Enhancing exercise motivation in young adults with lymphoma: A self–determination theory–guided intervention
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".