Group-based Program Research Articles

Feasibility of a novel exercise program for patients with breast cancer offering different modalities and based on patient preference

PurposeExercise improves quality of life and reduces the side effects of cancer therapies. Nevertheless, attendance to exercise programs remains a challenge for patients. This study explored the feasibility of an exercise program in which women with breast cancer may be allowed to choose among three exercise delivery modalities. MethodsForty-seven patients with breast cancer (stage I-IV) participated in a 12-week combined aerobic and resistance training program. The exercise modality was chosen by patients according to their preferences and needs among three options: the personal training program, the home-based program, or the group-based program. Exercise prescription was similar between the three modalities. Whereas the primary endpoint was feasibility, assessed through recruitment rate, attendance, adherence, dropout rate, tolerability, and safety, secondary endpoints included health-related skills and quality of life. ResultsOut of 47 recruited patients, 24 chose the home-based program, 19 the personal training program, and four the group-based program. Six dropouts (13%) were registered, and no severe adverse events were recorded. The median program attendance was 98% for personal training programs, 96% for home-based programs, and 100% for group-based programs, whereas compliance resulted in more than 90% in each modality. At postintervention, a significant increase in cardiorespiratory fitness, lower body flexibility, and body weight was observed. Different quality-of-life domains were improved following the intervention, including physical and social functioning, fatigue, and appetite loss. No significant changes in other parameters were detected. ConclusionsAn exercise prescription based on a patient-preferred delivery modality showed high feasibility in women with breast cancer.

Does group-based parent support during the transition to parenthood affect child socio-emotional problems and health care utilization? A randomized controlled trial

As government-funded universal programs for new parents continue to expand, it is critical to investigate their short- and longer-term effects. The level of knowledge, especially on the effect of group-based interventions, is sparse. This study is the second report from a large trial of a widely implemented universal group-based parenting program in Denmark and includes outcomes on child socio-emotional problems and use of health services. A sample of 1701 unborn children from families representative within the area, were randomized to intervention or care as usual beginning November 2014. From these families, 1268 mothers and 999 partners (mean age 29.4 and 31.19, respectively; 6% migration background) filled in the Ages and Stages Questionnaire. Intention-to-treat-analyses showed fewer socio-emotional problems in the intervention group (between-group difference - 2.34, 95% CI [0.40, 4.30], d = - 0.13) as reported by mothers, but not partners, when children were 10 months old. This finding was transitory (no longer significant at 19 months). No effects were found on health care utilization. The previous report from this trial showed no effects on measures of parenting. In total, these findings serve the purpose of adjusting future expectations to the size and type of effect to be gained from a universal parent program in a resourceful setting. We conclude that even if the Family Startup Program (DK: Familieiværksætterne) 2 was liked, well implemented, and well attended by the parents, the positive effect on children's socio-emotional problems, was too modest to be the argument that can carry the weight of policy going forward. Public significance statementThis study examined the effects of the Family Startup Program (DK: Familieiværksætterne), a universal, group-based program to support parents during the transition to parenthood. Results showed a modest transitory preventive effect on children's socio-emotional problems and no effects on health care utilization. These findings adjust down previous expectations to the size and type of effects to be gained from universal group-based parent support in a well-resourced setting.

Capturing Exercise Psychological Need Satisfaction Among Older Adults: The BPNES

ABSTRACT Regular exercise participation which is a component of promoting health and healthy aging among older adults necessitates the creation of environments that fulfill participants’ needs for autonomy, competence, and relatedness, thus, providing opportunities to promote authentic interest in the activities and meaningful social engagement. Appropriate tools to capture satisfaction of these needs may prove invaluable to gain an understanding of the effectiveness of exercise programs from participants’ perspective. The aim of the study was to examine psychometric aspects of the Basic Psychological Needs in Exercise Scale (BPNES) scores based on responses of 675 older adult Greek exercise participants, men and women, aged 65 to 80 years, attending indoor group-based exercise programs. The data supported the factorial validity, internal reliability, nomological validity, and equivalent item interpretation of BPNES scores between groups differing in demographic characteristics. Older adults with exercise experience greater than three years reported higher exercise needs satisfaction for all three needs compared to those exercising less than three years. The favorable psychometric characteristics of the BPNES in this population make it a valuable tool for the assessment of the extent to which older adults’ needs for autonomy, competence, and relatedness are fulfilled in group-based exercise settings.

Usability and Acceptability of a Web Platform to Host the Group-Based TOGETHER-YA Quality of Life Intervention for Young Adult Cancer Survivors.

Young adult (YA) cancer survivors aged 18-39 frequently report unmet health information and peer support needs, as well as poor health-related quality of life (HRQOL). Our team has developed a supportive care intervention, titled TOGETHER-YA, to improve YA cancer survivors' stress management skills. TOGETHER-YA is delivered via videoconference and has shown initial feasibility, acceptability, and promise for improving HRQOL among YA survivors. The purpose of this two-part study was to design and test a website to host the TOGETHER-YA intervention for YA cancer survivors aged 18-39. TOGETHER-YA is a 10-week, group-based program designed to promote health-related quality of life. In Part 1, we leveraged an existing online platform and adapted it to meet the needs of TOGETHER-YA. We conducted three iterative waves of usability testing with three YAs per wave to refine the website. In Part 2, we conducted a single-group feasibility trial of TOGETHER-YA using the website. Primary outcomes were feasibility (i.e., recruitment, retention, attendance) and acceptability (i.e., satisfaction). Usability testing participants (N=9) indicated that the TOGETHER-YA website was easy to use (M=5.9, SD=1.3) and easy to learn (M=6.5, SD=0.9) (possible ranges: 1-7). Qualitative feedback identified needed revisions to the aesthetics (e.g., images), content (e.g., session titles), function (e.g., clarity of functionality), and structure (e.g., expandable sections), which were implemented. In the feasibility trial, participants (N=7) were an average of 25 years old (SD=4.7) and mostly non-Hispanic White (57%). Recruitment (70%) and retention (71%) rates and average session attendance (M=7.1, SD=4.2) supported feasibility. Participant agreement with positive statements about TOGETHER-YA and average satisfaction ratings (M=5.06, SD=1.64; possible range: 1-7) demonstrated acceptability. Results supported the usability, feasibility, and acceptability of the TOGETHER-YA program and website. By hosting the content online, the program effectively addresses YAs' expressed preference for convenience. Future studies are needed to increase TOGETHER-YA's efficiency and explore its efficacy for improving targeted outcomes. NCT05597228, October 24, 2022.

Initial evaluation of the TALES (technology and literacy engagement after stroke) programme targeting functional literacy and social engagement in people with aphasia after stroke

ABSTRACT Background and aims Literacy skills are typically affected in people with stroke aphasia, leading to reduced engagement in functional everyday reading/writing tasks, such as email/messaging via social media. The aim of this study was to investigate the outcomes of the TALES (Technology And Literacy Engagement after Stroke) programme, a group-based online literacy-focused programme for people with aphasia after stroke. This first evaluation of this programme aimed to examine outcomes related to feasibility, changes in language, literacy and self-ratings of communication skills. Methods Five participants with aphasia were assessed on a range of outcome measures relating to language and self-perception of communication skills. These were: the Western Aphasia Battery-Revised (WAB-R; (Kertesz, 2007)), literacy subtests from the Psycholinguistic Assessment of Language Processing in Aphasia (PALPA; (Kay et al., 1996)) and the Communication Outcomes after Stroke (COAST; (Long et al., 2008)). TALES consisted of a weekly group online session, 1:1 supported telehealth reading/writing practice and regular messaging via email. Results and main contribution From a descriptive statistics perspective, the mean gains across the cohort were 7.94 (from 84.24 to 92.18) on the WAB AQ (aphasia quotient), 8.92 (from 81.18 to 90.10) on the WAB LQ (language quotient). Additionally, there was a change in the mean scores for PALPA subtests (31, 37 and 40) observed between the pre-treatment assessment and post-treatment assessment. Finally, the mean score increased by 8.8 (from 49.40 to 58.20) on the COAST (max score = 80). Results indicated gains in literacy and communication measures as well as changes to self-rating of communication reflecting changes in communication confidence. Conclusions Mindful of the threats to the internal validity inherent in the study design, the reported online therapy can overcome barriers such as distance and mobility limitations and may provide greater accessibility to therapy for individuals with aphasia. TALES was a low-therapist-input yet reasonably intensive treatment approach which embedded language practice immediately in functional use through the social group format and personally-relevant written communication. Implications The TALES programme meets many neuroscience principles of neurorehabilitation including “use it or lose it”, salience and transference. Future research may usefully investigate the contribution of the group format versus the functional literacy components towards these potentially promising early data.

Group-based instrumental musical training to enhance resilience among school-aged children from low-income families: A pilot randomised waitlist controlled trial.

To evaluate the acceptability, feasibility and potential effectiveness of a group-based instrumental musical training programme in improving resilience, depressive symptoms, self-esteem and quality of life among school-aged children from low-income families. Assessor-blinded pilot randomised waitlist controlled trial with process evaluation. This study was conducted in the community from January 2022 to July 2023. Sixty-four children from low-income families (aged 8-12 years) were randomised (1:1) to intervention and waitlist control groups. The intervention group (n = 32) received weekly 1-hour instrumental musical training for 6 months in groups of four to five from professionally qualified musicians at a music centre. The participants in the waitlist control group (n = 32) received the same intervention as the participants in the intervention group after the completion of all outcome assessments. The primary outcome was the children's levels of resilience, measured using the Resilience Scale for Children - 10. The secondary outcomes were depressive symptoms, self-esteem and quality of life. Assessments were conducted at baseline (T0) and immediately post-intervention (T1). An intention-to-treat analysis was performed. The 64 participants had a mean (SD) age of 9.5 (1.44) years, and 37 (57.8%) were boys. Compared with the waitlist control group, participants in the intervention group showed significantly greater improvements in resilience levels from baseline to T0 (group-by-time interaction coefficient β = 4.41; 95% CI, 1.82-6.99; p = 0.001), depressive symptoms (β = -6.42; 95% CI, -11.12 to -1.71; p = 0.008), self-esteem (β = -2.60; 95% CI, 0.28-4.92; p = 0.028) and quality of life (β = 6.69; 95% CI, 0.18-13.2; p = 0.044). The group-based instrumental musical training programme was feasible and acceptable for school-aged underprivileged children and showed the potential to improve the resilience and quality of life of this vulnerable population.

Effects of Multicomponent Exercise on Community-Dwelling Older Adults With Mild Cognitive Impairment.

To explore the effects of a group-based multicomponent exercise program on general cognitive functioning, depression, and social functioning in community-dwelling older adults with mild cognitive impairment (MCI) and whether the effects can be maintained. Fifty older adults with MCI were conveniently recruited from two communities in the study area and randomly assigned to the intervention group or control group. The intervention group received three sessions of 60-minute, multicomponent exercise per week for 3 months, plus MCI-related health education. The control group only received MCI-related health education. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Beijing Version (MoCA-BJ) were used to assess general cognitive function. The Functional Activities Questionnaire (FAQ) and Geriatric Depression Scale (GDS-30) were used to evaluate participants' social function and depression, respectively. Participants' exercise intensity was assessed using the Category Ratio Scale. After the 3-month intervention, there were significant improvements in general cognitive function (p = 0.046), attention (p = 0.009), delayed recall (p = 0.015), and social function (p = 0.011) in the intervention group compared with the control group. However, after 3-month postintervention follow up, no significant differences in MMSE, MoCA-BJ, GDS-30, and FAQ scores were noted between groups. The 3-month multicomponent exercise program improved general cognitive function and social functioning in community-dwelling older adults with MCI. However, there was no evidence that these benefits lasted for another 3 months after stopping the exercise program. [Research in Gerontological Nursing, 17(2), 65-79.].

Effectiveness of a pharmacist-led, community group-based education programme in enhancing diabetes management: A multicentre randomised control trial

AimsThis study presents a protocol for the Pharmacy Integrated Community Care (PICC) program, meticulously designed to enhance Hemoglobin A1c (HbA1c) levels and augment knowledge about diabetes mellitus (DM) among individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) in the Sarawak State of Malaysia. MethodsFrom 1 May to December 31, 2023, a prospective, multicenter, parallel-design randomised controlled trial will be conducted with two groups, each consisting of 47 participants. The intervention group will receive a structured, four-session group-based program guided by experienced pharmacists, focusing on medication adherence and diabetes management. The control group will follow the standard Diabetes Mellitus Adherence Clinic program. The primary outcomes of this study encompass enhancements in knowledge regarding diabetes medication management and adherence, followed by subsequent changes in HbA1c levels. ConclusionsThe successful implementation of the PICC program holds promise for enhancing health outcomes in the T2DM population, potentially leading to more effective diabetes management initiatives and better health practices in the community. Trial registration clinicaltrials.gov identifierNCT05106231.

Exercise and behaviour change support for individuals living with and beyond cancer: Interim results and program satisfaction of the EXCEL study

PurposeExamine the impact of the EXercise for Cancer to Enhance Living Well's (EXCEL) 10–12-week exercise and behaviour change support intervention on secondary effectiveness outcomes, including patient-reported outcomes, physical function, and program satisfaction. MethodsIndividuals with cancer up to 3 years post treatment with any tumour type were eligible. Outcomes were measured at baseline and immediately following the 10–12-week intervention. Patient-reported outcomes included participant characteristics, overall well-being, cognition, fatigue, symptom severity, exercise barrier self-efficacy, and program satisfaction. Physical function included shoulder flexion, 30-s sit to stand, sit and reach, 2-min step test or 6-min walk test (in-person only), and single leg balance. Wilcoxon signed-rank tests were used to assess changes in patient-reported outcomes and physical function assessments from baseline to 12-weeks. ResultsA total of 804 participants enrolled in the study in the first 2.5-years, with 699 completing the intervention. Wilcoxon signed rank tests and Rosenthal coefficients (r) showed significant (p ​< ​0.05) small improvements in well-being (r ​= ​0.10), fatigue (r ​= ​0.25), symptom severity (r ​= ​0.17), and self-efficacy (r ​= ​0.11). Significant (p ​< ​0.01) moderate to large improvements were observed for the 30-s sit to stand (r ​= ​0.54), sit and reach (left: r ​= ​0.46; right: r ​= ​0.41), 2-min step test (r ​= ​0.66), 6-min walk test (r ​= ​0.52), and single leg balance (left: r ​= ​0.32; right: r ​= ​0.34) assessments. Participants reported high satisfaction with program staff (average ​= ​4.5/5) and that the program was beneficial and enjoyable (average ​= ​4.6/5). ConclusionEXCEL's group-based exercise program with behaviour change support, delivered in an online supervised setting to individuals living with cancer, may improve patient-reported outcomes and physical function and is associated with high participant satisfaction.

In their own voices: immigrant mothers’ experiences and perceptions of the group-based self-assured parents programme for parents in disadvantaged areas in Sweden

ABSTRACT Culturally responsive parenting interventions are crucial for immigrant parents in disadvantaged areas. This qualitative study delves into the experiences of 18 immigrant mothers (Mage = 41.2 years) from Somalia, Syria, Turkey, Eritrea, and Iraq participating in the Swedish Self-Assured Parents programme, targeting immigrant parents who live in social disadvantage with teenage children. Thematic analysis revealed seven main themes (1) the meaning of the programme content and structure, (2) enjoying oneself and being comfortable, (3) putting the adolescent in the centre, (4) mothers’ own socioemotional development, (5) changing from being a passive reactor to an active agent, (6) empowered citizenship, and (7) having always been a strong and good mother. Overall, the mothers were positive about both the content and the format of the programme, appreciating the warm and supportive climate. They also perceived themselves as being more attentive to adolescent needs, having improved their own socio-emotional skills, and being empowered both as a citizen and as a mother on account of attending the programme. With the development of culturally responsive programmes that take into account the unique needs and experiences of diverse populations, governments can effectively support parents, promote child positive development, and help cultivate social cohesion among the members of society.

Online Group-based Pelvic Floor Muscle Training for Urinary Incontinence in Older Women: a Pilot Study.

Urinary incontinence (UI) is prevalent among older women, but conservative treatment rates remain low due to limited accessibility, despite evidence supporting pelvic floor muscle training (PFMT) efficacy. Group-based approaches, including online options, could offer cost-effective alternatives. Recent evidence supports the feasibility of online group-based PFMT for treating UI in older women. This pilot study now evaluated the clinical effects of this program on the number of leakage episodes per day, additional UI-specific outcomes, and other symptoms and indicators. Community-dwelling women aged 65 and over, with stress or mixed UI, were recruited. Eligibility was assessed through in-person evaluations conducted by pelvic floor physiotherapists, who instructed participants on pelvic floor muscle contraction using digital palpation. Participants engaged in a 12-week group-based PFMT program with weekly 1-h sessions. Data were collected at three time points: recruitment (PRE1), before the first session (PRE2), and after the program (POST). Participants recorded UI symptoms using 7-day bladder diaries and standardized questionnaires on UI symptoms, quality of life (QoL), UI self-efficacy, and perceived costs. After the program (POST), participants provided feedback on their impression of improvement and satisfaction. Participants reported a significant reduction in their number of leakage episodes per day. Standardized questionnaire scores also supported the positive effects of the program on UI symptoms and QoL, self-efficacy in avoiding leakage and performing PFMT exercises, and monthly costs for continence products. Older women expressed high satisfaction with symptom improvement and the program. Online group-based PFMT improved UI symptoms, QoL, UI self-efficacy, and perceived UI costs among older women. Pragmatic randomized controlledtrials are necessary for further validation.

Effects of aquatic exercise program versus on-land exercise program on cancer-related fatigue, neuropathy, activity and participation, quality of life, and return to work for cancer patients: study protocol for a randomized controlled trial

BackgroundExercise has shown positive effects on fatigue, exhaustion, neuropathy, and quality of life in cancer patients. While on-land exercises have been studied, the aquatic environment offers unique advantages. Water's density and viscosity provide resistance, enhancing muscle strength, while hydrostatic pressure improves venous return. This trial aims to investigate the effect of aquatic exercises on time to return to work, work hours, work-related difficulties, daily life activity and participation, quality of life, exhaustion, fatigue, and neuropathy among cancer patients, compared to on-land exercise intervention group and a non-exercise group.MethodsThis randomized controlled trial will include 150 cancer patients aged 18–65 years with stage III colon cancer or breast cancer patients with lymph node involvement. Participants in the aquatic exercise intervention group will undergo an 8-week, twice-weekly group-based Ai-Chi program, while the on-land exercise group will perform identical exercise. The control group will not engage in any exercise.The primary outcome will be assessed using an employment barriers questionnaire, capturing return to work date and working hours and daily life participation and activity and quality of life. Secondary outcomes include exhaustion, fatigue, and neuropathy. Data will be collected at baseline, post-intervention (8 weeks), and at 3,12, and 24 months. Mixed variance analyses will explore relationships among groups and over time for independent variables, with separate analyses for each dependent variable.DiscussionThe potential benefits include an earlier return to work for patients, reducing their need for social and economic support. The study's implications on socio-economic policies are noteworthy, as a successful intervention could offer a cost-effective and non-invasive solution, improving patients' quality of life and increasing their participation in daily activities. This, in turn, could lead to a faster return to work, contributing to both personal well-being and broader societal interests by reducing reliance on social services.Trial registrationThe trial is registered at ClinicalTrials.gov NCT05427344 (22 June 2022).

Not Just One Long Vacation: Revisiting the Importance of Lifestyle Planning in the Transition to Retirement.

There is a need to further understand the nature and role of planning for one's lifestyle in retirement. The purpose of this study was to examine retirement planning and how it impacts perceived preparedness and satisfaction with the retirement transition, as well as to explore personal experiences of retirement. Canadians (n=748) fully or partly retired participated in an online survey that included quantitative questions about perceived retirement preparedness and satisfaction and open-ended questions about retirement goals, fears, challenges, and advice. Results determined that while both financial and lifestyle planning were significant predictors of higher perceived preparedness, only lifestyle planning was a significant predictor for satisfaction. Overall, no gender differences were detected. Open-ended comments highlighted the importance of planning for one's lifestyle in retirement, including meaningful activities and social connections. Individualized career advising as well as group-based educational programs or peer-assisted learning initiatives appear warranted to support people in planning for their lifestyle in retirement.

The Whole Package: A Multi-Component Smoking Cessation Intervention for Adults With Serious Mental Illness: A Qualitative Study.

Introduction: Smoking is one of the most important modifiable risk factors for excess morbidity and mortality in adults with serious mental illness (SMI). Many smokers with SMI are reportedly motivated to quit, however success rates among these smokers remain low and evidence-based treatment targeting this vulnerable group is limited. The purpose of this paper is to report the results of a qualitative inquiry of participants. Methods: We conducted a pilot two-arm randomized controlled trial (RCT) targeting adults with SMI. Our smoking cessation intervention included: (a) group-based physical activity (PA) game intervention (50minutes, 3X/week for 12weeks), (b) pharmacotherapy (bupropion or nicotine replacement therapy), and (c) smoking cessation counseling. Upon completion of the program, participants in the active and control groups completed a qualitative semi-structured interview in order to determine how the program impacted their smoking cessation. Grounded Theory methodology guided our data collection and analysis. Results: Twenty participants completed an interview. Participants described how the "whole package" of the 3 components of the intervention were critical to their smoking cessation process. The group-based program provided the structure, resources, and encouragement needed to start the process of quitting. Conclusion: Adults with SMI need support, resources, and engaging activities as they begin quitting and practice the skills needed to quit.

Didge you sleep: a feasibility study of didgeridoo training for obstructive sleep apnea

Intolerance of positive airway pressure therapy for obstructive sleep apnea is common. Upper airway muscle therapies show promise as alternative treatments. The didgeridoo, which is a musical instrument, can be used for upper airway muscle training. Our goal was to develop a group-based didgeridoo training program for obstructive sleep apnea. We conducted a proof-of-concept single-arm study consisting of a structured didgeridoo training regimen. We surveyed patients at a large medical facility about their interest in the program. We developed and tested a manual of procedures for conducting a 4-session group program conducted over 8 weeks that instructed participants on use of the Medical Didgeridoo. We also refined procedures for baseline and 4-month follow-up assessments, which included measures of daytime sleepiness and apnea–hypopnea index. Interviews were conducted at follow-up to obtain feedback about the program. Of the 56 survey respondents, 67% reported difficulty with positive airway pressure, expressed interest in participating in a structured upper airway muscle training program, and indicated that they would be willing to practice exercises for 30 min per day. After in-depth screening of 15 patients, we recruited five patients to participate in the structured training program; all five completed the program and were able to learn to play basic sounds on the provided instrument, and four stated they would continue to play the Medical Didgeridoo after completion of the program. Given the significant level of interest and excellent participation in the didgeridoo training program, it may be feasible to conduct a large-scale study to assess treatment response.

"Everything has changed since COVID": Ongoing challenges faced by Canadian adults with intellectual disabilities during waves 2 and 3 of the COVID-19 pandemic.

The COVID-19 pandemic has disrupted the lives of people with intellectual disabilities in many ways, impacting their health and wellbeing. Early in the pandemic, the research team delivered a six-week virtual group-based program to help Canadian adults with intellectual disabilities cope and better manage their mental health. The study's objective was to explore ongoing concerns among individuals with intellectual disabilities following their participation in this education and support program. Thematic analysis was used to analyze participant feedback provided eight weeks after course completion. Twenty-four participants were interviewed in January 2021 and May 2021 across two cycles of the course. Three themes emerged: 1) employment and financial challenges; 2) navigating changes and ongoing restrictions; and 3) vaccine anticipation and experience. These findings suggest that despite benefiting from the program, participants continued to experience pandemic-related challenges in 2021, emphasising the need to continually engage people with intellectual disabilities.

A Feasibility Study Investigating an Exercise Program in Metastatic Cancer Based on the Patient-Preferred Delivery Mode.

Feasibility of exercise in patients with metastatic cancer is still a challenge. This study aimed to determine the feasibility and preliminary efficacy of an exercise intervention based on a patient-preferred delivery mode in patients affected by metastatic cancer. Forty-four patients with a confirmed diagnosis of metastatic cancer were recruited in a 3-month exercise program. Whereas the exercise program consisted of aerobic and resistance activities performed twice a week, the participants may choose the mode of delivery: home based, personal training, or group based. The primary endpoint was the feasibility, defined by recruitment rate, attendance, adherence, dropout rate, tolerability (comparing the session RPE with the target RPE), and safety (using the Common Terminology Criteria for Adverse Events, version 5.0). Secondary endpoints included cardiorespiratory fitness (six minutes walking test), muscle strength (handgrip strength test and isometric leg press test), flexibility (the back scratch and chair sit and reach tests), anthropometric parameters (body mass index and waist-hip ratio), quality of life (EORTC QLQ C-30 questionnaire), and amount of physical exercise (Godin's Shepard Leisure Time Exercise Questionnaire). Descriptive statistics, Student t test, and Wilcoxon signed rank test were used to analyze data. The study recruitment rate was 81%. Out of 44 recruited patients, 28 chose the personal training program, 16 chose the home-based program, and none chose the group-based program. Nine dropouts occurred (20%), 6 in the personal training program, and 3 in the home-based intervention. The median attendance rate was 92%, adherence was 88%, tolerability was 100%, and 9 nonsevere adverse events were registered during the exercise sessions. An increase in cardiorespiratory fitness (P < .001) and flexibility (P = .011 for chair sit and reach; P = .040 for back scratch) was observed at the end of the intervention, while no changes in anthropometric values and muscle strength were detected. Different quality-of-life domains were improved following the intervention, including physical (P = .002), emotional (P < .001), and role functioning (P = .018), fatigue (P = .030), and appetite loss (P = .005). A 3-month exercise program based on a patient-preferred delivery mode is feasible in patients with metastatic cancer and may improve physical function and quality of life. NCT04226508.

Synchronous Group-Based Online Exercise Programs for Older Adults Living in the Community: A Scoping Review.

Older adults are the least physically active group with specific barriers to regular exercise, and online exercise programs could overcome some of those barriers. This scoping review aimed to describe the characteristics of supervised group-based synchronous online exercise programs for older adults living in the community, their feasibility, acceptability, and potential benefits. MEDLINE (Ovid), Embase, SPORTDiscus, and the Cumulative Index to Nursing and Allied Health Literature were searched until November 2022. The included studies met the following criteria: participants aged 50years and above, a minimum of a 6-week group-based supervised and synchronous intervention, and original articles available in English. Eighteen articles were included, with 1,178 participants (67% female, average age of 71 [57-93]years), most (83%) published in the past 3years. From the limited reported studies, delivering supervised, synchronous online exercise programs (one to three times/week, between 8 and 32weeks) for older adults living in the community seems feasible, accepted, and can improve physical function.

A mixed-methods study of parents' social connectedness in a group-based parenting program in low-income communities.

Group-based parent training (PT) is an evidence-based approach for strengthening parenting skills and reducing child behavior problems. However, there has been little research on the social connectedness (SC) formed among PT participants, particularly in low-income communities where parents may be more socially isolated. This study describes SC formed among parents in a group-based PT program implemented in their children's school and its association with changes in child behavior. Using a convergent mixed-methods design, data collection occurred between 2020 and 2022. Parents (n = 97) completed measures of their SC to other parents in their PT group and their child's behavior. Qualitative interviews with a representative subsample of parents (n = 17) were also conducted to understand parents' perceptions and experiences of SC within their PT group. Parents reported high levels of SC (M = 4.45 [range = 3.04-5 on scale of 1-5]; SD = 0.4). From baseline to postintervention, the number of children with child behavior problems significantly decreased (32.12%, 37.5% behavior intensity and problems, respectively). The magnitude of decline in child behavior problems was significantly related to parents' SC (b = -11.52, p = .02, SE = 4.99). Qualitative data confirmed high levels of SC, which parents linked to improvements in their parenting and children's behavior. Themes focused on the building of connections, committing to a safe space with parents who share similar goals, supporting one another, and gaining connections within the school environment and during the COVID-19 pandemic. Results highlight the potential synergistic effects of SC formed in the context of group-based PT with implications for strengthening parenting skills and children's well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Navigating recovery: A qualitative interview study of patients’ experiences of a structured group-based educational programme after transient ischemic attack or minor stroke

Patients with transient ischemic attack (TIA) and minor stroke often struggle with long-term cognitive and psychological difficulties that impact their reintegration into work and leisure activities. The aim of the study was to evaluate the impact of a structured group-based stroke educational (SSGE) programme on patients’ ability to cope with a changed everyday life. Seven semi-structured qualitative interviews were conducted between February and March 2022 and analysed using thematic content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was applied. The analysis uncovered three themes: ‘the existence of remaining challenges’; ‘the significance of support from resource individuals’; and ‘a sense of safety and confidence derived from the educational programme’. This study provides pivotal knowledge of how the SSGE programme supported patients’ long-term ability to navigate challenges after a TIA or minor stroke. The group-based format facilitated crucial exchanges of experience and knowledge with healthcare professionals and peers. However, the necessity for healthcare professionals to initiate post-support groups were underscored, as patients lacked the physical and mental strength to organise these on their own.