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Physical Activity and Children in Care: A Scoping Review of Barriers, Facilitators, and Policy for Disadvantaged Youth

Thomas Quarmby and Katie Pickering

Background:

It is argued that regular engagement in physical activity (PA) has the potential to mitigate the negative health and educational outcomes that disadvantaged children living in care frequently face. However, little is currently known about children in care’s participation in PA. This scoping review primarily aimed to identify barriers and facilitators to PA participation for children in care.

Methods:

The main phases of the scoping review were 1) identifying relevant studies; 2) selecting studies based on predefined inclusion criteria; 3) charting the data; and 4) collating, summarizing, and reporting the results. All relevant studies were included in the review regardless of methodological quality and design.

Results:

The 7 articles that met the inclusion criteria were published between 1998 and 2013 and conducted in the USA (3), England (2), and Norway (2). A social ecological model was incorporated to map results against levels of influence.

Conclusions:

Various factors influence PA engagement for children in care. Barriers include low self-efficacy, instability of their social environment, which impacts on schooling and maintaining friendship groups, and, specific institutional practices and policies that may prevent access to PA. Before fully considering policy implications, further research with children in care is warranted in this area.

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Embedding Multimodal Rehabilitation Within Routine Cancer Care in Sheffield—The Active Together Service Evaluation Protocol

Anna Myers, Liam Humphreys, Michael Thelwell, Katie Pickering, Gabbi Frith, Gail Phillips, Carol Keen, Robert Copeland, and on behalf of the Active Together Clinical Advisory Group

Background: Approximately 3 million people in the United Kingdom are currently living with or beyond cancer. People undergoing treatment for cancer are at risk of complications following treatment. Increasing evidence supports the role of rehabilitation (including prehabilitation) in enhancing psychological and physical well-being in patients with cancer and improving outcomes. Active Together is an evidence-based, multimodal rehabilitation service for patients with cancer, providing support to help patients prepare for and recover from treatment. This paper presents the evaluation protocol for the Active Together service, aiming to determine its impact on patient-reported outcomes and clinical endpoints, as well as understand processes and mechanisms that influence its delivery and outcomes. Methods: This evaluation comprises an outcome and process evaluation, with service implementation data integrated into the analysis of outcome measures. The outcome evaluation will assess changes in outcomes of patients that attend the service and compare health care resource use against historical data. The process evaluation will use performance indicators, semistructured interviews, and focus groups to explore mechanisms of action and contextual factors influencing delivery and outcomes. Integrating psychological change mechanisms with outcome data might help to clarify complex causal pathways within the service. Conclusions: Evidence to support the role of multimodal rehabilitation before, during, and after cancer treatment is increasing. The translation of that evidence into practice is less advanced. Findings from this evaluation will contribute to our understanding of the real-world impact of cancer rehabilitation and strengthen the case for widespread adoption of rehabilitation into routine care for people with cancer.