An Online Dual-Task Cognitive and Motor Exercise Program for Individuals With Parkinson Disease (PD3 Move Program): Acceptability Study

BACKGROUND

Dual-task training is an emerging field used for people with Parkinson disease (PD) to improve their physical and cognitive well-being, but the patients' acceptability, safety, and adherence to such training in online settings are unknown.

OBJECTIVE

This study aims to evaluate the acceptability of a dual-task cognitive and motor online training program for people with PD as a group online community program.

METHODS

People with PD were invited to participate in an online program (PD3 Move) consisting of physical and vocal exercises in response to different cognitive challenges displayed as dynamic backgrounds on Zoom. The program ran twice per week for 16 weeks. Patient acceptability was assessed at 4 months by monitoring attendance rates and feedback from an exit questionnaire emailed to all participants assessing satisfaction, perceived benefit, safety, and willingness to continue and recommend to others.

RESULTS

The online program was delivered to 15 participants (n=9, 60%, females) with a diagnosis of PD, a mean age of 69.4 (SD 9.3) years, and Hoehn and Yahr (H&Y) stages I-IV. The attendance rate was high, with participants coming to more than 13 (81%) of the sessions. Participants were very satisfied (n=8, 53%) or satisfied (n=7, 47%) with the program. Participants reported that what they most liked were the new cognitive physical challenges. The 3 main facilitators to participating were perceiving the benefits, instructor's flexibility and engagement, and the social interaction moments with others. The 3 main difficulties were dealing with motor fluctuations (n=3, 20%), difficulties in using technology (n=2, 13%), and difficulty hearing instructions due to hearing loss (n=2, 13%). Patients had favorable perceived benefits of the program, with 14 (93%) considering it very useful for the current management of health and 1 (7%) moderately useful. No adverse events were reported, and all participants said that they were willing to continue the program and recommend it to others.

CONCLUSIONS

Our findings suggest that the online cognitive and motor program was well received, safe, and perceived to be of benefit to this group of medically stable people with PD in H&Y stages I-IV. Access to specialized care and enhancement of long-term adherence to regular exercise can be achieved with online community group programs.

Achieving Whole Health: A Preliminary Study of TCMLH, a Group-Based Program Promoting Self-Care and Empowerment Among Veterans

OBJECTIVE

An emerging literature suggests patients with chronic illnesses can benefit from integrated, person-centric approaches to health care, including group-based programs. However, much of the research in this area is disease specific. The objective of this study was to collect preliminary evidence on the efficacy of Taking Charge of My Life and Health (TCMLH), a Whole Health group-based program that emphasizes self-care and empowerment on the overall health and well-being of veterans, a population burdened with high rates of multiple chronic conditions.

METHOD

Self-reported outcomes, including standardized survey measures, were collected at pretest, posttest, and 2-month follow-up from 77 participants across 15 groups at four VA sites. Random intercept mixed-model regressions were used to analyze data.

RESULTS

Results from this initial study showed high satisfaction with the program and facilitators, and high attendance. There were significant pre-post gains in self-care attitudes and behaviors, patient motivation, meaning and purpose, mental health, perceived stress, goal progress, and goal-specific hope. Outcomes were maintained at 2-month follow-up for patient motivation, perceived stress, goal-specific hope, and goal progress. Significant gains were observed in health care empowerment and physical health from pretest to follow-up.

CONCLUSIONS

Preliminary findings support the efficacy of TCMLH, a Whole Health group-based program that emphasizes patient empowerment, self-care practices, and peer support. Future research priorities include a rigorous evaluation with a larger sample size and control group to assess effectiveness.

A psychological group intervention for high-risk pregnant women: a protocol of a feasibility and acceptability study of the STAR Mums program

BACKGROUND

In pregnancy, the attachment relationship between a mother and her baby begins to develop and women are more motivated and willing to make changes to become more engaged and responsive mothers and have better relationships with their children. A transgenerational framework has proposed that dysfunctional relationship patterns are often repeated across generations and this has broadened the understanding of early difficulties in parenting. Despite this there has been little research specifically examining high-risk perinatal women and how their interactions with their infants are related to attachment or relational outcomes.

METHODS

This pilot study aims to evaluate, and to explore the acceptability and feasibility, of participating in the Supporting Transitions, Attachment and Relationships (STAR Mums) program, a psychodynamic attachment-based group intervention, for pregnant women with risk factors for attachment difficulties. The STAR Mums program aims to intervene during pregnancy to assist women with risk factors in the transition to parenthood with the desired outcome to improve the quality of mother-infant emotional interactions, regulation and the attachment relationship. This is a mixed-methods design study incorporating both qualitative and quantitative assessments of five groups of five first-time mothers over a 12-month period.

CONCLUSIONS

This paper outlines the STAR Mums intervention and protocol for assessing acceptability and feasibility. The STAR Mums program takes a preventative approach and supports early intervention for parents at risk of attachment difficulties with their infants. The results of this study will inform revisions to the current treatment manual and a larger-scale program evaluation to further examine the efficacy of this intervention.

"We Thought We Were Alone": The Subjective Experience of the Siblings of Anorexic Adolescent Patients

Objective: The siblings of patients suffering from Anorexia Nervosa (AN) are potentially affected by a disturbed emotional experience that often remains undetected. In order to bring them a psychological support, the Maison de Solenn proposed a support group program for these siblings. The current research explores their mental representations of AN and their emotional experience in the support group named "sibling group." Method: This exploratory study is based on a phenomenological and inductive qualitative method. Four girls and three boys aged between 6 and 19 participating in the "sibling group" were included in a one-time focus group session using a semi-structured interview guide. The thematic data analysis was performed by applying the methods of interpretative phenomenological analysis. Results: Themes that emerged from the interview fall into four categories: AN explained by siblings; the individual emotional experience of siblings; the family experience of siblings and the experience inside the "sibling group." Discussion: According to our participants, the "sibling group" thus functions as a good compromise between keeping an active role in the anorexic patient's care and taking a step back to avoid being eaten up by the illness. Sibling-group participants retrieved a sense of belonging, which is normally one of the functions of being a sibling. It is important to note that the "sibling group" is part of the comprehensive (or global) family-based approach included in an institutional multidisciplinary integrative care framework.

Efficacy of a peer-led group program for unemployed people with mental health problems: Pilot randomized controlled trial

BACKGROUND

People with long-term unemployment and mental health problems often find it difficult to take active steps toward help-seeking and job search and to navigate the complex system of available services. Likewise, job center staff would welcome interventions to improve the reintegration of long-term unemployed individuals with mental health problems into the labor market.

AIM

To examine the efficacy of a peer-led group program that supports unemployed people with mental health problems in terms of help-seeking, job search and recovery.

METHODS

Based on participatory research, a four-session group program was designed and evaluated in a pilot randomized controlled trial (RCT) with 42 participants, randomized to the program ( n = 23) or treatment as usual ( n = 19). Outcomes were assessed at baseline (T0), 3 weeks (T1), 6 weeks (T2) and 6 months later (T3).

RESULTS

There were no significant intervention effects on primary outcomes (job search self-efficacy and help-seeking). But compared to the control group, intervention participants showed significant improvements in depressive symptoms ( p = .02) and recovery ( p = .04) at T2 with medium effect sizes. There were trend-level positive program effects on self-stigma, hopelessness and secrecy.

CONCLUSION

This pilot RCT provides initial evidence for the efficacy of a peer-led group program to improve symptoms and recovery among unemployed participants with mental health problems.

Group Yoga Effects on Cancer Patient and Caregiver Symptom Distress: Assessment of Self-reported Symptoms at a Comprehensive Cancer Center

Background. Complementary and integrative health approaches such as yoga provide support for psychosocial health. We explored the effects of group-based yoga classes offered through an integrative medicine center at a comprehensive cancer center. Methods. Patients and caregivers had access to two yoga group classes: a lower intensity (YLow) or higher intensity (YHigh) class. Participants completed the Edmonton Symptom Assessment System (ESAS; scale 0-10, 10 most severe) immediately before and after the class. ESAS subscales analyzed included global (GDS; score 0-90), physical (PHS; 0-60), and psychological distress (PSS; 0-20). Data were analyzed examining pre-yoga and post-yoga symptom scores using paired t-tests and between types of classes using ANOVAs. Results. From July 18, 2016, to August 8, 2017, 282 unique participants (205 patients, 77 caregivers; 85% female; ages 20-79 years) attended one or more yoga groups (mean 2.3). For all participants, we observed clinically significant reduction/improvement in GDS, PHS, and PSS scores and in symptoms (ESAS decrease ≥1; means) of anxiety, fatigue, well-being, depression, appetite, drowsiness, and sleep. Clinically significant improvement for both patients and caregivers was observed for anxiety, depression, fatigue, well-being, and all ESAS subscales. Comparing yoga groups, YLow contributed to greater improvement in sleep versus YHigh (−1.33 vs −0.50, P = .054). Improvement in fatigue for YLow was the greatest mean change (YLow −2.12). Conclusion. A single yoga group class resulted in clinically meaningful improvement of multiple self-reported symptoms. Further research is needed to better understand how yoga class content, intensity, and duration can affect outcomes.

Evaluation of a community-based program for young boys at-risk of antisocial behaviour: results and issues

OBJECTIVE

We assess the impact of a community-based intervention program for boys 6-11 years old at-risk of antisocial behaviour, and compare changes in behaviour and competence pre-post for intervention and wait-list comparison group.

METHOD

Interested parents called for enrolment. Inclusion required police contact and/or clinical scores (T>69) on Child Behaviour Checklist (CBCL) or Teacher Report Form (TRF), no developmental delay and English speaking. The program included two core 12-week groups (children's, parents') and optional additional services. Twelve sessions (February 2002-December 2005) provide pre-post intervention data, boys waiting at least 6 months formed a comparison group (starting April 2005). Outcomes included CBCL and TRF behaviour scales (rule-breaking, aggression, conduct, total problems) and competence. Repeated measures analysis of variance was done.

RESULTS

Pre-post outcome comparisons indicated improvements among all boys, with significant differences favouring intervention boys on CBCL behaviour scales, but not TRF outcomes. Effect sizes were small to medium. Persisting high post-behaviour levels, unmeasured variation in additional services, and other design and sampling issues are noted.

CONCLUSIONS

More rigorously designed program evaluation is required.