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Exploring the impact of targeted exercise in women experiencing homelessness, addiction and mental health challenges:
Fiona Kennedy1, Deirdre Murray2,3, Clíona Ní Cheallaigh4,5
1Discipline of Physiotherapy, School of Medicine, The University of Dublin Trinity College, Dublin, Ireland cromwelf@tcd.ie.
Objective:
Low physical functioning and frailty are prevalent in non-geriatric vulnerable populations such as people experiencing homelessness, addiction and mental health challenges. The objective of this study was to explore the feasibility and impact of a targeted exercise intervention with protein supplementation for women experiencing homelessness, addiction and mental health challenges.
Design:
Mixed-methods feasibility study.
Setting:
A women's-only day service for people with homelessness and addiction issues, in Dublin, Ireland.
Participants:
Women experiencing homelessness, addiction and mental health challenges.
Interventions:
The intervention was a 10-week low-threshold exercise and protein supplementation pre-post programme (LEAP-W). Qualitative interviews were conducted following the intervention with programme participants and key stakeholders.
Primary And Secondary Outcome Measures:
The primary outcome was feasibility measured by recruitment, retention, adherence, safety and acceptability, and secondary outcomes measured pre-post intervention change in physical function, pain, nutritional and frailty status, and overall health status.
Results:
Overall, 33 participants were recruited. Data generated demonstrated that LEAP-W was feasible by its safety, acceptability and high retention in certain subgroups, and high adherence to the exercise and protein supplement; its impact was demonstrated by pre-post intervention improvement in multiple domains (strength (chair stand test), balance (the single leg stance test), pain and quality of life/mental health (mental component summary of the Short Form-12; 95% CI, p<0.05)). Three themes emerged from the qualitative inquiry: (1) the power of exercise; (2) challenges to engagement and (3) the LEAP approach, driven by the trauma-informed and low threshold approach.
Conclusion:
Targeted exercise interventions with trauma-sensitive, flexible design can be successfully delivered and yield impact in women with complex needs who experience homelessness, addiction and mental health challenges. Service design should be considered when delivering interventions to this population. Further higher-powered longitudinal studies are warranted.
Trial Registration Number:
NCT06264895.
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