1. 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
3. 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
4. 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
5. 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
6. 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
7. 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
8. 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
10. 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
11. 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
12. 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
13. 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
14. 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
15. 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
16. 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
17. 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
18. 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
19. 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
