Functional quality of life among newly diagnosed young adult colorectal cancer survivors compared to older adults: results from the ColoCare Study.

PURPOSE: Colorectal cancer (CRC) incidence and mortality are increasing among young adults (YAs) aged 18-39. This study compared quality of life (QOL) between YA and older adult CRC survivors in the ColoCare Study. METHODS: Participants were grouped by age (years) as follows: 18-39 (YA), 40-49, 50-64, and 65 + . Functional QOL (physical, social, role, emotional, cognitive) and global QOL were assessed with the EORTC-QLQ-C30 at enrollment, 3, 6, and 12 months. Average scores were compared between groups over time using longitudinal mixed-effect modeling. Proportions with clinically meaningful QOL impairment were calculated using age-relevant thresholds and compared between groups over time using logistic regression with mixed effects. RESULTS: Participants (N = 1590) were n = 81 YAs, n = 196 aged 40-49, n = 627 aged 50-64, and n = 686 aged 65 + . Average physical function was better among YAs than participants aged 50-64 (p = 0.010) and 65 + (p < 0.001), and average social function was worse among YAs than aged 65 + (p = 0.046). Relative to YAs, all age groups were less likely to report clinically meaningful social dysfunction (aged 40-49 OR = 0.13, 95%CI = 0.06-0.29; aged 50-64 OR = 0.10, 95%CI = 0.05-0.21; aged 65 + OR = 0.07, 95%CI = 0.04-0.15) and role dysfunction (aged 40-49 OR = 0.36, 95%CI = 0.18-0.75; aged 50-64 OR = 0.41, 95%CI = 0.22-0.78; aged 65 + OR = 0.32, 95%CI = 0.17-0.61). Participants aged 40-49 were also less likely to report physical dysfunction (OR = 0.42, 95%CI = 0.19-0.93). CONCLUSION: YA CRC survivors reported better physical and worse social function compared to older CRC survivors, and YA CRC survivors were more likely to report clinically meaningful social, role, and physical disfunction. Future work should further investigate QOL using age-relevant benchmarks to inform best practices for CRC survivorship care. TRIAL REGISTRATION: NCT02328677, registered December 2014.

Alcohol consumption and smoking history at time of diagnosis, and risk of colorectal cancer recurrence and mortality: Results from the ColoCare Study.

BACKGROUND: Findings from studies investigating the impacts of alcohol use and smoking on colorectal cancer (CRC) outcomes are inconclusive. This study aimed to investigate associations between alcohol use and smoking status at the time of diagnosis on recurrence and overall mortality among patients with CRC. METHODS: The present study included 2,216 stage I-IV patients with CRC from the longitudinal multi-center ColoCare study, with available data on recurrence and CRC-specific mortality. Cox proportional hazards models adjusted for age, sex, race, ethnicity, stage, tumor site, treatment, comorbidities, body mass index, and study site were fit, with imputations for missing data. RESULTS: We observed 235 recurrences and 308 CRC-specific deaths over an average of 3 years of follow-up. After adjusting for confounders, current alcohol consumption and ever smoking, relative to not current consumption and never smoking, respectively, were not statistically significantly associated with CRC recurrence (Alcohol - HR: 0.95. 95% CI: 0.71-1.29; Ever smoking - HR: 0.98, 95% CI: 0.75-1.29) or CRC-specific mortality (Alcohol - HR: 0.95. 95% CI: 0.74-1.22; Ever smoking - HR: 0.98, 95% CI: 0.77-1.24). CONCLUSIONS: No associations were observed between alcohol and smoking at diagnosis and clinical outcomes in this well-annotated longitudinal cohort. IMPACT: Our cohort study reports no significant associations; however, limiting alcohol use and avoiding smoking are health behaviors recommended for CRC survivors for prevention of other cancers and chronic conditions.

Development of an Online Mind-Body Physical Activity Intervention for Young Adults during COVID-19: A Pilot Study.

The purpose of this study was to examine the association between the implementation of an online mind-body physical activity (MBPA) intervention and physical activity (PA), stress, and well-being in young adults during COVID-19. The participants were a sample of college students (N = 21; 81% female). The MBPA intervention was organized in four online modules that were administered asynchronously for 8 weeks with three separate 10 min sessions per week. The intervention components consisted of traditional deep breathing, diaphragm mindful breathing, yoga poses, and walking meditation. Objective PA behaviors were assessed using wrist-worn ActiGraph accelerometers, and stress and well-being data were collected using validated self-report instruments. A 2 (sex) × 3 (time) doubly multivariate analysis of variance test with a univariate follow-up showed that the % of wear time in light (LPA) and moderate-to-vigorous physical activity (MVPA) was significantly higher at the end of the intervention compared to baseline (LPA mean difference = 11.3%, p = 0.003, d = 0.70; MVPA mean difference = 2.9%, p < 0.001, d = 0.56). No significant differences were observed for perceived stress and well-being, and there was no moderating effect of sex. The MBPA intervention showed promise, as it was associated with higher PA in young adults during COVID-19. No improvements were observed for stress and well-being. These results warrant further testing of the intervention's effectiveness using larger samples.

"I Felt Grounded and Clear-Headed": Qualitative Exploration of a Mind-Body Physical Activity Intervention on Stress Among College Students During COVID-19.

The COVID-19 pandemic affected college students' overall health. The aims of this qualitative inquiry were to provide a more comprehensive understanding of the effectiveness of the mind-body physical activity (MBPA) intervention and to explore the MBPA intervention experiences through the use of journals and photographs (photovoice) of a purposeful sample of 21 college students during the COVID-19 pandemic. An inductive qualitative process was used to explore the data that emerged from photovoice images and journals. Students' experiences were encapsulated in 6 key themes: (1) holistic individual well-being; (2) physical activity as a matter of necessity; (3) mind-body physical activity intervention impacts; (4) broadening strategies for adapting and reacting; (5) systemic effect of stress management changes; and (6) perceiving causes of stress. Participants reflected collective intellectual, physical, and emotional fatigue as obstacles and perceived stress. The quality of COVID-19 related perspectives and stressful experiences are defined from traumatic and overwhelming to higher than normal. Findings from this study contribute to our understanding of the distinctive factors of the COVID-19 era among college students. Health educators should consider the implementation of multilevel and multicomponent MBPA interventions, and our findings highlight the utility of supporting higher education students in a meaningful way.

The Effects of Playground Interventions on Accelerometer-Assessed Physical Activity in Pediatric Populations: A Meta-Analysis.

Playgrounds are designed to be a safe, enjoyable, and effective means to promote physical activity in children and adolescents. The purpose of this study was to conduct a meta-analysis to determine the effectiveness of playground interventions for improving accelerometer-assessed ambulatory moderate-to-vigorous physical activity (MVPA) and to identify common aspects of playground interventions that may be beneficial to promote behavior change. An internet database search was performed. The final analyzed sample of studies was obtained from several criteria, including being a playground-based intervention targeting children or adolescents, having a control or comparison group, having an accelerometer-assessed MVPA outcome target variable, and reporting of the mean difference scores' variability. A random-effects model meta-analysis was employed to obtain pooled effect sizes. Ten studies (n = 10) were analyzed from the internet search. The weighted pooled effect (Hedges' g) across all studies was Hedges' g = 0.13, 95% CI: 0.02-0.24, p = 0.023. There was moderate study heterogeneity (I2 = 55.3%) but no evidence for publication bias (p = 0.230). These results suggest that school-based playground interventions have a small effect on increasing accelerometer-assessed MVPA within the pediatric population. The playground should still be an environmental target during school or community-based interventions aimed at providing opportunities to promote MVPA.

A multiple-method review of accommodations to gross motor assessments commonly used with children and adolescents on the autism spectrum.

The purpose of this study is to understand the common accommodations used during standardized motor assessment of children on the autism spectrum. This study was completed in three parts: (1) a narrative review of the literature; (2) an open-ended survey sent to the first authors of the identified articles; and (3) a descriptive analysis of responses. Results revealed that 56.7% of the identified articles did not report enough information of assessment procedures, 18.9% followed the assessment manual, 16.9% provided accommodations on a needs basis, and 7.5% used a consistent modified protocol. Individual responses showed that extra demonstrations (n = 5) were the most frequent accommodation, followed by extra breaks (n = 3), picture cards (n = 2), and hand-over-hand assistance (n = 1); some respondents stated that they did not provide accommodations. The findings indicate that a clear set of accommodation for motor skill assessments does not exist, though some commonalities were reported. Further research is necessary to understand the impact of accommodations in the assessment process, as well as which accommodations are needed and/or effective.

Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis.

Mind-Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges' g = -1.71, 95% Confidence Interval (CI): -2.43, -0.98), cortisol (Hedges' g = -1.32, 95% CI: -2.50, -0.16), and systolic and diastolic blood pressure (Hedges' g = -1.04, 95% CI: -1.53, -0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.