CanWell Program CPAC Presentation 2010
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Transcript of CanWell Program CPAC Presentation 2010
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Copyright CanWell Program 2010
CPAC Cancer Workforce SymposiumJan. 25th 2010, MontrealBreakout Session 1C Community
CanWell Program:An Innovative Community Cancer Care
Service Delivery Model
Presented byFidelma Serediuk & Jan Park Dorsay
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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.
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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 HealthCompetencies 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
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CanWell Program Goals
To promote optimal wellness for survivors of cancer To promote inter-agency and inter-professional
collaborative care, knowledge and competencies inthe area of exercise for people with cancer
To develop and establish competencies andexpertise related to exercise for cancer survivors bytesting a model which may be implemented in othercommunities
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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 andfat gain, and improve mood and QOL, and
Facilitates completion of difficult treatments
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CanWell – response to a need
Cancer and Exercise Survey (N=648) > patients’knowledge and preferences (Cheifetz & Park Dorsay, 2007)
adapt knowledge to the local communitycontext >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 inan exercise program
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CanWell -‐ response to a need
52% of respondents preferred a supervised exerciseprogram
43% plus 25% preferred an exercise program in thehome or community
The majority of respondents reported exercising withstaff knowledgeable about the specific needs ofcancer survivors was important; this contributed totheir feelings of safety and confidence
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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 than60%)
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The CanWell Pilot Project: Results “Exercise gives me back some of my self image. I’m
working through my frustration that cancer treatmentisn’t a do it, get it done, over deal.”
“Before cancer, I was fearless. I back packed through18 countries solo. After cancer, I became a personafraid to walk to the store. I became fearful, andagoraphobic. Eight weeks into the CanWell program, Irealized I was no longer fearful or agoraphobic. I’mfine outside of my home now. This is huge for me.Thank you CanWell.”
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Service Delivery Human Resource Model-‐CanWell
YMCA based; Kinisiologist Fitness Trainers
Hospital & YMCA based Health Professional consultationsupport;
Physiotherapist Nurse Practitioner
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CanWell Program Model
Intake Screening ProcessCanWell Trained YMCA Kinisiologist HHS
Physiotherapist &Nurse Practitioner
Participant accepted into 12 week Supervised CanWell Exercise & Education ProgramCanWell TrainedYMCA Kinisiologist & Fitness Trainers
Baseline
Consult PRN
Self Referral orHCP Referral
With Physician ClearanceSubmitted to YMCA
6 wk eval.
12 wk eval.
Participant continues independently Accesses CanWell team
as needed
Advise referralsource if notaccepted intoCanWell
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The CanWell Program Pilot Project: the process andproducts
Physiotherapist and NP developed YMCA staff trainingmaterials 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
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Challenges-‐ Myth Busting- overcoming beliefs that exercise
is not beneficial to people with cancer! Inter-agency and inter-professional
collaboration requires time+++ andcommitment to achieve effectivecommunication
Timeline of project – originally was 12 months-needed a time extension of 3 months toachieve all project deliverables
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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
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Strategies for Success
Identification of a service gap;lack of resources for cancer survivors to exercise safely inthe 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
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The CanWellProgram:An InnovativeCommunityCancer CareServiceDelivery Model
CanWell Pilot Research
Les Chater YMCA,2009
CanWellProgram:
Increasing capacity in the community thru
knowledge andskills
development
Cancer and exercise
Survey: JCC 2007,(Cheifetz &
Park Dorsay)
Adding to publishedevidence
on the benefits of exercise for cancer
survivors
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CanWell Key Learnings; Transfer of cancer and exercise knowledgeand competencies so as to provide a safe andeffective education and exercise program forpeople with cancer in a community setting is
possible For people with cancer - exercise can be both
safe and effective !
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www.canwellprogram.ca