Study protocol for two pilot randomised controlled trials aimed at increasing physical activity using electrically assisted bicycles to enhance prostate or breast cancer survival.

BACKGROUND: In 2020, 1.4 and 2.3 million new cases of prostate cancer and breast cancer respectively were diagnosed globally. In the UK, prostate cancer is the most common male cancer, while breast cancer is the most common female cancer. Engaging in physical activity (PA) is a key component of treatment. However, rates of PA are low in these clinical populations. This paper describes the protocol of CRANK-P and CRANK-B, two pilot randomised controlled trials, involving an e-cycling intervention aimed at increasing PA in individuals with prostate cancer or breast cancer respectively. METHODS: These two trials are single-centre, stratified, parallel-group, two-arm randomised waitlist-controlled pilot trials in which forty individuals with prostate cancer (CRANK-P) and forty individuals with breast cancer (CRANK-B) will be randomly assigned, in a 1:1 allocation ratio, to an e-cycling intervention or waitlist control. The intervention consists of e-bike training with a certified cycle instructor, followed by the provision of an e-bike for 12 weeks. Following the intervention period, participants in the e-bike condition will be directed to community-based initiatives through which they can access an e-bike. Data will be collected at baseline (T0), immediately post intervention (T1) and at 3-month follow-up (T2). In addition, in the intervention group, data will be collected during the intervention and follow-up periods. Quantitative and qualitative methods will be used. The primary objectives are to determine effective recruitment strategies, establish recruitment and consent rates, adherence and retention in the study, and determine the feasibility and acceptability of the study procedures and intervention. The potential impact of the intervention on clinical, physiological and behavioural outcomes will be assessed to examine intervention promise. Data analyses will be descriptive. DISCUSSION: The findings from these trials will provide information on trial feasibility and highlight the potential of e-cycling as a strategy to positively impact the health and behaviour of individuals with prostate cancer and breast cancer. If appropriate, this information can be used to design and deliver a fully powered definitive trial. TRIAL REGISTRATION: CRANK-B: [ISRCTN39112034]. CRANK-P [ISRCTN42852156]. Registered [08/04/2022] https://www.isrctn.com .

Differential Associations of Total and Context-Specific Sedentary Time with Depressive Symptoms Among Adolescents: Results from Ireland's CSPPA Study.

BACKGROUND: Higher levels of sedentary behaviour (SB) and screen-time are associated with greater symptoms of depression in adolescents, but the effect of the type and context of SB and screen-time remains underexplored. As part of a nationally-representative observational study, the current cross-sectional study examined associations between SB, screen-time and depressive symptoms among 422 adolescents (13.5 ± 0.92 years; 125 female) in the Republic of Ireland. METHOD: Participants completed the Quick Inventory of Depressive Symptomatology and self-reported weekly SB, categorised into mentally-active screen-time (e.g., computer use for fun), mentally-passive screen-time (e.g., television viewing) and mentally-active non-screen-based SB (e.g., reading). Mann-Whitney U tests and Kruskal-Wallis H tests examined differences in screen-time and depressive symptoms by relevant covariates. Linear regression quantified crude and adjusted associations between total SB and mentally-active and mentally-passive screen-time and SB, and depressive symptoms. RESULTS: Crude and adjusted linear regressions showed total SB was significantly, positively associated with depressive symptoms (unadjusted: ß = 0.27, p = 0.002, adjusted: ß = 0.27, p = 0.002). When type and context were examined in the same model, only mentally-active screen-time was positively associated with depressive symptoms (unadjusted: ß = 0.37, p = 0.009, adjusted: ß = 0.39, p = 0.007). CONCLUSION: Differential associations between total SB and mentally-active screen-time and SB, versus mentally-passive screen-time, and depressive symptoms among Irish adolescents were observed. Findings highlight the importance of investigating the context and type of SB and screen-time in adolescents.

Associations between screen-time, physical activity and depressive symptoms differ based on gender and screen-time mode.

Higher levels of physical activity (PA) and screen time (ST) are associated with positive and negative mental health outcomes among adolescents, respectively. Research is needed to determine the interrelationship between ST and PA with depressive symptoms and the influence of ST modes. This study examines the associations between ST and PA level with depressive symptoms among 1756 adolescents (15.2 ± 1.6y; 995 female) in Ireland. Participants completed the Quick Inventory of Depressive Symptomatology and self-reported weekly ST (TV, computer, and phone use) and PA level (low, moderate, and high). Linear regressions examined associations between ST mode, PA level and relevant covariates with depressive symptoms in the full sample by gender, and in a sample stratified by PA level. Chi-square tests and one-way ANOVA examined gender differences in hours of ST, PA levels, and depressive symptoms. Differential associations were observed depending on the gender and ST mode. Higher levels of computer (ß = 0.106, p ≤ 0.000) and phone use (ß = 0.138, p ≤ 0.000) showed the strongest associations with depressive symptoms. PA level was inversely associated with depressive symptoms (ß = - 0.175, p ≤ 0.000). When the sample was stratified by PA level, only associations between phone use and depressive symptoms were moderated by PA level for males and females. These findings highlight the complex interrelationships between ST, PA, and depressive symptoms, and that associations may vary based on gender and ST mode. This may have implications for future interventions. Increasing PA and reducing ST should be targeted concurrently with consideration given to different media and genders. Future research should explore longitudinal and prospective associations.