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CanWell Program CPAC Presentation 2010

CanWell Program CPAC Presentation 2010



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