The Makoyoh'sokoi (Wolf Trail) Program is a holistic wellness program that is highly
integrated both in its capacity as a program and in its mission to support its
participants. In doing so the program has multiple areas of evaluation. The focus of the
program evaluation is on making the evaluative measurements meaningful to either the
participants or the community. The evaluative elements will be woven into the education
components of the program so that each element/result is presented to a participant in
such a way that it is meaningful to them and will assist them in their health journey.
All elements not directly meaningful to either participants or the community have been
reviewed, justified and agreed upon by community leads.
Participants will be women of all ages, 18 and older. The benefit of being inclusive of
all ages is that there is intergenerational knowledge sharing and support, and role
modelling can occur. In previous programs having a wide range of ages was always seen as
a benefit for this reason and not as a deficit, despite the varied abilities to perform
the physical exercise. To deal with the latter, the fitness instructors are well versed
on adapting the exercises to the participants based on ability. An evaluation of the role
of past participants from Lloydminster revealed that, on average, the program
participants were responsible for food, clothing and care of 7-8 individuals each
(research by Megan Sampson, Master's student), many caring for multiple generations and
multiple families. The age of participants in all previous programming varied, the means
ranged from 37-39 years old.
As this is a self-control, non-randomised study, with an evaluative component, no pre-set
power calculations were made. Sample size is based largely on the size of the room
available to host the classes along with the budget and available in-kind resources with
a target of 25 participants initially enrolled and 20 completing each program. 25
participants will be recruited for each program, if individuals do not complete all the
T1 measures then new individuals will be taken from the waiting list. If individuals drop
out within the first 3 weeks, then new individuals will be taken from the waiting list.
The goal will be to have 20 women complete each program. The investigators will need to
define completion. The program is 24 weeks long with a total of 18 sessions.
All of the quantitative data will show descriptive statistics including mean, standard
deviation (SD), or median with inter-quantile range (IQR) for continuous data and counts
with percentages for categorical data. Statistical testing and modeling methods including
t-test (continuous data) and chi-square test (for categorical data) will be applied to
evaluate changes in key measures pre- and post programming. Nonparametric methods for
example Mann-Whitney test, Kruskal-Wallis test and Mood's median test will be applied
where the continuous data show significant skewness or pattern far from normal
distribution. Repeated measurements ANOVA and other longitudinal models including linear
mixed model or generalized linear mixed model or quantile regression (depending on
outcomes' distributions) will be used to identify factors that drive the changes of key
outcomes collected at T1 - T4. In addition, machine learning methods, for example,
k-means clustering, regression tree or random forest, will be employed to identify
subgroups with different patterns of changes in multiple outcomes through the
programming. The investigators are especially interested to investigate which group(s) of
patients have significant improvement in physical activities and health outcomes, and
which group(s) don't have changes in outcomes. If presence of missing values and
drop-outs, some inverse probability weighted likelihood methods may be used to consider
the informative messiness.
All data will be collected on-site or through Qualtrics (online) for this study. The
post-program data will be collected on-site also. If participants are unable to attend
the class during which measurements will be completed, then the participants will be
called and arrangements will be made for them to meet with the facilitator within two
weeks of that date.