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Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study

INTRODUCTION: We have previously shown that Environmental Enrichment (EE)-consisting of social support, novelty, and open spaces—decreased disease progression and anxiety in a rat model of endometriosis. We developed a novel EE intervention to be tested in a pilot randomized clinical trial (RCT) in...

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Autores principales: Nieves-Vázquez, Cristina I., Detrés-Marquéz, Amanda C., Torres-Reverón, Annelyn, Appleyard, Caroline B., Llorens-De Jesús, Astrid P., Resto, Ivana N., López-Rodríguez, Verónica, Ramos-Echevarría, Paola M., Castro, Eida M., Flores, Idhaliz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846621/
https://www.ncbi.nlm.nih.gov/pubmed/36683601
http://dx.doi.org/10.3389/fgwh.2022.1058559
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author Nieves-Vázquez, Cristina I.
Detrés-Marquéz, Amanda C.
Torres-Reverón, Annelyn
Appleyard, Caroline B.
Llorens-De Jesús, Astrid P.
Resto, Ivana N.
López-Rodríguez, Verónica
Ramos-Echevarría, Paola M.
Castro, Eida M.
Flores, Idhaliz
author_facet Nieves-Vázquez, Cristina I.
Detrés-Marquéz, Amanda C.
Torres-Reverón, Annelyn
Appleyard, Caroline B.
Llorens-De Jesús, Astrid P.
Resto, Ivana N.
López-Rodríguez, Verónica
Ramos-Echevarría, Paola M.
Castro, Eida M.
Flores, Idhaliz
author_sort Nieves-Vázquez, Cristina I.
collection PubMed
description INTRODUCTION: We have previously shown that Environmental Enrichment (EE)-consisting of social support, novelty, and open spaces—decreased disease progression and anxiety in a rat model of endometriosis. We developed a novel EE intervention to be tested in a pilot randomized clinical trial (RCT) in patients with endometriosis, a painful, stressful disease. OBJECTIVE: To translate and evaluate the feasibility and acceptability of an adapted EE intervention as an adjuvant to standard-of-care for endometriosis patients. METHODS: Feasibility was assessed through recruitment, enrollment, and adherence rates. Acceptability was evaluated through a post-intervention survey and focus group discussion 3-months after the end of the intervention. RESULTS: Of the 103 subjects recruited, 64 were randomized to the intervention group and 39 to the control group. At the start of the intervention, the study groups consisted of 29 (intervention) and 27 (control) subjects. Enrollment rates were 45.3% and 69.2%, and adherence rates were 41.4% and 100% for the intervention and control groups, respectively. Delays resulting from natural events (earthquakes, the COVID-19 pandemic) impacted enrollment and adherence rates. The most common reasons for missing an intervention were period pain (39.1%) and work-study (34.8%). There was high acceptability (>80%) of the intervention's logistics. The majority (82.4%) of subjects would continue participating in support groups regularly, and 95.7% would recommend the intervention to other patients. CONCLUSIONS: We showed that EE could be translated into an acceptable integrative multi-modal therapy perceived as valuable among participants who completed the intervention. High attrition/low adherence indicates that additional refinements would be needed to improve feasibility. Acceptability data indicate that EE has the potential to be integrated into the clinical management of patients with endometriosis and other inflammatory, painful disorders. Studies are ongoing to assess the efficacy of EE in improving pain symptoms, mental health, and quality of life (QoL).
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spelling pubmed-98466212023-01-19 Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study Nieves-Vázquez, Cristina I. Detrés-Marquéz, Amanda C. Torres-Reverón, Annelyn Appleyard, Caroline B. Llorens-De Jesús, Astrid P. Resto, Ivana N. López-Rodríguez, Verónica Ramos-Echevarría, Paola M. Castro, Eida M. Flores, Idhaliz Front Glob Womens Health Global Women's Health INTRODUCTION: We have previously shown that Environmental Enrichment (EE)-consisting of social support, novelty, and open spaces—decreased disease progression and anxiety in a rat model of endometriosis. We developed a novel EE intervention to be tested in a pilot randomized clinical trial (RCT) in patients with endometriosis, a painful, stressful disease. OBJECTIVE: To translate and evaluate the feasibility and acceptability of an adapted EE intervention as an adjuvant to standard-of-care for endometriosis patients. METHODS: Feasibility was assessed through recruitment, enrollment, and adherence rates. Acceptability was evaluated through a post-intervention survey and focus group discussion 3-months after the end of the intervention. RESULTS: Of the 103 subjects recruited, 64 were randomized to the intervention group and 39 to the control group. At the start of the intervention, the study groups consisted of 29 (intervention) and 27 (control) subjects. Enrollment rates were 45.3% and 69.2%, and adherence rates were 41.4% and 100% for the intervention and control groups, respectively. Delays resulting from natural events (earthquakes, the COVID-19 pandemic) impacted enrollment and adherence rates. The most common reasons for missing an intervention were period pain (39.1%) and work-study (34.8%). There was high acceptability (>80%) of the intervention's logistics. The majority (82.4%) of subjects would continue participating in support groups regularly, and 95.7% would recommend the intervention to other patients. CONCLUSIONS: We showed that EE could be translated into an acceptable integrative multi-modal therapy perceived as valuable among participants who completed the intervention. High attrition/low adherence indicates that additional refinements would be needed to improve feasibility. Acceptability data indicate that EE has the potential to be integrated into the clinical management of patients with endometriosis and other inflammatory, painful disorders. Studies are ongoing to assess the efficacy of EE in improving pain symptoms, mental health, and quality of life (QoL). Frontiers Media S.A. 2023-01-04 /pmc/articles/PMC9846621/ /pubmed/36683601 http://dx.doi.org/10.3389/fgwh.2022.1058559 Text en © 2023 Nieves-Vázquez, Detrés-Marquéz, Torres-Reverón, Appleyard, Llorens-De Jesús, Resto, López-Rodríguez, Ramos-Echevarría, Castro and Flores. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Global Women's Health
Nieves-Vázquez, Cristina I.
Detrés-Marquéz, Amanda C.
Torres-Reverón, Annelyn
Appleyard, Caroline B.
Llorens-De Jesús, Astrid P.
Resto, Ivana N.
López-Rodríguez, Verónica
Ramos-Echevarría, Paola M.
Castro, Eida M.
Flores, Idhaliz
Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study
title Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study
title_full Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study
title_fullStr Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study
title_full_unstemmed Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study
title_short Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: A pilot study
title_sort feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: a pilot study
topic Global Women's Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846621/
https://www.ncbi.nlm.nih.gov/pubmed/36683601
http://dx.doi.org/10.3389/fgwh.2022.1058559
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