The impact of cancer on theory of planned behavior measures and physical activity levels during the first weeks following cancer diagnosis in children



The theory of planned behavior (TPB) is used to document children’s health behaviors linked to their physical activity. The TPB model and its components have been applied to comprehend the adoption of physical activity along informational and motivational parameters. Thus, this exploratory study aims to assess the evolution of children’s physical activity levels (MVLPA) during the first weeks of their cancer, in addition to documenting the evolution of the TPB measures, self-reported fitness, and self-esteem in the physical domain to better understand children’s physical activity behavior.


A total of 16 children (8 boys and 8 girls) with cancer answered psychosocial questionnaires at the diagnosis of cancer (time 1) and at 6 to 8 weeks (time 2) to assess the TPB measures, self-reported fitness, self-esteem in the physical domain, and their daily physical activities.


A significant decrease of 41.2 min/days of daily MVLPA was observed between the time at cancer diagnosis (50.5 ± 32.8 min/days) and 6 to 8 weeks after the first interview (9.3 ± 9.1 min/days). We found that the time after the diagnosis of cancer negatively impacted children’s TPB measures (mean in attitude, injunctive norms, identity, facilitating factors, self-confidence, and intention) and MVLPA levels. The TPB model explains 40% of the variance in MVLPA by the injunctive norms during the first weeks following cancer diagnosis in children.


The findings of this study highlight the negative impacts of cancer on children’s TPB measures, self-reported fitness, and self-esteem in the physical domain and self-reported MVLPA levels over 4 to 6 weeks following the diagnosis. These findings help to better understand the effect of cancer diagnosis on children’s physical activity behavior.

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Data availability

Our data are not deposited in publicly available repositories. However, the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


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We would like to thank all the families and the clinical team of the oncology unit at Sainte-Justine University Health Center.


This research was funded by The Fondation Charles-Bruneau, IGA, the Fonds de Recherche du Québec en Santé, and the Canadian Institutes of Health Research. This research is also supported in part by PhD study grants from the Canadian Research Data Centre Network and the Quebec inter-University Centre for Social Statistics.

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Correspondence to Laurence Kern.

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The authors declare that they have no competing interests.

Ethical approval

Written informed consent was obtained from every patient and parent/legal guardian. The agreement of the oncologist was obtained for each patient eligible to participate in the study. This study was conducted in accordance with the Declaration of Helsinki and the protocol was approved by the Ethics Review Committee of Sainte-Justine University Health Center (SJUHC) in Montreal (Quebec), Canada.

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Caru, M., Curnier, D., Levesque, A. et al. The impact of cancer on theory of planned behavior measures and physical activity levels during the first weeks following cancer diagnosis in children. Support Care Cancer (2020).

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  • Theory of planned behavior
  • Physical activity behavior
  • Cancer diagnosis
  • Pediatric oncology
  • Cancer
  • Physical activity
  • Diagnosis