Factors influencing the physical activity among pediatric cancer survivors based on the parent-based expansion of the Theory of Planned Behavior

Purpose: This study descriptively analyzed the current status of physical activity among pediatric cancer survivors and their parents and further analyzed the factors influencing the physical activity among pediatric cancer survivors based on the parent-based expansion of the Theory of Planned Behavior.

Methods: A total of 271 pediatric cancer survivors and their parents were conveniently selected as participants for this cross-sectional survey conducted from June to November 2023. Using questionnaires to collect sociodemographic and physical activity data of pediatric cancer survivors and their parents, dimensions of the Theory of Planned Behavior among pediatric cancer survivors. IBM SPSS Statistics 26.0, including descriptive analysis and one-way analysis. IBM SPSS AMOS 24.0 was used to test the hypothetical path.

Results: The physical activity scores of pediatric cancer survivors and their parents were 35.60 (37.20) MET and 38.10 (32.70) MET, respectively, and both were dominated by low-intensity physical activity. Differences in the distributions of sex, BMI, and parental marital status were statistically significant (P < 0.05) for physical activity. The path model was well fitted with $x^2$ / df = 1.1561, RMSEA = 0.046, GFI = 0.975, NFI = 0.950, IFI = 0.982, TLI = 0.968, and CFI = 0.981. Parental physical activity directly affected the physical activity of pediatric cancer survivors, with an effect value of 0.396 (95% CI [0.266-0.534]). Parental physical activity affected behavioral intentions and, ultimately, physical activity indirectly through attitudes toward physical activity in pediatric cancer survivors, with an effect value of 0.011 (95% CI [0.003-0.025]).

Conclusion: Pediatric cancer survivors and their parents had low levels of physical activity. Parental physical activity can directly or indirectly affect physical activity in pediatric cancer survivors.

Implications for pediatric cancer survivors: The physical activity status of pediatric cancer survivors and their parents requires urgent attention. Improving parental participation in physical activity may be a cost-effective intervention to increase physical activity levels among pediatric cancer survivors.