Abstract
Background
Physical activity (PA) benefits young adults living with and beyond cancer, yet participation remains low. This pilot randomized controlled trial (RCT) evaluated the feasibility and acceptability of a PA behavior counseling intervention for young adults post-cancer treatment and trial methods.
Methods
A mixed-methods, open-label, parallel, two-arm pilot RCT was conducted with young adults recruited nationwide (Canada) by healthcare provider referral or advertising. Eligible participants were 18–39 years (with a first diagnosis of invasive, non-metastatic cancer at age 18–39 years), had completed active treatment for invasive, non-metastatic cancer < 5 years prior, self-reported < 150 min of moderate-to-vigorous intensity PA weekly, were fluent in English, and had access to/computer literacy for videoconferencing technology. Young adults were randomized to receive a 12-week individualized PA behavior counseling intervention delivered via videoconferencing technology by PA counselors or usual care. Informed by self-determination theory, the intervention emphasized autonomy support and applied motivational interviewing. Staff tracked feasibility and acceptability outcomes regarding enrollment, allocation, retention, adherence, and adverse events. Young adults and PA counselors were interviewed post-intervention (T1; primary endpoint) and at trial completion, respectively. Planned efficacy outcomes were assessed using accelerometers and online surveys at baseline (T0), T1, and follow-up (T2; secondary endpoint; 24 weeks post-baseline).
Results
Seventy-four young adults were screened for eligibility (recruitment rate ~ 4/month over 18 months); 47 (63.5%) were eligible, of which 42 (89%) consented, completed T0 assessments, and were randomized. Most (75% [15/20]) allocated to receive the intervention completed all sessions. Retention rates were 85.7% (T0 to T1 [36/42]) and 71.4% (T0 to T2 [30/42]). Analyzable data for the primary efficacy outcome (PA behavior) were available for 57.1% (24/42) at T1. Content analysis of interviews with 35 (80.0%) young adults and both (100.0%) PA counselors yielded three themes reflecting factors that positively impacted intervention acceptability and one theme reflecting factors that negatively impacted the trial methods’ acceptability, as well as recommendations to optimize the trial methods and intervention.
Conclusions
The trial methods and intervention were largely feasible and acceptable for young adults post-cancer treatment, although modifications are required to optimize recruitment strategies, enhance retention at follow-up, refine the intervention, and reduce missing data. A full-scale RCT to assess the efficacy of the intervention and estimate concomitant costs is warranted.
Physical activity (PA) benefits young adults living with and beyond cancer, yet participation remains low. This pilot randomized controlled trial (RCT) evaluated the feasibility and acceptability of a PA behavior counseling intervention for young adults post-cancer treatment and trial methods.
Methods
A mixed-methods, open-label, parallel, two-arm pilot RCT was conducted with young adults recruited nationwide (Canada) by healthcare provider referral or advertising. Eligible participants were 18–39 years (with a first diagnosis of invasive, non-metastatic cancer at age 18–39 years), had completed active treatment for invasive, non-metastatic cancer < 5 years prior, self-reported < 150 min of moderate-to-vigorous intensity PA weekly, were fluent in English, and had access to/computer literacy for videoconferencing technology. Young adults were randomized to receive a 12-week individualized PA behavior counseling intervention delivered via videoconferencing technology by PA counselors or usual care. Informed by self-determination theory, the intervention emphasized autonomy support and applied motivational interviewing. Staff tracked feasibility and acceptability outcomes regarding enrollment, allocation, retention, adherence, and adverse events. Young adults and PA counselors were interviewed post-intervention (T1; primary endpoint) and at trial completion, respectively. Planned efficacy outcomes were assessed using accelerometers and online surveys at baseline (T0), T1, and follow-up (T2; secondary endpoint; 24 weeks post-baseline).
Results
Seventy-four young adults were screened for eligibility (recruitment rate ~ 4/month over 18 months); 47 (63.5%) were eligible, of which 42 (89%) consented, completed T0 assessments, and were randomized. Most (75% [15/20]) allocated to receive the intervention completed all sessions. Retention rates were 85.7% (T0 to T1 [36/42]) and 71.4% (T0 to T2 [30/42]). Analyzable data for the primary efficacy outcome (PA behavior) were available for 57.1% (24/42) at T1. Content analysis of interviews with 35 (80.0%) young adults and both (100.0%) PA counselors yielded three themes reflecting factors that positively impacted intervention acceptability and one theme reflecting factors that negatively impacted the trial methods’ acceptability, as well as recommendations to optimize the trial methods and intervention.
Conclusions
The trial methods and intervention were largely feasible and acceptable for young adults post-cancer treatment, although modifications are required to optimize recruitment strategies, enhance retention at follow-up, refine the intervention, and reduce missing data. A full-scale RCT to assess the efficacy of the intervention and estimate concomitant costs is warranted.
| Original language | English |
|---|---|
| Article number | 131 |
| Journal | Pilot and Feasibility Studies |
| Volume | 11 |
| Early online date | 4 Nov 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 4 Nov 2025 |
Data Availability Statement
The data analyzed for the current study are not publicly available nor available upon request to protect the privacy of the participants. Young adult participants did not consent to have their data shared with persons outside the research team. Trial materials (i.e., informed consent form, interview guides, surveys) will be made available upon reasonable request to the corresponding author up to 5 years after article publication. Requests should be directed to [email protected].Acknowledgements
The authors thank Dr. Julia Hussien who helped manage data gathered for the physicAl aCtivity Counseling for young adult cancEr SurvivorS (ACCESS) trial, analyzed data reported in this manuscript, and provided helpful suggestions. The authors also thank all individuals who supported trial activities, Darien Wrona who assisted with the analysis of the qualitative data, the young adults and physical activity counselors for their participation and generous sharing of time and insights, and The Ottawa Hospital for granting access to its registry. This trial was conducted while JP was supported by a Joseph-Armand Bombardier Canada Graduate Doctoral Scholarship. JB holds a Tier II Canada Research Chair in Physical Activity Promotion for Cancer Prevention and Survivorship.Funding
A Strategic Research Support Grant provided by the Faculty of Health Sciences at the University of Ottawa to JB supported the implementation of the physicAl aCtivity Counseling for young adult cancEr SurvivorS (ACCESS) trial.
