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CanWell Program CPAC Presentation 2010
 

CanWell Program CPAC Presentation 2010

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Innovative Exercise and Education community based program for Well Cancer Survivors

Innovative Exercise and Education community based program for Well Cancer Survivors

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    CanWell Program CPAC Presentation 2010 CanWell Program CPAC Presentation 2010 Presentation Transcript

    • CPAC  Cancer  Workforce  Symposium Jan.  25th  2010,  Montreal Breakout  Session  1C  Community CanWell  Program: An  Innovative  Community  Cancer  Care  Service  Delivery  Model Presented  by Fidelma  Serediuk  &  Jan  Park  Dorsay Copyright  CanWell  Program  2010
    • Copyright  CanWell  Program  2010
    • CanWell  Project  Team  Fidelma  Serediuk,  PT,  B.Sc.(  PT)  Oren  Cheifetz,  PT,  M.  Sc.,  Jan  Park  Dorsay,  RN(EC),  MN,  NP-­‐Adult, CON  (C)  Genevieve  Hladysh,  B.  Sc.  Kin.  Linda  Woodhouse,  PT,  Ph.  D. Copyright  CanWell  Program  2010
    • What  was  the  CanWell  Project?  a demonstration project to create and deliver a community- based exercise and education program for people with cancer,  made possible through one time funding from Optimizing Health Competencies Fund (Health Force Ontario-MoHLTC) Participant Criteria:  over 18 yrs. with any cancer diagnosis or treatment stage, independent mobility with no gait aides, medically stable.  Study Size: 32 enrolled, 18 completed 12 week evaluations Copyright  CanWell  Program  2010
    • CanWell  Program  Goals  To promote optimal wellness for survivors of cancer  To promote inter-agency and inter-professional collaborative care, knowledge and competencies in the area of exercise for people with cancer  To develop and establish competencies and expertise related to exercise for cancer survivors by testing a model which may be implemented in other communities Copyright  CanWell  Program  2010
    • Why  CanWell  ?  The  evidence  supports;  Primary Prevention  Exercise may decrease the risk of developing cancer.  Secondary Prevention  Decreased risk of recurrence in long term follow-up.  Improved QOL and decreased symptoms  Helps manage treatment side effects and toxicities, maintain physical functioning, prevent muscle loss and fat gain, and improve mood and QOL, and  Facilitates completion of difficult treatments Copyright  CanWell  Program  2010
    • CanWell  –  response  to  a  need  Cancer and Exercise Survey (N=648) > patients’ knowledge and preferences (Cheifetz & Park Dorsay, 2007)  adapt knowledge to the local community context >survey conducted at Juravinski Cancer Centre, Hamilton, ON.  47% of men and 59% of women indicated interest in an exercise program  21% of breast cancer survivors and 18% of prostate cancer survivors actively participate in an exercise program Copyright  CanWell  Program  2010
    • CanWell  -­‐  response  to  a  need  52% of respondents preferred a supervised exercise program  43% plus 25% preferred an exercise program in the home or community  The majority of respondents reported exercising with staff knowledgeable about the specific needs of cancer survivors was important; this contributed to their feelings of safety and confidence Copyright  CanWell  Program  2010
    • Copyright  CanWell  Program  2010
    • The  CanWell  Pilot  Project:    Results  Average age 52.6 years (32-73)  72% female, majority breast cancer  Statistically significant results: participants walked faster, further and reported improved quality of life  No reported increase in pain or other symptoms  Safe: no injuries while exercising  More regular exercisers after 12 week program (pre- CanWell less than 10%, post-CanWell greater than 60%) Copyright  CanWell  Program  2010
    • The  CanWell  Pilot  Project:    Results  “Exercise gives me back some of my self image. I’m working through my frustration that cancer treatment isn’t a do it, get it done, over deal.”  “Before cancer, I was fearless. I back packed through 18 countries solo. After cancer, I became a person afraid to walk to the store. I became fearful, and agoraphobic. Eight weeks into the CanWell program, I realized I was no longer fearful or agoraphobic. I’m fine outside of my home now. This is huge for me. Thank you CanWell.” Copyright  CanWell  Program  2010
    • Service  Delivery  Human  Resource  Model-­‐ CanWell YMCA based;  Kinisiologist  Fitness Trainers Hospital & YMCA based Health Professional consultation support;  Physiotherapist  Nurse Practitioner Copyright  CanWell  Program  2010
    • Self Referral or CanWell  Program  Model HCP Referral With Physician Clearance Advi se Submitted to YMCA sour referral c acce e if not pted CanW into Intake Screening Process ell CanWell Trained YMCA Kinisiologist HHS Physiotherapist & 12 wk eval. Consult PRN 6 wk eval. Baseline Nurse Practitioner Participant accepted into 12 week Supervised Participant continues independently CanWell Exercise & Education Program Accesses CanWell team CanWell Trained as needed YMCA Kinisiologist & Fitness Trainers Copyright  CanWell  Program  2010
    • The  CanWell  Program  Pilot  Project:    the  process  and products  Physiotherapist and NP developed YMCA staff training materials based on best available evidence  Two day staff training sessions provided for YMCA staff  Physiotherapist and Kinisiologist provided 1-1 staff training on assessment and evaluation of participants  YMCA staff actively engaged in on-going data collection  Physiotherapist and NP available for on-going onsite consultation support to YMCA staff and participants as needed  Participant education sessions developed based on participant requests, delivered by health professionals in the community Copyright  CanWell  Program  2010
    • Challenges-­‐  Myth Busting- overcoming beliefs that exercise is not beneficial to people with cancer!  Inter-agency and inter-professional collaboration requires time+++ and commitment to achieve effective communication  Timeline of project – originally was 12 months- needed a time extension of 3 months to achieve all project deliverables Copyright  CanWell  Program  2010
    • Strategies  for  Success  Alignment with emerging Community Health Partnership framework  Building community based competencies & capacity through transfer of knowledge related to cancer and exercise  Multiple networking and communication strategies (Rounds, TV media, CanWell Video, webpage, brochures, posters, word of mouth, newsletters)  Building a founding inter-professional team that possessed diverse skills and strengths  Engagement of organizational senior leaders to support the vision  Integrating survey results that identified what people with cancer needed regarding exercising Copyright  CanWell  Program  2010
    • Strategies  for  Success  Identification of a service gap; lack of resources for cancer survivors to exercise safely in the community, participant preferences known from previous study  Knowledge adapted to local context ; opportunity for partnership with HHS-YMCA-McMaster University  Interventions selected, tailored & implemented; CanWell Demonstration Project Oct. 2008 –Dec.2009 Copyright  CanWell  Program  2010
    • Adding to Cancer published and exercise evidence Survey: on the benefits JCC 2007, of exercise for cancer (Cheifetz & The  CanWell survivors Park Dorsay) Program: An  Innovative Community Cancer  Care Service Delivery  Model CanWell Program: CanWell Pilot Increasing capacity Research in the community thru Les Chater YMCA, knowledge and 2009 skills development Copyright  CanWell  Program  2010
    • CanWell  Key  Learnings;  Transfer of cancer and exercise knowledge and competencies so as to provide a safe and effective education and exercise program for people with cancer in a community setting is possible  For people with cancer - exercise can be both safe and effective ! Copyright  CanWell  Program  2010
    • www.canwellprogram.ca Copyright  CanWell  Program  2010