17th Dec 2023

Introduction: During childhood cancer treatment, physical activity (PA) levels of the child and their family can decline. Maintaining PA during treatment has treatment-specific benefits for the child and can improve the physical and mental health of all family members. During treatment, PA is not prioritised, and the barriers are difficult to overcome. Whole family engagement in PA could facilitate behaviour change. This study aimed to use the Behaviour Change Wheel (BCW) to design an intervention to improve the PA levels of the whole family during childhood cancer treatment using evidence from families of childhood cancer survivors. Methods: Development followed three stages. First, to understand the behaviour, qualitative research methods were utilised to explore barriers, facilitators, and experiences of PA during treatment for the family. Transcripts of three family focus groups and 18 semi-structured interviews with parents were analysed and coded using the Capabilities, Opportunities and Motivation Behaviours (COM-B) model. Second, intervention options were identified using the BCW. Third, implementation options via suitable behaviour change techniques (BCT) and modes of delivery were identified.
Results: The Active Living for Families intervention (ALFIE) was developed to target PA for the whole family of childhood cancer patients during treatment. This flexible, family-based intervention is comprised of eight components including education sessions, goal setting and prompts. Using the BCW framework, this multi-component intervention targets six intervention functions including education,
training, and environmental restructuring, and 19 BCTs including goal setting and adding objects to the environment. Conclusions: The application of the BCW allowed for systematic, theory-driven development and design of the intervention to target physical activity for families during a child’s treatment for cancer. The feasibility of this intervention will be examined.