Hockey Fans in Training (Hockey FIT): Rationale, design, and baseline characteristics from a cluster randomized controlled trial in men with overweight or obesity.

BACKGROUND: Previous research highlights the need for effective lifestyle interventions for men. Hockey Fans in Training (Hockey FIT) was developed as a pragmatic healthy lifestyle program tailored to men with overweight or obesity. This paper overviews the rationale, program details, and design of a recently completed cluster randomized controlled trial (RCT) of Hockey FIT. Participant engagement and baseline characteristics are also described. METHODS: The RCT evaluated the effectiveness, cost-effectiveness, and implementation of Hockey FIT. Forty-two sites in Canada and the United States were randomized to either the Hockey FIT intervention group or wait-list control group. Participants were men, aged 35-65 years, with a body mass index (BMI) ≥27 kg/m2. Hockey FIT is a group-based, off-ice, in-person healthy lifestyle program, including both a 3-month active phase and a 9-month minimally-supported phase. Outcomes were assessed at baseline, 3, and 12 months. The primary outcome was weight loss at 12 months. RESULTS: The design of the cluster RCT incorporates evaluations of participant health outcomes, program implementation, and broader healthcare system impact. In the RCT, 1397 participants were assessed for eligibility and 997 were enrolled. Most participants heard about the program through social media or hockey team emails. Participants averaged 49 years of age, had BMI values of 35.3 kg/m2, were predominately white, and had varying levels of education. CONCLUSION: The intended audience for Hockey FIT was recruited successfully, however, targeted recruitment to better engage diverse populations is warranted. This paper affords a useful outline for evaluating future lifestyle interventions tailored to men. This trial was registered on August 17, 2018 with ClinicalTrials.gov (identifier: NCT03636282).

A Digital-First Health Care Approach to Managing Pandemics: Scoping Review of Pandemic Self-triage Tools.

BACKGROUND: During the COVID-19 pandemic, many patient-facing digital self-triage tools were designed and deployed to alleviate the demand for pandemic virus triage in hospitals and physicians' offices by providing a way for people to self-assess their health status and get advice on whether to seek care. These tools, provided via websites, apps, or patient portals, allow people to answer questions, for example, about symptoms and contact history, and receive guidance on appropriate care, which might be self-care. OBJECTIVE: This scoping review aimed to explore the state of literature on digital self-triage tools that direct or advise care for adults during a pandemic and to explore what has been learned about the intended purpose, use, and quality of guidance; tool usability; impact on providers; and ability to forecast health outcomes or care demand. METHODS: A literature search was conducted in July 2021 using MEDLINE, Embase, Scopus, PsycINFO, CINAHL, and Cochrane databases. A total of 1311 titles and abstracts were screened by 2 researchers using Covidence, and of these, 83 (6.76%) articles were reviewed via full-text screening. In total, 22 articles met the inclusion criteria; they allowed adults to self-assess for pandemic virus, and the adults were directed to care. Using Microsoft Excel, we extracted and charted the following data: authors, publication year and country, country the tool was used in, whether the tool was integrated into a health care system, number of users, research question and purpose, direction of care provided, and key findings. RESULTS: All but 2 studies reported on tools developed since early 2020 during the COVID-19 pandemic. Studies reported on tools that were developed in 17 countries. The direction of care advice included directing to an emergency room, seeking urgent care, contacting or seeing a physician, being tested, or staying at home and self-isolating. Only 2 studies evaluated tool usability. No study demonstrated that the tools reduce demand on the health care system, although at least one study suggested that data can predict demand for care and that data allow monitoring public health. CONCLUSIONS: Although self-triage tools developed and used around the world have similarities in directing to care (emergency room, physician, and self-care), they differ in important ways. Some collect data to predict health care demand. Some are intended for use when concerned about health status; others are intended to be used repeatedly by users to monitor public health. The quality of triage may vary. The high use of such tools during the COVID-19 pandemic suggests that research is needed to assess and ensure the quality of advice given by self-triage tools and to assess intended or unintended consequences on public health and health care systems.

Humor in rehabilitation professions: a scoping review.

PURPOSE: Studying humor in the rehabilitation professions is important given its positive effects on health and well-being. We conducted a scoping review to understand how the use of humor has been explored in the existing literature in four rehabilitation professions. The rehabilitation professions included audiology, speech-language pathology, physical therapy, and occupational therapy. MATERIALS AND METHODS: The five-stage method identified by Arksey and O'Malley was used to conduct this review. Six databases were searched. We included 57 articles in our final review, summarized in a narrative synthesis. RESULTS: We generated seven themes in our analysis: (1) humour as a management strategy in therapy; (2) humour as a power establisher vs. equalizer; (3) humour as a coping mechanism in rehabilitation; (4) conceptualizations of non-verbal humor cues in therapy; (5) Is humour trainable? (6) Humor used to foster group cohesion; and (7) Attitudes and beliefs surrounding humor practice. CONCLUSIONS: Our findings emphasize the importance of using humor in the rehabilitation professions, and the ways in which humor is conceptualized in a multitude of ways for both clinician and client. Future work is needed to further understand the presence and use of humor in rehabilitation professions.IMPLICATIONS FOR REHABILITATIONIn a scoping review of the literature, this study showed that humor was used mainly positively in rehabilitation by the included professions of audiology, speech-language pathology, physical therapy, and occupational therapy and contributed to a sense of belonging.Humor may be an effective way to improve management of client/clinician relations as well as improving group cohesion in rehabilitation settings.In the rehabilitation professions of audiology, speech-language pathology, physical therapy, and occupational therapy, non-verbal humor cues were used in instances where communication was difficult or impaired for clients.