Gender Outcomes INternational Group: to Further Well-being Development Study
Principal Investigators: L. Pilote (Canada), C. Norris (Canada), V. Raparelli (Canada)
Co-Investigators: M. Abrahamowicz (Canada), S. Bacon (Canada), J. Fishman (Canada), K. Humphries (Canada), E. Jonson (Cyprus), A. Kautzky-Willer (Austria), K. Kublickiene (Sweden), M. Parry (Canada) (Co-Lead of KTE), J. Patrikios Cyprus), Sapir-Pichhadze (Canada), A. Stephanou (Cyprus), M. Trinidad Herrero (Spain)
Funding: GENDER-NET Plus ERA-NET Cofund (2018 – 2021)
BACKGROUND AND OBJECTIVE: Beyond biological sex, gender is increasingly recognized as a pivotal determinant of health. However, there are no standardized gender measurements. We hypothesize that gender-related factors and their effect will vary substantially between countries and diseases. The overarching aims of this large Consortium are to integrate sex and gender dimensions in applied health research, to evaluate their impact on clinical cost-sensitive outcomes and patients reported outcomes related to quality of life in noncommunicable diseases including cardiovascular disease, metabolic disease, chronic kidney disease and neurological disease. We also aim to construct innovative ways to disseminate the application of gender measurement towards personalized approaches to chronic disease prevention, diagnosis and treatment.
METHODS: With a five-country transatlantic network comprised of 30 investigators, we will benchmark innovative solutions to measure gender in retrospective cohorts. Based on consensus, we will develop a framework to identify gender-related factors, as well as cost-sensitive and patients reported outcomes and measure their associations in 32 accessible cohorts of patients affected by cardiovascular, chronic kidney and neurological diseases and metabolic syndrome. Large database analysis and when appropriate machine learning approaches will allow the derivation of pan and within country disease specific gender scores which will be validated through e-Health and m-Health applications in prospective disease groups. Educational modules will be developed to promote awareness, implementation and dissemination.
Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD): Enhancement and Adaptation of Community-Driven Innovations and Scale-Up Toolkits
Principal Investigator: S. Harris
Co-Investigators: O. Bhattacharyya, E. Barre, K. Dawson, R. Dyck, M. Green, A. Hanley, B. Lavallee, M. Parry, S. Reichert, J. Salsberg, B. Te Hiwi, A. Thind, S. Tobe, A. Walsh, J. Wylie, M. Zwarenstein
Funding: Canadian Institutes of Health Research Team Grant: Pathways to Health Equity for Aboriginal People – Implementation Research Team Grants, Component 2 (2017 – 2020)
BACKGROUND AND OBJECTIVE: In Canada, there are significant disparities between the health status of Indigenous peoples and the general population with respect to diabetes mellitus. The overarching goal of this research is to improve the health and health equity of Indigenous peoples by strengthening the effectiveness of scalability of the TransFORmation of IndiGEnous PrimAry HEAlthcare (FORGE AHEAD) Quality Improvement (QI) Strategy.
METHODS: An implementation science approach of examining what works, for whom, and under what contexts will be used to guide this research. The research goal will be achieved and will be operationalized using a PR approach that simultaneously ensures culturally sensitive processes and KT/E throughout.
Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD): Community-Driven Innovations and Strategic Scale-up Toolkits
Principal Investigator: S. Harris
Co-Investigators: O. Bhattacharyya, E. Baxter, H. McDonald, E. Barre, K. Dawson, D. Dannenbaum, R. Dyck, J. Episkenew, M. Green, A. Hanley, A. Katz, B. Lavallee, A. McComber, A. Macaulay, M. Parry, S. Reichert, J. Salsberg, A. Thind, S. Tobe, E. Toth, A. Walsh, J. Wylie, J. Wortman, M. Zwarenstein, L. Houle, T. Jacobs, K. Kandukur, R. Littlechild, I. McComb, D. Montour, J. Morach, M. Nose, T. O’Keefe, D. Redmond, D. Spade, C. Tischer, S. Zeiler
Funding: Canadian Institutes of Health Research Planning Grant and a Canadian Institutes of Health Research Community-Based Primary Health Care Team Grant (2013 – 2018)
BACKGROUND AND OBJECTIVE: Given the dramatic rise and impact of chronic disease and gaps in care in Indigenous peoples in Canada, a shift from the existing episodic healthcare model most common in First Nations communities, to one that integrates prevention and chronic disease management is required. Five key objectives are to: 1) assess the current healthcare delivery and funding models in Indigenous communities in Canada, 2) assess community and clinical readiness to address and change chronic disease care, 3) enhance patient access to available community resources for chronic disease care, 4) implement and evaluate community and clinic quality improvement initiatives to improve chronic disease management, and 5) develop sustainable strategies and scale-up toolkits for improved chronic management in First Nations communities.
METHODS: A series of inter-related and progressive projects using a participatory research approach that simultaneously ensures culturally appropriate processes and integrates knowledge translation by involving relevant stakeholders throughout the entire program.
Diabetes and its Related Complications
Principal Investigators: G. Lewis, JP. Despres, P. Rochon, F. Sullivan, A. Brown, J. McGavock, J. Cafazzo, A. Carpentier, F. Legare, M. Brent, D. Maberley, B. Perkins, P. Fernyhough, M. Farkouh, M. Belanger
Co-Investigators: A. Paterson, B. Lamarche, G. Anderson, K. Gregory-Evans, H. Lee-Gosselin, L. MacCallum, M. Parry, D. Cherney, J. Maman, P. Harvey, H. Witteman, D. Prowten, B. Goldstein, J. Hux, M. Campbell, M. Tennant, A. Cruess, B. Zee, G. Fantus, A. Dart, M. Hillmer, , N. Calcutt, D. Zochodne, R. Dobrowsky, L. Kotra, S. Desroches, C. Whiteside, S. Seabrooke, R. Gilbert, R. Mason, S. Lagosky, E. Grunfeld, D. Manca, N. Drummond, L. Lipscombe, G. Booth, B. Shah, P. Segal, I. Halperin, G. Mukerji, M. Wolfs, M. Greiver, M. Mamdani, K. Sabihuddin, M. Ouimet, B. Lavallee, C. Chartrand, R. Rabasa-Lhoret, A. Haidar, S. Desroches, M. Campbell, D. Yuen, A. Advani, PM. Geraldes, A. Paterson, K. Connelly, CH. Cunningham, V. Montori, C. Jose, D. Sissmore, R. Gray, D. Prowten, B. Goldstein
Funding: SPOR Networks in Chronic Disease, Canadian Institutes of Health Research (2016 – 2021)
BACKGROUND AND OBJECTIVE: Individuals with diabetes, representing approximately 10% of Canadians, are concerned about their risk of complications (blindness, limb amputations, kidney and heart failure, and hypoglycemia). These complications are often under diagnosed and ineffectively treated. This SPOR Network will redefine interventions for early diagnosis and customized treatments that will transform healthcare for all individuals with diabetes.
METHODS: We have a team of experts in biomedical, clinical, population and health services research, education, and knowledge translation will conduct projects to establish a platform for a national registry to evaluate access to and implementation of effective methods for diagnosing complications, design a unique Canadian Risk Calculator, a smartphone app, identify biomarkers associated with risk of complications, and evaluate diet and lifestyle interventions. By aligning biomedical, clinical, population health and health services research and education with what matters most to patients we will bridge the knowledge translation gap with real impact on chronic disease outcomes.
Technology-Enabled Remote Monitoring and Self-Management: Vision for Patient Empowerment Following Cardiac and Vascular Surgery
Principal Investigator: M. McGillion, PJ Devereaux, D. Bender, A. Lamy, A. Turner, S. Carroll, J. Yost, E. Peter, P Ritvo
Co-Investigators: M. Parry and the SMArTVIEW Team
Funding: CIHR eHealth Innovation Partnership and Hamilton Health Sciences (HHS) Grants (2015 – 2019)
BACKGROUND AND OBJECTIVE: Tens of thousands of cardiac and vascular surgeries (CaVS) are performed on seniors each year to improve survival, relieve disease symptoms, and improve health-related quality of life (HRQL). However, chronic postsurgical pain (CPSP), undetected or delayed detection of hemodynamic compromise, complications, and related poor functional status are major problems for substantial numbers of patients during the recovery process. The objectives are to (1) refine SMArTVIEW via high-fidelity user testing and (2) examine the effectiveness of SMArTVIEW via a randomized controlled trial (RCT).
METHODS: CaVS patients and clinicians will engage in two cycles of focus groups and usability testing at each site; feedback will be elicited about expectations and experience of SMArTVIEW, in context. The data will be used to refine the SMArTVIEW eHealth delivery program. Upon transfer to the surgical ward (ie, post-intensive care unit [ICU]), 256 CaVS patients will be reassessed postoperatively and randomly allocated via an interactive Web randomization system to the intervention group or usual care. The SMArTVIEW intervention will run from surgical ward day 2 until 8 weeks following surgery. Outcome assessments will occur on postoperative day 30; at week 8; and at 3, 6, 9, and 12 months.