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The effectiveness of a proven chronic disease prevention and screening intervention in diverse and remote primary care settings: an implementation study on the BETTER 2 Program.
Aubrey-Bassler, Kris; Fernandes, Carolina; Penney, Carla; Cullen, Richard; Meaney, Christopher; Sopcak, Nicolette; Campbell-Scherer, Denise; Moineddin, Rahim; Baxter, Julia; Krueger, Paul; Wilson, Margo; Pike, Andrea; Grunfeld, Eva; Manca, Donna.
Afiliação
  • Aubrey-Bassler K; Director, Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Canada kaubrey@mun.ca.
  • Fernandes C; Lead Coordinator, Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.
  • Penney C; Research Coordinator, Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Canada.
  • Cullen R; Research Coordinator, Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Canada.
  • Meaney C; Biostatistician, Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
  • Sopcak N; Qualitative Research Lead, Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.
  • Campbell-Scherer D; Professor, Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.
  • Moineddin R; Professor, Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
  • Baxter J; Research Program Coordinator, Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
  • Krueger P; Associate Professor, Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
  • Wilson M; Clinical Assistant Professor of Emergency Medicine, Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada.
  • Pike A; Research Manager, Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Canada.
  • Grunfeld E; Professor, Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
  • Manca D; Director, Knowledge Translation Research, Health Services Research Program, Ontario Institute for Cancer Research, Toronto, Canada.
BJGP Open ; 3(3)2019 Oct.
Article em En | MEDLINE | ID: mdl-31581121
ABSTRACT

BACKGROUND:

The Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER) randomised control trial (RCT) showed that the BETTER Program improved chronic disease prevention and screening (CDPS) by 32.5% in urban team-based primary care clinics.

AIM:

To evaluate outcomes from implementation of BETTER in diverse clinical settings. DESIGN &

SETTING:

An implementation study was undertaken to apply the CDPS intervention from the BETTER trial to diverse settings in BETTER 2. Patients aged 40-65 years were invited to enrol in the study from three clinics in Newfoundland and Labrador, Canada.

METHOD:

At baseline, eligibility for 27 CDPS actions (for example, cancer, diabetes and hypertension screening, lifestyle) was determined. Patients then met with a trained provider and prioritised goals to address their eligible CDPS actions. Providers received training in behaviour change theory and practice. Descriptive analysis of clinical outcomes and success factors were reported.

RESULTS:

A total of 154 patients (119 female and 35 male) had a baseline visit; 106 had complete outcome assessments, and the remainder had partial outcome assessments. At baseline, patients were eligible for a mean of 12.3 CDPS actions and achieved a mean of 6.0 (49%, 95% confidence intervals [CI] = 24% to 74%) at 6-month follow-up, including reduced hypertension (86% of eligible patients, 95% CI = 67% to 96%), weight control (51% of eligible patients, 95% CI = 42% to 60%), and smoking cessation (36% of eligible patients, 95% CI = 17% to 59%). Male, highly educated, and lower income individuals achieved a higher proportion of CDPS manoeuvers than their counterparts.

CONCLUSION:

Clinical outcomes from this implementation study were comparable with those of the prior BETTER RCT, providing support for the BETTER Program as an effective approach to CDPS in more diverse general practice settings.
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Screening_studies / Sysrev_observational_studies Idioma: En Revista: BJGP Open Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Screening_studies / Sysrev_observational_studies Idioma: En Revista: BJGP Open Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Canadá