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van Allen Z, Orsholits D, Boisgontier MP. Pre-stroke physical activity matters for functional limitations: A longitudinal case-control study of 12,860 participants. medRxiv 2024:2023.09.14.23295576. [PMID: 37745591 PMCID: PMC10516084 DOI: 10.1101/2023.09.14.23295576] [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] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective In the chronic phase after a stroke, limitations in activities of daily living (ADLs) and instrumental ADL (IADLs) initially plateau before steadily increasing. The benefits of pre-stroke physical activity on these limitations remain unclear. To clarify this relationship, we examined the effect of physical activity on the long-term evolution of functional limitations in a cohort of stroke survivors and compared it to a cohort of matched stroke-free adults. Methods Longitudinal data from 2,143 stroke survivors and 10,717 stroke-free adults aged 50 years and older were drawn from a prospective cohort study based on the Survey of Health, Ageing and Retirement in Europe (2004-2022; 8 data collection waves). Physical activity was assessed in the pre-stroke wave. Functional limitations were assessed in the post-stroke waves. Each stroke survivor was matched with 5 stroke-free adults who had similar propensity scores computed on the basis of key covariates, including baseline age, sex, body mass index, limitations in ADL and IADL, chronic conditions and country of residence, before any of the participants from either cohort had experienced a stroke. Results Results showed an interaction between stroke status and physical activity on ADL limitations (b = -0.076; 95% CI = -0.142 to -0.011), with the effect of physical activity being stronger in stroke survivors (b = -0.345, 95% CI = -0.438 to -0.252) than in stroke-free adults (b = -0.269, 95% CI = -0.269 to -0.241). Conclusion The beneficial effect of pre-stroke physical activity on ADL limitations after stroke is stronger than its effect in matched stroke-free adults followed for a similar number of years. Impact Physical activity, an intervention within the physical therapist's scope of practice, is effective in reducing the risk of functional dependence after stroke. Moreover, pre-stroke levels of physical activity can inform the prognosis of functional dependence in stroke survivors.
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Affiliation(s)
- Zack van Allen
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada
- Perley Health Centre of Excellence in Frailty-Informed Care, Ottawa, Canada
| | - Dan Orsholits
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada
| | - Matthieu P. Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada
- Perley Health Centre of Excellence in Frailty-Informed Care, Ottawa, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada
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Fontaine G, Presseau J, Bruneau J, Patey AM, van Allen Z, Mortazhejri S, Høj SB, Hung JHC, Grimshaw JM. "Apparently, you can only be treated once": A qualitative study exploring perceptions of hepatitis C and access to treatment among people who inject drugs visiting a needle and syringe program. Int J Drug Policy 2023; 121:104124. [PMID: 37451942 DOI: 10.1016/j.drugpo.2023.104124] [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: 12/05/2022] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Access to hepatitis C care within harm reduction community organizations for people who inject drugs is crucial for achieving hepatitis C elimination. However, there is a lack of data on how perceptions of hepatitis C and treatment have changed among individuals visiting these organizations during the era of direct-acting antivirals (DAAs). This study aimed to explore the perceptions of hepatitis C and treatment access for (re)infection among individuals visiting a needle and syringe program in Canada. METHODS Eighteen semi-structured interviews were conducted with individuals who recently injected drugs and visited a needle and syringe program. The interviews were guided by the Common-Sense Self-Regulation Model (CS-SRM) and aimed to explore cognitive and emotional representations of hepatitis C, perceptions of treatment, coping strategies and sources of information. Interviews were audio recorded, transcribed, and coded using thematic analysis. RESULTS Most of the participants identified as male, were of white ethnicity and had a median age of 45. While most underscored the therapeutic advancements and the effectiveness of DAAs, they expressed confusion regarding the mechanisms of access to treatment, especially in cases of reinfection. Perceptions of the controllability of hepatitis C were significantly influenced by the stigmatizing discourse surrounding treatment access, cost, and public coverage. This influence extended to their intentions for seeking treatment. Participants emphasized the social consequences of hepatitis C, including stigma. Emotional representations of hepatitis C evolved along the care cascade, encompassing initial shock at diagnosis and later fear of reinfection following successful treatment. CONCLUSION Nearly a decade after the advent of DAAs, misinformation about treatment access persists. Findings underscore a nexus of internalized and institutionalized stigma associated with hepatitis C, drug use, and the challenges of cost and access to treatment, pointing to a clear need for education and service delivery optimisation in harm reduction community organizations.
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Affiliation(s)
- Guillaume Fontaine
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5; The Kirby Institute, UNSW, Wallace Wurth Building (C27), Cnr High St & Botany St, Kensington, NSW, Australia 2052.
| | - Justin Presseau
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, Canada K1G 5Z3; School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON, Canada K1N 6N5
| | - Julie Bruneau
- Research Centre, Université de Montréal Hospital Centre, 900 Saint Denis St, Montreal, QC, Canada, H2×0A9; Department of Family and Emergency Medicine, Université de Montréal, 2900, boulevard Édouard-Montpetit, Montréal, QC, Canada, H3T 1J4
| | - Andrea M Patey
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, Canada K1G 5Z3; School of Rehabilitation Therapy, Queen's University, Louise D Acton Building, 31 George St, Kingston, ON, Canada K7L 3N6
| | - Zack van Allen
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON, Canada K1N 6N5
| | - Sameh Mortazhejri
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, Canada K1G 5Z3
| | - Stine Bordier Høj
- Research Centre, Université de Montréal Hospital Centre, 900 Saint Denis St, Montreal, QC, Canada, H2×0A9
| | - Jui-Hsia Cleo Hung
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, Canada K1G 5Z3
| | - Jeremy M Grimshaw
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, L1255, Box 711, Ottawa, ON, Canada K1H 8L6; Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, Canada K1G 5Z3
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van Allen Z, Bacon SL, Bernard P, Brown H, Desroches S, Kastner M, Lavoie KL, Marques MM, McCleary N, Straus S, Taljaard M, Thavorn K, Tomasone JR, Presseau J. Clustering of Health Behaviors in Canadians: A Multiple Behavior Analysis of Data from the Canadian Longitudinal Study on Aging. Ann Behav Med 2023:7156981. [PMID: 37155331 PMCID: PMC10354845 DOI: 10.1093/abm/kaad008] [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] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Health behaviors such as physical inactivity, unhealthy eating, smoking tobacco, and alcohol use are each leading risk factors for non-communicable chronic disease. Better understanding which behaviors tend to co-occur (i.e., cluster together) and co-vary (i.e., are correlated) may provide novel opportunities to develop more comprehensive interventions to promote multiple health behavior change. However, whether co-occurrence or co-variation-based approaches are better suited for this task remains relatively unknown. PURPOSE To compare the utility of co-occurrence vs. co-variation-based approaches for understanding the interconnectedness between multiple health-impacting behaviors. METHODS Using baseline and follow-up data (N = 40,268) from the Canadian Longitudinal Study of Aging, we examined the co-occurrence and co-variation of health behaviors. We used cluster analysis to group individuals based on their behavioral tendencies across multiple behaviors and to examine how these clusters are associated with demographic characteristics and health indicators. We compared outputs from cluster analysis to behavioral correlations and compared regression analyses of clusters and individual behaviors predicting future health outcomes. RESULTS Seven clusters were identified, with clusters differentiated by six of the seven health behaviors included in the analysis. Sociodemographic characteristics varied across several clusters. Correlations between behaviors were generally small. In regression analyses individual behaviors accounted for more variance in health outcomes than clusters. CONCLUSIONS Co-occurrence-based approaches may be more suitable for identifying sub-groups for intervention targeting while co-variation approaches are more suitable for building an understanding of the relationships between health behaviors.
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Affiliation(s)
- Zack van Allen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, University of Quebec at Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Heather Brown
- Lancaster University, Division of Health Research, Lancaster UK
| | | | | | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, QC, Canada
- Departement is Psychology, University of Quebec at Montreal, Montreal, QC, Canada
| | - Marta M Marques
- Comprehensive Health Research Centre (CHRC), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM,) Universidade Nova de Lisboa, Lisboa, Portugal
| | - Nicola McCleary
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Sharon Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queens University, Kingston, ON, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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van Allen Z, Bacon SL, Bernard P, Brown H, Desroches S, Kastner M, Lavoie K, Marques M, McCleary N, Straus S, Taljaard M, Thavorn K, Tomasone JR, Presseau J. Clustering of Unhealthy Behaviors: Protocol for a Multiple Behavior Analysis of Data From the Canadian Longitudinal Study on Aging. JMIR Res Protoc 2021; 10:e24887. [PMID: 34114962 PMCID: PMC8235290 DOI: 10.2196/24887] [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: 10/09/2020] [Revised: 03/08/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Health behaviors such as physical inactivity, unhealthy eating, smoking tobacco, and alcohol use are leading risk factors for noncommunicable chronic diseases and play a central role in limiting health and life satisfaction. To date, however, health behaviors tend to be considered separately from one another, resulting in guidelines and interventions for healthy aging siloed by specific behaviors and often focused only on a given health behavior without considering the co-occurrence of family, social, work, and other behaviors of everyday life. OBJECTIVE The aim of this study is to understand how behaviors cluster and how such clusters are associated with physical and mental health, life satisfaction, and health care utilization may provide opportunities to leverage this co-occurrence to develop and evaluate interventions to promote multiple health behavior changes. METHODS Using cross-sectional baseline data from the Canadian Longitudinal Study on Aging, we will perform a predefined set of exploratory and hypothesis-generating analyses to examine the co-occurrence of health and everyday life behaviors. We will use agglomerative hierarchical cluster analysis to cluster individuals based on their behavioral tendencies. Multinomial logistic regression will then be used to model the relationships between clusters and demographic indicators, health care utilization, and general health and life satisfaction, and assess whether sex and age moderate these relationships. In addition, we will conduct network community detection analysis using the clique percolation algorithm to detect overlapping communities of behaviors based on the strength of relationships between variables. RESULTS Baseline data for the Canadian Longitudinal Study on Aging were collected from 51,338 participants aged between 45 and 85 years. Data were collected between 2010 and 2015. Secondary data analysis for this project was approved by the Ottawa Health Science Network Research Ethics Board (protocol ID #20190506-01H). CONCLUSIONS This study will help to inform the development of interventions tailored to subpopulations of adults (eg, physically inactive smokers) defined by the multiple behaviors that describe their everyday life experiences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24887.
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Affiliation(s)
- Zack van Allen
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, Le Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, University of Quebec in Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Heather Brown
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sophie Desroches
- Department of Food and Nutrition Sciences, Laval University, Quebec City, QC, Canada
| | - Monika Kastner
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
| | - Kim Lavoie
- Montreal Behavioural Medicine Centre, Le Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Marta Marques
- ADAPT Science Foundation Ireland Research Centre, Trinity College Dublin, Dublin, Ireland
- Comprehensive Health Research Centre, NOVA Medical School, Lisbon, Portugal
| | - Nicola McCleary
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Sharon Straus
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Monica Taljaard
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kednapa Thavorn
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | - Justin Presseau
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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van Allen Z, Dogba MJ, Brent MH, Bach C, Grimshaw JM, Ivers NM, Wang X, McCleary N, Asad S, Chorghay Z, Hakim H, Sutakovic O, Drescher O, Légaré F, Witteman HO, Zettl M, Squires J, Tremblay MC, Randhawa A, Lopez G, Ben Guiza A, Presseau J. Barriers to and enablers of attendance at diabetic retinopathy screening experienced by immigrants to Canada from multiple cultural and linguistic minority groups. Diabet Med 2021; 38:e14429. [PMID: 33068305 DOI: 10.1111/dme.14429] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/11/2020] [Accepted: 10/14/2020] [Indexed: 12/27/2022]
Abstract
AIM To identify barriers to/enablers of attendance at eye screening among three groups of immigrantsto Canada from cultural/linguistic minority groups living with diabetes. METHODS Using a patient-oriented research approach leveraging Diabetes Action Canada's patient engagement platform, we interviewed a purposeful sample of people with type 2 diabetes who had immigrated to Canada from: Pakistan (interviews in Urdu), China (interviews in Mandarin) and French-speaking African and Caribbean nations (interviews in French). We collected and analysed data based on the Theoretical Domains Framework covering key modifiable factors that may operate as barriers to or enablers of attending eye screening. We used directed content analysis to code barrier/enabler domains. Barriers/enablers were mapped to behaviour change techniques to inform future intervention development. RESULTS We interviewed 39 people (13 per group). Many barriers/enablers were consistent across groups, including views about harms caused by screening itself, practical appointment issues including forgetting, screening costs, wait times and making/getting to an appointment, lack of awareness about retinopathy screening, language barriers, and family and clinical support. Group-specific barriers/enablers included a preference to return to one's country of birth for screening, the impact of winter, and preferences for alternative medicine. CONCLUSION Our results can inform linguistic and culturally competent interventions to support immigrants living with diabetes in attending eye screening to prevent avoidable blindness.
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Affiliation(s)
- Zack van Allen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Maman Joyce Dogba
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
- Centre for Research on Primary Care and Services, Université Laval, Québec City, QC, Canada
| | - Michael H Brent
- Donald K Johnson Eye Institute, University Health Network, Toronto, Canada
| | - Catherine Bach
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Noah M Ivers
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Xiaoqin Wang
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Evidence-based Medicine Centre, Lanzhou University, Lanzhou, China
| | - Nicola McCleary
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Sarah Asad
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Zahraa Chorghay
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Hina Hakim
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
- Centre for Research on Primary Care and Services, Université Laval, Québec City, QC, Canada
| | - Olivera Sutakovic
- Donald K Johnson Eye Institute, University Health Network, Toronto, Canada
| | - Olivia Drescher
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - France Légaré
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
- Centre for Research on Primary Care and Services, Université Laval, Québec City, QC, Canada
| | - Holly O Witteman
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
- Centre for Research on Primary Care and Services, Université Laval, Québec City, QC, Canada
| | - Mary Zettl
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - Janet Squires
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Marie-Claude Tremblay
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
- Centre for Research on Primary Care and Services, Université Laval, Québec City, QC, Canada
| | | | | | | | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Dogba MJ, Brent MH, Bach C, Asad S, Grimshaw J, Ivers N, Légaré F, Witteman HO, Squires J, Wang X, Sutakovic O, Zettl M, Drescher O, van Allen Z, McCleary N, Tremblay MC, Linklater S, Presseau J. Identifying Barriers and Enablers to Attending Diabetic Retinopathy Screening in Immigrants to Canada From Ethnocultural Minority Groups: Protocol for a Qualitative Descriptive Study. JMIR Res Protoc 2020; 9:e15109. [PMID: 32049067 PMCID: PMC7055809 DOI: 10.2196/15109] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/26/2019] [Accepted: 10/29/2019] [Indexed: 12/13/2022] Open
Abstract
Background Immigrants to Canada belonging to ethnocultural minority groups are at increased risk of developing diabetes and complications, including diabetic retinopathy, and they are also less likely to be screened and treated. Improved attendance to retinopathy screening (eye tests) has the potential to reduce permanent complications, including blindness. Objective This study aims to identify the barriers and enablers of attending diabetic retinopathy screening among ethnocultural minority immigrants living with diabetes in Quebec and Ontario, Canada, to inform the development of a behavior change intervention to improve diabetic retinopathy screening attendance. Methods The research question draws on the needs of patients and clinicians. Using an integrated knowledge translation approach, the research team includes clinicians, researchers, and patient partners who will contribute throughout the study to developing and reviewing materials and procedures, helping to recruit participants, and disseminating findings. Using a convenience snowball strategy, we will recruit participants from three target groups: South Asian and Chinese people, and French-speaking people of African descent. To better facilitate reaching these groups and support participant recruitment, we will partner with community organizations and clinics serving our target populations in Ontario and Quebec. Data will be collected using semistructured interviews, using topic guides developed in English and translated into French, Mandarin, Hindi, and Urdu, and conducted in those languages. Data collection and analysis will be structured according to the Theoretical Domains Framework (TDF), which synthesizes predominant theories of behavior change into 14 domains covering key modifiable factors that may operate as barriers or enablers to attending eye screening. We will use directed content analysis to code barriers and enablers to TDF domains, then thematic analysis to define key themes within domains. Results This study was approved for funding in December 2017, and the research ethics board approved the conduct of the study as of January 13, 2018. Data collection then began in April 2018. As of August 28, 2018, we have recruited 22 participants, and analysis is ongoing, with results expected to be published in 2020. Conclusions Findings from this study will inform the codevelopment of theory-informed, culturally- and linguistically-tailored interventions to support patients in attending retinopathy screening. International Registered Report Identifier (IRRID) DERR1-10.2196/15109
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Affiliation(s)
| | | | - Catherine Bach
- Department of Family Medicine and Emergency Medicine, Laval Unviersity, Québec, QC, Canada
| | - Sarah Asad
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Jeremy Grimshaw
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Noah Ivers
- Women's Health College, Toronto, ON, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Laval Unviersity, Québec, QC, Canada
| | - Holly O Witteman
- Department of Family Medicine and Emergency Medicine, Laval Unviersity, Québec, QC, Canada
| | - Janet Squires
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Xiaoqin Wang
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | | - Mary Zettl
- Department of Family Medicine and Emergency Medicine, Laval Unviersity, Québec, QC, Canada
| | - Olivia Drescher
- Department of Family Medicine and Emergency Medicine, Laval Unviersity, Québec, QC, Canada
| | - Zack van Allen
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Nicola McCleary
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Laval Unviersity, Québec, QC, Canada
| | - Stefanie Linklater
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Justin Presseau
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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7
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Crawshaw J, Presseau J, van Allen Z, Pinheiro Carvalho L, Jordison K, English S, Fergusson DA, Lauzier F, Turgeon AF, Sarti AJ, Martin C, D'Aragon F, Li AHT, Knoll G, Ball I, Brehaut J, Burns KEA, Fortin MC, Weiss M, Meade M, Marsolais P, Shemie S, Zaabat S, Dhanani S, Kitto SC, Chassé M. Exploring the experiences and perspectives of substitute decision-makers involved in decisions about deceased organ donation: a qualitative study protocol. BMJ Open 2019; 9:e034594. [PMID: 31874899 PMCID: PMC7008441 DOI: 10.1136/bmjopen-2019-034594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/26/2019] [Accepted: 12/05/2019] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In Canada, deceased organ donation provides over 80% of transplanted organs. At the time of death, families, friends or others assume responsibility as substitute decision-makers (SDMs) to consent to organ donation. Despite their central role in this process, little is known about what barriers, enablers and beliefs influence decision-making among SDMs. This study aims to explore the experiences and perspectives of SDMs involved in making decisions around the withdrawal of life-sustaining therapies, end-of-life care and deceased organ donation. METHODS AND ANALYSIS SDMs of 60 patients admitted to intensive care units will be enrolled for this study. Ten hospitals across five provinces in Canada in a prospective multicentre qualitative cohort study. We will conduct semistructured telephone interviews in English or French with SDMs between 6 and 8 weeks after the patient's death. Our sampling frame will stratify SDMs into three groups: SDMs who were not approached for organ donation; SDMs who were approached and consented to donate and SDMs who were approached but did not consent to donate. We will use two complementary theoretical frameworks-the Common-Sense Self-Regulation Model and the Theoretical Domains Framework- to inform our interview guide. Interview data will be analysed using deductive directed content analysis and inductive thematic analysis. ETHICS AND DISSEMINATION This study has been approved by the Centre Hospitalier de l'Université de Montréal Research Ethics Board. The findings from this study will help identify key factors affecting substitute decision-making in deceased organ donation, reasons for non-consent and barriers to achieve congruency between SDM and patient wishes. Ultimately, these data will contribute to the development and evaluation of tools and training for healthcare providers to support SDMs in making decisions about organ donation. TRIAL REGISTRATION NUMBER NCT03850847.
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Affiliation(s)
- Jacob Crawshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Zack van Allen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kim Jordison
- Canadian Donation and Transplant Research Program, Edmonton, Alberta, Canada
| | - Shane English
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Francois Lauzier
- Population Health and Optimal Health Practices Unit (Trauma-Emergency-Critical Care Medicine), CHU de Quebec-Universite Laval, Quebec City, Québec, Canada
- Department of Anesthesiology and Critical Care, Division of Critical Care Medicine, Université Laval, Quebec City, Québec, Canada
| | - Alexis F Turgeon
- Population Health and Optimal Health Practices Unit (Trauma-Emergency-Critical Care Medicine), CHU de Quebec-Universite Laval, Quebec City, Québec, Canada
- Department of Anesthesiology and Critical Care, Division of Critical Care Medicine, Université Laval, Quebec City, Québec, Canada
| | - Aimee J Sarti
- Critical Care Medicine, Ottawa Hospital, Ottawa, Ontario, Canada
| | - Claudio Martin
- Medicine (Critical Care), Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Frédérick D'Aragon
- Anesthesiology, Universite de Sherbrooke Faculte de medecine et des sciences de la sante, Sherbrooke, Quebec, Canada
- Centre de recherche du CHUS, Sherbrooke, Quebec, Canada
| | - Alvin Ho-Ting Li
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Greg Knoll
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Ian Ball
- Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Jamie Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Karen E A Burns
- Critical Care, St Michael's Hospital, Toronto, Ontario, Canada
| | - Marie-Chantal Fortin
- Medicine (Critical Care), Centre Hospitalier de L'Universite de Montreal, Montréal, Québec, Canada
- Medicine (Critical Care), Université de Montréal, Montreal, Québec, Canada
| | - Matthew Weiss
- Canadian Donation and Transplant Research Program, Edmonton, Alberta, Canada
- Trauma-Emergency-Critical Care Medicine, Université Laval Faculté de médecine, Quebec City, Quebec, Canada
| | - Maureen Meade
- Medicine (Critical Care), McMaster University, Hamilton, Ontario, Canada
| | - Pierre Marsolais
- Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Québec, Canada
| | - Sam Shemie
- Critical Care, McGill University, Montreal, Québec, Canada
| | | | | | - Simon C Kitto
- Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Michaël Chassé
- Innovation Hub, Centre de Recherche du CHUM, Montréal, Québec, Canada
- Medicine (Critical Care), Centre Hospitalier de L'Universite de Montreal, Montréal, Québec, Canada
- Medicine (Critical Care), Université de Montréal, Montreal, Québec, Canada
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Ebersole CR, Atherton OE, Belanger AL, Skulborstad HM, Allen JM, Banks JB, Baranski E, Bernstein MJ, Bonfiglio DB, Boucher L, Brown ER, Budiman NI, Cairo AH, Capaldi CA, Chartier CR, Chung JM, Cicero DC, Coleman JA, Conway JG, Davis WE, Devos T, Fletcher MM, German K, Grahe JE, Hermann AD, Hicks JA, Honeycutt N, Humphrey B, Janus M, Johnson DJ, Joy-Gaba JA, Juzeler H, Keres A, Kinney D, Kirshenbaum J, Klein RA, Lucas RE, Lustgraaf CJ, Martin D, Menon M, Metzger M, Moloney JM, Morse PJ, Prislin R, Razza T, Re DE, Rule NO, Sacco DF, Sauerberger K, Shrider E, Shultz M, Siemsen C, Sobocko K, Weylin Sternglanz R, Summerville A, Tskhay KO, van Allen Z, Vaughn LA, Walker RJ, Weinberg A, Wilson JP, Wirth JH, Wortman J, Nosek BA. Many Labs 3: Evaluating participant pool quality across the academic semester via replication. Journal of Experimental Social Psychology 2016. [DOI: 10.1016/j.jesp.2015.10.012] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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