Browsing by Author "Duchek, Delaney"

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    Exploring feasibility, perceptions of acceptability, and potential benefits of an 8-week yoga intervention delivered by videoconference for young adults affected by cancer: a single-arm hybrid effectiveness-implementation pilot study
    (2023-03-10) Wurz, Amanda; McLaughlin, Emma; Hughes, Kimberly; Ellis, Kelsey; Chen, Amy; Cowley, Lauren; Molina, Heather; Duchek, Delaney; Eisele, Maximilian; Culos-Reed, S. N.
    Abstract Background Young adults affected by cancer face physical and psychological challenges and desire online supportive care. Yoga can be delivered online and may improve physical and psychological outcomes. Yet, yoga has rarely been studied with young adults affected by cancer. To address this, an 8-week yoga intervention was developed, and a pilot study was deemed necessary to explore feasibility, acceptability, implementation, and potential benefits. Methods A mixed-methods, single-arm hybrid effectiveness-implementation pilot study evaluating the yoga intervention was conducted. Feasibility was assessed by tracking enrollment, retention, attendance, completeness of data, and adverse events. Acceptability was explored through interviews. Implementation metrics included training time, delivery resources, and fidelity. Potential effectiveness was evaluated by exploring changes in physical (i.e., balance, flexibility, range of motion, functional mobility) and psychological (i.e., quality of life, fatigue, resilience, posttraumatic growth, body image, mindfulness, perceived stress) outcomes at pre- (week 0), post- (week 8), and follow-up (week 16) time points. Data were analyzed with descriptive statistics, repeated measures analysis of variance, and content analysis. Results Thirty young adults participated in this study (recruitment rate = 33%). Retention to study procedures was 70%, and attendance ranged from 38 to 100%. There were little missing data (< 5%) and no adverse events. Though most participants were satisfied with the yoga intervention, recommendations for improvement were shared. Sixty study-specific training hours and > 240 delivery and assessment hours were accrued and fidelity was high. Functional mobility, flexibility, quality of life (energy/fatigue, social well-being), body image (appearance evaluation), mindfulness (non-reactivity), and perceived stress improved significantly over time (all p< 0.050; $$\eta_{p}{}^{2}s=0.124-0.292$$ η p 2 s = 0.124 - 0.292 ). No other significant changes were observed (all p> 0.050;  $$\eta_{p}{}^{2}s=0.005-0.115$$ η p 2 s = 0.005 - 0.115 ). Conclusions The yoga intervention may confer physical and psychological benefits, though intervention and study-specific modifications are required to improve feasibility and acceptability. Requiring study participation and providing greater scheduling flexibility could enhance recruitment and retention. Increasing the frequency of classes offered each week and offering more opportunities for participant interaction could improve satisfaction. This study highlights the value of doing pilot work and provides data that has directly informed intervention and study modifications. Findings could also be used by others offering yoga or supportive care by videoconference to young adults affected by cancer. Trial registration Not available—not registered
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    Feasibility of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer
    (2021-02-13) Ester, Manuel; Culos-Reed, S. N; Abdul-Razzak, Amane; Daun, Julia T; Duchek, Delaney; Francis, George; Bebb, Gwyn; Black, Jennifer; Arlain, Audra; Gillis, Chelsia; Galloway, Lyle; Capozzi, Lauren C
    Abstract Background Advanced lung cancer patients face significant physical and psychological burden leading to reduced physical function and quality of life. Separately, physical activity, nutrition, and palliative symptom management interventions have been shown to improve functioning in this population, however no study has combined all three in a multimodal intervention. Therefore, we assessed the feasibility of a multimodal physical activity, nutrition, and palliative symptom management intervention in advanced lung cancer. Methods Participants received an individually tailored 12-week intervention featuring in-person group-based exercise classes, at-home physical activity prescription, behaviour change education, and nutrition and palliative care consultations. Patients reported symptom burden, energy, and fatigue before and after each class. At baseline and post-intervention, symptom burden, quality of life, fatigue, physical activity, dietary intake, and physical function were assessed. Post-intervention interviews examined participant perspectives. Results The multimodal program was feasible, with 44% (10/23) recruitment, 75% (75/100) class attendance, 89% (8/9) nutrition and palliative consult attendance, and 85% (17/20) assessment completion. Of ten participants, 70% (7/10) completed the post-intervention follow-up. Participants perceived the intervention as feasible and valuable. Physical activity, symptom burden, and quality of life were maintained, while tiredness decreased significantly. Exercise classes prompted acute clinically meaningful reductions in fatigue, tiredness, depression, pain, and increases in energy and well-being. Conclusion A multimodal physical activity, nutrition, and palliative symptom management intervention is feasible and shows potential benefits on quality of life that warrant further investigation in a larger cohort trial. Trial registration NCT04575831 , Registered 05 October 2020 – Retrospectively registered.
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    Understanding In-Person and Online Exercise Oncology Program Delivery: Participant Perspectives
    (2021-06-30) Duchek, Delaney; Culos-Reed, Nicole; McDonough, Meghan; Bridel, William; Berzins, Sandra
    Background: Alberta Cancer Exercise (ACE) is an exercise oncology program delivered in community-based settings until the onset of the COVID-19 pandemic, when ACE was forced to transition to an online platform for remote delivery. Purpose: To evaluate the perspectives of cancer survivors who have transitioned from an in-person to an online exercise oncology program. Specifically, survivors' exercise facilitators and barriers in both delivery modes, delivery mode preference, and experience with the program elements targeting behaviour change were gathered. Methods: A retrospective cohort design using explanatory sequential mixed-methods was used to assess participants' experiences with participation in both settings. Participants who have completed both in-person and online ACE classes were asked to complete a survey, with the option to complete a subsequent interview. Results: A total of 57 (response rate 46%) completed the survey and 19 interviews were conducted. Most participants indicated preferring in-person programs (58%), followed by online (32%), and no preference (10%). There were significantly fewer barriers (p<0.01), but also fewer facilitators/benefits (p<0.01), to exercising online. Qualitative data analysis supported survey findings, with participants frequently noting the convenience of attending online, but a lack of equivalent social connection gained. Content analysis (survey comments) and thematic analysis (interview analysis) demonstrated that the online setting was less conducive to providing behaviour change support, largely attributed to limitations inherent to the online platform. Conclusion: ACE participants experienced facilitators and barriers to both the online and in-person delivery modes. The transition to online was supported by participants' in-person experiences, and for future work that includes solely online (i.e., for rural and remote cancer survivor exercise program delivery), focusing on building social support and a sense of community will be critical to optimizing program benefits. Addressing the need for promoting and maintaining exercise in people with cancer using an online platform when standard exercise formats are restricted due to COVID-19 is timely and necessary. Beyond the COVID-19 pandemic, results of this research will remain relevant as we aim to increase the reach of online exercise oncology programming to more underserved populations of individuals living with cancer (i.e., rural/remote, immunocompromised, young adult populations).