MacMillan Get Active, Feel Good Physical activity programme: final evaluation report

1.0 Executive Summary The purpose of this report was to examine data collected by Lincolnshire Sport and the University of Lincoln in relation to the implementation, impact and receipt of the Lincolnshire GAFG programme. The primary findings are summarised below. In relation to the reach and efficiency of the programme (including uptake, adherence and attrition) it was evident that during the first 24 months of the GAFG programme: 193 individuals had attended the initial screening and 53 had reached 12months on the programme. Participants had an average age of 63.5 (+15.9) and were predominantly female (54% female, 46% male). Whilst the sample was incomplete, 34% of participants who accessed the service considered their cancer to be stable. Patterns of referral had remained relatively consistent from 12 to 24months of the programme with the majority of referrals coming from LN2 and PE21. New referrals were noted from the following geographical areas; PE32, PE24 and PE6. More males than females dropped out of the programme, this was most pronounced between 9- 12months. Those who dropped out of the programme were from the most deprived areas. For the impact of the programme it was evident from the quantitative data that significant findings were: Participants reported their mobility and ability to walk had improved up to 9months of the programme. The number of participants who reported no issues regarding self-care increased up to 9months of the programme. Participants reported that they had no problems performing usual activities increased up to 9months of the programme. Mobility, self-care and ability to perform usual activities all declined between 9-12months. Participant’s perception of pain decreased over the 12month programme. The number of participants who reported feelings of anxiety and depression decreased over 12 months. Participant’s perception of health improved over the 12months, from 56% at baseline to 83% at 12months. In relation to the perceptions of the programme and the guidance received it was found that both participants and stakeholders: Recognised and valued the client-centred approach adopted as the GAFG model. It was felt that this approach was most appropriate to those who had experienced cancer or were recovering from cancer. In particular the following themes emerged from the data as a being valued and unique elements of the programme: o Practitioners truly knowing the participant as an individual, through investing time in face to face appointments o Offering a different kind of support that is highly relevant to those with cancer or recovering from cancer o Practitioners knowing when to guide, motivate or give space o Use of technology including: tablets for Macmillan Physical Activity Practitioner (MPAP) meetings, email and text support. o Providing the programme at the participants home Felt that the time of access or referral was key to the individual. Reported that the programme filled a void in current cancer support and physical activity provision. The GAFG programme design and approach enabled participants to reflect upon the changes they wished to make to their lives through engagement in motivational interviews and participant led discussions. 3 The approaches used within the GAFG programme allows the MPAPs to respond to the individual’s cancer journey and changing narrative. The stakeholders interviewed acknowledged the following potential barrier to the programme’s expansion: The continued viability of a time intensive, client-centred approach should the programme increase the number of referrals or expand its geographical reach. In relation to the impact of the programme, including how the GAFG programme influenced how participant’s perceived and managed their cancer, the following was reported: The majority of participants demonstrated restitution narratives and were able to utilise the programme in order to rebuild themselves and regain the pre-cancer identity. Some participants articulated quest narratives and utilised the programme to improve or begin to transform themselves and their identity. For both sets of narratives, the aspect of identity participants sought to regain varied from individual to individual but included: o The physical self: strength, mobility or body image (including regaining and losing weight) o The psychological self: confidence, motivation and mental strength o The social self: the desire and ability to socialise A small number of participants articulated chaos narratives and at that moment in time, felt a degree of lost hope in relation to their cancer. Whilst participating in physical activity was perhaps overwhelming for these individuals, the GAFG programme was still seen as a future resource from which they could (at a later point in time) utilise to begin to rebuild themselves. Participants and stakeholders reported that the GAFG programme enabled them to regain control by offering an experiences (i.e. physical activity) which is the opposite of cancer and cancer treatment. The control gained through the GAFG programme transferred into other aspects of the participants lives, for example work, family, social life and thus impacted on their independence. 4 Participants and stakeholders reported that the GAFG had allowed them to regain the confidence they had lost through cancer