Integrating Kapa Haka and pulmonary rehabilitation for Maori with chronic airways disease

This is a pilot study integrating Kapa Haka and Pulmonary Rehabilitation for Maori with chronic airways disease Setting: - Marae - Available twice weekly, capacity for 30 people, facilities such as rest-rooms, chairs, heating, power defibrillator (AED). - Transport will be provided for participants if needed Intervention: Integrated Kapa Haka/pulmonary rehabilitation programme - Run over 8 weeks, twice per week (16 sessions in total) - 2 hour sessions run on Tuesdays and Thursdays 9.30 - 11.30am - 15 participants in total; all participants will take part in the same session. - Led by 2x Kapa Haka experts and 1x pulmonary rehabilitation physiotherapist - Week 1: - Session 1: Whakawhanaungatanga session: - Mihimihi - Demographic and health information collection - Assessing preferences for education sessions - Session 2: Testing session: - 2x six minute walk test - 5 x sit to stand test - BMI - Questionnaires: CRD-Q, Hua Oranga, CAT - Weeks 2-8: Combined Kapa Haka and pulmonary rehabilitation sessions - Comprising endurance (aerobic) and strength (upper and lower body) exercises (90mins) as per pulmonary rehabilitation essential criteria, which will include: - Karakia timatanga (opening prayer) - Waiata (an example of endurance exercise) - Poi (an example of endurance exercise) - Rakau - Haka (an example of strength exercise) - Karakia whakamutunga (closing) - And education sessions (to be guided by participant preferences) (30mins), which will be delivered using Powerpoint slides combined with interactive group discussion, the topics of which may include: - Disease (chronic airways disease) definition, cause, diagnosis, management, prognosis - Management of chronic airways disease - Inhalers, medications (antibiotics, prednisone) - Monitoring symptoms and action plan - Breathing and relaxation strategies - Airway clearance strategies - Goal setting, advanced care planning - Lifestyle change - Smoking cessation - Nutrition - Exercise - Kapu ti (refreshments) - Note sessions will aim to meet criteria as set out in the Official American Thoracic Society Workshop Report on Defining Modern Pulmonary Rehabilitation (Holland et al, 2021) as much as practically possible, as designed by Delphi consensus - Data on adverse events will be collected at the time of any events arising throughout the programme - Attendance of each participant at each session will be recorded in a session attendance checklist - Week 8 final session: - 2x six minute walk test - 5x sit to stand test - Questionnaires: Hua Oranga, CAT, CRD-Q, sense of control, acceptability questionnaire, participant reported experience Reimbursement: - Transport (and/or parking costs) will be provided (or reimbursed) for participants who require it to and from the venue for each session. - Additionally, a small koha will also be offered to each participant at each session for participating in the study. Safety and Data Monitoring: - There will always be medically trained people who have completed basic life support training (either on interventional team or on steering committee) and a defibrillator (AED) on site in the event of injury or a medical emergency. - If quality of life questionnaires raise concerns about psychosocial distress, then this will be reported to the Principal Investigator who will assess the concerns and take action if needed e.g. referrals, and whether continued participation in the study is appropriate. - If the data collection step incidentally finds any other health issues, these will be brought to the attention of the Principal Investigator for appropriate referral and follow up to be made - Adverse events will be reported to the Primary Investigator, immediately assessed, acted on and recorded in the Adverse Events record and reported to the steering committee to determine whether there are ongoing safety concerns for individual or other participants. - Any adverse event or result of clinical concern will be notified to the GP and/or referring health practitioner and this notification will not be optional. - The study will be terminated if the frequency and severity of adverse events is such that the steering committee decides it unsafe to continue with the study.