Browsing by Author "Schulte, Fiona S. M."

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    Evaluation of Community-Based Physical Activity Programming for Childhood Cancer Survivors
    (2018-09-21) Shank, Jena Ann; Culos-Reed, Susan Nicole; Schulte, Fiona S. M.; Guilcher, Gregory M. T.; Emery, Carolyn A.; Laing, Catherine M.
    Background: Childhood cancer treatments include numerous negative physical and psychosocial outcomes. Preliminary evidence suggests cancer-related side effects may be reduced by physical activity (PA). Fortunately, early research supports the physical and psychosocial benefits of PA in childhood cancer survivors. However, only a handful of research studies have been translated into community-based PA programs. One of these community- based programs is the Pediatric Cancer Patients and Survivors Engaging in Exercise for Recovery (PEER) program. The next step in translation is to evaluate patient outcomes regarding PEER participation. Thus, the purpose of the current proposal was to determine applicable evidence-based evaluation tools for the PEER program. Methods: The knowledge- to-action framework was used to compile feasible and sustainable evaluation tools, along with an algorithm to determine which tools are appropriate in the assessment of each PEER participant. Specifically, (a) a scoping review determined evaluation tools used to date in childhood cancer PA/exercise programs and studies. Based on the results of this review, (b) interviews were conducted with key stakeholders to understand what they find valuable to evaluate in PEER. This work, along with the goals of the PEER program, (c) guided the development of the evaluation tools along with an algorithm for tool implementation based on participant age, cognitive and physical ability. Finally, (d) the evaluation tools were tested for feasibility in PEER. Conclusions: The present work was the first to establish evidence-based evaluation tools that are feasible for the community-based PEER program. Ongoing PEER evaluation may enhance program translation and support the sustainability.
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    EXERCISE in pediatric autologous stem cell transplant patients: a randomized controlled trial protocol
    (BioMed Central, 2012-09-10) Khan, Faisal M.; Chamorro-Vina, Carolina; Culos-Reed, S. Nicole; Guilcher, Gregory M.T.; Mazil, Karen; Schulte, Fiona S. M.; Wurz, Amanda; Williamson, Tanya; Reimer, Raylene A.
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    Sleep Disturbances and Fatigue in Survivors of Pediatric Acute Lymphoblastic Leukemia and their Siblings
    (2019-08-19) Russell, Karleen Brooke; Tomfohr-Madsen, Lianne M.; Schulte, Fiona S. M.; Noel, Melanie; Brooks, Brian L.; Laing, Catherine M.
    Sleep disturbances and fatigue have been identified by patients with cancer as common and distressing. Conflicting evidence about the prevalence of these outcomes, however, exists for survivors of childhood cancers. Additionally, little is known about how the cancer trajectory might impact survivor siblings’ sleep and fatigue. The current study compared sleep and fatigue in survivors of acute lymphoblastic leukemia (ALL) (2-7 years off therapy) and their siblings to healthy control sibling dyads. We hypothesized that survivors would have less total sleep time (TST), greater wake after sleep onset (WASO), poorer sleep efficiency (SE), and higher ratings of fatigue than controls. Participants (survivors, n=45; survivor siblings, n=27; controls, n=45; control siblings, n=41; 58% male) aged 8-18 (m=11.64, SD=2.62) completed the PedsQL Multidimensional Fatigue Scale, a 7-day sleep diary, and 7-consecutive days of actigraphy. Parents (n=90) completed the Children’s Sleep Habits Questionnaire for each of their children. No between-group differences were found on measures of fatigue, sleep diaries, or actigraphy. Parents reported that survivor siblings had significantly poorer sleep habits than survivors or controls. For survivors, greater time off treatment and younger age at diagnosis were significantly related to poorer outcomes via actigraphy on TST, WASO, and SE, as well as sleep-onset latency (SOL) via sleep diaries. This research suggests that poorer sleep in later survivorship from childhood cancer may be related to late-effects, which may account for variability in these findings in the broader literature, and that siblings of survivors of childhood cancer may be at risk for sleep problems.
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    The Interpersonal Context of Co-occurring Posttraumatic Stress Disorder Symptoms and Pediatric Chronic Pain: The Role of Parent Responses
    (2018-09-18) Neville, Alexandra; Noel, Melanie; Giesbrecht, Gerald; Yeates, Keith Owen; Schulte, Fiona S. M.
    Introduction: Posttraumatic stress disorder (PTSD) symptoms occur at elevated rates among youth with chronic pain and their parents and are associated with worse youth pain outcomes. Interpersonal factors, such as parent distress and protective behaviours, have been posited as key mechanisms likely to influence the persistence of pain and PTSD symptoms in youth. Parent responses to youth pain have been shown to be dynamic over time, pointing to the importance of examining the interpersonal context of pediatric chronic pain using an ecological momentary assessment (EMA) approach. Method: The current study adopted a multi-method approach to examine the role of parent protective responses in the relationship between parent and youth PTSD symptoms and youth chronic pain outcomes, among a sample of youth with chronic pain and their parents. Eighty-four youth with chronic pain (70% female, Mage = 14.2 years), recruited from a tertiary level pediatric chronic pain program, and one of their parents, participated. At baseline, youth and one of their parents participated in a diagnostic clinical interview of internalizing mental health symptoms. Youth also completed self-report measures assessing pain intensity, pain interference, pain unpleasantness, and PTSD symptoms. Parents completed self-report measures of their own PTSD symptoms and protective responses to youth pain. Following baseline assessment, youth and parents completed daily electronic assessments of pain and parent protective responses for 7 days. Finally, youth and parents participated in a lab-visit, where parents and youth engaged in a discussion task following youth completion of the cold pressor task. Results: Findings revealed that higher parent PTSD symptoms predicted a stronger daily association between parent protective behaviours and youth pain unpleasantness, but not youth pain intensity or interference. However, parent protective responses measured with a static questionnaire, parents’ stop tendency following an experimental pain task, and pain attending talk during a discussion task following the experimental pain task, were not associated with youth or parent PTSD symptoms or youth pain outcomes. Conclusion: These findings suggest that parent protective responses to youth pain may be an interpersonal mechanism through which parent PTSD impacts children’s chronic pain symptoms. Additionally, EMA methodology may be a more ecologically valid approach to studying pediatric chronic pain.