Development and preliminary validation of the Exercise Fit Tool for adolescents undergoing cancer treatment in Hong Kong.
The Exercise Fit Tool shows promise as a reliable self-assessment tool for adolescents undergoing cancer treatment, but further validation is needed before widespread clinical use.
Where it sits
this study against the rest of the slu-pp-332 (exercise mimetic) corpusSummary and findings
This study developed and preliminarily validated the Exercise Fit Tool (EFT) for adolescents undergoing cancer treatment in Hong Kong. A sample of 158 adolescents aged 13-18 years was recruited, and the EFT demonstrated satisfactory content validity and good internal consistency. The findings suggest that the EFT may be a reliable self-assessment tool for this population.
Abstract
<h4>Objective</h4>This study aimed to develop and preliminarily validate the Exercise Fit Tool (EFT), a patient-reported self-assessment tool for adolescents undergoing cancer treatment in Hong Kong.<h4>Methods</h4>A convenience sample of 158 adolescents aged 13-18 years who were undergoing cancer treatment and could communicate in Cantonese and read Chinese was recruited in Hong Kong. Instrument development followed the procedures recommended in AMEE Guide No. 87. Candidate items were generated from a literature review and focus groups with adolescents and healthcare professionals, refined by an expert panel, assessed for content validity, and revised through cognitive interviews. Pilot testing was conducted in 158 adolescents. Convergent validity was examined using pain scores and forced expiratory volume in 1 second (FEV1, % predicted), and criterion-related validity was evaluated by comparing EFT scores with physiotherapists' ratings. Test-retest reliability was assessed in 50 participants, and principal component analysis with Varimax rotation was performed.<h4>Results</h4>The final 10-item EFT demonstrated satisfactory content validity, with I-CVIs ranging from 0.86 to 1.00, and good internal consistency (Cronbach's alpha = 0.92). The 2-week test-retest ICC was 0.82 (<i>P</i> < 0.001). EFT scores were negatively correlated with pain scores and positively correlated with FEV1 (% predicted), supporting convergent validity. The Kaiser-Meyer-Olkin measure was 0.87, and Bartlett's test of sphericity was significant (<i>P</i> < 0.001). Principal component analysis identified a two-component solution: cancer- and treatment-related influences on physical activity (7 items; Cronbach's alpha = 0.96; 55.7% of the rotated variance) and perceived physical activity exertion (3 items; Cronbach's alpha = 0.74; 20.6% of the rotated variance). Primary component loadings ranged from 0.74 to 0.93, and communalities ranged from 0.55 to 0.91. The two components explained 76.3% of the total variance.<h4>Conclusions</h4>The EFT demonstrated preliminary evidence of validity and reliability for adolescents undergoing cancer treatment in Hong Kong. Further evaluation of its latent structure and implementation in independent samples is required before wider clinical use.
Background
This paper addresses the need for a self-assessment tool for physical activity in adolescents undergoing cancer treatment. Prior research has indicated that physical activity can be beneficial for this population, but there has been a lack of validated tools tailored for their specific needs. The development of the Exercise Fit Tool (EFT) is significant as it aims to fill this gap and provide a means for adolescents to assess their physical activity levels.
Methods
The study utilized a convenience sample of 158 adolescents aged 13-18 years undergoing cancer treatment in Hong Kong. The EFT was developed following AMEE Guide No. 87, with candidate items generated from literature reviews and focus groups. The study assessed content validity, convergent validity using pain scores and FEV1, and test-retest reliability in 50 participants.
Results
The EFT demonstrated satisfactory content validity with I-CVIs ranging from 0.86 to 1.00. The internal consistency was good, with a Cronbach's alpha of 0.92. The 2-week test-retest ICC was 0.82 (p < 0.001). Principal component analysis revealed a two-component solution explaining 76.3% of the total variance.
Interpretation
The findings suggest that the EFT is a reliable and valid tool for assessing physical activity in adolescents with cancer. While the statistical significance of the results is notable, the clinical significance remains to be fully established. Limitations include the small sample size and the need for validation in independent cohorts, which may affect the generalizability of the findings.
Key findings
- I-CVIs ranged from 0.86 to 1.00 for content validity.
- Cronbach's alpha = 0.92 for internal consistency.
- The 2-week test-retest ICC was 0.82 (p < 0.001).
- Kaiser-Meyer-Olkin measure was 0.87.
- Bartlett's test of sphericity was significant (p < 0.001).
- The two components explained 76.3% of the total variance.
Limitations
- Convenience sample of 158 adolescents.
- Requires further evaluation in independent samples.
- Short follow-up period for test-retest reliability.