Determinants of physical activity commitment in adolescents and young adult with cancer
Résumé
Adolescents and Young Adults (AYA) with cancer undergo physical transformations due to disease and treatment occurring alongside puberty and adolescence. Although physical activity is recommended for its benefits, its practice among AYA with cancer remains insufficient. The aim of the ETAPE-AJA study is to identify the evolution of AYA with cancer medical knowledge and powers (power to act, to express oneself) over life and cancer care, and their role in commitment in Adapted Physical Activity (APA) and therapeutic patient education during and after oncological treatments.
This prospective mixed methods mono center study will be conducted in a French comprehensive cancer center. Observations will be conducted twice a week during medical consultations, adapted physical activity interventions and therapeutic education sessions for AYA with cancer. Semi-directive interviews will involve 70 participants, including AYA with cancer aged 15 to 25, health professionals, APA teachers and parents. Quantitative data will be collected on AYA's social characteristics and participation in physical activity intervention and therapeutic education sessions. A correspondence factor analysis will supplement inductive analysis of ethnographic qualitative data, involving patient co-researchers. The results will help to improve the understanding of AYAs' medical knowledge and powers, their commitment in physical activity, and to develop strategies to increase their participation.
We show how AYA with cancer adopt health messages during their hospitalization, which may (or may not) benefit their commitment in APA. Although AYA are aware of the benefits of APA, they do not always follow recommendations for regular practice due to their disease trajectory. We distinguish between two types of trajectories. On one hand, a curative approach focuses on medication, leaving little room for APA; on the other hand, a well-being approach encourages APA practice as it is beneficial for health. Furthermore, we demonstrate that AYAs' health knowledge is structured through physical activities. Those with high cultural capital are eager for knowledge, while others limit themselves to the messages from healthcare providers, thereby perpetuating epistemic inequalities.
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