Building blocks to promote healthy eating and physical activity among childhood central nervous system tumor survivors
Rapid increase in body mass index (BMI) has been noted among childhood central nervous system tumor survivors (CNSTS) compared to the cancer-free pediatric population. Adolescent and young adult (AYA) CNSTS also are at higher risk for developing long-term health problems such as dysfunction of endocrine, cardiovascular, and neurocognitive systems in comparison to cancer-free population. Development of obesity is a major concern among childhood and AYA CNSTS because it may exacerbate the risk of other chronic health conditions. Currently there is limited information regarding the underlying factors that may influence changes in BMI among childhood CNSTS. There are no validated assessments to screen for possible disordered eating behaviors that can accommodate neurological dysfunction of childhood AYA CNSTS, and little known about the needs of childhood CNSTS and their families for information about weight management. Thus, the purpose of this study is to identify factors that influence BMI trajectories among adult childhood CNSTS (Aim1), to adapt an existing eating behavior assessment measure for use with childhood and AYA CNSTS (Aim 2), and to identify weight management needs for childhood CNSTS and families (Aim 3). Research design and methods for each of the aims include, 1) secondary data analysis using linear mixed models using childhood cancer survivor cohort data (Aim1), 2) cross-sectional pilot study using confirmatory factor analysis among childhood and AYA CNSTS (Aim 2), and 3) complete thematic content analysis on group interview data collected among a group of adolescent childhood CNSTS and mothers (Aim 3). From our studies we found several factors that are amenable to change. We found that childhood CNSTS who have physical limitations or are using antipsychotic medications may be more vulnerable to weight gain. We also found that emotional eating is associated with BMI. Our qualitative results highlighted the need to address uncertainty in cancer survivorship, for it may influence whether or not families adopt health promotional behavior. Identifying factors that influence BMI trajectories, developing assessments that can accommodate neurological dysfunction and identifying weight management needs are important to inform evidence-based long-term cancer survivorship care guidelines for childhood and AYA CNSTS.
Swartz, Maria Ching-Yi Chang, "Building blocks to promote healthy eating and physical activity among childhood central nervous system tumor survivors" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3665058.