{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:31:04Z","timestamp":1782171064727,"version":"3.54.5"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,7]],"date-time":"2024-04-07T00:00:00Z","timestamp":1712448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Changes in health behaviors and weight are common during the early phases of pediatric acute lymphoblastic leukemia treatment, and may negatively impact treatment tolerability. Given that ALL is most prevalent in children, caregivers play an essential role in shaping health behaviors during treatment. This study presents a qualitative analysis of semi\u2010structured interviews with caregivers of youth in the early phases of ALL treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Caregivers (<jats:italic>N<\/jats:italic>\u00a0=\u00a017, 95% female) of a child (<jats:italic>M<\/jats:italic> age\u00a0=\u00a06.76\u00a0years) diagnosed with ALL and on treatment for less than 1\u00a0year (<jats:italic>M<\/jats:italic>\u00a0=\u00a08.7\u00a0months since diagnosis) completed a semi\u2010structured interview about perceptions of their child's nutrition, physical activity, sedentary time, and weight during ALL treatment. Thematic analysis followed Braun and Clark's six\u2010step framework (2006). Two coders established reliability (alpha\u00a0=\u00a0.88) and used a multi\u2010pass coding system to extract themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Caregivers\u2019 concerns around their child's weight during ALL treatment primarily centered around avoiding malnutrition. Weight gain during treatment was less of a concern and often viewed as protective. Caregivers reported encouraging their child to eat palatable, calorie\u2010dense foods to mitigate risk for weight loss. Caregivers also expressed concern that children were less active and more sedentary due to treatment\u2010related pain. Caregivers discussed health behaviors during treatment as being child\u2010directed, rather than parent\u2010 or provider\u2010directed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Future interventions may consider strategies to engage in joint parent\u2013child decisions and caregiver education around risks of excessive weight gain during treatment. Interventions should include anticipatory guidance and aim to support parents in developing skills to support their child's health behaviors during treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30984","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:19:35Z","timestamp":1712535575000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Caregiver perceptions of child heath behaviors and weight during treatment for acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0445-1705","authenticated-orcid":false,"given":"Meghan","family":"Tokala","sequence":"first","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacee","family":"Weber","sequence":"additional","affiliation":[{"name":"Kansas City University College of Osteopathic Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Gilbert","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2508-2175","authenticated-orcid":false,"given":"Meredith L.","family":"Dreyer Gillette","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's Mercy Kansas City  Kansas City Missouri USA"},{"name":"University of Missouri Kansas City School of Medicine  Kansas City Missouri USA"},{"name":"Center for Children's Healthy Lifestyles &amp; 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