ABSTRACT
Physical activity (PA) promotes survival and mitigates symptoms in older breast cancer survivors (BCS), especially to reduce joint pain associated with adjuvant hormonal treatment. The purpose is to describe the adaptation process for an evidence-based exercise and education curriculum (i.e., Fit & Strong!) to support older BCS participating in the Using Exercise to Relieve Joint Pain and Improve Aromatase Inhibitor Adherence in Older Breast Cancer Survivors trial. We reviewed all educational materials with scientific/clinical experts to identify necessary content changes. Next, we conducted semistructured phone interviews with BCS to review all educational materials and conducted a real-time pretest for the trial. Overall, BCS found the adapted materials and experience acceptable (mean score of 9.2/10 for satisfaction). Content changes included simplifying exercise instructions, prioritizing content related to the trial goals, and updating photographs. Because of COVID, the pretest was conducted via Zoom. Our multistep adaptation process provided an acceptable intervention to meet the needs of older BCS. Lessons learned will be applied to the forthcoming pilot trial.
ABSTRACT
A pandemia de Covid-19 incidiu diretamente sobre os arranjos e exercício do cuidado interpelado às mulheres. Investigou-se como mulheres mães exerceram esses cuidados, as mudanças ocorridas nesse exercício e os efeitos ressentidos, por meio de um survey online (N = 5.643). Responderam principalmente mulheres brancas de classe média a alta com escolarização avançada. Mesmo para esse segmento privilegiado, constatou-se que a pandemia exacerbou as desigualdades de gênero no cuidado doméstico e familiar. As mulheres encontravam-se sobrecarregadas e cansadas;sozinhas na encruzilhada entre trabalho profissional e trabalho de cuidados múltiplos;cuidando muito e sendo pouco cuidadas;muito disponíveis para outros e pouco disponíveis para si;e relataram culpa e sentimento de inadequação no cuidado e relação com os filhos.Alternate : The Covid-19 pandemic has directly affected the configuration of unpaid care work that women are routinely called upon to exercise. We investigated changes in how women mothers exercised this care and the effects of these changes on them, using an online questionnaire (N = 5.643). Respondents were mainly middle and higher class, white, with high educational levels. Even for this privileged segment, the pandemic was found to exacerbate gender inequalities in domestic and family care. The women were overworked and tired;alone at the crossroads between professional work and multiple care work;caring a lot and being little cared for;constantly available to others and very little to themselves;and reported feelings of guilt and inadequacy related to the care of and relationship with their children.Alternate : La pandemia de Covid-19 ha afectado directamente a la configuración del trabajo de cuidados no remunerado que las mujeres son habitualmente llamadas a realizar. Investigamos los cambios en cómo las madres ejercían este cuidado y los efectos de estos cambios en ellas, utilizando un cuestionario en línea (N = 5.643). Las encuestadas fueron principalmente mujeres blancas, de clase media y media alta, con altos niveles educativos. Incluso para este segmento privilegiado, se encontró que la pandemia exacerbó las desigualdades de género en el cuidado doméstico y familiar. Las mujeres reportaron cansancio y soledad en la encrucijada entre el trabajo profesional y el trabajo de cuidados múltiples;se percibían cuidando mucho y recibiendo poco cuidado;se veían como siempre disponibles para los demás y muy poco disponibles para ellas mismas;y reportaron sentimientos de culpa e insuficiencia relacionados con el cuidado y la relación con sus hijos.
ABSTRACT
The purpose of our study was to understand the capacity of Silver Sneakers, a federally funded and community-based exercise program, to serve older adults (aged ≥65 years) in our mixed rural/urban catchment area of central Pennsylvania. We identified 139 registered Silver Sneakers program locations; of these, 18 were closed because of the COVID-19 pandemic. We used questionnaires to interview Silver Sneakers program staff by telephone (n = 80 of 121, response rate of 66%). Most programs were offered by private gyms (52%). Fewer programs were in rural counties than in urban counties. Most facilities reported that membership was equally mixed by gender, and member retention strategies included program perks and promotion of Silver Sneakers as a Medicare benefit. Most (89%) programs were able to continue classes during the pandemic, in part by adapting to video platforms. Overall, Silver Sneakers programs offer a sustainable option to facilitate access to exercise programs and reduce barriers to physical activity among older adults in our catchment area.