Browsing by Author "Kania-Richmond, Ania"

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    Feasibility of Postpartum Community Research: Results of a Systematic Review and A Pilot Randomized Controlled Trial to Optimize Postpartum Health Through Self-Scar Massage
    (2024-05-29) Cerantola, Gina-Marie; Brennand, Erin; Metcalfe, Amy; Kania-Richmond, Ania; Bennion, Laura
    Background The postpartum population is under-represented and under-funded in research. Postpartum pelvic health dysfunction is common, yet few evidence-informed pelvic health treatment options exist. Objectives 1. Assess feasibility of a randomized controlled trial (RCT) investigating self-massage of postpartum pelvic floor scar tissue on pelvic health outcomes. 2. Perform a systematic review to determine recruitment rate and retention in RCTs studying the postpartum population and recruitment strategies used in successful trials. Methods A pilot RCT was conducted to examine feasibility for a larger trial. Eligible and consenting primiparous postpartum adults with healed perineal tear(s) and/or episiotomy in Calgary, Alberta, were recruited for participation between 42 and 365 days postpartum. Participants were randomized into two groups with a 1:1 allocation. The intervention group performed self-scar massage of their pelvic floor scar tissue and the control group received routine postnatal care. Patient medical records were used to collect demographic and obstetrical data. All participants were asked to complete two reliable and validated pelvic health questionnaires upon enrollment in the study and then again 6 weeks later. The primary analysis determined the monthly recruitment rate, acceptability of intervention and questionnaires, and participant adherence to the intervention protocol. For the systematic review, eligible studies were selected through an electronic literature search. Databases were searched for original RCTs investigating interventions between 42 and 365 days postpartum that recruited participants postpartum. Results For the pilot RCT, the recruitment rate was one participant/month (n=6), and participant retention was 100%. Participants deemed the intervention and outcome measures acceptable, but reported challenges adhering to the intervention protocol, at times, due to competing demands of newborn care. For the systematic review, 39 studies were included from 18,580 records initially identified. The median recruitment rate was 6.58 participants/recruitment site/month (Interquartile Range (IQR):2.92-9.21) and the median percentage of retained participants was 90% (IQR:80-96). Conclusions Due to low recruitment rates for the pilot RCT, a future trial was deemed infeasible if the existing indirect recruitment strategy was used. Findings from the systematic review suggest that a future targeted recruitment approach may be preferred based on strategies used in postpartum RCTs with successful recruitment.
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    Integrative health care – What are the relevant health outcomes from a practice perspective? A survey
    (2017-12-22) Kania-Richmond, Ania; Metcalfe, Amy
    Abstract Background Integrative health care (IHC) is an innovative approach to health care delivery. There is increasing focus on and demand for the evaluation of IHC practices. To ensure such evaluations capture their full scope, a clear understanding of the types of outcomes relevant to an IHC approach is needed. The objective was to describe the health domains and health outcomes relevant to IHC practices in Canada. Methods An online survey of Canadian IHC clinics. Survey questions were informed by the IN-CAM Health Outcomes Database. Descriptive statistics were used to summarize the data. Chi square tests were used to compare responses between clinic types and patient groups served. Results Surveys were completed by 21 clinics (response rate: 50%). Physical, psychological, social, individualized and holistic were identified as applicable health domains by more than 90% of the clinics. Spiritual domain was the least relevant (70% of clinics). A number of relevant outcomes within each domain were identified. A core set of outcomes were identified and included: fatigue, anxiety, stress, and patient-provider relationship, and quality of life. Clinics with primarily conventional health practitioners were less likely to address overall well-being (p = 0.04), while clinics that provided care to a specialized patient population (i.e. cancer patients) or a mix of general and specialized patients were less likely to address religious practices (p = 0.04) or spiritual experiences (p = 0.007). Conclusions Outcomes across health domains should be considered in the evaluation of IHC models to generate an understanding of the full scope of effectiveness of IHC approaches. The core set of outcomes identified may facilitate this task. Ethics approval (Ethics ID REB14-0495) was received from the Conjoint Health Research Ethics Board at the University of Calgary.
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    Participants’ perceived benefits from the GLA:D™ program for individuals living with hip and knee osteoarthritis: a qualitative study
    (2024-06-26) Kania-Richmond, Ania; Beaupre, Lauren A.; Jessiman-Perreault, Geneviève; Tribo, Danika; Martyn, Jason; Hart, David A.; Robert, Jill; Slomp, Mel; Jones, C. Allyson
    Abstract Background The Good Life with osteoArthritis: Denmark (GLA:D™), an evidence-based education and exercise program designed for conservative management of knee and hip osteoarthritis (OA), has been shown to benefit participants by reducing pain, improving function, and quality of life. Standardized reporting in the GLA:D databases enabled the measurement of self-reported and performance-based outcomes. There is a paucity of qualitative research on the participants’ perceptions of this program, and it is important to understand whether participants’ perceptions of the benefits of the program align with reported quantitative findings. Methods We conducted semi-structured telephone interviews with individuals who participated in the GLA:D program from January 2017 to December 2018 in Alberta, Canada. Data were analyzed using an interpretive description approach and thematic analysis to identify emergent themes and sub-themes associated with participants perceived benefits of the GLA:D program. We analyzed the data using NVivo Pro software. Member checking and bracketing were used to ensure the rigour of the analysis. Results 30 participants were interviewed (70% female, 57% rural, 73% knee OA). Most participants felt the program positively benefited them. Two themes emerged from the analysis: wellness and self-efficacy. Participants felt the program benefited their wellness, particularly with regard to pain relief, and improvements in mobility, strength, and overall well-being. Participants felt the program benefited them by promoting a sense of self-efficacy through improving the confidence to perform exercise and routine activities, as well as awareness, and motivation to manage their OA symptoms. Twenty percent of participants felt no benefits from the program due to experiencing increased pain and feeling their OA was too severe to participate. Discussion The GLA:D program was viewed as beneficial to most participants, this study also identified factors (e.g., severe OA, extreme pain) as to why some participants did not experience meaningful improvements. Early intervention with the GLA:D program prior to individuals experiencing severe OA could help increase the number of participants who experience benefits from their participation. Conclusion As the GLA:D program expands across jurisdictions, providers of the program may consider recruitment earlier in disease progression and targeting those with mild and moderate OA.