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Cancer-related fatigue is one of the most distressing symptoms reported by childhood cancer survivors. Despite the body of evidence that regular physical activity helps alleviate cancer-related fatigue, insufficient participation in physical activity is frequently observed among childhood cancer survivors.This study examined the effectiveness of an adventure-based training programme in promoting physical activity, reducing fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors.A prospective randomised controlled trial.A paediatric oncology outpatient clinic, a non-governmental organisation, and a non-profit voluntary organisation.Hong Kong Chinese childhood cancer survivors aged 9-16 years who reported symptoms of fatigue and had not engaged in regular physical exercise in the past 6 months.The experimental group underwent a 4-day adventure-based training programme. The control group received a placebo intervention. The primary outcome was fatigue at 12 months. Secondary outcomes were physical activity levels, self-efficacy and quality of life at 12 months. Data collection was conducted at baseline, and 6 and 12 months after the intervention began. We performed intention-to-treat analyses.From 6 January, 2014 to 8 June, 2015, we randomly assigned 222 eligible childhood cancer survivors to either an experimental (n = 117) or a control group (n = 105). The experimental group showed statistically significantly lower levels of cancer-related fatigue (P 0.001), higher levels of self-efficacy (P 0.001) and physical activity (P 0.001), and better quality of life (P 0.01) than the control group at 12 months.This study provides evidence that adventure-based training is effective in promoting physical activity, reducing cancer-related fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors. These results may help inform parents and healthcare professionals that regular physical activity is crucial for the physical and psychological wellbeing and quality of life of childhood cancer survivors.

Objectives To compare the effectiveness of quitting immediately and cutting down to quit in promoting smoking abstinence among smokers in an outpatient clinic. Methods A total of 100 subjects were randomized into two groups, 50 in the quit immediately group, who received an intervention on abruptly quitting, and 50 in the cut down to quit group, who received an intervention on gradual reduction. All subjects were followed up at 6 and 12 months via telephone. The intention-to-treat principle was used. Results At the 6-month follow-up, the self-reported quit rate of subjects in the quit immediately group was significantly higher than in the cut down to quit group (18.0% vs. 4.0%, p = 0.04). However, this difference was not significant at the 12-month follow-up (12.0% vs. 4.0%, p = 0.16). Conclusion These data suggest that quitting immediately might be more effective than cutting down to quit at 6 months but not at 12 months. Practice implications It is crucial to allow smokers to select quitting immediately or reducing the number of cigarettes smoked. Further studies are warranted to compare the effectiveness of various approaches for achieving smoking abstinence.

Background More than a third of Chinese expectant fathers are smokers. Secondhand smoke can cause adverse pregnancy outcomes. The implementation of interventions to help expectant fathers quit smoking is crucial. Video-based intervention has been increasingly used in health promotion. We examined the effectiveness of a video-based smoking cessation intervention focusing on maternal and child health in helping expectant fathers quit smoking. Methods We did an open-label, investigator-blind, multicentre, three-arm, randomised controlled trial at the obstetrics and gynaecology registration centres of three Chinese tertiary public hospitals. Expectant fathers (≥18 years) were eligible for this study if they had smoked at least one cigarette per day in the past 30 days and had a carbon monoxide concentration in expired air of four parts per million or higher, had smartphones, and were able to read Chinese and communicate in Mandarin. We excluded those who were unable to provide informed consent or receive counselling because of impaired mental status, cognitive impairment, or communication barriers identified from their medical records, or if they had participated in other smoking cessation programmes or services. After providing written informed consent, eligible participants were randomly (1:1:1) allocated using random-number tables into a video-based group, a text message-based group, or a control group. The participants received four 1-min videos (video-based group) or four text messages (text message-based group) on the risks of smoking for maternal and child health via instant messaging every 2 weeks, or a smoking cessation leaflet only (control group). Follow-up visits were done at 1 week and at 1 month, 3 months, and 6 months. The primary outcome, assessed by intention-to-treat, was biochemically validated abstinence at 6 months. This trial was approved by the Institutional Review Board of the University of Hong Kong and Hospital Authority Hong Kong West Cluster (UW 17-269) and Institutional Review Board of the Shenzhen Hospital, and registered with ClinicalTrials.gov (trial number NCT03236025). Findings From Aug 14, 2017, to Feb 28, 2018, 1023 eligible expectant fathers were randomly assigned to a video-based (n=333), text message-based (n=322), or control (n=368) group. At 6 months, we found the video-based group had a significantly higher prevalence of validated abstinence than the text message-based group (75 [22·5%] of 333 participants vs 48 [14·9%] of 322, p=0·013) and control group (75 [22·5%] of 333 vs 34 [9·2%] of 368; p Interpretation The video-based smoking cessation intervention focusing on maternal and child health was effective and feasible in helping expectant fathers quit smoking. The findings could guide health-care professionals to incorporate this simple and effective innovation to promote smoking cessation and other lifestyle habits in clinical practice. Funding Sanming Project of Medicine in Shenzhen, China (SZSM201612018).