Feasibility and acceptability of a parent–child intervention to improve step count in childhood cancer survivors exposed to cardiotoxic therapy: The STEP UP for FAMILIES Study

Abstract Background Late morbidity after childhood cancer may be mitigated by healthy lifestyle behaviors. We piloted a game‐based, parent–child digital intervention to increase activity in sedentary survivors. Methods S urvivors aged 10–16 treated with cardiotoxic therapy and not meeting US physical activity guidelines were enrolled in a single‐arm study with a parent. Following a 14‐day run‐in, participants chose a prespecified step goal and wore an accelerometer daily for 24 weeks (12‐week game‐based intervention; 12‐week follow‐up). Participants completed the Acceptability of Intervention Measure (AIM) at 24 weeks; a subset of dyads completed qualitative interviews. Results Among 129 eligible survivors, 27 enrolled (20.9% participation rate) with a parent. Four dyads were removed during the 14‐day run‐in period due to noncompliance. Among the 23 dyads who continued to the study, the tracker was worn for 95% of days during the 12‐week intervention (95% confidence interval CI: 94–96) and 81% during the 12‐week follow‐up (95% CI: 79–82). Overall, the prespecified step goal was met for 64% (95% CI: 63–66) of days during the intervention and 37% (95% CI: 35–38) during the follow‐up. At the end of study, 17/23 dyads responded to AIM; 82% of survivors and 94% of parents reported the intervention as acceptable. During qualitative interviews ( n = 5), dyads noted that they liked the accountability of the “buddy system,” but would have liked more personalized goal‐setting. Conclusions Despite high ratings of acceptability among participants, difficulties with sustained adherence and retention were encountered in this parent–child gamification intervention. Alternate, tailored designs should be considered in the future.