KiKli Fit: Investigating the Implementation of a Physical Activity Program in Pediatric Cancer

Abstract

Introduction Growing evidence in pediatric oncology underscores the significant benefits of physical activity (PA) during and after treatment (Benzing et al., 2021, 2022; Wurz et al., 2021). However, physical activity promotion in acute care settings within Swiss pediatric oncology units remains underdeveloped. To address this gap, the KiKli Fit program was developed and implemented at the Department of Pediatric Oncology and Hematology at the University Hospital Bern over the last 1.5 years. The aim of this research project was to accompany this process with implementation research to evaluate and support the integration of the developed PA program into clinical practice.

Methods This study was conducted within the Consolidated Framework for Implementation Research (CFIR), which guided the PA program's development, implementation, and evaluation. Qualitative interviews were conducted with children, parents, nurses, physiotherapists, psychologists, doctors, a sport scientist leading the PA program, and two implementation leaders to gather comprehensive, multi-perspective insights. In total 15 interviews explored attitudes, perceived barriers, facilitators, and expectations regarding implementing the PA program in the pediatric oncology setting. Interview questions were tailored to each stakeholder group, ensuring relevance to their specific roles and experiences. Data was analyzed deductively using qualitative content analysis.

Results Data analysis is currently ongoing. Preliminary findings indicate strong acceptance of the PA program among stakeholders, including patients, parents, and healthcare professionals. Children and their families expressed enthusiasm for engaging in structured PA, reporting perceived benefits such as reduced treatment-related side effects, increased PA levels, and improved self-esteem. Stakeholders also highlighted challenges, including resource limitations and logistical barriers, that must be addressed for successful program integration. Notably, healthcare professionals from other hospital units, particularly those caring for children with chronic illnesses, expressed interest in adapting the intervention to benefit additional clinical populations.

Discussion/Conclusion Preliminary findings highlight the value of a participatory approach in implementing a PA program in pediatric oncology. High stakeholder acceptance and reported benefits, such as reduced side effects and improved self-esteem, demonstrate the program’s potential. The CFIR framework helped identify barriers, including logistical and resource constraints, which require attention for successful integration. Interest from other hospital units suggests the program’s broader applicability. Future efforts will focus on completing data analysis and exploring adaptations for other clinical settings.

References

Benzing, V., Siegwart, V., Anzeneder, S., Spitzhuettl, J., Grotzer, M., Roebers, C. M., Steinlin, M., Leibundgut, K., Everts, R., & Schmidt, M. (2022). The mediational role of executive functions for the relationship between motor ability and academic performance in pediatric cancer survivors. Psychology of Sport and Exercise, 60, 102160. https://doi.org/10.1016/j.psychsport.2022.102160

Benzing, V., Siegwart, V., Spitzhüttl, J., Schmid, J., Grotzer, M., Roebers, C. M., Steinlin, M., Leibundgut, K., Everts, R., & Schmidt, M. (2021). Motor ability, physical self‐concept and health‐related quality of life in pediatric cancer survivors. Cancer Medicine, cam4.3750. https://doi.org/10.1002/cam4.3750

Wurz, A., Mclaughlin, E., Lategan, C., Ellis, K., & Culos-Reed, S. N. (2021). Synthesizing the literature on physical activity among children and adolescents affected by cancer: Evidence for the international Pediatric Oncology Exercise Guidelines (iPOEG). Translational Behavioral Medicine, 11(3), 699–708. https://doi.org/10.1093/tbm/ibaa136