Dance For Joy to build community. Irene Martinez, MD FACP Stroger Hospital of Cook County Chicago Integrative Medicine for the Underserved 2017

Transcription

1 Dance For Joy to build community Irene Martinez, MD FACP Stroger Hospital of Cook County Chicago Integrative Medicine for the Underserved 2017

2 Relevant Financial Disclosure Irene Martinez, DM FACP I have nothing to disclose

3 Art and healing Dance for Joy program WORLD HEALTH ORGANIZATION ( WHO) in preamble 1946 Heath is state of COMPLETE PHYSICAL MENTAL AND SOCIAL WELL-BEING

4 Why Dance? Dance can be a powerful tool for exploring cultural identity, promoting self-awareness, and creating positive self-esteem. The project was inspired by our belief that dance could promote happiness while increasing physical activity among sedentary women.

5 Benefits of physical activity Physical activity benefits chronic disease, obesity, and depression Physical activity benefits viewed in terms of only weight loss, rather than in terms of overall health Confluence of predictors of low rates of physical activity and exercise in our clinical population: Women, especially African American and Latino Women residing in urban areas (environmental and economic barriers) Women in the Midwest region (weather)

6 Dance For Joy First Steps Dance for Joy : Promoting Exercise in African American Women through West African Dance -feasibility Irene Martinez MD, Jini Han MD, David Goldberg MD, Monica Peek MD. Collaborations: Dance Instructor and drummers, researches, filmmakers. Site: beautiful, clean Safety issues Day and time Recruitment two clinics Randomization one group dance other home exercise

7 Aims To design a culturally tailored intervention to increase physical activity among African American women using an 8-week West African dance class program To determine the feasibility and acceptability of this culturally tailored intervention

8 Feasibility Study Methods Recruitment: Two outpatient medicine clinics: Rush University Internists and Cook County General Medicine Clinic Inclusion Criteria: African American women age years (insufficient funds to implement for other ethnic groups; this will be a future study) No regular exercise during 6 months prior to enrollment and no contraindications to exercise as determined by screening PAR-Q Not pregnant and approved by PCP

9 Study Design Randomization of women into two study conditions 8-week dance class 8-week home based exercise Attendees of the dance class were asked to complete a quantitative and qualitative post-class assessment The dance intervention was videotaped at week 5 and 8 We report on the assessments of the class in this presentation

10 Description of the Intervention: Dance Class Structure Once a week for 8 weeks, 90 minutes long Conducted by a professional instructor Class accompanied by live African drumming Warm-up: stretching, light aerobics and introduction of dance steps Rehearsal and performance of a traditional West African Dance of Welcome

11 Pilot and Study Recruitment Pilot Patient interviews (30 women each at Cook County and Rush) to determine preferred season and suitable time and day to hold dance classes Recruitment Cook County 135 approached 25 recruited 1 later deemed ineligible Rush 120 approached 25 recruited Reasons for Not Participating Cook County Rush Time constraints Cannot exercise Childcare 3 2 Other 35 37

12 Demographics Mean Range Age 50.4 years % % % Weight 210 pounds BMI 35.4 kg/m

13 Adherence of Dance Participants Attendance Comments Attended at least once (n=24) Did not attend Number of sessions attended (n=16) Median number of sessions attended (n=16) 16 (67%) 8 (33%) 7 from Cook County 5 (31%) 11 (69%) (2 work, 1 chest pain) All from Rush 4 Rush/7 County 6 8 sessions Attendance at each session (n=16) 10.1/class Range of participants from Rush 14 participants from Cook County

14 Assessment of Dance Intervention Score The instructor was excellent 4.8 The instructor went at the right pace 4.7 The space was clean and adequate 4.9 The drummers made a positive impact 4.9 I would recommend this class 4.9 The class was too hard for me 1.1 Responses 1= Strongly disagree, 3= No opinion, 5= Strongly agree N=12

15 How often did you experience or feel? Score Score Release of tension 9.5 Empowered 8.5 Joy 9.4 Teamwork 8.2 Felt part of a group 9.4 Drumming felt close to my heart Committed 9.3 Motivation to exercise Laughter 9.0 Let go of worries 7.3 Mental Concentration Score: 0=No feeling, 10=Strongest feeling N= Physical pain 3.7

16 Overall evaluation Overall Experience (Scale of 0-10) Do you feel comfortable participating in other dance or exercise programs? 9.8 Yes 12 No 0

17 Favorite Parts of the Class Dancing and drums Just being part of the dance experience did it for me. I would do it again in a New York minute. Meeting others, getting into the mindset of working out, learning the dance routine. My favorite part of the class was when the drums were added. This made me feel like I was in a real African dance class performance. Learning new dance steps, meeting new people, and just having fun.

18 Was this class special in any way? The class changed my attitude about my ability to exercise on a daily basis. Being African American, learning African dance movements were intriguing. The teacher and his assistants were very good and treated us like queens. African Dance was a new experience for me. This class has given me courage to try new things. I feel like I overcame my insecurities about working out in front of men.. I am a black woman that has no rhythm. The beat of the drum and the instructions from the teacher enabled me to just do it. It made me feel positive and invigorated me.

19 Other Comments It made me feel wonderful to be a part of this group The class motivated me.. Everything was fun.. All the women stuck together, encouraging and helping each other. Positive attitudes. I felt like a teenager. Other people need to experience African dance

20 Conclusions We invited African American women to participate in this clinical pilot of West African Dance as a way to promote physical activity. The participants were middle-aged with a mean BMI of 35. The program assumes an artistic movement form embedded in the historical fiber of African/Latino cultures. The program respectfully challenged women and supported them in a way to decrease physical barriers and medical fears about moderate to vigorous physical activity. The rate of attendance and comments about the intervention support the feasibility and acceptability of this pilot program. The women experienced joy; likely reflecting some combination of artistic expression, mastery of skills, community, and emotional and physical release.

21 Conclusions DANCE FOR JOY respectfully challenges women, especially of African/Hispanic heritage, to maximize health, sensuality and sexuality by first searching self-- manifested as culture and community. Trough this project they overcome the negativestereotype surrounding the sick role, body image obesity as typically portrait in US media and medicine.

22 Dance for Joy Video Fragments Irene Martinez (Producer) September Williams (Director) youtu.be/hr5gd3rbh0k

23 DFJ DVD Evaluation Shown to viewers In waiting rooms of two General Medicine Clinics- one in urban Public Hospital and the other in a community urban clinic Waiting to see their provider in an individual room Two community groups for HIV positive women Health care providers, nurses, counselors and staff participated in surveys

24 DVD evaluation results and conclusion Sample of 38 subjects 80% female 80% consider themselves African American 70% range years old 78% income less ( 38% less ) 73% home makers or job not in medical area 73% one or more medical illness 65% Their doctors consider obese 10% of the sample thinks get enough exercise

25 DVD evaluation continuation 84% had never participated in African Dance Class (ADC) 97% AFTER seen video felt more likely to participate in ADC 100% find the program could make them healthier 90% did not find the program will make them sick 90% would like to participate in similar programs 85% would like to see African dance offered at the institution where they work More than half 60% feel more likely to try a new exercise program other than ADC and to dance by themselves

26 Dance For Joy DVD Adds emotional texture to didactic analysis of Dance For Joy Project Promotes exercise in African American other Women of Color Encourages Health Care Providers to prescribe Cultural Relevant Exercise for patients Encourage people including medical ill patients to explore new exercise programs Inspire institutions to foster the development of programs that offer dance to their staff or patients for well being

27 Dance Found its Way to the Clinics Incorporated in Diabetes Self Management Classes English and Spanish patients at General Medicine Clinic at Stroger Hospital Any dance, standing or sitting chair or wheel chair, with or without a cane At Graduation: Dance to get your diploma!!!!

28 Saca a Bailar tu Diabetes Irene Martinez(producer) Max Long (editor) I Saca a Bailar tu Diabetes-Dance your Diabetes Away

29 Medical Providers, Administration Personnel Dancing Stress away Dancing at General Medicine Division retreats Survivors of Cancer annual celebration at Stroger Hospital Now Let s dance! Participants at this presentation are invited to get up and dance

30 Thanks to our collaborators! Alice Furumoto-Dawson, PhD Senior Research Associate, University of Chicago Center for Interdisciplinary Health Disparities Research, Institute for Mind and Biology Mr. Idy Ciss Assistant to the Artistic Director Muntu Dance Company Old Town School of Music Instructor Drummers All the Dancers