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Wahl KJ, Brooks M, Trenaman L, Desjardins-Lorimer K, Bell CM, Chokmorova N, Segall R, Syring J, Williams A, Li LC, Norman WV, Munro S. User-Centered Development of a Patient Decision Aid for Choice of Early Abortion Method: Multi-Cycle Mixed Methods Study. J Med Internet Res 2024; 26:e48793. [PMID: 38625731 PMCID: PMC11061794 DOI: 10.2196/48793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND People seeking abortion in early pregnancy have the choice between medication and procedural options for care. The choice is preference-sensitive-there is no clinically superior option and the choice depends on what matters most to the individual patient. Patient decision aids (PtDAs) are shared decision-making tools that support people in making informed, values-aligned health care choices. OBJECTIVE We aimed to develop and evaluate the usability of a web-based PtDA for the Canadian context, where abortion care is publicly funded and available without legal restriction. METHODS We used a systematic, user-centered design approach guided by principles of integrated knowledge translation. We first developed a prototype using available evidence for abortion seekers' decisional needs and the risks, benefits, and consequences of each option. We then refined the prototype through think-aloud interviews with participants at risk of unintended pregnancy ("patient" participants). Interviews were audio-recorded and documented through field notes. Finally, we conducted a web-based survey of patients and health care professionals involved with abortion care, which included the System Usability Scale. We used content analysis to identify usability issues described in the field notes and open-ended survey questions, and descriptive statistics to summarize participant characteristics and close-ended survey responses. RESULTS A total of 61 individuals participated in this study. Further, 11 patients participated in think-aloud interviews. Overall, the response to the PtDA was positive; however, the content analysis identified issues related to the design, language, and information about the process and experience of obtaining abortion care. In response, we adapted the PtDA into an interactive website and revised it to include consistent and plain language, additional information (eg, pain experience narratives), and links to additional resources on how to find an abortion health care professional. In total, 25 patients and 25 health care professionals completed the survey. The mean System Usability Scale score met the threshold for good usability among both patient and health care professional participants. Most participants felt that the PtDA was user-friendly (patients: n=25, 100%; health care professionals: n=22, 88%), was not missing information (patients: n=21, 84%; health care professionals: n=18, 72%), and that it was appropriate for patients to complete the PtDA before a consultation (patients: n=23, 92%; health care professionals: n=23, 92%). Open-ended responses focused on improving usability by reducing the length of the PtDA and making the website more mobile-friendly. CONCLUSIONS We systematically designed the PtDA to address an unmet need to support informed, values-aligned decision-making about the method of abortion. The design process responded to a need identified by potential users and addressed unique sensitivities related to reproductive health decision-making.
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Affiliation(s)
- Kate J Wahl
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Melissa Brooks
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS, Canada
| | - Logan Trenaman
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States
| | | | - Carolyn M Bell
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Nazgul Chokmorova
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Romy Segall
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS, Canada
| | - Janelle Syring
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Aleyah Williams
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Wendy V Norman
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sarah Munro
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States
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Losciale JM, Truong LK, Zhang K, Silvester-Lee T, Miciak M, Pajkic A, Le CY, Xie H, Hoens AM, Mosewich AD, Hunt MA, Li LC, Roos EM, Whittaker JL. Assessing the efficacy of the Stop OsteoARthritis (SOAR) program: A randomized delayed-controlled trial in persons at increased risk of early onset post-traumatic knee osteoarthritis. Osteoarthritis Cartilage 2024:S1063-4584(24)01151-8. [PMID: 38615974 DOI: 10.1016/j.joca.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Assess the efficacy of an 8-week virtual, physiotherapist (PT)-guided knee health program (Stop OsteoARthritis (SOAR)) to improve knee extensor strength in individuals at risk of post-traumatic knee osteoarthritis (PTOA). METHOD In this superiority, randomized delayed-control trial, persons aged 16-35 years, 1-4 years after a self-reported knee joint injury were randomly assigned (1:1) to receive the SOAR program immediately (experimental group) or after a 9-week delay (control group). SOAR includes 1) one-time Knee Camp (virtual PT-guided group education, knee assessment, 1:1 exercise and physical activity (PA) goal-setting); 2) Weekly personalized home-based exercise and PA program with tracking; 3) Weekly 1:1 PT counseling (virtual). The primary outcome was a change in isokinetic knee extensor strength (baseline to 9-weeks). Additional outcomes included change in self-reported knee-related quality-of-life (QOL), self-efficacy, self-management and kinesiophobia, and PA (accelerometer) at 9 and 18-weeks. Linear regression models estimated the effect of the 8-week intervention at the primary endpoint (9-week). RESULTS 49 of 54 randomized participants completed the study (91%). Participants were a mean ± standard deviation age of 27 ± 5.0 years, and 2.4 ± 0.9 years post-injury. No mean between group differences for the primary (0.05; 95% confidence interval (CI): -0.10, 0.19) or other outcomes were seen at 9 weeks except for greater improvements in perceived self-management (Partner in Health Scale; 11.3/96, 95%CI: 5.5, 17.1) and kinesiophobia (Tampa Scale of Kinesiophobia; -4.4/33, 95%CI: -7.0, -1.8). CONCLUSION For active persons with elevated risk of PTOA, an 8-week SOAR program did not change knee-related strength, QOL, self-efficacy, or PA, on average, but may benefit the ability to self-manage knee health and kinesiophobia.
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Affiliation(s)
- Justin M Losciale
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Linda K Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Kexin Zhang
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Andrea Pajkic
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Christina Y Le
- Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada
| | - Hui Xie
- Arthritis Research Canada, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Alison M Hoens
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Amber D Mosewich
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Michael A Hunt
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Ewa M Roos
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Décary S, de Wit M, Naye F, Barton JL, Fraenkel L, Li LC, Brooks P, Stacey D, Maxwell LJ, Campbell W, Hofstetter C, Voshaar M, Meara A, Christensen R, Boonen A, Suarez-Almazor ME, Meade T, March L, Jull JE, Alten R, Morgan EM, Stewart Hazlewood G, Barber CEH, Guillemin F, El-Miedany Y, Mittoo S, Robertson TW, Bartlett SJ, Singh JA, Mannion M, Nasef SI, Boel A, Adebajo A, Arnaud L, Gill TK, Moholt E, Burt J, Jayatilleke A, Hmamouchi I, Berthelsen DB, Blanco FJ, Mather K, Maharaj A, Sharma S, Caso F, Beaton D, Shea B, Fong C, Fernandez AP, Mackie S, Nikiphorou E, Jones A, Greer-Smith R, Sloan VS, Akpabio A, Strand V, Lee RR, Umaefulam V, Monti S, Abaza N, Schultz G, Stones S, Gossec L, Nielsen SM, Cavallo S, Srinivasalu H, Constien D, Evans V, Tugwell P, Toupin-April K. Consensus on the definitions and descriptions of the domains of the OMERACT Core Outcome Set for shared decision making interventions in rheumatology trials. Semin Arthritis Rheum 2024; 65:152381. [PMID: 38306813 DOI: 10.1016/j.semarthrit.2024.152381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To gain consensus on the definitions and descriptions of the domains of the Outcome Measures in Rheumatology (OMERACT) core domain set for rheumatology trials evaluating shared decision making (SDM) interventions. METHODS Following the OMERACT Handbook methods, our Working Group (WG), comprised of 90 members, including 17 patient research partners (PRPs) and 73 clinicians and researchers, had six virtual meetings in addition to email exchanges to develop draft definitions and descriptions. The WG then conducted an international survey of its members to gain consensus on the definitions and descriptions. Finally, the WG members had virtual meetings and e-mail exchanges to review survey results and finalize names, definitions and descriptions of the domains. RESULTS WG members contributed to developing the definitions. Fifty-two members representing four continents and 13 countries completed the survey, including 15 PRPs, 33 clinicians and 37 researchers. PRPs and clinicians/researchers agreed with all definitions and descriptions with agreements ranging from 87% to 100%. Respondents suggested wording changes to the names, definitions and descriptions to better reflect the domains. Discussions led to further simplification and clarification to address common questions/concerns about the domains. CONCLUSION Our WG reached consensus on the definitions and descriptions of the domains of the core domain set for rheumatology trials of SDM interventions. This step is crucial to understand each domain and provides the foundation to identify instruments to measure each domain for inclusion in the Core Outcome Measurement Set. CLINICAL SIGNIFICANCE The current study provides consensus-based definitions and descriptions for the domains of the OMERACT core domain set for shared decision making interventions from patients/caregivers, clinicians and researchers. This is a crucial step to understand each domain and provides the foundation to identify instruments to measure each domain for inclusion in the Core Outcome Measurement Set for trials of SDM interventions.
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Affiliation(s)
- Simon Décary
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Florian Naye
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, Sherbrooke, Canada
| | - Jennifer L Barton
- VA Portland Health Care System, Oregon Health & Science University, Portland, USA
| | - Liana Fraenkel
- Department of Internal Medicine, Yale University, New Haven, USA
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia; Arthritis Research Canada, Canada
| | - Peter Brooks
- School of Population and Global Health, University of Melbourne and Northern Health, Melbourne, Australia
| | - Dawn Stacey
- School of Nursing, University of Ottawa and The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lara J Maxwell
- Centre for Practice Changing Research, Ottawa Hospital Research Institute and Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Willemina Campbell
- Patient Research Partner, Toronto Western Hospital, University Health Network, Canada
| | | | - Marieke Voshaar
- Patient Research Partner; Department of Pharmacy and Department of Research & Innovation, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Pharmacy, Radboud university medical center, Nijmegen, The Netherlands
| | - Alexa Meara
- Division of Rheumatology, The Ohio State University, Columbus, USA
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, & Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, Section of Rheumatology and Clinical Immunology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Tanya Meade
- Western Sydney University, Sydney, Australia
| | - Lyn March
- Department of Rheumatology, Royal North Shore Hospital; The University of Sydney, Australia
| | | | - Rieke Alten
- Department of Internal Medicine II, Rheumatology Research Center, Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany
| | - Esi M Morgan
- Department of Pediatrics, University of Washington. Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington, USA
| | | | - Claire E H Barber
- Department of Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Yasser El-Miedany
- Canterbury Christ Church University, Canterbury; King's College London, London, United Kingdom
| | - Shikha Mittoo
- Vanshavardhana Canada Integrated Health, Toronto, Canada
| | - Tiffany Westrich Robertson
- CEO, Patient research partner, International Foundation for Autoimmune & Autoinflammatory Arthritis (AiArthritis), USA
| | - Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respiratory Epidemiology and Clinical Trials Unit, McGill University; Research Institute, McGill University Health Centre; Johns Hopkins Medicine Division of Rheumatology, Montreal, Canada
| | | | - Melissa Mannion
- Department of Pediatrics, Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Samah Ismail Nasef
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Anne Boel
- Department of Rheumatology, Leiden University Medical Centre; UCB Pharma, B.V. Netherlands, Leiden, the Netherlands
| | - Adewale Adebajo
- Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Laurent Arnaud
- Department of Rheumatology, CRMR RESO, University Hospitals of Strasbourg, Strasbourg, France
| | - Tiffany K Gill
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Australia
| | - Ellen Moholt
- Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Norway
| | - Jennifer Burt
- Newfoundland and Labrador Health Services, St. Clare's Mercy Hospital, St John's, Newfoundland and Labrador, Canada
| | | | - Ihsane Hmamouchi
- Health Sciences Research Centre (CReSS), Faculty of Medicine, International University of Rabat (UIR), Rabat, Morocco
| | - Dorthe B Berthelsen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense; Department of Rehabilitation, Municipality of Guldborgsund, Nykoebing F, Denmark
| | - Francisco J Blanco
- Departamento de Fisioterapia, Medicina y Ciencias Médicas, Universidad de A Coruña, A Coruña, Spain, Spain
| | | | - Ajesh Maharaj
- Department of Internal Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Beverly Shea
- Bruyère Research Institute; Ottawa Hospital Research Institute; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Christopher Fong
- Eastern Clinical Research Unit, Monash University, Melbourne, Australia
| | - Anthony P Fernandez
- Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College Hospital, School of Immunology and Microbial Sciences, King's College London; Rheumatology Department, King's College Hospital, London, United Kingdom
| | - Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Regina Greer-Smith
- Patient Research Partner, President/CEO, Healthcare Research Associates, LLC/S.T.A.R. Initiative; Ambassador, Patient-Centered Outcomes Research Institute, Apple Valley, CA, USA
| | - Victor S Sloan
- Sheng Consulting LLC, Flemington, New Jersey USA; The Peace Corps, Washington, DC, USA
| | | | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University, Stanford, California, USA
| | - Rebecca R Lee
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester, UK
| | - Valerie Umaefulam
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Sara Monti
- Department of Rheumatology, Policlinico S. Matteo, IRCCS Fondazione, University of Pavia, Pavia, Italy
| | - Nouran Abaza
- Professor of Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Simon Stones
- Patient research partner, Envision Pharma Group, Wilmslow, UK
| | - Laure Gossec
- Professor of Rheumatology, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; AP-HP, Pitié-Salpêtrière hospital, Rheumatology department, Paris, France
| | - Sabrina Mai Nielsen
- Musculoskeletal Statistics Unit, the Parker Institute, Department of Rheumatology, Odense University Hospital, and University of Southern Denmark, Copenhagen, Denmark
| | - Sabrina Cavallo
- School of Rehabilitation, Faculty of Medicine, University of Montreal; Researcher Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada; Sainte-Justine University Health Center Research Center, Montreal, Canada
| | - Hemalatha Srinivasalu
- Pediatric Rheumatology, Children's National Hospital; GW School of Medicine, Washington, DC, USA
| | - Deb Constien
- Patient Research Partner, Central Regional Lead, Advocacy Leadership Board Chair, International Foundation of Autoimmune Autoinflammatory Arthritis (AiArthritis), Madison, Wisconsin, USA
| | - Vicki Evans
- Patient Research Partner and Discipline of Optometry, Faculty of Health, University of Canberra, Canberra, Australia
| | - Peter Tugwell
- Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa; Department of Pediatrics, Faculty of Medicine, University of Ottawa; Affiliate scientist, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada; Institut du savoir Montfort, Ottawa, Canada.
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Naye F, Toupin-April K, de Wit M, LeBlanc A, Dubois O, Boonen A, Barton JL, Fraenkel L, Li LC, Stacey D, March L, Barber CEH, Hazlewood GS, Guillemin F, Bartlett SJ, Berthelsen DB, Mather K, Arnaud L, Akpabio A, Adebajo A, Schultz G, Sloan VS, Gill TK, Sharma S, Scholte-Voshaar M, Caso F, Nikiphorou E, Nasef SI, Campbell W, Meara A, Christensen R, Suarez-Almazor ME, Jull JE, Alten R, Morgan EM, El-Miedany Y, Singh JA, Burt J, Jayatilleke A, Hmamouchi I, Blanco FJ, Fernandez AP, Mackie S, Jones A, Strand V, Monti S, Stones SR, Lee RR, Nielsen SM, Evans V, Srinivasalu H, Gérard T, Demers JL, Bouchard R, Stefan T, Dugas M, Bergeron F, Beaton D, Maxwell LJ, Tugwell P, Décary S. OMERACT Core outcome measurement set for shared decision making in rheumatic and musculoskeletal conditions: a scoping review to identify candidate instruments. Semin Arthritis Rheum 2024; 65:152344. [PMID: 38232625 DOI: 10.1016/j.semarthrit.2023.152344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Shared decision making (SDM) is a central tenet in rheumatic and musculoskeletal care. The lack of standardization regarding SDM instruments and outcomes in clinical trials threatens the comparative effectiveness of interventions. The Outcome Measures in Rheumatology (OMERACT) SDM Working Group is developing a Core Outcome Set for trials of SDM interventions in rheumatology and musculoskeletal health. The working group reached consensus on a Core Outcome Domain Set in 2020. The next step is to develop a Core Outcome Measurement Set through the OMERACT Filter 2.2. METHODS We conducted a scoping review (PRISMA-ScR) to identify candidate instruments for the OMERACT Filter 2.2 We systematically reviewed five databases (Ovid MEDLINE®, Embase, Cochrane Library, CINAHL and Web of Science). An information specialist designed search strategies to identify all measurement instruments used in SDM studies in adults or children living with rheumatic or musculoskeletal diseases or their important others. Paired reviewers independently screened titles, abstracts, and full text articles. We extracted characteristics of all candidate instruments (e.g., measured construct, measurement properties). We classified candidate instruments and summarized evidence gaps with an adapted version of the Summary of Measurement Properties (SOMP) table. RESULTS We found 14,464 citations, read 239 full text articles, and included 99 eligible studies. We identified 220 potential candidate instruments. The five most used measurement instruments were the Decisional Conflict Scale (traditional and low literacy versions) (n=38), the Hip/Knee-Decision Quality Instrument (n=20), the Decision Regret Scale (n=9), the Preparation for Decision Making Scale (n=8), and the CollaboRATE (n=8). Only 44 candidate instruments (20%) had any measurement properties reported by the included studies. Of these instruments, only 57% matched with at least one of the 7-criteria adapted SOMP table. CONCLUSION We identified 220 candidate instruments used in the SDM literature amongst people with rheumatic and musculoskeletal diseases. Our classification of instruments showed evidence gaps and inconsistent reporting of measurement properties. The next steps for the OMERACT SDM Working Group are to match candidate instruments with Core Domains, assess feasibility and review validation studies of measurement instruments in rheumatic diseases or other conditions. Development and validation of new instruments may be required for some Core Domains.
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Affiliation(s)
- Florian Naye
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada; Institut du savoir Montfort, Ottawa, Canada
| | | | - Annie LeBlanc
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada; VITAM Centre de recherche en santé durable, Quebec City, Canada
| | - Olivia Dubois
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jennifer L Barton
- VA Portland Health Care System, Oregon Health & Science University, Portland, USA
| | - Liana Fraenkel
- Department of Internal Medicine, Yale University, New Haven, USA
| | - Linda C Li
- Department of Physical Therapy, Arthritis Research Canada, University of British Columbia, Vancouver, Canada
| | - Dawn Stacey
- School of Nursing, University of Ottawa, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lyn March
- Department of Medicine, The University of Sydney, Sydney, Australia; Institute of Bone and Joint Research, Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia
| | - Claire E H Barber
- Department of Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | | | - Susan J Bartlett
- Divisions of Clinical Epidemiology, Rheumatology and Respiratory Epidemiology and Clinical Trials Unit, McGill University, Canada; Research Institute - McGill University Health Centre, Canada; Johns Hopkins Medicine Division of Rheumatology, Montreal, Canada
| | - Dorthe B Berthelsen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen & Research Unit of Rheumatology, Department of Clinical Research, Odense & Department of Rehabilitation, Municipality of Guldborgsund, Odense University Hospital, University of Southern Denmark, Nykoebing, Denmark
| | | | - Laurent Arnaud
- Department of Rheumatology, CRMR RESO, University Hospitals of Strasbourg, France
| | | | - Adewale Adebajo
- Faculty of Medicine, Dentistry and Health, University of Sheffield, UK
| | | | - Victor S Sloan
- Sheng Consulting LLC, Flemington, NJ, USA; The Peace Corps, Washington, DC, USA
| | - Tiffany K Gill
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Australia
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Marieke Scholte-Voshaar
- Patient Research Partner, Department of Pharmacy and Department of Research & Innovation, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Pharmacy, Radboud university medical center, Nijmegen
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College Hospital, School of Immunology and Microbial Sciences, King's College London, UK; Rheumatology Department, King's College Hospital, London, UK
| | - Samah Ismail Nasef
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Willemina Campbell
- Patient research partner, Toronto Western Hospital, University Health Network, Canada
| | - Alexa Meara
- Division of Rheumatology, The Ohio State University, Columbus, USA
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, & Department of Rheumatology, Odense University Hospital, Denmark
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, Section of Rheumatology and Clinical Immunology, University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - Rieke Alten
- Department of Internal Medicine II, Rheumatology Research Center, Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany
| | - Esi M Morgan
- Department of Pediatrics, University of Washington, Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington, USA
| | | | | | - Jennifer Burt
- Newfoundland and Labrador Health Services, St. Clare's Mercy Hospital, St John's, Newfoundland and Labrador, Canada
| | | | - Ihsane Hmamouchi
- Health Sciences Research Centre (CReSS), Faculty of Medicine, International University of Rabat (UIR), Rabat, Morocco
| | - Francisco J Blanco
- Departamento de Fisioterapia, Medicina y Ciencias Médicas, Universidad de A Coruña, A Coruña, Spain
| | - Anthony P Fernandez
- Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University, Stanford, California, USA
| | - Sara Monti
- Department of Rheumatology, Policlinico S. Matteo, IRCCS Fondazione, University of Pavia, Pavia, Italy
| | - Simon R Stones
- Patient research partner, Envision Pharma Group, Wilmslow, UK
| | - Rebecca R Lee
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester, UK
| | - Sabrina Mai Nielsen
- Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Odense University Hospital, and University of Southern Denmark, Copenhagen, Demark, Copenhagen, Denmark
| | - Vicki Evans
- Patient Research Partner and Discipline of Optometry, Faculty of Health, University of Canberra, Canberra, Australia
| | - Hemalatha Srinivasalu
- Pediatric Rheumatology, Children's National Hospital, Washington DC, USA; GW School of Medicine, Washington DC, USA
| | - Thomas Gérard
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada
| | | | - Roxanne Bouchard
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | - Théo Stefan
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | - Michèle Dugas
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | | | | | - Lara J Maxwell
- Centre for Practice Changing Research, Ottawa Hospital Research Institute and Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Simon Décary
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada.
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Wu ML, Ma JK, Tsui K, Hoens AM, Li LC. Tailoring Strength Training Prescriptions for People with Rheumatoid Arthritis: A Scoping Review. Am J Lifestyle Med 2024; 18:200-215. [PMID: 38456164 PMCID: PMC10914594 DOI: 10.1177/15598276221125415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Introduction: Prescribing strength training (ST) for people with rheumatoid arthritis (RA) is complicated by factors (barriers and facilitators) that affect participation. It is unclear whether guidelines include recommendations beyond prescription parameters (frequency, intensity, time, type, volume, and progression) and adequately incorporate participation factors tailored to people with RA. Objective: To summarize available recommendations to aid in the tailoring of ST prescriptions for people with RA. Methods: Medline, Embase, and CINAHL databases and gray literature were searched for guidelines, recommendations, and review articles containing ST prescription recommendations for RA. Article screening and data extraction were performed in duplicate by two reviewers. Results: Twenty-seven articles met the inclusion criteria. The recommendations address RA-specific ST participation factors including: knowledge gaps (of equipment, ST benefits, disease), memory problems, the management of joint deformity, comorbidity, the fluctuating nature of the disease and symptoms (pain, stiffness, flares), fear avoidance, motivation, need for referral to other professionals, and provision of RA-specific resources. Conclusion: This review summarizes recommendations for tailoring ST prescriptions for people with RA. Future research is required to understand how pain, symptom assessment, and unaddressed ST participation factors like sleep and medication side effects can be addressed to support ST participation amongst people with RA.
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Affiliation(s)
| | - Jasmin K. Ma
- Jasmin K. Ma, PhD, B.Kin, Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada; e-mail:
| | - Karen Tsui
- University of British Columbia, Vancouver, BC, Canada (MLW, AMH); Arthritis Research Canada, Vancouver, BC, Canada (JKM, LCL); and William Osler Health System, Brampton, ON, Canada (KT)
| | - Alison M. Hoens
- University of British Columbia, Vancouver, BC, Canada (MLW, AMH); Arthritis Research Canada, Vancouver, BC, Canada (JKM, LCL); and William Osler Health System, Brampton, ON, Canada (KT)
| | - Linda C. Li
- University of British Columbia, Vancouver, BC, Canada (MLW, AMH); Arthritis Research Canada, Vancouver, BC, Canada (JKM, LCL); and William Osler Health System, Brampton, ON, Canada (KT)
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6
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Truong LK, Mosewich AD, Miciak M, Losciale JM, Li LC, Whittaker JL. Social support and therapeutic relationships intertwine to influence exercise behavior in people with sport-related knee injuries. Physiother Theory Pract 2024:1-14. [PMID: 38374585 DOI: 10.1080/09593985.2024.2315520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Explore how social support influences exercise therapy participation and adherence before and after enrolling in an education and exercise therapy intervention (Stop OsteoARthritis, SOAR). METHODS Study design: Interpretative description. We sampled participants with sport-related knee injuries from the SOAR randomized controlled trial. SOAR is a virtual, physiotherapist-guided, education and exercise therapy-based knee health program that targets individuals at risk of early osteoarthritis. One-on-one semi-structured interviews were completed, and an inductive approach was guided by Braun & Clarke's reflexive thematic analysis. RESULTS Fifteen participants (67% female, median age 26 [19-35] years) were interviewed. Three themes were generated that encapsulated participants' social support experiences that fostered exercise participation: 1) Treat me as a whole person represented the value of social support that went beyond participants' physical needs, 2) Work with me highlighted the working partnership between the clinician and the participant, and 3) Journey with me indicated a need for on-going support is necessary for the long-term management of participants' knee health. A theme of the therapeutic relationship was evident across the findings. CONCLUSIONS Insight was gained into how and why perceived support may be linked to exercise behavior, with the therapeutic relationship being potentially linked to perceived support. Social support strategies embedded within an education and exercise therapy program may boost exercise adherence after sport-related knee injuries.
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Affiliation(s)
- Linda K Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Amber D Mosewich
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Maxi Miciak
- College of Health Sciences, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Justin M Losciale
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
- College of Health Sciences, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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7
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Falck RS, Hsu CL, Best JR, Boa Sorte Silva NC, Hall PA, Li LC, Liu-Ambrose T. Cross-sectional and longitudinal neural predictors of physical activity and sedentary behaviour from a 6-month randomized controlled trial. Sci Rep 2024; 14:919. [PMID: 38195673 PMCID: PMC10776740 DOI: 10.1038/s41598-023-48715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024] Open
Abstract
A sedentary lifestyle offers immediate gratification, but at the expense of long-term health. It is thus critical to understand how the brain evaluates immediate rewards and long-term health effects in the context of deciding whether to engage in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour (SB). In this secondary analysis of a 6-month randomized controlled trial to increase MVPA and reduce SB among community-dwelling adults, we explored how neural activity during an executive control task was associated with MVPA and SB levels. At baseline, a subset of participants (n = 26/61) underwent task-based functional magnetic resonance imaging (fMRI) to examine neural activity underlying executive control using the Now/Later task. MVPA and SB were measured objectively using the Sensewear Mini at baseline, and 2, 4, and 6 months follow-up. We then examined the associations of baseline neural activation underlying executive control with: (1) baseline MVPA or SB; and (2) changes in MVPA and SB over 6 months. Our results determined that there is a complex neurocognitive system associated with MVPA levels, while SB appears to lack any neurocognitive control. In other words, MVPA appears to require neurocognitive effort, while SB may be the default behavioural pattern in adults.
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Affiliation(s)
- Ryan Stanley Falck
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Chun Liang Hsu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - Narlon Cassio Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Peter A Hall
- School of Kinesiology, The University of Waterloo, Waterloo, ON, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, Vancouver Coastal Health Research Institute, Faculty of Medicine, University of British Columbia, 212-177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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8
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Leese J, Therrien S, Ramachandran S, Backman CL, Ma JK, Koehn CL, Hoens AM, English K, Davidson E, McQuitty S, Gavin J, Adams J, Li LC. Decision-Making Around COVID-19 Public Health Measures and Implications for Self-Care Activities: Experiences of Persons With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2024; 76:140-152. [PMID: 37870115 DOI: 10.1002/acr.25262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE We aimed to advance understanding of how persons with rheumatoid arthritis (RA) experience decision-making about adopting public health measures during the COVID-19 pandemic. METHODS Persons living with RA partnered throughout this nested qualitative study. One-to-one semistructured telephone interviews were conducted with participants with RA between December 2020 and December 2021. They were strategically sampled from a randomized controlled trial that was underway to test a physical activity counseling intervention. Analysis was guided by reflexive thematic analysis. RESULTS Thirty-nine participants (aged 26-86 years; 36 women) in British Columbia, Canada were interviewed. We developed three themes. Participants described how their decision-making about public health measures related to 1) "upholding moral values of togetherness" because decisions were intertwined with moral values of neighborliness and reciprocity. Some adapted their self-care routines to uphold these moral values; 2) "relational autonomy-supports and challenges," because they sometimes felt supported and undermined in different relational settings (eg, by family, local community, or provincial government); and 3) "differing trust in information sources," in which decisions were shaped by the degree of faith they had in various information sources, including their rheumatologists. CONCLUSION Across themes, experiences of decision-making about public health measures during the pandemic were embedded with moral concepts of solidarity, autonomy, and trust, with implications for how persons with RA chose and sustained their self-care activities. Insights gained help sensitize researchers and clinicians to moral issues experienced by persons with RA, which may inform support for self-care activities during and after the pandemic.
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Affiliation(s)
- Jenny Leese
- Arthritis Research Canada, Vancouver, British Columbia, and University of Ottawa, Ottawa, Ontario, Canada
| | | | - Smruthi Ramachandran
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmin K Ma
- Arthritis Research Canada and University of British Columbia and International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
| | - Cheryl L Koehn
- Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | - Alison M Hoens
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly English
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Shanon McQuitty
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Jo Adams
- University of Southampton, Southampton, UK
| | - Linda C Li
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
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Macdonald GG, Leese J, Hoens AM, Kerr S, Lum W, Gulka L, Nimmon L, Li LC. A patienthood that transcends the patient: An analysis of patient research partners' narratives of involvement in a Canadian arthritis patient advisory board. J Health Serv Res Policy 2024; 29:22-30. [PMID: 37632271 PMCID: PMC10729530 DOI: 10.1177/13558196231197288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Incorporating the perspectives of patients and public into the conduct of research has the potential to make scientific research more democratic. This paper explores how being a patient partner on an arthritis patient advisory board shapes the patienthood of a person living with arthritis. METHODS An analysis was undertaken of the narratives of 22 patient research partners interviewed about their experiences on the Arthritis Patient Advisory Board (APAB), based in Vancouver, Canada. RESULTS Participants' motivations to become involved in APAB stemmed largely from their desire to change their relationship with their condition. APAB was a living collective project in which participants invested their hope, both for their own lives as patients and for others with the disease. CONCLUSIONS Our findings highlight how the journeys of patient partners connect and integrate seemingly disparate conceptions of what it means to be a patient. One's experience as a clinical 'patient' transforms into the broader notion of civic patienthood.
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Affiliation(s)
- Graham G Macdonald
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheila Kerr
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Wendy Lum
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Lianne Gulka
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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10
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Bhuiya AR, Sutherland J, Boateng R, Bain T, Skidmore B, Perrier L, Makarski J, Munce S, Lewis I, Graham ID, Holroyd-Leduc J, Straus SE, Stelfox HT, Strifler L, Lokker C, Li LC, Leung FH, Dobbins M, Puchalski Ritchie LM, Squires JE, Rac VE, Fahim C, Kastner M. A scoping review reveals candidate quality indicators of knowledge translation and implementation science practice tools. J Clin Epidemiol 2024; 165:111205. [PMID: 37939744 DOI: 10.1016/j.jclinepi.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To identify candidate quality indicators from existing tools that provide guidance on how to practice knowledge translation and implemenation science (KT practice tools) across KT domains (dissemination, implementation, sustainability, and scalability). STUDY DESIGN AND SETTING We conducted a scoping review using the Joanna Briggs Institute Manual for Evidence Synthesis. We systematically searched multiple electronic databases and the gray literature. Documents were independently screened, selected, and extracted by pairs of reviewers. Data about the included articles, KT practice tools, and candidate quality indicators were analyzed, categorized, and summarized descriptively. RESULTS Of 43,060 titles and abstracts that were screened from electronic databases and gray literature, 850 potentially relevant full-text articles were identified, and 253 articles were included in the scoping review. Of these, we identified 232 unique KT practice tools from which 27 unique candidate quality indicators were generated. The identified candidate quality indicators were categorized according to the development (n = 17), evaluation (n = 5) and adaptation (n = 3) of the tools, and engagement of knowledge users (n = 2). No tools were identified that appraised the quality of KT practice tools. CONCLUSIONS The development of a quality appraisal instrument of KT practice tools is needed. The results will be further refined and finalized in order to develop a quality appraisal instrument for KT practice tools.
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Affiliation(s)
- Aunima R Bhuiya
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada.
| | - Justin Sutherland
- North York General Hospital, Research and Innovation, North York, Ontario, Canada
| | - Rhonda Boateng
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Téjia Bain
- North York General Hospital, Research and Innovation, North York, Ontario, Canada
| | - Becky Skidmore
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Laure Perrier
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Julie Makarski
- North York General Hospital, Research and Innovation, North York, Ontario, Canada
| | - Sarah Munce
- University Health Network, Toronto, Ontario, Canada
| | - Iveta Lewis
- North York General Hospital, Research and Innovation, North York, Ontario, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa and Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jayna Holroyd-Leduc
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine and the O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Lisa Strifler
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Cynthia Lokker
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fok-Han Leung
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Ontario, Canada; National Collaborating Centre for Methods and Tools, Hamilton, Ontario, Canada
| | - Lisa M Puchalski Ritchie
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
| | - Janet E Squires
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Valeria E Rac
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Christine Fahim
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Monika Kastner
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; North York General Hospital, Research and Innovation, North York, Ontario, Canada
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11
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Li LC, Xie H, Feehan LM, Shaw C, Lu N, Ramachandran S, Wang E, Therrien S, Mucha J, Hoens AM, English K, Davidson E, Liu-Ambrose T, Backman CL, Esdaile JM, Miller KJ, Lacaille D. Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial. Rheumatology (Oxford) 2023:kead709. [PMID: 38152927 DOI: 10.1093/rheumatology/kead709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES To assess a remote physiotherapist (PT) counselling intervention using self-monitoring tools for improving self-management ability, physical activity participation, and health outcomes in people with rheumatoid arthritis (RA). METHODS Eligible participants were randomly assigned to receive group education, a Fitbit®, a self-monitoring app, and PT counselling phone calls (Immediate Group). The Delayed Group received a monthly e-newsletter until week 26, and then the intervention. The primary outcome was Patient Activation Measure (PAM-13). Participants were assessed at baseline, 27 weeks (the primary end point) and 53 weeks. Secondary outcomes included disease activity, pain, fatigue, depression, sitting/walking habits, daily physical activity time, and daily awake sedentary time. Generalized Linear Mixed-effect Models (GLMMs) were used to assess the effect of the intervention on the change of each outcome measure from the initiation to 27 weeks after the intervention. RESULTS Analysis included 131 participants (91.6% women; 80.2% completed during the COVID-19 pandemic). The mean change of PAM-13 at 27 weeks was 4.6 (SD = 14.7) in the Immediate Group vs -1.6 (SD = 12.5) in the Delayed Group. The mean change in Delayed Group at 53 weeks (after the 26-week intervention) was 3.6 (SD = 14.6). Overall, the intervention improved PAM-13 at 27 weeks post-intervention from the GLMM analysis (adjusted coefficient: 5.3; 95% CI: 2.0, 8.7; p = <0.001). Favourable intervention effects were also found in disease activity, fatigue, depression, and self-reported walking habit. CONCLUSION Remote counselling paired with self-monitoring tools improved self-management ability in people with RA. Findings of secondary outcomes indicate that the intervention had a positive effect on symptom management.
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive Burnaby, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Chris Shaw
- School of Interactive Arts and Technology, Simon Fraser University, 102 Avenue Surrey BC, 250-13450, Canada
| | - Na Lu
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Smruthi Ramachandran
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Ellen Wang
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Stephanie Therrien
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Julia Mucha
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Kelly English
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Wesbrook Mall, Vancouver BC, 212-2177, Canada
| | - Catherine L Backman
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Wesbrook Mall, Vancouver, BC, 325-2211, Canada
| | - John M Esdaile
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
| | - Kimberly J Miller
- New Knowledge and Innovation, BC Children's Hospital and BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC, Canada
| | - Diane Lacaille
- Arthritis Research Canada, Yukon Street, Vancouver, BC, 230-2238, Canada
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12
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Rice J, Li LC, Davis JC, Pahor M, Madden K, Wei N, Wong H, Skelton DA, McCormick S, Falck RS, Barha CK, Rhodes RE, Loomba S, Sadatsafavi M, Liu-Ambrose T. Supporting physical activity for mobility in older adults with mobility limitations (SuPA Mobility): study protocol for a randomized controlled trial. Trials 2023; 24:769. [PMID: 38017467 PMCID: PMC10685660 DOI: 10.1186/s13063-023-07798-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Limited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15-24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient physical activity. Evidence shows that increasing physical activity by 50 min of moderate intensity physical activity in sedentary older adults with mobility limitations can improve mobility and reduce the incidence of mobility disability. To maximize the healthy life span of older adults, it is necessary to find effective and efficient interventions that can be delivered widely to prevent mobility limitations, increase physical activity participation, and improve quality of life in older adults. We propose a randomized controlled trial to assess the effect of a physical activity health coaching intervention on mobility in older adults with mobility limitations. METHODS This randomized controlled trial among 290 (145 per group) community-dwelling older adults with mobility limitations, aged 70-89 years old, will compare the effect of a physical activity health coaching intervention versus a general healthy aging education program on mobility, as assessed with the Short Physical Performance Battery. The physical activity health coaching intervention will be delivered by exercise individuals who are trained in Brief Action Planning. The coaches will use evidence-based behavior change techniques including goal-setting, action planning, self-monitoring, and feedback to improve participation in physical activity by a known dose of 50 min per week. There will be a total of 9 health coaching or education sessions delivered over 26 weeks with a subsequent 26-week follow-up period, wherein both groups will receive the same duration and frequency of study visits and activities. DISCUSSION The consequences of limited mobility pose a significant burden on the quality of life of older adults. Our trial is novel in that it investigates implementing a dose of physical activity that is known to improve mobility in older adults utilizing a health coaching intervention. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: NCT05978336; registered on 28 July 2023.
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Affiliation(s)
- Jordyn Rice
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Linda C Li
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Jennifer C Davis
- University of British Columbia-Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Marco Pahor
- University of Florida, Gainesville, FL, 32611, USA
| | - Kenneth Madden
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Nathan Wei
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Hubert Wong
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Dawn A Skelton
- Glasgow Caledonian University, Cowcaddens Rd, Glasgow, G4 0BA, UK
| | - Sioban McCormick
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Ryan S Falck
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Cindy K Barha
- University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Ryan E Rhodes
- University of Victoria, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada
| | - Sohail Loomba
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Mohsen Sadatsafavi
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Teresa Liu-Ambrose
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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Falck RS, Sorte Silva NCB, Balbim GM, Li LC, Barha CK, Liu-Ambrose T. Addressing the elephant in the room: the need to examine the role of social determinants of health in the relationship of the 24-hour activity cycle and adult cognitive health. Br J Sports Med 2023; 57:1416-1418. [PMID: 37798079 DOI: 10.1136/bjsports-2023-106893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Affiliation(s)
- Ryan S Falck
- School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
- Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART, Vancouver, British Columbia, Canada
| | - Narlon Cassio Boa Sorte Silva
- Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART, Vancouver, British Columbia, Canada
| | - Guilherme Moraes Balbim
- Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART, Vancouver, British Columbia, Canada
| | - Linda C Li
- Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Cindy K Barha
- Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Teresa Liu-Ambrose
- Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART, Vancouver, British Columbia, Canada
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Losciale JM, Truong LK, Zhang K, Scarr T, Xie H, Li LC, Mitchell C, Hunt MA, Whittaker JL. The association between knee muscle performance and clinical outcomes of knee function 1-4 years after a sport-related knee joint injury. Phys Ther Sport 2023; 64:147-155. [PMID: 37922747 DOI: 10.1016/j.ptsp.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Estimate the association between index leg knee muscle strength and rate of torque development (RTD), and self-reported and performance-based (i.e., hop) knee function in persons 1-4 years after a sport-related knee joint injury. METHODS Data were collected at baseline of a clinical trial. Assessments included the Knee injury and Osteoarthritis Outcome Score Sport & Recreation subscale (KOOSsport), 6-m timed hop (TH), and peak concentric isokinetic knee extensor and flexor torque and isometric RTD. Associations between peak torque and RTD with KOOSsport and TH were assessed using multivariable regression with nonlinear transformations. RESULTS 53 participants (64.2% female) were included. Knee extensor peak torque was nonlinearly related to TH time, with a strong inverse relationship at lower torque values that changed as torque increased. Results were inconsistent for flexor peak torque, extensor RTD and flexor RTD, with inconsistencies in relationship shape and estimates of association between primary and sensitivity analyses. There was no association between strength/RTD and KOOSsport. CONCLUSION There was a nonlinear relationship between knee extensor strength and hop function, with lower strength being associated with a stronger relationship. As strength values increased, the relationship attenuated. Knee extensor and flexor strength, or RTD, were not associated with self-reported function.
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Affiliation(s)
- Justin M Losciale
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada
| | - Linda K Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada
| | - Kexin Zhang
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Thomas Scarr
- Allan McGavin Sports Medicine Clinic, Vancouver, Canada
| | - Hui Xie
- Arthritis Research Canada, Vancouver, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada
| | - Cameron Mitchell
- Department of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, Canada
| | - Michael A Hunt
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada.
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15
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Ghanouni P, Inouye K, Gowan C, Hartford W, McKinnon A, McQuitty S, Backman CL, Li LC, Nimmon L. Beyond dyadic communication: Network of communication in inflammatory arthritis teams. Chronic Illn 2023; 19:591-604. [PMID: 35635126 DOI: 10.1177/17423953221102629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore how communication is perceived and care is negotiated amongst IA healthcare teams by drawing on the perspectives of each team member. METHOD This analysis drew on data from an ongoing three-year study exploring team-based IA care. We interviewed 11 participants including two men with IA and their family care providers and healthcare providers. We used a three-staged analytic process and integrated broad tenets of social network theory to understand the relational dimensions of team members experiences. RESULT Analysis revealed three themes regarding communication and care: (1) seeking/sharing information, (2) striving to coordinate unified care, and (3) providing patients a voice. DISCUSSION This study emphasizes the importance of understanding team dynamics beyond the dyad of patient and care provider. Negotiating power and decision-making in IA care is a dynamic process involving shifting levels of responsibility amongst a care team. Communication-based strategies that extend dyadic interactions may enhance teamwork and health outcomes in chronic conditions.
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Affiliation(s)
- Parisa Ghanouni
- Department of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Kristy Inouye
- Department of Occupation Science and Occupational Therapy, University of British Columbia, Canada
| | - Chelsey Gowan
- Department of Occupation Science and Occupational Therapy, University of British Columbia, Canada
| | - Wendy Hartford
- Department of Occupation Science and Occupational Therapy, University of British Columbia, Canada
| | - Annette McKinnon
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, Canada
| | - Shanon McQuitty
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, Canada
| | - Catherine L Backman
- Department of Occupation Science and Occupational Therapy, University of British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Laura Nimmon
- Department of Occupation Science and Occupational Therapy, University of British Columbia, Canada
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England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Constien D, Chan KK, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips L“R, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR. 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Rheumatol 2023; 75:1299-1311. [PMID: 37227071 PMCID: PMC10947582 DOI: 10.1002/art.42507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop initial American College of Rheumatology (ACR) guidelines on the use of exercise, rehabilitation, diet, and additional interventions in conjunction with disease-modifying antirheumatic drugs (DMARDs) as part of an integrative management approach for people with rheumatoid arthritis (RA). METHODS An interprofessional guideline development group constructed clinically relevant Population, Intervention, Comparator, and Outcome (PICO) questions. A literature review team then completed a systematic literature review and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the certainty of evidence. An interprofessional Voting Panel (n = 20 participants) that included 3 individuals with RA achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS The Voting Panel achieved consensus on 28 recommendations for the use of integrative interventions in conjunction with DMARDs for the management of RA. Consistent engagement in exercise received a strong recommendation. Of 27 conditional recommendations, 4 pertained to exercise, 13 to rehabilitation, 3 to diet, and 7 to additional integrative interventions. These recommendations are specific to RA management, recognizing that other medical indications and general health benefits may exist for many of these interventions. CONCLUSION This guideline provides initial ACR recommendations on integrative interventions for the management of RA to accompany DMARD treatments. The broad range of interventions included in these recommendations illustrates the importance of an interprofessional, team-based approach to RA management. The conditional nature of most recommendations requires clinicians to engage persons with RA in shared decision-making when applying these recommendations.
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Affiliation(s)
- Bryant R. England
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE
| | | | | | - Jennifer L. Barton
- VA Portland Health Care System and Oregon Health & Science University, Portland, OR
| | | | | | | | | | | | | | | | - Carole V. Dodge
- University of Michigan Hospital and Health System, Ann Arbor, MI
| | | | - Sotiria Everett
- Department of Family, Population, Preventive Medicine, Stony Brook Renaissance School of Medicine, Stony Brook, NY
| | | | | | | | | | | | | | | | - Sarah Patterson
- UCSF Osher Center for Integrative Medicine, San Francisco, CA
| | | | | | | | | | | | | | | | | | | | - Tate Johnson
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE
| | | | - Chris Y. Lane
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Linda C. Li
- University of British Columbia and Arthritis Research Canada, Vancouver, BC, Canada
| | - Hiral Master
- Vanderbilt University Medical Center, VICTR, Nashville, TN
| | | | | | | | | | - Louise Thoma
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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17
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Toupin-April K, Gaboury I, Proulx L, Huber AM, Duffy CM, Morgan EM, Li LC, Stringer E, Connelly M, Weiss JE, Gibbon M, Sachs H, Sivakumar A, Sirois A, Sirotich E, Trehan N, Abrahams N, Cohen JS, Cavallo S, Hindi TE, Ragusa M, Légaré F, Brinkman WB, Fortin PR, Décary S, Lee R, Gmuca S, Paterson G, Tugwell P, Stinson JN. "I'd like more options!": Interviews to explore young people and family decision-making needs for pain management in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:74. [PMID: 37491246 PMCID: PMC10369758 DOI: 10.1186/s12969-023-00849-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is a common pediatric rheumatic condition and is associated with symptoms such as joint pain that can negatively impact health-related quality of life. To effectively manage pain in JIA, young people, their families, and health care providers (HCPs) should be supported to discuss pain management options and make a shared decision. However, pain is often under-recognized, and pain management discussions are not optimal. No studies have explored decision-making needs for pain management in JIA using a shared decision making (SDM) model. We sought to explore families' decision-making needs with respect to pain management among young people with JIA, parents/caregivers, and HCPs. METHODS We conducted semi-structured virtual or face-to-face individual interviews with young people with JIA 8-18 years of age, parents/caregivers and HCPs using a qualitative descriptive study design. We recruited participants online across Canada and the United States, from a hospital and from a quality improvement network. We used interview guides based on the Ottawa Decision Support Framework to assess decision-making needs. We audiotaped, transcribed verbatim and analyzed interviews using thematic analysis. RESULTS A total of 12 young people (n = 6 children and n = 6 adolescents), 13 parents/caregivers and 11 HCPs participated in interviews. Pediatric HCPs were comprised of rheumatologists (n = 4), physical therapists (n = 3), rheumatology nurses (n = 2) and occupational therapists (n = 2). The following themes were identified: (1) need to assess pain in an accurate manner; (2) need to address pain in pediatric rheumatology consultations; (3) need for information on pain management options, especially nonpharmacological approaches; (4) importance of effectiveness, safety and ease of use of treatments; (5) need to discuss young people/families' values and preferences for pain management options; and the (6) need for decision support. Themes were similar for young people, parents/caregivers and HCPs, although their respective importance varied. CONCLUSIONS Findings suggest a need for evidence-based information and communication about pain management options, which would be addressed by decision support interventions and HCP training in pain and SDM. Work is underway to develop such interventions and implement them into practice to improve pain management in JIA and in turn lead to better health outcomes.
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Affiliation(s)
- Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
- Institut du Savoir Montfort, Ottawa, ON Canada
| | - Isabelle Gaboury
- Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec Canada
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Ottawa, ON Canada
| | - Adam M. Huber
- Division of Rheumatology, IWK Health Centre, Halifax, NS Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS Canada
| | - Ciarán M. Duffy
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
- Department of Pediatrics, Faculty of Medicine, Ottawa, ON Canada
| | - Esi M. Morgan
- Division of Rheumatology, Seattle Children’s Hospital, Seattle, Washington USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA USA
| | - Linda C. Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC Canada
- Arthritis Research Canada, Vancouver, BC Canada
| | - Elizabeth Stringer
- Division of Rheumatology, IWK Health Centre, Halifax, NS Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS Canada
| | - Mark Connelly
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO USA
| | - Jennifer E. Weiss
- Division of Rheumatology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ USA
| | - Michele Gibbon
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
| | - Hannah Sachs
- Public Health Agency of Canada, Ottawa, ON Canada
| | - Aditi Sivakumar
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
- Queen’s University, ON Ottawa, Canada
| | | | - Emily Sirotich
- Canadian Arthritis Patient Alliance, New Haven, CT USA
- Yale University School of Medicine, New Haven, CT USA
| | | | - Naomi Abrahams
- Faculty of Social Sciences, University of Ottawa, Ottawa, ON Canada
| | - Janice S. Cohen
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
- Behavioural Neurosciences and Consultation Liaison Team, Mental Health, Children’s Hospital of Eastern Ontario, Ottawa, ON Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, ON Ottawa, Canada
| | - Sabrina Cavallo
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, QC Canada
- Research Centre of the Sainte-Justine University Hospital, Montreal, QC Canada
| | - Tania El Hindi
- Statistics Canada, Government of Canada, Ottawa, ON Canada
| | - Marco Ragusa
- The Ottawa Hospital, University of Ottawa, Ottawa, ON Canada
| | - France Légaré
- Department of Family and Emergency Medicine, Université Laval, Québec City, QC Canada
- VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale Nationale, Québec City, QC Canada
| | - William B. Brinkman
- Cincinnati Children’s Hospital Medical Center, OH Cincinnati, USA
- College of Medicine, Department of Pediatrics, University of Cincinnati, Cincinnati, OH United States
| | - Paul R. Fortin
- Université Laval, QC, Canada
- CHU de Québec, Québec City, QC Canada
| | - Simon Décary
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC Canada
- Research Center of the Centre Hospitalier de l’Université de Sherbrooke, Sherbrooke, QC Canada
| | - Rebecca Lee
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- National Institute for Health Research Biomedical Research Centre, Manchester University Hospital NHS Trust, Manchester, UK
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Sabrina Gmuca
- Division of Rheumatology, Children’s Hospital of Philadelphia, Philadelphia, PA USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Gail Paterson
- Arthritis Rehabilitation and Education Program, Arthritis Society Canada, Ottawa, ON Canada
| | - Peter Tugwell
- School of Epidemiology and Community Medicine, Department of Medicine, University of Ottawa, Ottawa, ON Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, ON Canada
| | - Jennifer N. Stinson
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, ON Canada
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Wang E, Otamendi T, Li LC, Hoens AM, Wilhelm L, Bubber V, PausJenssen E, McKinnon A, McQuitty S, English K, Silva AS, Leese J, Zarin W, Tricco AC, Hamilton CB. Researcher-patient partnership generated actionable recommendations, using quantitative evaluation and deliberative dialogue, to improve meaningful engagement. J Clin Epidemiol 2023; 159:49-57. [PMID: 37182587 DOI: 10.1016/j.jclinepi.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/25/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To demonstrate how the 22-item Patient Engagement in Research Scale (PEIRS-22) can be used to develop recommendations for improving the meaningfulness of patient engagement. STUDY DESIGN AND SETTING PEIRS-22 previously captured quantitative evaluation data from 15 patient partners in a self-study of the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance. Guided by deliberative dialogue, the current study involved 3 steps: (1) In-depth analysis and interpretation of the PEIRS-22 data produced a lay evidence summary with identified areas for improvement of meaningful engagement; (2) A 3-hour virtual workshop with patient partners and researchers generated initial recommendations; and (3) In two successive post-workshop surveys, ratings by workshop invitees led to consensus on the recommendations. RESULTS Twenty-five participants attended the workshops and dialogued on 8 areas for improvement identified from the PEIRS-22 data. Twenty-eight unique initial recommendations led to consensus on 14 key recommendations organized across 4 categories: setting expectations for all team members, building trust and ongoing communication, providing opportunities to enhance learning and to develop skills, and acknowledging contributions of patient partners. CONCLUSION Using PEIRS-22 data within a deliberate dialogue elucidated 14 actionable recommendations to support ongoing improvement of patient engagement at SPOR Evidence Alliance, a pan-Canadian health research initiative.
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Affiliation(s)
- Ellen Wang
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, British Columbia, Canada; Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, British Columbia, Canada
| | - Thalia Otamendi
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, British Columbia, Canada; Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, British Columbia, Canada; Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, British Columbia, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, British Columbia, Canada; Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, British Columbia, Canada
| | - Linda Wilhelm
- SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada; Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Vikram Bubber
- SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada; Patient Voices Network, BC Patient Safety and Quality Council, 201-750 Pender St W, Vancouver, British Columbia, Canada
| | - Elliot PausJenssen
- SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada; Saskatoon Council on Aging, 2020 College Dr, Saskatoon, Saskatchewan, Canada
| | - Annette McKinnon
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, British Columbia, Canada; SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada; Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Shanon McQuitty
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, British Columbia, Canada; SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada
| | - Kelly English
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, British Columbia, Canada; SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada
| | - Aline S Silva
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Jenny Leese
- Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, British Columbia, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario, Canada
| | - Wasifa Zarin
- SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada; Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, Canada
| | - Andrea C Tricco
- SPOR Evidence Alliance, 209 Victoria St, Toronto, Ontario, Canada; Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, Canada; Epidemiology Division and Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, Canada; Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University School of Nursing, 92 Barrie Street, Kingston, Ontario, Canada
| | - Clayon B Hamilton
- Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Surrey, British Columbia, Canada; BC Mental Health and Substance Use Services, Provincial Health Services Authority, 4949 Heather Street, Vancouver, British Columbia, Canada.
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19
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Thoma LM, Li LC, White DK, Oatis C. Physical Therapists Play a Key Role in the Comprehensive Management of Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2023. [PMID: 37227072 DOI: 10.1002/acr.25123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 02/28/2023] [Accepted: 03/23/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Louise M Thoma
- University of North Carolina at Chapel Hill, Chapel Hill
| | - Linda C Li
- University of British Columbia and Arthritis Research Canada, Vancouver, British Columbia, Canada
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England BR, Smith BJ, Baker NA, Barton JL, Oatis CA, Guyatt G, Anandarajah A, Carandang K, Chan KK, Constien D, Davidson E, Dodge CV, Bemis-Dougherty A, Everett S, Fisher N, Fraenkel L, Goodman SM, Lewis J, Menzies V, Moreland LW, Navarro-Millan I, Patterson S, Phillips LR, Shah N, Singh N, White D, AlHeresh R, Barbour KE, Bye T, Guglielmo D, Haberman R, Johnson T, Kleiner A, Lane CY, Li LC, Master H, Pinto D, Poole JL, Steinbarger K, Sztubinski D, Thoma L, Tsaltskan V, Turgunbaev M, Wells C, Turner AS, Treadwell JR. 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2023. [PMID: 37227116 DOI: 10.1002/acr.25117] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop initial American College of Rheumatology (ACR) guidelines on the use of exercise, rehabilitation, diet, and additional interventions in conjunction with disease-modifying antirheumatic drugs (DMARDs) as part of an integrative management approach for people with rheumatoid arthritis (RA). METHODS An interprofessional guideline development group constructed clinically relevant Population, Intervention, Comparator, and Outcome (PICO) questions. A literature review team then completed a systematic literature review and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the certainty of evidence. An interprofessional Voting Panel (n = 20 participants) that included 3 individuals with RA achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. RESULTS The Voting Panel achieved consensus on 28 recommendations for the use of integrative interventions in conjunction with DMARDs for the management of RA. Consistent engagement in exercise received a strong recommendation. Of 27 conditional recommendations, 4 pertained to exercise, 13 to rehabilitation, 3 to diet, and 7 to additional integrative interventions. These recommendations are specific to RA management, recognizing that other medical indications and general health benefits may exist for many of these interventions. CONCLUSION This guideline provides initial ACR recommendations on integrative interventions for the management of RA to accompany DMARD treatments. The broad range of interventions included in these recommendations illustrates the importance of an interprofessional, team-based approach to RA management. The conditional nature of most recommendations requires clinicians to engage persons with RA in shared decision-making when applying these recommendations.
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Affiliation(s)
- Bryant R England
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha
| | | | | | - Jennifer L Barton
- VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon
| | | | | | | | | | | | | | | | - Carole V Dodge
- University of Michigan Hospital and Health System, Ann Arbor
| | | | - Sotiria Everett
- Department of Family, Population, Preventive Medicine, Stony Brook Renaissance School of Medicine, Stony Brook, New York
| | | | | | | | - Janet Lewis
- University of Virginia, Charlottesville, Virginia
| | | | | | | | - Sarah Patterson
- UCSF Osher Center for Integrative Medicine, San Francisco, California
| | | | - Neha Shah
- Stanford Health Care, Palo Alto, California
| | | | | | - Rawan AlHeresh
- MGH Institute of Health Professions, Boston, Massachusetts
| | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Tate Johnson
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha
| | | | | | - Linda C Li
- University of British Columbia and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Hiral Master
- Vanderbilt University Medical Center, VICTR, Nashville, Tennesee
| | | | | | | | | | | | | | | | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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21
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Naye F, Légaré F, Paquette JS, Tousignant-Laflamme Y, LeBlanc A, Gaboury I, Poitras ME, Toupin-April K, Li LC, Hoens A, Poirier MD, Décary S. Decisional needs assessment for patient-centred pain care in Canada: the DECIDE-PAIN study protocol. BMJ Open 2023; 13:e066189. [PMID: 37156591 PMCID: PMC10173373 DOI: 10.1136/bmjopen-2022-066189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION The 2021 Action Plan for Pain from the Canadian Pain Task Force advocates for patient-centred pain care at all levels of healthcare across provinces. Shared decision-making is the crux of patient-centred care. Implementing the action plan will require innovative shared decision-making interventions, specifically following the disruption of chronic pain care during the COVID-19 pandemic. The first step in this endeavour is to assess current decisional needs (ie, decisions most important to them) of Canadians with chronic pain across their care pathways. METHODS AND ANALYSIS DesignGrounded in patient-oriented research approaches, we will perform an online population-based survey across the ten Canadian provinces. We will report methods and data following the CROSS reporting guidelines.SamplingThe Léger Marketing company will administer the online population-based survey to its representative panel of 500 000 Canadians to recruit 1646 adults (age ≥18 years old) with chronic pain according to the definition by the International Association for the Study of Pain (eg, pain ≥12 weeks). ContentBased on the Ottawa Decision Support Framework, the self-administered survey has been codesigned with patients and contain six core domains: (1) healthcare services, consultation and postpandemic needs, (2) difficult decisions experienced, (3) decisional conflict, (4) decisional regret, (5) decisional needs and (6) sociodemographic characteristics. We will use several strategies such as random sampling to improve survey quality. AnalysisWe will perform descriptive statistical analysis. We will identify factors associated with clinically significant decisional conflict and decision regret using multivariate analyses. ETHICS AND DISSEMINATION Ethics was approved by the Research Ethics Board at the Research Centre of the Centre Hospitalier Universitaire de Sherbrooke (project #2022-4645). We will codesign knowledge mobilisation products with research patient partners (eg, graphical summaries and videos). Results will be disseminated via peer-reviewed journals and national and international conferences to inform the development of innovative shared decision-making interventions for Canadians with chronic pain.
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Affiliation(s)
- Florian Naye
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - France Légaré
- Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec, Quebec, Canada
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Québec, Québec, Canada
| | - Jean-Sébastien Paquette
- Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec, Quebec, Canada
| | - Yannick Tousignant-Laflamme
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Annie LeBlanc
- Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec, Quebec, Canada
| | - Isabelle Gaboury
- Faculty of Medicine and Health Sciences, Department of Family Medecine and Emergency Medicine, Research Centre of the CIUSSS de l'Estrie-CHUS, Universite de Sherbrooke Faculte de medecine et des sciences de la sante, Longueuil, Quebec, Canada
| | - Marie-Eve Poitras
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Research Centre of the CIUSS du Saguenay-Lac-Saint-Jean, Université de Sherbrooke, Chicoutimi, Quebec, Canada
- Centre de santé et de services sociaux de Chicoutimi, Quebec, Quebec, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Alison Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marie-Dominique Poirier
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Quebec, Canada
| | - Simon Décary
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada
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Charlton JM, Krowchuk NM, Eng JJ, Li LC, Hunt MA. Remotely delivered, individualized, and self-directed gait modification for knee osteoarthritis: A pilot trial. Clin Biomech (Bristol, Avon) 2023; 106:105981. [PMID: 37201438 DOI: 10.1016/j.clinbiomech.2023.105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 03/29/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Gait modification interventions have reported variable results and relied on in-person biofeedback limiting clinical accessibility. Our objective was to assess a remotely delivered and self-directed gait modification for knee osteoarthritis. METHODS This was an unblinded, 2-arm, delayed control, randomized pilot trial (NCT04683913). Adults aged ≥50 years with symptomatic medial knee osteoarthritis were randomized to an immediate group (Week 0: Baseline, Intervention; Week 6: Follow-up, Week 10: Retention) or delayed group (Week 0: Baseline, Wait Period, Week 6: Secondary Baseline, Intervention, Week 12: Follow-up, Week 16: Retention). Participants practiced modifying their foot progression angle "as much as was comfortable" while receiving support via weekly telerehabilitation appointments and remote monitoring with an instrumented shoe. Primary outcomes included participation, foot progression angle modification magnitude, confidence, difficulty, and satisfaction while secondary outcomes included symptoms and knee biomechanics during gait. RESULTS We screened 134 people and randomized 20. There was no loss to follow up and 100% attendance at the telerehabilitation appointments. By follow up, participants reported high confidence (8.6/10), low difficulty (2.0/10), and satisfaction (75%) with the intervention and no significant adverse events. Foot progression angle was modified by 11.4° ± 5.6, which was significantly different (p < 0.001, η2g = 0.8) when compared between groups. No other between-group differences were significant, while several significant pre-post improvements in pain (d = 0.6, p = 0.006) and knee moments (d = 0.6, p = 0.01) were observed. INTERPRETATION A personalized, self-directed gait modification supported with telerehabilitation is feasible, and the preliminary effects on symptoms and biomechanics align with past trials. A larger trial is warranted to evaluate efficacy.
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Affiliation(s)
- Jesse M Charlton
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada.
| | - Natasha M Krowchuk
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada
| | - Michael A Hunt
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
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Charlton JM, Xia H, Shull PB, Eng JJ, Li LC, Hunt MA. Multi-day monitoring of foot progression angles during unsupervised, real-world walking in people with and without knee osteoarthritis. Clin Biomech (Bristol, Avon) 2023; 105:105957. [PMID: 37084548 DOI: 10.1016/j.clinbiomech.2023.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 03/03/2023] [Accepted: 04/13/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Foot progression angle is a biomechanical target in gait modification interventions for knee osteoarthritis. To date, it has only been evaluated within laboratory settings. METHODS Adults with symptomatic knee osteoarthritis (n = 30) and healthy adults (n = 15) completed two conditions: 1) treadmill walking in the laboratory (5-min), and 2) real-world walking outside of the laboratory (1-week). Foot progression angle was estimated via shoe-embedded inertial sensing. We calculated the foot progression angle magnitude (median) and variability (interquartile range, coefficient of variation), and used mixed models to compare outcomes between the conditions, participant groups, and disease severities. Reliability was quantified by the intraclass correlation coefficient, standardized error of the measurement, and the minimum detectable change. FINDINGS Foot progression angle magnitude did not differ between groups or conditions but variability significantly higher in real-world walking (P < 0.001). Structural and symptomatic severity were unrelated to FPA in either walking condition, except for real-world coefficient of variation which was higher for moderate-severe structural osteoarthritis compared to the treadmill for those with mild structural severity (P < 0.034). All real-world outcomes showed excellent reliability including intraclass correlation coefficients above 0.95. The participants recorded a mean (standard deviation) of 298 (33) and 10,447 (5232) steps in the laboratory and real-world walking conditions, respectively. INTERPRETATION This study provides the first characterization of foot progression angles during real-world walking in people with and without symptomatic knee osteoarthritis. These results indicate that foot progression angles can be feasibly and reliably measured in unsupervised real-world walking conditions.
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Affiliation(s)
- Jesse M Charlton
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada.
| | - Haisheng Xia
- Department of Automation, University of Science and Technology of China, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, China
| | - Peter B Shull
- State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada
| | - Michael A Hunt
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
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Bhuiya AR, Makarski J, Hayden L, Perrier L, Munce S, Lewis I, Graham ID, Holroyd-Leduc J, Straus SE, Stelfox HT, Strifler L, Lokker C, Li LC, Leung FH, Dobbins M, Ritchie LMP, Squires J, Rac V, Fahim C, Kastner M. Identifying candidate quality indicators of tools that support the practice of knowledge translation: a scoping review protocol. JBI Evid Synth 2023; 21:264-278. [PMID: 36111878 DOI: 10.11124/jbies-22-00055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The objective of this scoping review is to identify and characterize relevant knowledge translation methods tools (those that provide guidance for optimized knowledge translation practice) to uncover candidate quality indicators to inform a future quality assessment tool for knowledge translation strategies. INTRODUCTION Knowledge translation strategies (defined as including knowledge translation interventions, tools, and products) target various knowledge users, including patients, clinicians, researchers, and policy-makers. The development and use of strategies that support knowledge translation practice have been rapidly increasing, making it difficult for knowledge users to decide which to use. There is limited evidence-based guidance or measures to help assess the overall quality of knowledge translation strategies. INCLUSION CRITERIA Empirical and non-empirical documents will be considered if they explicitly describe a knowledge translation methods tool and its development, evaluation or validation, methodological strengths or limitations, and/or use over time. The review will consider a knowledge translation methods tool if it falls within at least one knowledge translation domain (ie, implementation, dissemination, sustainability, scalability, integrated knowledge translation) in the health field. METHODS We will conduct a systematic search of relevant electronic databases and gray literature. The search strategy will be developed iteratively by an experienced medical information specialist and peer-reviewed with the PRESS checklist. The search will be limited to English-only documents published from 2005 onward. Documents will be independently screened, selected, and extracted by 2 researchers. Data will be analyzed and summarized descriptively, including the characteristics of the included documents, knowledge translation methods tools, and candidate quality indicators. SCOPING REVIEW REGISTRATION Open Science Framework ( https://osf.io/chxvq ).
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Affiliation(s)
- Aunima R Bhuiya
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada
| | - Julie Makarski
- North York General Hospital, Research and Innovation, North York, ON, Canada
| | - Leigh Hayden
- Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Laure Perrier
- University of Toronto Libraries, University of Toronto, Toronto, ON, Canada
| | - Sarah Munce
- University Health Network, Toronto, ON, Canada
| | - Iveta Lewis
- North York General Hospital, Research and Innovation, North York, ON, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa and Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jayna Holroyd-Leduc
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine and the O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Lisa Strifler
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Cynthia Lokker
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Fok-Han Leung
- St Michael's Hospital, Unity Health, Tornoto, ON, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Lisa M Puchalski Ritchie
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Janet Squires
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Valeria Rac
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada.,Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Christine Fahim
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Monika Kastner
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,North York General Hospital, Research and Innovation, North York, ON, Canada
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Truong LK, Mosewich AD, Miciak M, Pajkic A, Silvester-Lee T, Li LC, Whittaker JL. "I feel I'm leading the charge." Experiences of a virtual physiotherapist-guided knee health program for persons at-risk of osteoarthritis after a sport-related knee injury. Osteoarthr Cartil Open 2022; 5:100333. [PMID: 36685259 PMCID: PMC9850175 DOI: 10.1016/j.ocarto.2022.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/25/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Objective Describe participants' perspectives about the feasibility of a virtual, physiotherapist-guided knee health program for people at risk of post-traumatic osteoarthritis after a sport-related knee injury. Design Qualitative description study nested within a quasi-experimental study evaluating the feasibility of the Stop OsteoARthritis (SOAR) with persons with sport-related knee injuries. SOAR includes: 1) one-time Knee Camp (group education, 1:1 exercise/activity goal-setting); 2) weekly home-based exercise/activity program with tracking, and; 3) weekly 1:1 physiotherapy-guided action-planning. Upon program completion, semi-structured 1:1 interviews were conducted with participants identified by convenience and maximum variation sampling (age, gender, program satisfaction). Open-ended questions elicited participants' experiences with the program. Content analysis was conducted. Results 12 women and 4 men [median (min-max) age; 30 (19-46) years] were interviewed. Four categories depicted participants' experiences: 1) 'SOAR satisfies an unmet need' portrayed the perceived relevance and need for a program that promotes knowledge about knee health and self-efficacy for independent exercise behaviour, 2) 'Regaining control of knee health' described how SOAR empowered participants and fostered a sense of 'leading the charge' to their own knee health, 3) 'Social support encourages exercise participation' highlighted that weekly physiotherapy interactions provided accountability for achieving exercise goals, and that relating to other participants was inspirational, 4) 'Program refinements and barriers' suggested enhancements to meet the needs of future participants. Conclusions Participants report the SOAR program to be acceptable, relevant, and empowering. Improved knowledge about one's knee health, self-efficacy, autonomy, and social support may encourage exercise adherence and self-management of future knee OA risk.
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Affiliation(s)
- Linda K. Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada,Arthritis Research Canada, Vancouver, Canada
| | - Amber D. Mosewich
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Andrea Pajkic
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Linda C. Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada,Arthritis Research Canada, Vancouver, Canada
| | - Jackie L. Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada,Arthritis Research Canada, Vancouver, Canada,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada,Corresponding author.Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada. #223, 212 Friedman Building 2177 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 1Z3.
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Zhu S, Wu T, Leese J, Li LC, He C, Yang L. What is the value and impact of the adaptation process on quality indicators for local use? A scoping review. PLoS One 2022; 17:e0278379. [PMID: 36480565 PMCID: PMC9731415 DOI: 10.1371/journal.pone.0278379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Quality indicators (QIs) are designed for improving quality of care, but the development of QIs is resource intensive and time consuming. OBJECTIVE To describe and identify the impact and potential attributes of the adaptation process for the local use of existing QIs. DATA SOURCES EMBASE, MEDLINE, CINAHL and grey literature were searched. STUDY SELECTION Literatures operationalizing or implementing QIs that were developed in a different jurisdiction from the place where the QIs were included. RESULTS Of 7704 citations identified, 10 out of 33 articles were included. Our results revealed a lack of definition and conceptualization for an adaptation process in which an existing set of QIs was applied. Four out of ten studies involved a consensus process (e.g., Delphi or RAND process) to determine the suitability of QIs for local use. QIs for chronic conditions in primary and secondary settings were mostly used for adaptation. Of the ones that underwent a consensus process, 56.3 to 85.7% of original QIs were considered valid for local use, and 2 to 21.8% of proposed QIs were newly added. Four attributes should be considered in the adaptation: 1) identifying areas/conditions; 2) a consensus process; 3) proposing adapted QIs; 4) operationalization and evaluation. CONCLUSION The existing QIs, although serving as a good starting point, were not adequately adapted before for use in a different jurisdiction from their origin. Adaptation of QIs under a systematic approach is critical for informing future research planning for QIs adaptation and potentially establishing a new pathway for healthcare improvement.
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Affiliation(s)
- Siyi Zhu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- * E-mail: (SZ); (CH); (LY)
| | - Tao Wu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Jenny Leese
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chengqi He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- * E-mail: (SZ); (CH); (LY)
| | - Lin Yang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- * E-mail: (SZ); (CH); (LY)
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27
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Kopec JA, Sayre EC, Cibere J, Li LC, Wong H, Okhmatovskaia A, Esdaile JM. Reducing the burden of low back pain: results from a new microsimulation model. BMC Musculoskelet Disord 2022; 23:804. [PMID: 35996103 PMCID: PMC9396830 DOI: 10.1186/s12891-022-05747-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Low back pain (LBP) causes the highest morbidity burden globally. The purpose of the present study was to project and compare the impact of three strategies for reducing the population health burden of LBP: weight loss, ergonomic interventions, and an exercise program. Methods We have developed a microsimulation model of LBP in Canada using a new modeling platform called SimYouLate. The initial population was derived from Cycle 1 (2001) of the Canadian Community Health Survey (CCHS). We modeled an open population 20 years of age and older. Key variables included age, sex, education, body mass index (BMI), type of work, having back problems, pain level in persons with back problems, and exercise participation. The effects of interventions on the risk of LBP were obtained from the CCHS for the effect of BMI, the Global Burden of Disease Study for occupational risks, and a published meta-analysis for the effect of exercise. All interventions lasted from 2021 to 2040. The population health impact of the interventions was calculated as a difference in years lived with disability (YLDs) between the base-case scenario and each intervention scenario, and expressed as YLDs averted per intervention unit or a proportion (%) of total LBP-related YLDs. Results In the base-case scenario, LBP in 2020 was responsible for 424,900 YLDs in Canada and the amount increased to 460,312 YLDs in 2040. The effects of the interventions were as follows: 27,993 (95% CI 23,373, 32,614) YLDs averted over 20 years per 0.1 unit change in log-transformed BMI (9.5% change in BMI) among individuals who were overweight and those with obesity, 19,416 (16,275, 22,557) YLDs per 1% reduction in the proportion of workers exposed to occupational risks, and 26,058 (22,455, 29,661) YLDs averted per 1% increase in the proportion of eligible patients with back problems participating in an exercise program. Conclusions The study provides new data on the relationship between three types of interventions and the resultant reductions in LBP burden in Canada. According to our model, each of the interventions studied could potentially result in a substantial reduction in LBP-related disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05747-2.
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Affiliation(s)
- Jacek A Kopec
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada. .,Arthritis Research Canada, Vancouver, BC, Canada.
| | - Eric C Sayre
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Jolanda Cibere
- Arthritis Research Canada, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, BC, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Hubert Wong
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada
| | - Anya Okhmatovskaia
- McGill Clinical and Health Informatics, McGill University, Montreal, QC, Canada
| | - John M Esdaile
- Arthritis Research Canada, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Ma JK, Ramachandran S, Sandhu A, Tsui K, Hoens AM, Hu D, Li LC. Tailored Interventions for Supporting Physical Activity Participation in People with Arthritis and Related Conditions: a Systematic Review. Curr Treat Options in Rheum 2022. [DOI: 10.1007/s40674-022-00194-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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MacLeod MLP, Leese J, Garraway L, Oelke ND, Munro S, Bailey S, Hoens AM, Loo S, Valdovinos A, Wick U, Zimmer P, Li LC. Engaging with patients in research on knowledge translation/implementation science methods: a self study. Res Involv Engagem 2022; 8:41. [PMID: 35941661 PMCID: PMC9358643 DOI: 10.1186/s40900-022-00375-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In 2017, the British Columbia (Canada) SUPPORT (SUpport for People and Patient-Oriented Research) Unit created six methods clusters to advance methodologies in patient and public oriented research (POR). The knowledge translation (KT)/implementation science methods cluster identified that although there was guidance about how to involve patients and public members in POR research generally, little was known about how best to involve patients and public members on teams specifically exploring POR KT/implementation science methodologies. The purpose of this self-study was to explore what it means to engage patients and the public in studies of POR methods through the reflections of members of five KT/implementation science teams. METHODS Informed by a collaborative action research approach, this quality improvement self-study focused on reflection within four KT/implementation science research teams in 2020-2021. The self-study included two rounds of individual interviews with 18 members across four teams. Qualitative data were analyzed using a thematic analysis approach followed by a structured discussion of preliminary findings with the research teams. Subsequently, through two small group discussion sessions, the patients/public members from the teams refined the findings. RESULTS Undertaking research on POR KT/implementation science methodologies typically requires teams to work with the uncertainty of exploratory and processual research approaches, make good matches between patients/public members and the team, work intentionally yet flexibly, and be attuned to the external context and its influences on the team. POR methodological research teams need to consider that patients/public members bring their life experiences and world views to the research project. They become researchers in their own right. Individual and team reflection allows teams to become aware of team needs, acknowledge team members' vulnerabilities, gain greater sensitivity, and enhance communication. CONCLUSIONS The iterative self-study process provided research team members with opportunities for reflection and new understanding. Working with patients/public team members as co-researchers opens up new ways of understanding important aspects of research methodologies, which may influence future KT/implementation science research approaches.
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Affiliation(s)
- Martha L. P. MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9 Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Centre for Implementation Research, The Ottawa Hospital Research Institute, Ottawa, Canada
- Arthritis Research Canada, Vancouver, BC Canada
| | - Leana Garraway
- Health Research Institute, University of Northern British Columbia, Prince George, BC Canada
| | - Nelly D. Oelke
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC Canada
- Rural Coordination Centre of BC, Vancouver, BC Canada
| | - Sarah Munro
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC Canada
| | - Sacha Bailey
- BC Centre for Ability, Vancouver, BC Canada
- Centre for Research on Children and Families, Montreal, QC Canada
| | - Alison M. Hoens
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
| | - Sunny Loo
- Patient Partner, Michael Smith Health Research BC, PaCER Certified, University of Calgary, Calgary, AB Canada
| | - Ana Valdovinos
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
| | - Ursula Wick
- University of British Columbia, Okanagan, Kelowna, BC Canada
| | - Peter Zimmer
- University of Northern British Columbia, Prince George, BC Canada
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
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Kopec JA, Sayre EC, Shams B, Li LC, Xie H, Feehan LM, Esdaile JM. The Impact of 51 Risk Factors on Life Expectancy in Canada: Findings from a New Risk Prediction Model Based on Data from the Global Burden of Disease Study. IJERPH 2022; 19:ijerph19158958. [PMID: 35897329 PMCID: PMC9332720 DOI: 10.3390/ijerph19158958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 12/04/2022]
Abstract
The aims of this study were (1) to develop a comprehensive risk-of-death and life expectancy (LE) model and (2) to provide data on the effects of multiple risk factors on LE. We used data for Canada from the Global Burden of Disease (GBD) Study. To create period life tables for males and females, we obtained age/sex-specific deaths rates for 270 diseases, population distributions for 51 risk factors, and relative risk functions for all disease-exposure pairs. We computed LE gains from eliminating each factor, LE values for different levels of exposure to each factor, and LE gains from simultaneous reductions in multiple risk factors at various ages. If all risk factors were eliminated, LE in Canada would increase by 6.26 years for males and 5.05 for females. The greatest benefit would come from eliminating smoking in males (2.45 years) and high blood pressure in females (1.42 years). For most risk factors, their dose-response relationships with LE were non-linear and depended on the presence of other factors. In individuals with high levels of risk, eliminating or reducing exposure to multiple factors could improve LE by several years, even at a relatively advanced age.
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Affiliation(s)
- Jacek A. Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Correspondence:
| | - Eric C. Sayre
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
| | - Benajir Shams
- Fraser Health Authority, Surrey, BC V3T 0H1, Canada;
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Hui Xie
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Lynne M. Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - John M. Esdaile
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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Falck RS, Hsu CL, Silva NCBS, Li LC, Best JR, Liu-Ambrose T. The independent associations of physical activity and sleep with neural activity during an inhibitory task: cross-sectional results from the MONITOR-OA study. J Sleep Res 2022; 31:e13692. [PMID: 35821379 DOI: 10.1111/jsr.13692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 06/18/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
Sleep and physical activity (PA) are important for the maintenance of executive functions. Whether these lifestyle factors independently contribute to associated neural correlates of executive functions is unknown. We therefore investigated the independent associations of PA and sleep with neural activity during executive performance using task-based functional magnetic resonance imaging (fMRI). Baseline data from a subset of participants (n = 29) enrolled in a randomised trial were used for this cross-sectional analysis. We measured PA, sleep duration and efficiency for 7 days using the SenseWear Mini and examined neural activity underlying response inhibition using the Go/NoGo executive performance task. Brain activation patterns during the NoGo condition were contrasted to activation patterns during the Go condition (i.e., NoGo-Go). We constructed two separate models (controlling for age, sex, and education) to examine the independent associations of (i) PA and sleep duration; and (ii) PA and sleep efficiency with brain activation. Significant clusters were corrected for multiple comparisons (p < 0.05) to determine region-specific activation patterns. The mean (SD) participant age was 61 (9) years, and 79% were female. PA was independently associated with greater task-related blood-oxygen-level dependent (BOLD) signal activity in the left cingulate gyrus; longer sleep duration was independently associated with greater BOLD signal activity in the left putamen. Higher sleep efficiency was independently associated with increased BOLD signal activity in the left hippocampus. PA, sleep duration, and efficiency are each independently associated with greater neural activity underlying response inhibition, which further illustrates that PA and sleep are each uniquely important for brain health.
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Affiliation(s)
- Ryan Stanley Falck
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.,Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA
| | - Narlon Cassio Boa Sorte Silva
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.,Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, University of British Columbia, Vancouver, British Columbia, Canada
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.,Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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Silverberg ND, Otamendi T, Brasher PM, Brubacher JR, Li LC, Lizotte PP, Panenka WJ, Scheuermeyer FX, Archambault P. Effectiveness of a guideline implementation tool for supporting management of mental health complications after mild traumatic brain injury in primary care: protocol for a randomised controlled trial. BMJ Open 2022; 12:e062527. [PMID: 35728892 PMCID: PMC9214410 DOI: 10.1136/bmjopen-2022-062527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Mental health problems frequently interfere with recovery from mild traumatic brain injury (mTBI) but are under-recognised and undertreated. Consistent implementation of clinical practice guidelines for proactive detection and treatment of mental health complications after mTBI will require evidence-based knowledge translation strategies. This study aims to determine if a guideline implementation tool can reduce the risk of mental health complications following mTBI. If effective, our guideline implementation tool could be readily scaled up and/or adapted to other healthcare settings. METHODS AND ANALYSIS We will conduct a triple-blind cluster randomised trial to evaluate a clinical practice guideline implementation tool designed to support proactive management of mental health complications after mTBI in primary care. We will recruit 535 adults (aged 18-69 years) with mTBI from six emergency departments and two urgent care centres in the Greater Vancouver Area, Canada. Upon enrolment at 2 weeks post-injury, they will complete mental health symptom screening tools and designate a general practitioner (GP) or primary care clinic where they plan to seek follow-up care. Primary care clinics will be randomised into one of two arms. In the guideline implementation tool arm, GPs will receive actionable mental health screening test results tailored to their patient and their patients will receive written education about mental health problems after mTBI and treatment options. In the usual care control arm, GPs and their patients will receive generic information about mTBI. Patient participants will complete outcome measures remotely at 2, 12 and 26 weeks post-injury. The primary outcome is rate of new or worsened mood, anxiety or trauma-related disorder on the Mini International Neuropsychiatric Interview at 26 weeks. ETHICS AND DISSEMINATION Study procedures were approved by the University of British Columbia's research ethics board (H20-00562). The primary report for the trial results will be published in a peer-reviewed journal. Our knowledge user team members (patients, GPs, policymakers) will co-create a plan for public dissemination. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04704037).
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Affiliation(s)
- Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Thalia Otamendi
- Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Penelope Ma Brasher
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Jeffrey R Brubacher
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Pierre-Paul Lizotte
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Frank X Scheuermeyer
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Emergency Medicine, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Patrick Archambault
- Department of Family and Emergency Medicine, Université Laval, Québec, Québec, Canada
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Leese J, Zhu S, Townsend AF, Backman CL, Nimmon L, Li LC. Ethical issues experienced by persons with rheumatoid arthritis in a wearable-enabled physical activity intervention study. Health Expect 2022; 25:1418-1431. [PMID: 35303379 PMCID: PMC9327860 DOI: 10.1111/hex.13481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/29/2021] [Accepted: 03/02/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction Using wearables to self‐monitor physical activity is a promising approach to support arthritis self‐management. Little is known, however, about the context in which ethical issues may be experienced when using a wearable in self‐management. We used a relational ethics lens to better understand how persons with rheumatoid arthritis (RA) experience their use of a wearable as part of a physical activity counselling intervention study involving a physiotherapist (PT). Methods Constructivist grounded theory and a relational ethics lens guided the study design. This conceptual framework drew attention to benefits, downsides and tensions experienced in a context of relational settings (micro and macro) in which participants live. Fourteen initial and eleven follow‐up interviews took place with persons with RA in British Columbia, Canada, following participation in a wearable‐enabled intervention study. Results We created three main categories, exploring how experiences of benefits, downsides and tensions when using the intervention intertwined with shared moral values placed on self‐control, trustworthiness, independence and productivity: (1) For some, using a wearable helped to ‘do something right’ by taking more control over reaching physical activity goals. Some, however, felt ambivalent, believing both there was nothing more they could do and that they had not done enough to reach their goal; (2) Some participants described how sharing wearable data supported and challenged mutual trustworthiness in their relationship with the PT; (3) For some, using a wearable affirmed or challenged their sense of self‐respect as an independent and productive person. Conclusion Participants in this study reported that using a wearable could support and challenge their arthritis self‐management. Constructing moral identity, with qualities of self‐control, trustworthiness, independence and productivity, within the relational settings in which participants live, was integral to ethical issues encountered. This study is a key step to advance understanding of ethical issues of using a wearable as an adjunct for engaging in physical activity from a patient's perspective. Patient or Public Contribution Perspectives of persons with arthritis (mostly members of Arthritis Research Canada's Arthritis Patient Advisory Board) were sought to shape the research question and interpretations throughout data analysis.
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Affiliation(s)
- Jenny Leese
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Siyi Zhu
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Anne F Townsend
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Division of Health Research, Health Innovation One, Lancaster University, Lancaster, UK
| | - Catherine L Backman
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Faculty of Medicine, Centre for Health Education Scholarship, P.A. Woodward Instructional Resources Centre (IRC), University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Sloss S, Dhiman K, Zafar S, Hartfeld NMS, Lacaille D, Then KL, Li LC, Barnabe C, Hazlewood G, Rankin JA, Hall M, Marshall DA, English K, Tsui K, MacMullan P, Homik J, Mosher D, Barber CE. Development and testing of the Rheumatoid Arthritis Quality of Care Survey. Semin Arthritis Rheum 2022; 54:152002. [DOI: 10.1016/j.semarthrit.2022.152002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022]
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Whittaker JL, Truong LK, Losciale JM, Silvester-Lee T, Miciak M, Pajkic A, Le CY, Hoens AM, Mosewich A, Hunt MA, Li LC, Roos EM. Efficacy of the SOAR knee health program: protocol for a two-arm stepped-wedge randomized delayed-controlled trial. BMC Musculoskelet Disord 2022; 23:85. [PMID: 35078446 PMCID: PMC8790851 DOI: 10.1186/s12891-022-05019-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/11/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Knee trauma permanently elevates one's risk for knee osteoarthritis. Despite this, people at-risk of post-traumatic knee osteoarthritis rarely seek or receive care, and accessible and efficacious interventions to promote knee health after injury are lacking. Exercise can ameliorate some mechanisms and independent risk factors for osteoarthritis and, education and action-planning improve adherence to exercise and promote healthy behaviours. METHODS To assess the efficacy of a virtually-delivered, physiotherapist-guided exercise-based program (SOAR) to improve knee health in persons discharged from care after an activity-related knee injury, 70 people (16-35 years of age, 12-48 months post-injury) in Vancouver Canada will be recruited for a two-arm step-wedged assessor-blinded delayed-control randomized trial. Participants will be randomly allocated to receive the intervention immediately or after a 10-week delay. The program consists of 1) one-time Knee Camp (group education, 1:1 individualized exercise and activity goal-setting); 2) weekly individualized home-based exercise and activity program with tracking, and; 3) weekly 1:1 physiotherapy-guided action-planning with optional group exercise class. Outcomes will be measured at baseline, 9- (primary endpoint), and 18-weeks. The primary outcome is 9-week change in knee extension strength (normalized peak concentric torque; isokinetic dynamometer). Secondary outcomes include 9-week change in moderate-to-vigorous physical activity (accelerometer) and self-reported knee-related quality-of-life (Knee injury and OA Outcome Score subscale) and self-efficacy (Knee Self Efficacy Scale). Exploratory outcomes include 18-week change in primary and secondary outcomes, and 9- and 18- week change in other components of knee extensor and flexor muscle function, hop function, and self-reported symptoms, function, physical activity, social support, perceived self-care and kinesiophobia. Secondary study objectives will assess the feasibility of a future hybrid effectiveness-implementation trial protocol, determine the optimal intervention length, and explore stakeholder experiences. DISCUSSION This study will assess the efficacy of a novel, virtually-delivered, physiotherapist-guided exercise-based program to optimize knee health in persons at increased risk of osteoarthritis due to a past knee injury. Findings will provide valuable information to inform the management of osteoarthritis risk after knee trauma and the conduct of a future effectiveness-implementation trial. TRIAL REGISTRATION Clinicaltrials.gov reference: NTC04956393. Registered August 5, 2021, https://clinicaltrials.gov/ct2/show/NCT04956393?term=SOAR&cond=osteoarthritis&cntry=CA&city=Vancouver&draw=2&rank=1.
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Affiliation(s)
- Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Arthritis Research Canada, Vancouver, Canada.
| | - Linda K Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Justin M Losciale
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | | | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Andrea Pajkic
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Canada
| | - Christina Y Le
- Arthritis Research Canada, Vancouver, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Alison M Hoens
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Amber Mosewich
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Canada
| | - Michael A Hunt
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Ewa M Roos
- Department of Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
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Zarin W, Lunny C, Chaudhry S, Thomas SM, LeBlanc A, Clement F, Abou-Setta AM, Curran JA, Hutton B, Florez ID, Li LC, Bornstein S, Hamilton CB, Moffitt P, Godfrey C, Zitzelsberger L, Gardiner L, Fahim C, Straus SE, Tricco AC. A Canadian model for providing high-quality, timely and relevant evidence to meet health system decision-maker needs: the SPOR Evidence Alliance. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Canada has made great progress in synthesizing, disseminating, and integrating research findings into health systems and clinical decision-making; yet gaps exist in the research-to-practice continuum. The Strategy for Patient-Oriented Research (SPOR) Evidence Alliance aims to help close gaps by providing decision-makers with evidence that is timely, context sensitive, and demand driven to better inform patient-oriented practices and policies in health systems. In this article, we introduce a model established in Canada to support decision-maker needs for high-quality evidence that is patient oriented to enhance health systems performance. We provide an overview of how this model was implemented, who is involved, who it serves, as well as its organizational structure and remit. We discuss key milestones achieved to date and the impact this initiative has made within the health research community. The strength of the SPOR Evidence Alliance lies in its unique ability to simultaneously: ( i) serve as a national platform for researchers to stay connected and collaborate to minimize duplication of efforts and ( ii) facilitate access to research knowledge for patient partners and decision-makers. In doing so, the SPOR Evidence Alliance is supporting health policy and practice decisions that support and strengthen Canada’s dynamic health systems.
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Affiliation(s)
- Wasifa Zarin
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
| | - Carole Lunny
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Sabrina Chaudhry
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
| | - Sonia M. Thomas
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, CIUSSS de la Capitale Nationale, Quebec City, QC G1J 0A4, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada
| | - Fiona Clement
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW Calgary, Calgary, AB T2N 4Z6, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, Rady Faculty of Health Sciences, University of Manitoba, 367-753 McDermot Ave, Winnipeg, MB R3E 0T6, Canada
| | - Janet A. Curran
- School of Nursing, Faculty of Health, Dalhousie University, 5869 University Ave, Halifax, NS B3H 4R2, Canada
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa ON, K1H 8L6, Canada
| | - Ivan D. Florez
- Department of Pediatrics, University of Antioquia, Medellin, Colombia
- School of Rehab Science, McMaster University, 1400 Main Street West, Hamilton, ON L8S 1C7, Canada
| | - Linda C. Li
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Stephen Bornstein
- Centre of Applied Health Research, Memorial Univeristy of Newfoundland, 95 Bonaventure Avenue, St. John’s, NL A1B 2X5, Canada
| | - Clayon B. Hamilton
- Fraser Health, Suite 400, Central City Tower, 13450-102nd Avenue, Surrey, BC V3T 0H1, Canada
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Pertice Moffitt
- North Slave Research Centre, Aurora College, Bag 9700, 5004-54th St, Yellowknife, NT X1A 2R3, Canada
| | - Christina Godfrey
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, Queen’s University, Kingston, ON, Canada
| | - Louise Zitzelsberger
- Office of Grants and Contributions, Strategic Policy Branch, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Leanne Gardiner
- Department of Justice, Government of the Northwest Territories, Yellowknife, NT X1A 2L9, Canada
| | - Christine Fahim
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
| | - Sharon E. Straus
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, 6 Queen’s Park Crescent West, 3rd floor, Toronto, ON M5S 3H2, Canada
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute of St Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, Queen’s University, Kingston, ON, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
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Liu-Ambrose T, Li LC. Physiotherapy for Healthy Aging. Physiother Can 2022; 74:1-3. [PMID: 35185240 PMCID: PMC8816357 DOI: 10.3138/ptc-2021-0106-gee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada
| | - Linda C. Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada, Arthritis Research Canada, Vancouver, British Columbia, Canada
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Tricco AC, Zarin W, Clement F, Abou-Setta AM, Curran JA, LeBlanc A, Li LC, Godfrey C, Moffitt P, Moher D, Colquhoun H, Graham ID, Florez ID, Wilhelm L, Isaranuwatchaia W, Mann J, Hamilton M, Srinivasan V, Bornstein S, Straus SE. Introducing the Strategy for Patient Oriented Research (SPOR) Evidence Alliance: a partnership between researchers, patients and health system decision-makers to support rapid-learning and responsive health systems in Canada and beyond. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This is the introductory paper in a collection of four papers on the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance, a pan-Canadian research initiative that was funded by the Canadian Institutes of Health Research in September of 2017. Here, we introduce the SPOR enterprise in Canada, provide a rationale for the creation of the SPOR Evidence Alliance, provide information on the mandate and approach, and describe how the SPOR Evidence Alliance adds to the health research ecosystem in Canada and beyond.
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Affiliation(s)
- Andrea C. Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing, Queen’s University, 92 Barrie Street, Kingston, ON K7L 3N6, Canada
| | - Wasifa Zarin
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Fiona Clement
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4N6, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, Rady Faculty of Health Sciences, University of Manitoba, 367-753 McDermot Ave, Winnipeg, MB R3E 0T6, Canada
| | - Janet A. Curran
- School of Nursing, Faculty of Health, Dalhousie University, 5869 University Ave, Halifax, NS B3H 4R2, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, CIUSSS de la Capitale Nationale, Quebec City, QC G1J 0A4, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, 230 – 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Christina Godfrey
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing, Queen’s University, 92 Barrie Street, Kingston, ON K7L 3N6, Canada
| | - Pertice Moffitt
- North Slave Research Centre, Aurora College, Bag 9700, 5004-54th St, Yellowknife, NT X1A 2R3, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7, Canada
| | - Ian D. Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
- Centre for Practice-Changing Research, Ottawa Hospital Research Institute, 501 Smyth Road, Box 711, Ottawa, ON K1H 8L6, Canada
| | - Ivan D. Florez
- Department of Pediatrics, University of Antioquia, Medellin, Colombia
- School of Rehab Science, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada
| | | | - Wanrudee Isaranuwatchaia
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
| | - Jackie Mann
- Askatchewan Centre for Patient-Oriented Research, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Marina Hamilton
- Maritime SPOR SUPPORT Unit, 5790 University Avenue, Halifax, NS B3H 1V7, Canada
| | - Vasanthi Srinivasan
- Ontario SPOR SUPPORT Unit, MaRS Centre, West Tower, 405-661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Stephen Bornstein
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, 300 Prince Philip Dr, St. John’s, NL A1B 3V6, Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
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Liu-Ambrose T, Li LC. La physiothérapie pour un vieillissement en bonne santé. Physiother Can 2022; 74:3-5. [PMID: 35185241 PMCID: PMC8816356 DOI: 10.3138/ptc-2021-0106-gef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Teresa Liu-Ambrose
- Département de physiothérapie, Université de la Colombie-Britannique, Vancouver, Colombie-Britannique, Canada, Centre for Hip Health and Mobility, Vancouver, Colombie-Britannique, Canada, Djavad Mowafaghian Centre for Brain Health, Vancouver, Colombie-Britannique, Canada
| | - Linda C. Li
- Département de physiothérapie, Université de la Colombie-Britannique, Vancouver, Colombie-Britannique, Canada, Arthritis Research Canada, Vancouver, Colombie-Britannique, Canada
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40
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Truong LK, Mosewich AD, Miciak M, Pajkic A, Le CY, Li LC, Whittaker JL. Balance, reframe, and overcome: The attitudes, priorities, and perceptions of exercise-based activities in youth 12-24 months after a sport-related ACL injury. J Orthop Res 2022; 40:170-181. [PMID: 33951223 DOI: 10.1002/jor.25064] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/13/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
Attitudes, priorities, and perceptions of exercise directly influence exercise behaviors. Despite the benefits of exercise-based activities for future health, little is known about how youth who experience an ACL injury view exercise-based activity beyond the immediate recovery period. A qualitative (interpretative description) approach with one-to-one semistructured interviews was used to probe the current attitudes, priorities, and perceptions of exercise-therapy, physical activity, and sport participation with a purposive sample of youth from an ongoing inception cohort study who experienced an ACL tear or reconstruction in the past 12-24 months. Analyses followed an inductive approach guided by an analytic interpretative description process. Reflexive journaling, memoing, and a detailed audit trail promoted data trustworthiness. A patient-partner was involved throughout. Ten youth (six women, four men), 15-19 years of age, and a median of 20-months (16-26) from injury were interviewed. Three overarching themes were identified. 'Balancing physical activity and future knee health' highlighted ongoing negotiations between what were perceived to be competing priorities for return-to-sport and future knee health. 'Reframing the value of exercise-therapy and physical activity' reflected the importance of reshaping attitudes toward exercise as positive and was linked to exercise adherence. 'Overcoming unforeseen exercise challenges' encompassed persisting psychological and physical challenges perceived to limit exercise-based activities. Clinical significance: reframing exercise-based activities in a positive light and leveraging motivation for return-to-sport and life-long knee health may be important strategies for encouraging ongoing exercise therapy and physical activity following a youth ACL injury.
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Affiliation(s)
- Linda K Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Arthritis Research Centre, Richmond, Canada
| | - Amber D Mosewich
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Alberta Innovates, Edmonton, Canada
| | - Andrea Pajkic
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Christina Y Le
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Arthritis Research Centre, Richmond, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Arthritis Research Centre, Richmond, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Arthritis Research Centre, Richmond, Canada
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41
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Hartford W, Backman CL, Li LC, McQuitty S, McKinnon A, Kherani R, Nimmon L. Networks of Care: A Social Network Perspective of Distributed Multidisciplinary Care for People With Inflammatory Arthritis. ACR Open Rheumatol 2022; 4:40-56. [PMID: 34687173 PMCID: PMC8754010 DOI: 10.1002/acr2.11349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To explore how multidisciplinary inflammatory arthritis (IA) care is accessed from the perspectives of people with IA and their health care network members. METHODS In this phenomenological study, we used purposive sampling to recruit patients with IA for less than 5 years and age of more than 18 years who spoke English and reported two or more health care network members. We conducted one-to-one interviews with patients and their health care network members. Data were analysed using a social network perspective. RESULTS We interviewed 14 patient participants and 19 health care network members comprising health care providers and informal caregivers. An overarching theme of whole person (holistic) IA care was identified, with the following two broad multifaceted subthemes: 1) connected networks and whole person care and 2) network disconnect and disrupted access to care. The first subtheme notes how access to health care providers and social support was fundamental to holistic care and how care was facilitated by communication pathways that promoted care. The second subtheme illustrates impediments to access, including appointment time pressures, inadequacies in communication delivery modes, and family physicians' unfamiliarity with rheumatology care. Inequities in care were also reported. CONCLUSION Participants shared a goal of whole person care. Although health care networks included multiple disciplines, they did not always provide coordinated multidisciplinary care. Communication modes, linkages between network actors, and organizational structures governed the flow of information and resources through networks and influenced access to equitable whole person care. The development of health care system structures to support the flow of information and resource transfer is needed to promote network collaboration and equitable access to resources.
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Affiliation(s)
- Wendy Hartford
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Linda C. Li
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | | | | | - Raheem Kherani
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Laura Nimmon
- University of British ColumbiaVancouverBritish ColumbiaCanada
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42
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Li LC, Hoens AM, Wilhelm L, Bubber V, PausJenssen E, McKinnon A, Leese J, Otamendi T, Hamilton CB, Zarin W, Tricco AC. Patient engagement in the SPOR Evidence Alliance: Reflection and learnings. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The Evidence Alliance (EA) is a Canada-wide multi-stakeholder organization providing national-level support in knowledge synthesis, clinical practice guidelines development, and knowledge translation. With a mandate to deliver the best available evidence to inform health policy and improve patient care, the EA involves patients and their caregivers in its governance, research priority setting and conduct, and capacity building. To reflect on the experiences of patient involvement in its first three years, the organization conducted a self-study with 17 actively involved patient partners. They answered the Patient Engagement in Research Scale 22-item short form (PEIRS-22) and open-ended questions. Of the 15 respondents, 12 were women with a mean age of 62.6 years (SD 10.1). The mean PEIRS-22 score was 82.1 (SD 15.9), indicating perceived meaningful engagement. Analysis of the free-text answers identified three themes: ( i) communication: successes, changes, and improvements; ( ii) a respectful and welcoming environment; and ( iii) opportunities to learn and contribute. Patient partners noted the EA made genuine efforts to welcome them and value their contributions. They also identified a need for the organization to increase patient partner diversity. This self-study was perceived as rewarding as it provided a foundation for further growth in patient involvement within the organization.
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Affiliation(s)
- Linda C. Li
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Alison M. Hoens
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
- BC SUPPORT Unit, 1367 W Broadway Suite 420, Vancouver, BC V6H 4A7, Canada
| | | | - Vikram Bubber
- Patient Voices Network, 201–750 Pender St W, Vancouver, BC V6C 2T8, Canada
| | - Elliot PausJenssen
- Saskatoon Council on Aging, 2020 College Dr, Saskatoon, SK S7N 2W4, Canada
| | - Annette McKinnon
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
- Canadian Arthritis Patient Alliance, Canada
| | - Jenny Leese
- Arthritis Research Canada, 230 - 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON K1G 5Z3, Canada
| | - Thalia Otamendi
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Clayon B. Hamilton
- Department of Evaluation and Research Services, Fraser Health Authority, 13450 – 102nd Avenue, Surrey, BC V3T 0H1, Canada
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Surrey, BC V5A 1S6, Canada
| | - Wasifa Zarin
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Andrea C. Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, 92 Barrie Street, Kingston, ON K7L 3J8, Canada
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Lunny C, Zarin W, Chaudhry S, Thomas SM, LeBlanc A, Desroches S, Horsley T, Colquhoun H, Sanon PN, Downey M, Goodarzi Z, Baxter NN, English K, PausJenssen E, McQuitty S, Wilhelm L, McKinnon A, Hoens AM, Li LC, Clement F, Curran JA, Abou-Setta AM, Godfrey C, Moher D, Moffitt P, Walker J, Jull J, Koehn C, Isaranuwatchai W, Straus SE, Tricco AC. An inclusive and diverse governance structure of the strategy for patient-oriented research (SPOR) Evidence Alliance. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The Strategy for Patient Oriented Research (SPOR) Evidence Alliance is a research initiative in Canada whose mission is to promote the synthesis, dissemination, and integration of research results into health care and public health decision-making and clinical practice. The aim of this paper is to ( i) outline the governance and committee structure of the SPOR Evidence Alliance, ( ii) outline the procedures for patient and health system decision-maker engagement, and ( iii) present the capacity-building strategy for governance members. The governance structure includes the following six standing committees: the International Advisory Committee, Steering Committee, Executive Committee, Knowledge Translation Committee, Partnerships Committee, and Training and Capacity Development Committee. The guiding principles embrace inclusiveness, support, mutual respect, transparency, and co-building. There are currently 64 committee members across the six committees, 13 patient and public partners, 8 health system decision-makers, 7 research trainees, and 36 researchers. A multi-disciplinary and diverse group of people in Canada are represented from all regions and at various levels of training in knowledge generation, exchange, and translation. This collaborative model makes the SPOR Evidence Alliance strong and sustainable by leveraging the knowledge, lived experiences, expertise, skills, and networks among its 342 members and 12 principal investigators.
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Affiliation(s)
- Carole Lunny
- Cochrane Hypertension Review Group, Therapeutics Initiative, Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, 2176 Health Science Mall, Vancouver, BC V6T 1Z3, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Wasifa Zarin
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Sabrina Chaudhry
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Sonia M. Thomas
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, CIUSSS de la Capitale Nationale, Quebec City, QC G1J 0A4, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada
| | - Sophie Desroches
- School of Nutrition, Université Laval, Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, 2440 Blvd Hochelaga, Quebec City, QC G1V 0A6, Canada
| | - Tanya Horsley
- Research Unit, Royal College of Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa, ON K1S 5N8, Canada
- North Slave Research Centre, Aurora College, Bag 9700, 5004-54th St, Yellowknife, NT X1A 2R3, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7, Canada
| | - Priscille-Nice Sanon
- Sickle Cell Anemia Association of Quebec, 333, Saint-Denis Street, office 3, Montréal, QC H2R 2E5, Canada
| | - Minnie Downey
- BC SUPPORT Unit, Suite 420, 1367 West Broadway, Vancouver, BC V6H 4A7, Canada
| | - Zahra Goodarzi
- Department of Medicine and Community Health Sciences, Hotchkiss Brain Institute and O’Brien Institute of Public Health, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Nancy N. Baxter
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC 3053, Australia
| | - Kelly English
- Arthritis Patients Advisory Board, 5591 No. 3 Rd., Richmond, BC V6X 2C7, Canada
| | - Elliot PausJenssen
- Saskatoon Council on Aging, 2020 College Dr, Saskatoon, SK S7N 2W4, Canada
| | - Shanon McQuitty
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | | | | | - Alison M. Hoens
- BC SUPPORT Unit, Suite 420, 1367 West Broadway, Vancouver, BC V6H 4A7, Canada
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
- Arthritis Research Canada, 230 – 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Linda C. Li
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, 230 – 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Fiona Clement
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4N6, Canada
| | - Janet A. Curran
- School of Nursing, Faculty of Health, Dalhousie University, 5869 University Ave, Halifax, NS B3H 4R2, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, Rady Faculty of Health Sciences, University of Manitoba, 367-753 McDermot Ave, Winnipeg, MB R3E 0T6, Canada
| | - Christina Godfrey
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, 92 Barrie Street, Kingston, ON K7L 3J8, Canada
| | - David Moher
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada
| | - Pertice Moffitt
- North Slave Research Centre, Aurora College, Bag 9700, 5004-54th St, Yellowknife, NT X1A 2R3, Canada
| | - Jennifer Walker
- Associate Professor, Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, 31 George Street, Kingston, ON K7L 3N6, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, 1529 West 6th Ave, Vancouver, BC V6J 1R1, Canada
| | - Wanrudee Isaranuwatchai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Andrea C. Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, 92 Barrie Street, Kingston, ON K7L 3J8, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
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Whittaker JL, Truong LK, Silvester-Lee T, Losciale JM, Miciak M, Pajkic A, Le CY, Hoens AM, Mosewich AD, Hunt MA, Li LC, Roos EM. Feasibility of the SOAR (Stop OsteoARthritis) program. Osteoarthritis and Cartilage Open 2022; 4:100239. [DOI: 10.1016/j.ocarto.2022.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/26/2022] [Indexed: 10/19/2022] Open
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45
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Kopec JA, Sayre EC, Okhmatovskaia A, Cibere J, Li LC, Bansback N, Wong H, Ghanbarian S, Esdaile JM. A comparison of three strategies to reduce the burden of osteoarthritis: A population-based microsimulation study. PLoS One 2021; 16:e0261017. [PMID: 34879102 PMCID: PMC8654220 DOI: 10.1371/journal.pone.0261017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 11/22/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives The purpose of this study was to compare three strategies for reducing population health burden of osteoarthritis (OA): improved pharmacological treatment of OA-related pain, improved access to joint replacement surgery, and prevention of OA by reducing obesity and overweight. Methods We applied a validated computer microsimulation model of OA in Canada. The model simulated a Canadian-representative open population aged 20 years and older. Variables in the model included demographics, body mass index, OA diagnosis, OA treatment, mortality, and health-related quality of life. Model parameters were derived from analyses of national surveys, population-based administrative data, a hospital-based cohort study, and the literature. We compared 8 what-if intervention scenarios in terms of disability-adjusted life years (DALYs) relative to base-case, over a wide range of time horizons. Results Reductions in DALYs depended on the type of intervention, magnitude of the intervention, and the time horizon. Medical interventions (a targeted increase in the use of painkillers) tended to produce effects quickly and were, therefore, most effective over a short time horizon (a decade). Surgical interventions (increased access to joint replacement) were most effective over a medium time horizon (two decades or longer). Preventive interventions required a substantial change in BMI to generate a significant impact, but produced more reduction in DALYs than treatment strategies over a very long time horizon (several decades). Conclusions In this population-based modeling study we assessed the potential impact of three different burden reduction strategies in OA. Data generated by our model may help inform the implementation of strategies to reduce the burden of OA in Canada and elsewhere.
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Affiliation(s)
- Jacek A. Kopec
- University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
| | - Eric C. Sayre
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | - Jolanda Cibere
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C. Li
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Nick Bansback
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Hubert Wong
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Shahzad Ghanbarian
- Centre of Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada
| | - John M. Esdaile
- University of British Columbia, Vancouver, British Columbia, Canada
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46
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Mosor E, Ritschl V, Andrews MR, Omara M, Studenic P, Schaffer G, Leitgeb E, Oppenauer C, Li LC, Stamm T. The lockdown and its consequences-Perspectives and needs of people at increased risk of severe illness from COVID-19 : Results from a qualitative longitudinal study. Wien Klin Wochenschr 2021; 133:1255-1264. [PMID: 34820699 PMCID: PMC8612388 DOI: 10.1007/s00508-021-01979-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/27/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is a lack of knowledge on how people at increased risk of severe illness from Coronavirus disease 2019 (COVID-19) experienced the infection control measures. This study aimed to explore their perspectives and needs during the coronavirus outbreak. METHODS A qualitative longitudinal interview study was conducted in Austria during lockdown due to COVID-19 containment and afterwards. People older than 65 years of age and/or affected by a chronic medical condition participated in individual telephone interviews at two time points. Thematic analysis was used to analyze the data and saturation was defined as no new emerging concepts in at least 10 subsequent interviews. RESULTS Thematic saturation was reached when 33 individuals (75.8% female, mean age ± standard deviation [SD] 73.7±10.9 years) were included. A total of 44 lower level concepts were extracted and summarized into 6 higher level concepts. They included (i) a general positive attitude toward COVID-19 measures, (ii) challenges of being isolated from the community, (iii) deterioration of health status, (iv) difficulties with measures due to their health condition, (v) lack of physical contact and (vi) lack of information versus overload. Participants suggested environmental adaptations for strengthening resilience in people at increased risk of severe illness from COVID-19. CONCLUSION Strategies and interventions are needed to support people at risk under pandemic conditions. Their perceptions and needs should be addressed to reduce the potential deterioration of health conditions and ensure well-being even during prolonged periods of crisis.
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Affiliation(s)
- Erika Mosor
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Valentin Ritschl
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Margaret R Andrews
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Maisa Omara
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Paul Studenic
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Gertraud Schaffer
- Österreichische Rheumaliga (ÖRL), Dorfstraße 4, 5761, Maria Alm, Austria
| | - Ernst Leitgeb
- Austrian Association for Patient Advocacy and Support (AAPAS), Lamprechtgasse 5/7, 1040, Vienna, Austria
| | - Claudia Oppenauer
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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47
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Shewchuk B, Green LA, Barber T, Miller J, Teare S, Campbell-Scherer D, Mrklas KJ, Li LC, Marlett N, Wasylak T, Lopatina E, McCaughey D, Marshall DA. Patients' Use of Mobile Health for Self-management of Knee Osteoarthritis: Results of a 6-Week Pilot Study. JMIR Form Res 2021; 5:e30495. [PMID: 34842526 PMCID: PMC8663438 DOI: 10.2196/30495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 02/06/2023] Open
Abstract
Background In a previous study, a prototype mobile health (mHealth) app was co-designed with patients, family physicians, and researchers to enhance self-management and optimize conservative management for patients with mild to moderate knee osteoarthritis (OA). Objective This study aims to evaluate the overall usability, quality, and effectiveness of the mHealth app prototype for aiding knee OA self-management from the perspectives of patients with OA and health care providers (HCPs). Methods Using methods triangulation of qualitative and quantitative data, we conducted a pilot evaluation of an mHealth app prototype that was codeveloped with patients and HCPs. We recruited adult patients aged ≥20 years with early knee OA (n=18) who experienced knee pain on most days of the month at any time in the past and HCPs (n=7) to participate. In the qualitative assessment, patient and HCP perspectives were elicited on the likeability and usefulness of app features and functionalities and the perceived impact of the app on patient-HCP communication. The quantitative assessment involved evaluating the app using usability, quality, and effectiveness metrics. Patient baseline assessments included a semistructured interview and survey to gather demographics and assess the quality of life (European Quality-of-Life 5-Dimension 5-Level Questionnaire [EQ-5D-5L]) and patient activation (patient activation measure [PAM]). Following the 6-week usability trial period, a follow-up survey assessed patients’ perceptions of app usability and quality and longitudinal changes in quality of life and patient activation. Semistructured interviews and surveys were also conducted with HCPs (n=7) at baseline to evaluate the usability and quality of the app prototype. Results Interviews with patients and HCPs revealed overall positive impressions of the app prototype features and functionalities related to likeability and usefulness. Between the baseline and follow-up patient assessments, the mean EQ-5D-5L scores improved from 0.77 to 0.67 (P=.04), and PAM scores increased from 80.4 to 87.9 (P=.01). Following the 6-week evaluation, patients reported a mean System Usability Scale (SUS) score of 57.8, indicating marginal acceptability according to SUS cutoffs. The mean number of goals set during the usability period was 2.47 (SD 3.08), and the mean number of activities completed for knee OA self-management during the study period was 22.2 (SD 17.8). Spearman rank correlation (rs) calculations revealed that the follow-up PAM scores were weakly correlated (rs=−0.32) with the number of goals achieved and the number (rs=0.19) of activities performed during the 6-week usability period. HCPs reported a mean SUS score of 39.1, indicating unacceptable usability. Conclusions This evidence-based and patient-centered app prototype represents a potential use of mHealth for improving outcomes and enhancing conservative care by promoting patient activation and patient-HCP communication regarding OA management. However, future iterations of the app prototype are required to address the limitations related to usability and quality.
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Affiliation(s)
- Brittany Shewchuk
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lee A Green
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.,Enhancing Alberta Primary Care Research Networks, Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tanya Barber
- Enhancing Alberta Primary Care Research Networks, Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jean Miller
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Sylvia Teare
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Denise Campbell-Scherer
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Office of Lifelong Learning and Physician Learning Program, Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Kelly J Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Strategic Clinical Networks, System Innovation and Programs, Alberta Health Services, Calgary, AB, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Nancy Marlett
- Patient and Community Engagement Research Unit, O'Brien Institute for Public Health, Calgary, AB, Canada.,Community Rehabilitation and Disability Studies, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tracy Wasylak
- Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada.,Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Elena Lopatina
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deirdre McCaughey
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Leese J, MacDonald G, Backman CL, Townsend A, Nimmon L, Li LC. Experiences of Wearable Technology by Persons with Knee Osteoarthritis Participating in a Physical Activity Counseling Intervention: Qualitative Study Using a Relational Ethics Lens. JMIR Mhealth Uhealth 2021; 9:e30332. [PMID: 34766912 PMCID: PMC8663466 DOI: 10.2196/30332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/27/2021] [Accepted: 09/19/2021] [Indexed: 12/27/2022] Open
Abstract
Background Current evidence indicates physical activity wearables could support persons with knee osteoarthritis (OA) to be more physically active. However, recent evidence also identifies some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they feel they should be. Questions remain around how persons with knee OA experience benefits or downsides using a wearable in their everyday lives. Better understanding is needed if wearables are to be incorporated in arthritis self-management in ethically aware ways. Objective Using an ethics lens, we aimed to describe a range of experiences from persons with knee OA who used a wearable during a physical activity counseling intervention study. Methods This is a secondary analysis of qualitative interviews nested within a randomized controlled trial. Guided by phenomenography, we explored the experiences of persons with knee OA following participation in a physical activity counseling intervention that involved using a Fitbit Flex and biweekly phone calls with a study physiotherapist (PT) in an 8-week period. Benefits or downsides experienced in participants’ relationships with themselves or the study PT when using the wearable were identified using a relational ethics lens. Results Interviews with 21 participants (12 females and 9 males) aged 40 to 82 years were analyzed. Education levels ranged from high school graduates (4/21, 19%) to bachelor’s degrees or above (11/21, 52%). We identified 3 categories of description: (1) participants experienced their wearable as a motivating or nagging influence to be more active, depending on how freely they were able to make autonomous choices about physical activity in their everyday lives; (2) some participants felt a sense of accomplishment from seeing progress in their wearable data, which fueled their motivation; (3) for some participants, sharing wearable data helped to build mutual trust in their relationship with the study PT. However, they also expressed there was potential for sharing wearable data to undermine this trust, particularly if this data was inaccurate. Conclusions Findings provide an early glimpse into positive and negative emotional impacts of using a wearable that can be experienced by participants with knee OA when participating in a randomized controlled trial to support physical activity. To our knowledge, this is the first qualitative study that uses a relational ethics lens to explore how persons with arthritis experienced changes in their relationship with a health professional when using a wearable during research participation.
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Affiliation(s)
- Jenny Leese
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Vancouver, BC, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Graham MacDonald
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Catherine L Backman
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Vancouver, BC, Canada
| | - Anne Townsend
- Arthritis Research Canada, Vancouver, BC, Canada.,Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Laura Nimmon
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Vancouver, BC, Canada
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49
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Kopec JA, Heath AJ, Sayre EC, Cibere J, Li LC, Marra CA, Liu RR, Esdaile JM. Prevalence of joint-specific osteoarthritis and joint pain in British Columbia, Canada. Rheumatol Int 2021; 42:1623-1628. [PMID: 34716488 DOI: 10.1007/s00296-021-05031-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
The objective is to determine the prevalence of self-reported physician-diagnosed osteoarthritis (OA) and musculoskeletal symptoms (pain, stiffness or discomfort) in specific joints among adults in British Columbia (BC), Canada. We carried out a cross-sectional mixed-mode survey in a random population sample of persons 18 years of age and older. Estimates were weighted to reflect the age and sex distribution of the population of BC. We obtained responses from 2,233 individuals. Overall, 18.4% (95% CI 16.8-20.1) of the adult population reported OA. Of those, more than 40% had OA in multiple sites. Prevalence ranged from 8.8% (95% CI 7.6-10.1) in the knee to 2.7% (2.1-3.5) in the foot. One-year prevalence of symptoms ranged from 49.1% (47.0-51.2) in the lower back to 23.3% (21.5-25.1) in the hip. Females reported more symptoms and OA than males in all joints. The most common site of self-reported physician-diagnosed OA in BC is the knee, but OA in the hands, hips, and feet is also common. Having OA in one joint is a strong predictor of OA in other joints.
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Affiliation(s)
- Jacek A Kopec
- School of Population and Public Health, University of British Columbia, 230-2238 Yukon Street, Vancouver, BC, V5Y 3P2, Canada. .,Arthritis Research Canada, Vancouver, Canada.
| | | | | | - Jolanda Cibere
- Arthritis Research Canada, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Carlo A Marra
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Ran R Liu
- Department of Medicine, Queens University, Kingston, Canada
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50
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Lo CH, Yang SF, Li LC, Ueng KC. MicroRNA let-7a, -7e and -133a attenuate hypoxia-induced atrial fibrosis via targeting collagen expression and the JNK pathway in HL1 cardiomyocytes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is becoming an enormous public health challenge, and it is associated with major cardiovascular morbidity and mortality. There is a need for a better understanding of the causes and consequences of the hypoxia-related development of AF and atrial remodeling. Fibrosis is a hallmark of atrial structural remodeling. Micro-ribonucleic acids (miRNAs) have been reported to have an impact on the pathogenesis of cardiac diseases. Evidence that specific miRNAs can influence AF related to atrial structural remodeling and fibrosis via the modulation of collagens under myocardial hypoxic conditions is lacking. The aim of this study was to investigate the role of miRNAs in the modulation of fibrotic molecular mechanisms in response to hypoxic conditions, which may mediate atrial fibrosis.
Methods
Hypoxia was induced by cobalt chloride and hypoxia chamber respectively. MiRNA arrays were used to identify the specific miRNAs associated with the modulation of fibrotic genes. Luciferase assay, real-time polymerase chain reaction, immunofluorescence and Western blotting were used to investigate the effects of miRNAs on the expressions of the fibrotic markers collagen I and III (COL1A, COL3A) and phosphorylation levels of the stress kinase c-Jun N-terminal kinase (JNK) pathway in cultured HL-1 atrial cardiomyocytes cell line.
Results
COL1A and COL3A were found to be the direct regulatory targets of miR-let-7a, miR-let-7e and miR-133a in hypoxic atrial cardiac cells in vitro. The expressions of COL1A and COL3A were influenced by treatment with miRNA mimic and antagomir. The delivery of miR-133a, miR-let-7a or miR-let-7e inhibited hypoxia-induced collagen expression. The JNK pathway was critical in the pathogenesis of atrial fibrosis. Inhibition of JNK phosphorylation (JNK inhibitor SP600125) could be able to increase expression of miRNAs and repressed the fibrotic markers COL1A and COL3A which in turn might reduce the arrhythmogenic atrial remodeling. This study highlights the important role of miRNA in hypoxia-related atrial remodeling as well as atrial fibrosis.
Conclusion
MiRNA let-7a, miR-let-7e and miR-133a play important roles in hypoxia-related atrial fibrosis by inhibiting collagen expression and post-transcriptional repression by the JNK pathway. These novel findings may lead to the development of new therapeutic strategies.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by the grants from the Ministry of Science and Technology (MOST), Taiwan, ROC Regulation of cardiac fibrosisRegulation of collagen types by miRNAs
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Affiliation(s)
- C H Lo
- Chung Shan Medical University Hospital, Institute of Medicine, Chung Shan Medical University, Division of Cardiology, Taichung, Taiwan
| | - S F Yang
- Chung Shan Medical University Hospital, Institute of Medicine, Chung Shan Medical University, Department of Medical Research, Taichung, Taiwan
| | - L C Li
- Chung Shan Medical University Hospital, Department of Internal Medicine, Taichung, Taiwan
| | - K C Ueng
- Chung Shan Medical University Hospital, Institute of Medicine, Chung Shan Medical University, Division of Cardiology, Taichung, Taiwan
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