Protocol of a mixed-method randomised controlled pilot study evaluating a wilderness programme for adolescent and young adult cancer survivors: the WAYA study

Jong, Miek C.; Mulder, Eric; Kristoffersen, Agnete Egilsdatter; Dahlqvist, Heléne Zetterström; Viitasara, Eija; Lown, E. Anne; Schats, Winnie; Jong, Mats

doi:10.1136/bmjopen-2022-061502

Cited by 7 publications

(14 citation statements)

References 46 publications

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“…In the development of the previous pilot RCT design, considerable effort was invested to define an appropriate control group activity. 21 A hotel stay was chosen to control for attention from facilitators, group support and being away from their home environment. Although it might be expected that relaxation and connecting with other AYAs offer positive experiences and time to recharge, it is expected that these may have less impact on their health and well-being in the long term.…”

Section: Discussionmentioning

confidence: 99%

“… 20 Therefore, in 2021–2022, we performed a pilot study to investigate whether it would be feasible to perform an RCT design on a nature-based intervention. 21 For this pilot study, we developed a Wilderness programme for AYAs (WAYA programme) affected by cancer. The WAYA programme is grounded in Næss’s ecosophy 22 and the Positive Health Model.…”

Section: Introductionmentioning

confidence: 99%

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Protocol of a randomised controlled multicentre trial investigating the effectiveness and safety of a wilderness programme on the mental and physical well-being of adolescents and young adults affected by cancer: the WAYA-2 study

Jong,

Fernee,

Stenling

et al. 2024

BMJ Open

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IntroductionAdolescents and young adults (AYAs) affected by cancer are an understudied group. Effective interventions are needed to support coping with the late effects of cancer, its treatment and to promote quality of life. Nature-based interventions may be promising in support of the self-management and health of AYAs affected by cancer. However, randomised controlled studies (RCTs) on the effectiveness of such interventions are lacking. We performed a first pilot RCT (n=42) that showed that it is feasible and safe to conduct such a study. Here, we propose a full-scale RCT to investigate the effectiveness and safety of a wilderness programme on the mental and physical health of AYAs affected by cancer.Methods and analysisParticipants are 150 AYAs affected by cancer, aged 16–39 years, who will be randomised to a wilderness (n=75) or a hotel stay (n=75). The wilderness programme is an 8-day intervention including a 6-day wilderness expedition. This is followed 3 months later by a 4-day intervention including a 2-day basecamp. Activities include hiking, backpacking, kayaking, rock climbing, mindfulness and bush-crafting. The comparison group is an 8-day hotel stay followed by a 4-day hotel stay (interventions include two travel days) at the same hotel after 3 months. Primary outcomes are psychological well-being and nature connectedness up to 1 year after the study start. Secondary outcomes are quality of life, physical activity and safety parameters.Ethics and disseminationThe Swedish Ethical Review Authority approved the study protocol on 27 September 2023 (reference: 2023-05247-01). The recruitment started on 19 February 2024 and the first part is planned to end on 31 December 2027. Study results will be disseminated by means of scientific publications, presentations at conferences, popular articles, interviews, chronicles and books. News items will be spread via social media, websites and newsletters.Trial registration numberISRCTN93856392.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Protocol of a randomised controlled multicentre trial investigating the effectiveness and safety of a wilderness programme on the mental and physical well-being of adolescents and young adults affected by cancer: the WAYA-2 study

Jong,

Fernee,

Stenling

et al. 2024

BMJ Open

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“…This study was a pilot RCT with a two-armed parallel-design using individual randomization. The protocol for this study was registered in a public trial registry (ClinicalTrials.gov: NCT04761042) and previously published [ 43 ]. The study was conducted according to the guidelines of the Declaration of Helsinki, and results are reported according to the Consolidated Standards of Reporting Trials (CONSORT), 25-item checklist and flow diagram [ 44 ].…”

Section: Methodsmentioning

confidence: 99%

A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

et al. 2023

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Background The majority of childhood, Adolescent and Young Adult (AYA) cancer survivors suffers from long-lasting health issues following cancer treatment. It is therefore critical to explore effective health promotion strategies to address their needs. Exposure to nature is a promising approach to support the needs of young cancer survivors. This study investigated whether it is feasible to conduct a randomized controlled trial (RCT) of a wilderness program for childhood and AYA cancer survivors. Methods Eligible participants were aged 16–39 years, had a cancer diagnosis, and met minimal criteria. Seventy-one individuals expressed interest and 59 were randomized to either a wilderness or a holiday program. The wilderness program involved an 8-day expedition including backpacking, sea kayaking, gorge climbing, camping, bush-craft skills, and mindfulness-practices. It was followed by a 4-day basecamp after 3 months. The comparison was an 8-day holiday program at a Spa-hotel followed by a 4-day holiday program at the same hotel after 3 months. Primary outcome was study feasibility and safety. Results Ultimately, 19 AYAs participated in the wilderness and 23 in the holiday program. All completed the study at one-year follow-up. Participants were mostly female (70%) and represented diverse cancers. Clinical characteristics were similar between study arms excepting greater age at cancer diagnosis in the wilderness program (age 19.1 vs. 12.5; p = 0.024). Program adherence and data completeness was high (> 90%) in both arms. Adverse Effects (AEs) in the wilderness vs. the holiday program were similar (Relative Risk: 1.0, 95% Confidence Interval 0.8–1.3). The most frequent AE was tiredness, all were mild to moderate in severity, and serious AEs were not reported. Nature connectedness significantly increased over time in the wilderness program participants, but not in the holiday program (p < 0.001). No differences were found between the two study arms regarding quality of life, self-esteem, or self-efficacy. Conclusion It is feasible to conduct a RCT and a supervised wilderness adventure is equally safe for childhood and AYA cancer survivors as a holiday program. This pilot study lays the foundation for a larger RCT to investigate the effectiveness of wilderness programs on the health of young cancer survivors. Trial registration date and number 18/02/2021, NCT04761042 (clinicaltrials.gov).

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“…Two of the questions in ESS originated from CBR indicators [ 40 ]. One of the questions, relating to the existence of a cash margin (12,000 SEK), originated from Statistics Sweden (Swedish: SCB), and one question was a demographic question used in other studies [ 41 ]. The last question was created for this study.…”

Section: Methodsmentioning

confidence: 99%

Quality of Life of People with Mobility-Related Disabilities in Sweden: A Comparative Cross-Sectional Study

Westlund

Jong

2022

IJERPH

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Little is known about the Quality of Life (QoL) and how QoL is related to the social and economic situation of people with mobility-related disabilities in Sweden. QoL and well-being do not only relate to the absence of impairments but also to the level of social inclusion and the economic situation. The objective of this study was to explore if there were differences in QoL between a group with and a group without mobility-related disabilities in Sweden. Cross-sectional data were collected through self-reported questionnaires. WHOQOL-BREF was used to assess QoL. Recruitment was conducted through social media platforms. Comparisons were made between and within groups using the Welch t-test. Generalized linear models were used to predict score change for the WHOQOL-BREF items and domains accounting for sex, age, education, social inclusion, economic situation, and presence of additional or other disability. Included in the analysis was data from 381 participants, 143 with mobility-related disabilities and 238 without. Participants in the mobility-related disability group scored significantly lower than those without on General Health, General QoL, Health Satisfaction, and the four WHOQOL-BREF domains. The group with mobility-related disabilities also reported a lower Social Inclusion Score (SIS) and a higher proportion of people without a cash margin. An increased SIS indicated higher QoL in the generalized linear model, whereas the absence of cash margin and mobility-related disability negatively influenced the QoL scores. This study indicated that a person with mobility-related disabilities has lower QoL than those without mobility-related disabilities. A lower QoL was also related to a lack of cash margin, a lower social inclusion score, and whether there were additional or other disabilities present.

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Protocol of a mixed-method randomised controlled pilot study evaluating a wilderness programme for adolescent and young adult cancer survivors: the WAYA study

Cited by 7 publications

References 46 publications

Protocol of a randomised controlled multicentre trial investigating the effectiveness and safety of a wilderness programme on the mental and physical well-being of adolescents and young adults affected by cancer: the WAYA-2 study

Protocol of a randomised controlled multicentre trial investigating the effectiveness and safety of a wilderness programme on the mental and physical well-being of adolescents and young adults affected by cancer: the WAYA-2 study

A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

Quality of Life of People with Mobility-Related Disabilities in Sweden: A Comparative Cross-Sectional Study

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