Implementing Screening, Brief Intervention and Referral Intervention for Health Promotion and Disease Prevention in Hospital Settings in Alberta: A Pilot Study.

Objective: This study assessed the feasibility of implementing screening, brief intervention and referral (SBIR) intervention in hospital settings. Methods: This cross-sectional study evaluated the implementation of the SBIR intervention in a hospital in Alberta for tobacco use, alcohol intake, physical inactivity, and insufficient vegetable and fruit consumption. Patients were interviewed approximately 4-month later to collect data on the acceptability and effectiveness of the intervention received (n = 108). The data were primarily analyzed using descriptive statistics. Results: Of 108 patients, >80% agreed that "they were ok with being screened" for the risk factors during their hospital visit. Up to 68% of patients recalled the provider's brief education. At the follow-up, 20% of patients quit tobacco, 50% reduced alcohol use, 30% increased physical activity, and 25% increased vegetable and fruit intake. Conclusion: Risk factor screening was acceptable for patients. Patients recalled the brief education they received from healthcare providers. Patients reported risk-reducing changes in their risk factors. Our future work will integrate the SBIR approach within the Electronic Clinical Information System and use robust research methods to investigate the impact of SBIR on patients' behavior change.

Interventions to Increase Colorectal Cancer Screening Uptake in Primary Care: A Systematic Review.

OBJECTIVE: We systematically reviewed and summarized previous studies that examined facilitators and barriers to implementing interventions to increase CRCS uptake in primary care practice. METHODS: We searched PubMed, Medline (EBSCO), and CINAHL databases, from the inception of these databases to April 2020. The search strategy combined a set of terms related to facilitators/barriers, intervention implementation, CRCS, and uptake/participation. A priori set inclusion and exclusion criteria were used during both title/abstract screening and full-text screening phases to identify the eligible studies. Quality of the included studies was appraised using quality assessment tools, and data were extracted using a predetermined data extraction tool. We classified facilitators and barriers according to the Consolidated Framework for Implementation Research domains and constructs and identified the common facilitators and barriers looking at how common they were across studies. RESULTS: A total of 12 studies were included in the review. Engagement of the clinic team, leadership team, and partners, clinics' motivation to improve CRCS rates, use of the EMR system, continuous monitoring and feedback system, and having a supportive environment for implementation were the most commonly reported implementation facilitators. Limited time for the clinic team to devote to a new project, challenges in getting accurate, timely data related to CRCS, limited capacity/support to use the EMR system, and disconnect between clinic team members were the most commonly reported implementation barriers. CONCLUSIONS: The synthesized findings improve our understanding of facilitators of and barriers to the implementation of interventions to increase CRCS participation in primary care practice, and inform the customized implementation strategies. Many of the included studies had limited use of rigorous implementation science frameworks to guide their implementation and evaluation, which precludes a comprehensive understanding of the implementation factors specific to CRCS interventions in primary care. Future studies assessing the CRCS intervention implementation factors would benefit from the use of implementation science frameworks.

Which literacy for health promotion: health, food, nutrition or media?

Education and literacy are important aspects of health promotion. The potential for health literacy to promote healthier choices has been widely examined, with studies variously incorporating food literacy, nutrition literacy and/or media literacy as components of health literacy, rather than treating each as unique concepts for health promotion. This study examines similarities and differences across health literacy, food literacy, nutrition literacy and health-promoting media literacy to highlight how each literacy type theorizes the relationship between education and health. A meta-review of existing scoping and systematic reviews examining literacy conceptualizations was conducted to examine the four literacies. Representative concept definitions were extracted and key competencies (or skills) and desired consequences were identified and grouped into subcategories for analysis. This study located 378 articles, of which 17 scoping/systematic reviews were included (10 for health literacy, 3 for food, 1 for nutrition and 3 for media). Representative concept definitions of the four literacy types revealed three skill categories (information acquisition, information analysis, and the application of information) and three categories of desired consequences (knowledge, attitudes and behaviors), with each of the four literacy types emphasizing varied collections of skills and desired consequences. Despite perceived similarities in content, health, food, nutrition and media literacy conceptualize the relationship between education and health differently, emphasizing the distinct types of knowledge to promote health-related outcomes. A better understanding of the differences between these four literacies will lead to informed decision making for researchers, educators and health practitioners in intervention design and implementation.