A group program for overweight and obese women with urinary incontinence (ATHENA): an implementation-effectiveness hybrid type 3 study

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Howard, Zara
Ross, Lynda
Weir, Kelly A
Baker, Nadine
Smith, Leanne
Nucifora, Jennifer
Townsend, Heidi
Roberts, Shelley
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2021
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Abstract

Introduction and hypothesis: Supervised pelvic floor muscle training (PFMT), weight loss and exercise are recommended for overweight/obese women with urinary incontinence (UI). This study aimed to implement and evaluate the feasibility, acceptability and effectiveness of a 12-week group exercise and healthy eating program (ATHENA) for overweight/obese women with UI. Methods: This study, using an implementation-effectiveness hybrid type 3 design, was conducted within a Women’s Health Physiotherapy outpatient service at an Australian tertiary public hospital. Intervention feasibility and acceptability were assessed through process evaluation of implementation, while clinical effectiveness was assessed via pre-/post-clinical and quality of life surveys. Process data were analyzed using descriptive statistics and effectiveness data were compared pre-/post-intervention using inferential statistics. Results: Of 156 eligible patients, 37 (24%) agreed to participate; 29 (78%) completed the ATHENA program. Median (IQR) age and body mass index were 53 (47–65) years and 30.8 (29.1–34.8) kg/m2 respectively. ATHENA was feasible to implement, with all components delivered as intended and high participant satisfaction. Ninety-seven percent of participants reported improved UI symptoms (global rating of change) and significant improvements in overall pelvic floor dysfunction and quality of life utility scores (p = 0.001). While weight did not change, significant improvements were found in body-food choice congruence (intuitive eating scale-2; p < 0.01). Conclusions: The ATHENA intervention was feasible, acceptable and clinically effective for overweight and obese women with urinary incontinence at a tertiary public hospital in Australia. Further research into longer term outcomes and the cost effectiveness of this group intervention is recommended. Trial registration: N/A. Ethics approval, HREC/2018/QGC/46582, date of registration 14/11/2018.

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International Urogynecology Journal

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This publication has been entered in Griffith Research Online as an advanced online version.

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Allied health and rehabilitation science

Physiotherapy

Obstetrics and gynaecology

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Life Sciences & Biomedicine

Obstetrics & Gynecology

Exercise

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Howard, Z; Ross, L; Weir, KA; Baker, N; Smith, L; Nucifora, J; Townsend, H; Roberts, S, A group program for overweight and obese women with urinary incontinence (ATHENA): an implementation-effectiveness hybrid type 3 study, International Urogynecology Journal, 2021

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