchmarks were met, including a 100% retention rate of the wait-list control group participants, confirming the feasibility of the study control group design. Intervention acceptability assessment showed high ratings, with eight out of ten items receiving a score of four or above on a five-point Likert scale. The benchmark for an effect size of at least 0.2 was met on all four main study outcomes. Lymfit also led to meaningful within-group changes in six quality of life domains in the intervention group, and meaningful between-group comparisons in seven domains. Conclusion: The study results show that Lymfit is a highly feasible and accepted intervention among YAs with lymphoma. Further, the findings support Lymfit as a promising means to promote psychological needs, exercise motivation, physical activity level and quality of life in this group. A fully powered efficacy trial is warranted to assess the validity of these findings on a larger population. If further corroborated, self-determination theory-guided interventions may be more broadly implemented to promote exercise motivation and quality of life among YA cancer survivors.Keywords. young adult cancer survivors, lymphoma, exercise motivation, exercise intervention, self-determination theory, pilot feasibility study, randomized controlled trial
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».