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Physical activity program intervention is associated with reduced time cost and overall greater efficacy in improving psychological distress and promoting physical activity in young adults and adolescent cancer patients.

The majority of young adult and adolescent cancer patients report psychological distress, which can be alleviated by behavioral activation and physical activity. A 2023 study demonstrated that a physical activity program was more effective than a modified behavioral activation program in reducing anxiety and depression, improving physical activity, and reducing salivary cortisol levels. Physical activity programs may also reduce the time cost for these cancer patients. The study findings are published in the journal Cancer Medicine.

Lowers Stress Hormones in Young Cancer Patients

Salivary cortisol levels in young adult and adolescent cancer patients were statistically different among the control, behavioral activation, and physical activity groups. Both the intervention groups demonstrated significantly lower levels of salivary cortisol 1 week after the designated interventions.

Higher IPAQ Score in Physical Activity Program Participants

This study demonstrated that participants undergoing an intelligent wearable device-based physical activity program for 8 weeks had a higher total International Physical Activity Questionnaire (IPAQ) score compared to cancer patients who were included in the web-based modified behavioral activation program. The difference between the IPAQ scores was statistically significant, with P < 0.001, and indicates that physical activity programs promote greater levels of physical activity in young adult and adolescent cancer patients.

Physical Activity Trumps Behavioral Activation for Young Cancer Patients

The study found no significant differences between physical activity programs and behavioral activation regarding remaining study outcomes, including reduction in morning salivary cortisol, improvement in the quality of life, alleviation of depression and anxiety, sleep quality, and social support. However, the study findings suggested that the physical activity program tended to be more effective than the behavioral activation program.

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Physical Activity Program Was Effective in Retaining the Positive Effects of Intervention

The study investigators also observed that cancer patients in the physical activity intervention group scored significantly higher in IPAQ, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), General Self-Efficacy Scale (GSES), and Social Support Rating Scale (SSRS), at three months following the intervention.

Web-Based Behavioral Activation: Time-Consuming and Intensive

Compared with other study groups, the physical activity intervention group participants had the lowest attrition rate at only 12.8%. In contrast to the physical activity intervention, behavioral activation required a web-based modified program that was time-consuming and required intensive participation.

Overall, a physical activity program had greater overall efficacy compared to a behavioral activation program in promoting physical activity and reducing psychological distress in young adult and adolescent cancer patients, in this study.


Li, L., Wang, L., Duan, Y., Xiao, P., Zhou, Y., Luo, X., Liu, X., Xie, J., & Cheng, A. S. K. (2023). Intelligent physical activity versus modified behavioral activation in adolescent and young adult cancer patients with psychological distress: A randomized, controlled pilot trial. Cancer Med, 12(2), 1935-1948. https://doi.org/10.1002/cam4.5030