Soutien à la recherche et concours Félicitations aux 3 lauréat.e.s du concours soutien à la participation à des conférences internationales 2021-2022
Félicitations à Julie Bélanger, Owolabi Gaudens Pamphile Acakpo et Tierry Morel-Laforce - lauréat.e.s du concours de soutien à la participation à des conférences internationales 2021-2022! Découvrez leurs résumés ci-dessous!
Julie Bélanger (ULaval). “Tailoring a collaborative platform to develop decision aids and support their broad implementation”. International Conference on Communication in Health (ICCH 2021). 17-20 octobre 2021, affiche, virtuel
Auteur.e.s: Julie Bélanger; Jean Légaré; Carissa C. Bonner; Paulina Bravo; Philippe Després; Émilie Dionne; Philippe Fekete; Katherine Hastings; France Légaré; Karina Prévost; Kevin Selby; Dawn Stacey; Sharon Straus; Brett D. Thombs; Anik Giguère
Résumé
Introduction: We are creating a web-based platform to support the collaborative development of high-quality decision aids (DAs) by a diversity of stakeholders. In this project, we sought to describe the factors influencing sustainability of this platform. Methods: In this ongoing qualitative descriptive study, a user-centered design approach serves to tailor a mockup of the platform to users’ needs. Using the team members’ networks, we are recruiting 24 DA authors (e.g., researchers, clinicians, patient/citizen partners), from low-/middle-income, and high-income countries, who speak French, English or Spanish. Think-aloud sessions help assess the usability of the platform, and open-ended questions based on the Normalization Process Theory, its potential for sustainability. Thematic analyses sorting out the strengths/weaknesses of the platform support its adaptation. Evaluation/modification processes are replicated over several iterative cycles, to ensure delivery of the desired functionalities. Results: Of the five participants recruited so far, three were clinical researchers, one a researcher and one a patient. They had developed 2 to 10 DAs each. They appreciated that the platform could support collaborative DAs development with partners less familiar with shared decision making, and welcomed its editing/commenting functionalities. During think-aloud, navigation appeared intuitive. Adding an introduction was suggested to clarify the overall process. Participants proposed some strategies to inform authors of the IPDAS criteria and support them in their application. They also mentioned that the platform should support authors in considering patients’ needs. Discussion: Several functionalities are needed to support sustainability of the platform, e.g. to ensure a significant engagement of partners in the development process, to support compliance with IPDAS criteria, to allow creation of web-based and printable versions. We will therefore use an incremental development and validation process. Conclusion: This project will allow creating a collaborative platform that meet the needs of diverse stakeholders internationally.
Owolabi Gaudens Pamphile Acakpo (ULaval). “Implementation of an integrated care pathway in primary care clinics to improve the health of older adults: a realist evaluation”. NACIC2021 – 1st North American Conference on Integrated Care. 4-7 octobre 2021, communication orale, Toronto, Canada
Auteur.e.s : Owolabi Gaudens Pamphile Acakpo, Laval University (Primary Presenter) Émilie Dionne, Université Laval, Laeticia Coudert, Pôle animation et urbanisme au ministère de la Cohésion des territoires, Toulon, France Jacobi Elliott, University of Waterloo, Ontario, Canada Paul Stolee, University of Waterloo, Ontario, Canada Julie Fortin, Université Laval, Québec, Canada Pierre-Hugues Carmichael Susie Gregg, Canadian Mental Health Association Waterloo Wellington (CMHA WW) Joanie Sims-Gould, University of British Columbia, British Columbia, Canada Anik Giguere, Université Laval, Québec, Canada
Résumé
Introduction : Older adults look to their primary care practitioners to assess their needs and coordinate their care, but their health concerns are often missed in too-short office visits and appropriate referrals may not be made for further assessment or community services. We have therefore implemented a novel care pathway in primary care clinics, consisting of three integrated strategies: frailty screening using an interRAI instrument; shared decision-making to choose a treatment plan using decision aids; and facilitated access to specialized assessment and community resources using a novel digital platform. Aims, Objectives, Theory or Methods : We aimed to describe how, for whom and under what circumstances the proposed pathway was correctly implemented. We used a realist evaluation, based on mixed-methods. Four family medicine clinics in Quebec agreed to implement it. We asked older adults (aged 70+) rostered in these clinics, healthcare providers (HCPs), and clinic managers, to complete surveys before and after the implementation (CIHI providers and organizational surveys, PACIC,EQ-5D-5L). Interviews were conducted to understand and describe the factors influencing implementation fidelity. We usedmixed statistical models, inductive/deductive thematic analyses guided by the Consolidated Framework for Implementation Research. Findings were integrated into Context-Mechanism-Outcome configurations. Highlights or Results or Key Findings: We recruited 113 HCPs (73%women), 310 older adults (58%women, mean age 79.06 ±5.6SD). We conducted 34 interviews with a sample of older adults and eight focus groups (40participants) with HCPs and managers. Only one of the four participating clinics fully implemented the pathway. We found increased patient activation and pain/comfort after implementation. The clinic with full implementation showed, high fidelity in using screening (91% older adults), low fidelity in using decision aids (35%) and the referral platform (2%). Good collaboration between the implementation and clinical teams and co-designing the pathway (C), generated good perceptions and receptivity towards the pathway (M), leading to a better acceptability and adoption (O). Conversely, internal challenges (logistical, administrative, human resources) (C) led participants to perceive the pathway as requiring too many resources, as less of a priority and more likely to hinder their objective of accessibility and attendance to the clinic (M), leading to abandonment (O). Conclusions: Collaboration between the implementation and clinical teams, and promotion and support of the pathway at the organizational level, are key factors to implementation success of strategies to improve primary care of older adults. Implications for applicability/transferability, sustainability and limitations: Results of this study highlight the importance of good collaboration and user involvement in implementing similar integrated approaches. Obstacles encountered and lack of completion in study sites highlight the challenges of implementing strategies to enhance integrated care in primary care settings.
Tierry Morel-Laforce (UdeM). “Using an implementation research tool to guide the implementation of non invasive prenatal screening”. 14th World Conference on Bioethics, Medical Ethics & Health Law. 7-10 mars 2022, communication orale, Porto, Portugal
Résumé de l'auteur:
J’ai présenté une analyse préliminaire des résultats de ma thèse de doctorat. J’ai présenté une brève portion de l’analyse thématique que j’avais colligée. Compte tenu de l’ampleur des résultats des entrevues que j’ai faites, j’ai choisi de concentrer ma présentation sur 3 aspects de l’implantation du test génomique prénatal non invasif (TGPNI).
D’abord, j’ai contextualisé mon projet de recherche dans le contexte canadien. Étant devant un auditoire international qui n’était pas nécessairement spécialisé en dépistage prénatal, j’ai pris le temps de décrire ce qu’est le TGPNI et son utilisation au Canada. Mon auditoire a pu constater que l’implantation du TGPNI est inégale dans les provinces canadiennes alors que certaines remboursent son utilisation – dans certains cas – et que d’autres non.
Ensuite, j’ai rapidement couvert la méthodologie de mon projet de recherche. J’ai présenté brièvement l’outil de collecte de données utilisé – le consolidated framework for implementation research – et la méthode utilisée – entrevues semi-dirigées avec des professionnels de la santé.
Puis, j’ai présenté 3 aspects de l’implantation du TGPNI au Canada. Premièrement, les participants considèrent que le TGPNI est un meilleur outil que ce qui est présentement utilisé en première intention. Il ne peut toutefois pas remplacer les tests diagnostics ou les échographies. Deuxièmement, advenant une utilisation de première intention, ce seraient les professionnels de première ligne qui devraient l’offrir aux femmes enceintes, réduisant la pression sur les services spécialisés de génétique. Une telle avenue impliquerait que plus de professionnels devraient être informés au sujet du TGPNI et plus de femmes devront prendre une décision quant à son utilisation. Troisièmement, lors de l’implantation en deuxième intention, les professionnels se sont formés par eux-mêmes pour offrir le TGPNI. Je soulève donc la question à savoir si une formation similaire doit être attendue pour l’implantation en première intention.
