Project EXCEL:

Regions: Inuvialuit Settlement Region, Gwich'in Settlement Area, Sahtu Settlement Area, Dehcho Region, North Slave Region, South Slave Region, Qikiqtaaluk Region

Tags: health, wellness, cancer, oncology

Principal Investigator: Culos-Reed, Nicole (1)
Licence Number: 16978
Organization: University of Calgary
Licensed Year(s): 2022
Issued: Mar 01, 2022
Project Team: Margaret McNeely, Daniel Santa-Mina, Melanie Keats, Chris Sellar

Objective(s): To disseminate, implement, and assess the effectiveness of our exercise oncology survivorship partnership model to increase the reach and delivery of exercise programs to rural/remote and underserved Canadians, living with and beyond cancer.

Project Description: This licence has been issued for the scientific research application No.5162.

To disseminate, implement, and assess the effectiveness of the Exercise Oncology Survivorship (EOS) partnership model to increase the reach and delivery of exercise programs to rural/remote and underserved Canadians, living with and beyond cancer. Reaching more individuals living with and beyond cancer, with an exercise program enhances equitable access to supportive cancer care resources that will enhance cancer survivorship, providing fitness, health, and psychosocial benefits.

Based on clinical collaborations with NWT healthcare providers we have the opportunity to offer Project Exercise for Cancer to Enhance Living Well (EXCEL) to remote cancer survivors (RCS) in NWT. To date there is no exercise oncology resources available for this population.

Using implementation science and a focus on the reach of the EOS partnership model to RCS, the research team will use the: 1) Canadian Institute of Health Research (CIHR) knowledge to action framework to guide the process of translating research evidence into practice; 2) Capability, Opportunity, Motivation and Behaviour to understand and explain influences on implementation outcomes; and, (3) Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate implementation and support of programming at sites, which includes assessment of the RE-AIM of establishing EXCEL and the specific interventions (e.g. Alberta Cancer Exercise (ACE), in Alberta; Activating Cancer Communities through an Exercise Strategy (ACCESS), in Nova Scotia and the Maritimes). Specifically, the research team will assess the dissemination and implementation of EXCEL and the specific exercise programs (ACE, ACCESS), using markers of reach (numbers), implementation (training, logistics, delivery) and maintenance (ongoing delivery, sustainability measures). Effectiveness of the exercise program for participants will be captured through objective exercise behaviour data, participant-reported physical and psychosocial outcomes, and program satisfaction. Approximately 45-50 sites across Canada and over 1500 RCS participants will be targeted over 5 years. The research team currently have sites running throughout Alberta, Saskatchewan, Ontario, and the Atlantic provinces - all of which (except 1-2 sites in Nova Scotia) run online.

The exercise program to be implemented for RCS will be based on ACE and ACCESS programs, adapted as required for online implementation. The program includes a combination of aerobic, resistance, balance, and flexibility exercises delivered in an hour-long circuit-type class, twice weekly for a 12-week period. The online exercise sessions will be conducted over the Zoom platform. Classes will have 8-15 participants, directly under the supervision of the trained community-based qualified exercise professional (QEP). As an additional safety measure, a moderator will assist the instructor by ensuring visual contact is maintained with participants at all times and to assist with emergency procedures should an emergency situation arose. If a community is able to deliver an in-person class (based on region-specific public health recommendations and provided it is feasible (e.g. at least 8 participants can join the class), the exercise program protocol remains the same. Whether delivered in class or remotely, the program follows exercise progression principles (e.g. principles of frequency, intensity, time, type, overload and progression) over the 12-weeks, with tailoring of any exercise to meet individual participant needs as required, in order to promote fitness and wellness benefits.

The EOS partnership model is built upon a participant-oriented research approach, ensuring both the clinical (health care providers, administrators) and patient (CS, caregivers) voices are used to inform decisions across the design, implementation, and evaluation phases. Using an integrated knowledge translation framework, quality improvement cycles are built into the timeline (every 6 months) to ensure that the best practice-based evidence is being gathered, used to update key program components, and implemented across the community sites.

The fieldwork for this study will be conducted from February 28 to December 31, 2022