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Ghisi GLDM, Marzolini S, Price J, Beckie TM, Mamataz T, Naheed A, Grace SL. Women-Focused Cardiovascular Rehabilitation: An International Council of Cardiovascular Prevention and Rehabilitation Clinical Practice Guideline. Can J Cardiol 2022; 38:1786-1798. [PMID: 36085185 DOI: 10.1016/j.cjca.2022.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 12/14/2022] Open
Abstract
Women-focused cardiovascular rehabilitation (CR; phase II) aims to better engage women, and might result in better quality of life than traditional programs. This first clinical practice guideline by the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) provides guidance on how to deliver women-focused programming. The writing panel comprised experts with diverse geographic representation, including multidisciplinary health care providers, a policy-maker, and patient partners. The guideline was developed in accordance with Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Reporting Items for practice Guidelines in HealTh care (RIGHT). Initial recommendations were on the basis of a meta-analysis. These were circulated to a Delphi panel (comprised of corresponding authors from review articles and of programs delivering women-focused CR identified through ICCPR's audit; N = 76), who were asked to rate each on a 7-point Likert scale in terms of impact and implementability (higher scores positive). A Web call was convened to achieve consensus; 15 panelists confirmed strength of revised recommendations (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]). The draft underwent external review from CR societies internationally and was posted for public comment. The 14 drafted recommendations related to referral (systematic, encouragement), setting (model choice, privacy, staffing), and delivery (exercise mode, psychosocial, education, self-management empowerment). Nineteen (25.0%) survey responses were received. For all but 1 recommendation, ≥ 75% voted to include; implementability ratings were < 5/7 for 4 recommendations, but only 1 for effect. Ultimately 1 recommendation was excluded, 1 separated into 2 and all revised (2 substantively); 1 recommendation was added. Overall, certainty of evidence for the final recommendations was low to moderate, and strength mostly strong. These recommendations and associated tools can support all programs to feasibly offer some women-focused programming.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Susan Marzolini
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada
| | | | - Theresa M Beckie
- College of Nursing, Division of Cardiovascular Sciences, University of South Florida, Tampa, Florida, USA; College of Medicine, Division of Cardiovascular Sciences, University of South Florida, Tampa, Florida, USA
| | - Taslima Mamataz
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada
| | - Aliya Naheed
- Initiative for Non-Communicable Diseases, Health System and Population Studies Division, International Centre for Diarrheal Diseases Research Bangladesh, Dhaka, Bangladesh
| | - Sherry L Grace
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada; Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
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Parry M, Van Spall HG, Mullen KA, Mulvagh SL, Pacheco C, Colella TJF, Clavel MA, Jaffer S, Foulds HJ, Grewal J, Hardy M, Price JA, Levinsson AL, Gonsalves CA, Norris CM. The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women-Chapter 6: Sex- And Gender-Specific Diagnosis and Treatment. CJC Open 2022; 4:589-608. [PMID: 35865023 PMCID: PMC9294990 DOI: 10.1016/j.cjco.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/12/2022] [Indexed: 10/26/2022] Open
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O’Neill CD, Vidal-Almela S, Terada T, Way KL, Kamiya K, Sperlich B, Duking P, Chaput JP, Prince SA, Pipe AL, Reed JL. Moving Together While Staying Apart: Practical Recommendations for 24-Hour Home-Based Movement Behaviours for Those With Cardiovascular Disease. CJC Open 2021; 3:1495-1504. [PMID: 34778736 PMCID: PMC8573736 DOI: 10.1016/j.cjco.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/21/2021] [Indexed: 11/27/2022] Open
Abstract
The novel coronavirus disease 2019 is a global public health crisis that disproportionately affects those with preexisting conditions. Cardiovascular disease (CVD) is the leading cause of death worldwide and many key CVD risk factors are modifiable (e.g., physical inactivity, sedentary behaviour, obesity). To limit the spread of coronavirus 2019, most governments have implemented restrictions and recommended staying at home, reducing social contact to a select and exclusive few, and limiting large gatherings. Such public health constraints may have unintended, negative health consequences on 24-hour movement behaviours. The primary purpose of this review is to provide practical at-home recommendations for sedentary time, sleep, and physical activity in those living with CVD. Adults with CVD will benefit from practical recommendations to reduce sedentary time, increase purposeful exercise, and maintain optimal sleep patterns while being at home and adhering to public health restrictions. Our recommendations include the following: (i) self-monitoring sitting time; (ii) engaging in 2-3 days per week of purposeful exercise for those with low exercise capacity and > 3 days per week for those with moderate-to-high exercise capacity; (iii) self-monitoring exercise intensity through the use of scales or wearable devices; (iv) maintaining a regular sleep schedule; and (v) moving daily. Clinicians should be aware that clear communication of the importance of limiting prolonged sedentary time, engaging in regular physical activity and exercise, and ensuring optimal sleep in association with the provision of clear, comprehensible, and practical advice is fundamental to ensuring that those living with CVD respond optimally to the challenges posed by the pandemic.
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Affiliation(s)
- Carley D. O’Neill
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa Ontario, Canada
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Kimberley L. Way
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Kentaro Kamiya
- School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Billy Sperlich
- Department of Sports Sciences, University of Wuerzburg, Wurzburg, Bavaria, Germany
| | - Peter Duking
- Department of Sports Sciences, University of Wuerzburg, Wurzburg, Bavaria, Germany
| | - Jean-Phillipe Chaput
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa Ontario, Canada
| | - Stephanie A. Prince
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa Ontario, Canada
| | - Andrew L. Pipe
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer L. Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Mamataz T, Ghisi GLM, Pakosh M, Grace SL. Nature, availability, and utilization of women-focused cardiac rehabilitation: a systematic review. BMC Cardiovasc Disord 2021; 21:459. [PMID: 34556036 PMCID: PMC8458788 DOI: 10.1186/s12872-021-02267-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/15/2021] [Indexed: 12/28/2022] Open
Abstract
Background Women do not participate in cardiac rehabilitation (CR) to the same degree as men; women-focused CR may address this. This systematic review investigated the: (1) nature, (2) availability, as well as (3a) utilization of, and (b) satisfaction with women-focused CR. Methods Medline, Pubmed, Embase, PsycINFO, CINAHL, Web of Science, Scopus and Emcare were searched for articles from inception to May 2020. Primary studies of any design were included. Adult females with any cardiac diseases, participating in women-focused CR (i.e., program or sessions included ≥ 50% females, or was 1-1 and tailored to women’s needs) were considered. Two authors rated citations for inclusion. One extracted data, including study quality rated as per the Mixed-Methods Assessment Tool (MMAT), which was checked independently by a second author. Results were analyzed in accordance with the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results 3498 unique citations were identified, with 28 studies (53 papers) included (3697 women; ≥ 10 countries). Globally, women-focused CR is offered by 40.9% of countries that have CR, with 32.1% of programs in those countries offering it. Thirteen (46.4%) studies offered women-focused sessions (vs. full program), 17 (60.7%) were women-only, and 11 (39.3%) had gender-tailoring. Five (17.9%) programs offered alternate forms of exercise, and 17 (60.7%) focused on psychosocial aspects. With regard to utilization, women-focused CR cannot be offered as frequently, so could be less accessible. Adherence may be greater with gender-tailored CR, and completion effects are not known. Satisfaction was assessed in 1 trial, and results were equivocal. Conclusions Women-focused CR involves tailoring of content, mode and/or sex composition. Availability is limited. Effects on utilization require further study. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02267-0.
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Affiliation(s)
- Taslima Mamataz
- Faculty of Health, York University, Bethune 368, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Gabriela L M Ghisi
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Maureen Pakosh
- Library & Information Services, Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Sherry L Grace
- Faculty of Health, York University, Bethune 368, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada. .,Peter Munk Cardiac Centre, KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
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Reid RD, Wooding EA, Blanchard CM, Moghei M, Harris J, Proulx GA, Prince SA, Mullen KA, Ghisi GM, Krahn M, Chessex C, Pipe AL, Mark AE, Grace SL. A Randomized Controlled Trial of an Exercise Maintenance Intervention in Men and Women After Cardiac Rehabilitation (ECO-PCR Trial). Can J Cardiol 2020; 37:794-802. [PMID: 33161148 DOI: 10.1016/j.cjca.2020.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/19/2020] [Accepted: 10/30/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Exercise maintenance interventions are needed for cardiac rehabilitation (CR) graduates to maintain moderate and vigorous-intensity physical activity (MVPA). We tested an exercise facilitator intervention (EFI) to promote exercise maintenance compared with usual care (UC) separately in men and women. METHODS This was a 3-site, randomized (1:1), parallel-group, superiority trial (ECO-PCR). CR graduates were stratified by site and sex and randomly allocated (concealed). EFI participants received a face-to-face introductory session, 5 small-group counseling teleconferences, and 3 personal calls from a trained facilitator over 50 weeks. In-person assessments were undertaken at baseline and 26 and 52 weeks after randomization. The primary outcome was weekly minutes of MVPA, measured by accelerometer. Secondary outcomes were exercise capacity, risk factors, quality of life, and enrollment in community-based exercise programs. Effects were tested with the use of linear mixed models. RESULTS A total of 449 CR graduates (135 women, 314 men) were randomised (n = 226 EFI, n = 223 UC). In the intention-to-treat analysis for men and for women, there were no significant effects for treatment or time on MVPA. In a planned secondary analysis that considered only those adherent to EFI (completed ≥ 66% of sessions; per-protocol), bouted MVPA (ie, in sustained bouts of ≥ 10 min) was higher in women in the EFI group (mean = 132.6 ± 135.2 min/wk at 52 weeks) compared with UC (111.8 ± 113.1; P = 0.013). Regarding secondary outcomes, in women, a treatment group main effect was observed for blood pressure (P = 0.011) and exercise capacity (P = 0.019; both per-protocol) favouring EFI; no other differences were observed. CONCLUSIONS In this trial of CR completers, an EFI showed promise for women, but was ineffective in men.
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Affiliation(s)
- Robert D Reid
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada.
| | | | | | | | - Jennifer Harris
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Guy-Anne Proulx
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Kerri A Mullen
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Murray Krahn
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Caroline Chessex
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Andrew L Pipe
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada
| | | | - Sherry L Grace
- York University, Toronto, Ontario, Canada; University Health Network, University of Toronto, Toronto, Ontario, Canada
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Vidal-Almela S, Czajkowski B, Prince SA, Chirico D, Way KL, Pipe AL, Reed JL. Lessons learned from community- and home-based physical activity programs: A narrative review of factors influencing women's participation in cardiac rehabilitation. Eur J Prev Cardiol 2020; 28:761-778. [PMID: 33611528 DOI: 10.1177/2047487320907748] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination. OBJECTIVES This narrative review aimed to: (a) summarize women's barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs. METHODS Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function. RESULTS Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women's cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants' needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions. CONCLUSION Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.
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Affiliation(s)
- Sol Vidal-Almela
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
- Institut du savoir Montfort, l'Hôpital Montfort, Canada
| | - Brenna Czajkowski
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Stephanie A Prince
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Daniele Chirico
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Kimberley L Way
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | - Andrew L Pipe
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- Faculty of Medicine, University of Ottawa, Canada
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Canada
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O'Regan A, Glynn L, Garcia Bengoechea E, Casey M, Clifford A, Donnelly A, Murphy AW, Gallagher S, Gillespie P, Newell J, Harkin M, Macken P, Sweeney J, Foley-Walsh M, Quinn G, Ng K, O'Sullivan N, Balfry G, Woods C. An evaluation of an intervention designed to help inactive adults become more active with a peer mentoring component: a protocol for a cluster randomised feasibility trial of the Move for Life programme. Pilot Feasibility Stud 2019; 5:88. [PMID: 31333875 PMCID: PMC6615191 DOI: 10.1186/s40814-019-0473-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/26/2019] [Indexed: 01/14/2023] Open
Abstract
Background There is overwhelming evidence to support the promotion of physical activity in adults in terms of benefits to well-being, physical and mental health. Physical activity guidelines suggest that adults should accumulate at least 150 min of moderate to vigorous physical activity per week. In Ireland, the majority of adults do not achieve these guidelines, with costs to health and economy. ‘Move for Life’ (MFL) employs behavioural change techniques delivered by an instructor and peer mentor, using a train-the-trainer (cascade) model. This study will conduct a feasibility cluster randomised controlled trial of the MFL intervention for modifying physical activity behaviours in inactive adults aged 45 years and older. Methods The trial is set in eight Local Sports Partnership (LSP) hubs that have structured physical activity programmes. The hubs are the units of randomisation (clusters), and individuals are the units of analysis (participants). Eligible participants will contact one of the hubs, with each hub running four physical activity programmes. Each programme requires between 12–15 inactive adults, resulting in 48–60 participants per hub. Allowing for 20% dropout rate, an additional 96 people will be recruited giving a maximum sample of 576. The hub will be randomised: true control, usual programme or MFL intervention. The true control group will be given information about physical activity but will not be included in a programme for the duration of the trial; the intervention will involve the instructor training one (or more) of the participants to be a peer mentor using an educational toolkit; and usual care groups will have physical activity classes delivered as normal. Baseline data will collect physical activity measures and follow-up measurements will be obtained at 3 and 6 months. All participants will be asked to wear a device for measuring activity on the thigh (activPAL) for 7 days before commencing the programme and at 3 and 6 months. The primary objective of the study is to investigate if it is feasible to deliver the intervention and collect data on moderate to vigorous physical activity (MVPA) on all participants, thereby providing valuable information to guide sample size calculation for a future, more definitive trial. Trial registration number ISRCTN11235176 Electronic supplementary material The online version of this article (10.1186/s40814-019-0473-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrew O'Regan
- 1Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- 1Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - Monica Casey
- 1Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Amanda Clifford
- 3School of Allied Health, University of Limerick, Limerick, Ireland
| | - Alan Donnelly
- 2Department of Physical Education & Sport Sciences, University of Limerick, Limerick, Ireland
| | - Andrew W Murphy
- NUI and HRB Primary Care Clinical Trial Network Ireland, Galway, Ireland
| | - Stephen Gallagher
- 5Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Paddy Gillespie
- 6Health Economics & Policy Analysis Centre (HEPA), NUI Galway, Galway, Ireland
| | - John Newell
- 7School of Mathematics, Statistics & Applied Mathematics Clinical Research Facility, NUI Galway, Galway, Ireland
| | - Mary Harkin
- Go for Life Programme, Age and Opportunity, Dublin, Ireland
| | - Phelim Macken
- Limerick Local Sports Partnership, Limerick, Ireland
| | | | | | - Geraldine Quinn
- 12Health Service Executive: Health & Wellbeing Division, Naas, Ireland
| | - Kwok Ng
- 2Department of Physical Education & Sport Sciences, University of Limerick, Limerick, Ireland
| | - Nollaig O'Sullivan
- 2Department of Physical Education & Sport Sciences, University of Limerick, Limerick, Ireland
| | - Gearoid Balfry
- 2Department of Physical Education & Sport Sciences, University of Limerick, Limerick, Ireland
| | - Catherine Woods
- 2Department of Physical Education & Sport Sciences, University of Limerick, Limerick, Ireland
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Bjerre ED, Leth M, Hammer NM, Midtgaard J. Development of an Educational Program for Non-Professional Soccer Coaches in Charge of Community-Based Soccer in Men with Prostate Cancer: a Qualitative Study. SPORTS MEDICINE - OPEN 2018; 4:31. [PMID: 30003501 PMCID: PMC6043465 DOI: 10.1186/s40798-018-0147-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/03/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND While clinical trials have demonstrated the benefits of structured exercise for prostate cancer survivors, few attempts have been made to investigate and implement sustainable community-based exercise programs supporting adoption of long-term physical activity behavior. Against this background, the aims of this study was to explore the perspectives of experts and stakeholders on the development of a training course and intervention manual used to support the delivery of community-based soccer training in men with prostate cancer (the FC Prostate Community [FCPC] trial). METHODS A two-step qualitative design including triangulation of methods, data sources, and researchers. Step 1 comprised key informant interviews with clinical and scientific experts (n = 4). Step 2 included stakeholder focus group interviews with nurses (n = 5), non-professional soccer coaches and club representatives (n = 5), and prostate cancer survivors (n = 7). RESULTS Four themes emerged from the analysis of the key informant interviews: The Coach's Qualifications, Structure of the Training, Prevention of Injuries, and A Non-Patient Environment, which informed development of the training course and intervention manual. The stakeholders added the importance of clarifying the Responsibility of the Coach, the value of Positive Competition, and Social Inclusion of the prostate cancer survivors in the club. Based on these results, we present the final templates for the training course and intervention manual. CONCLUSIONS No general set of rules or safety measures to promote or optimize the delivery of community-based exercise in cancer survivors is recommended. However, the general principles related to the necessary clarification of the coach's responsibility in relation to the prevention and management of injuries and participant adherence through a non-patient environment may be transferable to the training and education of other groups of lay persons in charge of delivering exercise interventions to other clinical subpopulations in a non-hospital setting.
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Affiliation(s)
- Eik Dybboe Bjerre
- The University Hospitals’ Centre for Health Research, Copenhagen University Hospital Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Mette Leth
- The University Hospitals’ Centre for Health Research, Copenhagen University Hospital Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Nanna Maria Hammer
- The University Hospitals’ Centre for Health Research, Copenhagen University Hospital Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - Julie Midtgaard
- The University Hospitals’ Centre for Health Research, Copenhagen University Hospital Rigshospitalet, Department 9701, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, DK-1014 Copenhagen K, Denmark
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de Almeida ML, Casemiro FG, Baba CT, Monteiro D, Fornazieri M, Cerri N, Fernandes DFM, de Oliveira Gomes GA. Studies About Physical Activity Interventions Including Follow-Up Analysis: A Systematic Review. J Phys Act Health 2018; 15:462-467. [PMID: 29542365 DOI: 10.1123/jpah.2016-0580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Some studies have used the follow-up method to analyze real behavioral changes in research involving physical activity (PA) interventions. This has great scientific value; however, it is hard to apply without satisfactory resources and research funding. Little is known about how many studies have used this method to analyze PA interventions in low-income and middle-income countries, especially Brazil. PURPOSE To describe Brazilian studies using follow-up analysis after PA interventions. METHODS A systematic review was performed including Brazilian studies with follow-up analysis after PA interventions; the analyzed papers were from the previous 10 years. The search was carried out in Portuguese, English, and Spanish in the following databases: SciELO, Latin American and Caribbean Health Science Literature, PubMed, and Scopus. The Preferred Reporting Items for Systematic Review and Meta-Analysis method was used. RESULTS In total, 6 of the 7 studies analyzed were from the southeast region, with the intervention time ranging from 2 to 12 months, carrying out follow-up every 5.3 months with 2.2 observations on average. The interventions had a behavioral approach and were generally carried out in universities, hospitals, and ambulatory care. CONCLUSION Studies on PA interventions using follow-up analysis are scarce. Considering the relevance of follow-up studies to measure behavior changes, the results suggest that more studies about this topic are essential in Brazil.
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Kachur S, Rahim F, Lavie CJ, Morledge M, Cash M, Dinshaw H, Milani R. Cardiac Rehabilitation and Exercise Training in the Elderly. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0224-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Reid R, Blanchard CM, Wooding E, Harris J, Krahn M, Pipe A, Chessex C, Grace SL. Ecologically optimizing exercise maintenance in men and women post-cardiac rehabilitation: Protocol for a randomized controlled trial of efficacy with economics (ECO-PCR). Contemp Clin Trials 2016; 50:116-23. [PMID: 27475772 DOI: 10.1016/j.cct.2016.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Exercise-based cardiac rehabilitation (CR) participation results in increased cardio-metabolic fitness, which is associated with reduced mortality. However, many graduates fail to maintain exercise post-program. ECO-PCR investigates the efficacy and cost-effectiveness of a social ecologically-based intervention to increase long-term exercise maintenance following the completion of CR. METHODS/DESIGN A three-site, 2-group, parallel randomized controlled trial is underway. 412 male and 192 female (N=604) supervised CR participants are being recruited just before CR graduation. Participants are randomized (1:1 concealed allocation) to intervention or usual care. A 50-week exercise facilitator intervention has been designed to assist CR graduates in the transition from structured, supervised exercise to self-managed home- or community-based (e.g., Heart Wise Exercise programs) exercise. The intervention consists of 8 telephone contacts over the 50week period: 3 individual and 5 group. Assessments occur at CR graduation, and 26, 52 and 78weeks post-randomization. The primary outcome is change in minutes of accelerometer-measured moderate to vigorous-intensity physical activity (MVPA) from CR graduation to 52weeks post-randomization. Secondary measures include exercise capacity, quality of life, and cardiovascular risk factors. Analyses will be undertaken based on intention-to-treat. For the primary outcome, an analysis of variance will be computed to test the change in minutes of MVPA in each group between CR graduation and 52week follow-up (2 [arm]×2 [time]). Secondary objectives will be assessed using mixed-model repeated measures analyses to compare differences between groups over time. Mean costs and quality-adjusted life years for each arm will be estimated.
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Affiliation(s)
- Robert Reid
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Chris M Blanchard
- Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada.
| | - Evyanne Wooding
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Jennifer Harris
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Murray Krahn
- University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada.
| | - Andrew Pipe
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Caroline Chessex
- University Health Network, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
| | - Sherry L Grace
- University Health Network, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada; York University - Bethune 368, 4700 Keele St., Toronto, ON M3J 1P3, Canada.
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