Medicine and Health Sciences Commons^™

Global Alliance For The Promotion Of Physical Activity: The Hamburg Declaration., Jürgen M Steinacker, Willem Van Mechelen, Wilhelm Bloch, Mats Börjesson, Maurizio Casasco, Bernd Wolfarth, Carolin Knoke, Theodora Papadopoulou, Janine Wendt, Hashel Al Tunaiji, Dietrich Andresen, Olena Andrieieva, Norbert Bachl, Victoriya Badtieva, Friedhelm J Beucher, Cheri A Blauwet, Jose-Antonio Casajus Mallen, Ju-Ho Chang, German Clénin, Naama Constantini, Demitri Constantinou, Luigi Di Luigi, Lukas Declercq, Stephane Doutreleau, Svitlana Drozdovska, Martine Duclos, Andrea Ermolao, Thomas Fischbach, Anastasia N Fischer, Chiara Fossati, Jeorge Franchella, Mark Fulcher, Jan C Galle, Christian Gerloff, Evelina Georgiades, Boris Gojanovic, Marcela González Gross, Andy Grote, Martin Halle, Hans Hauner, Matthew Payton Herring, Mikio Hiura, Kerstin Holze, Gerhard Huber, David Hughes, Mark R Hutchinson, Anca Ionescu, Dina Christina Janse Van Rensburg, Anna Jegier, Natasha Jones, Kirsten Kappert-Gonther, Monika Kellerer, Yutaka Kimura, Agrita Kiopa, Bernd Kladny, Gerhard Koch, Elin Kolle, Greg Kolt, Yiannis Koutedakis, Stephan Kress, Susi Kriemler, Jens Kröger, Christian Kuhn, Roman Laszlo, Ralph Lehnert, François J Lhuissier, Kerstin Lüdtke, Shigeru Makita, Pedro Manonelles Marqueta, Winfried März, Kirill Micallef-Stafrace, Mike Miller, Melita Moore, Erich Müller, Daniel Neunhäuserer, I Renay Onur, Vahur Ööpik, Malgorzata Perl, Anastassios Philippou, Hans-Georg Predel, Sebastien Racinais, Algirdas Raslanas, Ruediger Reer, Klaus Reinhardt, Claus Reinsberger, Sandra Rozenstoka, Robert Sallis, Luis B Sardinha, Martin Scherer, Jasper Schipperijn, Romain Seil, Benedict Tan, Arno Schmidt-Trucksäss, Nils Schumacher, Bernhard Schwaab, Ansgar Schwirtz, Masato Suzuki, Jeroen Swart, Ralph Tiesler, Ulf Tippelt, Eleanor Tillet, Jane Thornton, Bulent Ulkar, Eve Unt, Evert Verhagen, Thomas Weikert, Roberto Vettor, Sheng Zeng, Richard Budgett, Lars Engebretsen, Ugur Erdener, Fabio Pigozzi, Yannis P Pitsiladis

Family Medicine Publications

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the 'Hamburg Declaration'. This represented an international commitment to take all necessary actions to …

Female Athlete Health Domains: A Supplement To The International Olympic Committee Consensus Statement On Methods For Recording And Reporting Epidemiological Data On Injury And Illness In Sport., Isabel S Moore, Kay M Crossley, Kari Bo, Margo Mountjoy, Kathryn E Ackerman, Juliana Da Silva Antero, Jorunn Sundgot Borgen, Wendy J Brown, Caroline S Bolling, Benjamin Clarsen, Wayne Derman, Paul Dijkstra, Amber Donaldson, Kirsty J Elliott-Sale, Carolyn A Emery, Lene Haakstad, Astrid Junge, Nonhlanhla S Mkumbuzi, Sophia Nimphius, Debbie Palmer, Mireille Van Poppel, Jane S Thornton, Rita Tomás, Phathokuhle C Zondi, Evert Verhagen

Family Medicine Publications

The IOC made recommendations for recording and reporting epidemiological data on injuries and illness in sports in 2020, but with little, if any, focus on female athletes. Therefore, the aims of this supplement to the IOC consensus statement are to (i) propose a taxonomy for categorisation of female athlete health problems across the lifespan; (ii) make recommendations for data capture to inform consistent recording and reporting of symptoms, injuries, illnesses and other health outcomes in sports injury epidemiology and (iii) make recommendations for specifications when applying the Strengthening the Reporting of Observational Studies in Epidemiology-Sport Injury and Illness Surveillance (STROBE-SIIS) …

Hockey Fans In Training (Hockey Fit): Rationale, Design, And Baseline Characteristics From A Cluster Randomized Controlled Trial In Men With Overweight Or Obesity., Robert J Petrella, Dawn P Gill, Marisa Kfrerer, Brendan Riggin, Melissa Majoni, Wendy Blunt, Brooke Bliss, Narlon Cassio Boa Sorte Silva, Paul S Aspinall, Precious Adekoya, Matthew Dinunzio, Jacquelyn Marsh, Guangyong Zou, Jennifer D Irwin

Family Medicine Publications

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 …

Calling For Improved Equity, Diversity And Inclusion In Sport And Exercise Medicine – It Starts With Us, Jane S. Thornton, Lee Schofield, Victor Lun

Family Medicine Publications

No abstract provided.

Beyond The Medals: A Cross-Sectional Study Exploring Retired Elite Female Athletes' Health., Jane Thornton, Casey Rosen, Margie Davenport, Margo Lynn Mountjoy, Paul Dorian, Vincent Gouttebarge, Becky Breau, Eva Pila, Kristen Reilly, Jane Yuan, Kelly Mok, Steve Di Ciacca, Mark Speechley, Kay Crossley

Family Medicine Publications

OBJECTIVES: Little is known about the impact of elite sport participation on long-term athlete health. We aimed to: (1) describe musculoskeletal, mental health, reproductive/endocrine and cardiovascular characteristics in retired elite female athletes and compare to the general population and (2) explore athletes' perceptions of their elite sport participation and its impact on health.

METHODS: A 136-item online questionnaire was disseminated to Canadian elite female rowing and rugby athletes >18 years old, >2 years retired from elite competition. Matched general population data were obtained from Statistics Canada when available.

RESULTS: Seventy-four (24% response rate) athletes (average age 45 (±9) years; retired …

A Framework To Support The Progressive Implementation Of Integrated Team-Based Care For The Management Of Copd: A Collective Case Study, Shannon L. Sibbald, Vaidehi Misra, Madelyn Dasilva, Christopher Licskai

Family Medicine Publications

Background In Canada, there is widespread agreement about the need for integrated models of team-based care. However, there is less agreement on how to support the scale-up and spread of successful models, and there is limited empirical evidence to support this process in chronic disease management. We studied the supporting and mitigating factors required to successfully implement and scale-up an integrated model of team-based care in primary care. Methods We conducted a collective case study using multiple methods of data collection including interviews, document analysis, living documents, and a focus group. Our study explored a team-based model of care for …

Moving Forward Together For Maximum Impact: Research In Sport And Exercise Medicine Demands A Team Effort!, Jane S. Thornton, Luc De Garie, Cathy Campbell

Family Medicine Publications

No abstract provided.

Family Physician Clinical Inertia In Managing Hypoglycemia, Caroline V.M. Rebicki, Bridget L. Ryan, Alexandria Ratzki-Leewing, Paul F. Tremblay, Stewart B. Harris

Family Medicine Publications

Aims: Clinical inertia behaviour affects family physicians managing chronic disease such as diabetes. Literature addressing clinical inertia in the management of hypoglycemia is scarce. The objectives of this study were to create a measurement for physician clinical inertia in managing hypoglycemia (ClinInert_InHypoDM), and to determine physicians’ characteristics associated with clinical inertia. Methods: The study was a secondary analysis of data provided by family physicians from the InHypo-DM Study, applying exploratory factor analysis. Principal axis factoring with an Oblimin rotation was employed to detect underlying factors associated with physician behaviors. Multiple linear regression was used to determine association between the ClinInert_InHypoDM …

The Prevalence Of Multimorbidity In Primary Care: A Comparison Of Two Definitions Of Multimorbidity With Two Different Lists Of Chronic Conditions In Singapore, Eng Sing Lee, Poay Sian Sabrina Lee, Ying Xie, Bridget L. Ryan, Martin Fortin, Moira Stewart

Family Medicine Publications

Background: The prevalence of multimorbidity varies widely due to the lack of consensus in defining multimorbidity. This study aimed to measure the prevalence of multimorbidity in a primary care setting using two definitions of multimorbidity with two different lists of chronic conditions. Methods: We conducted a cross-sectional study of 787,446 patients, aged 0 to 99 years, who consulted a family physician between July 2015 to June 2016. Multimorbidity was defined as ‘two or more’ (MM2+) or ‘three or more’ (MM3+) chronic conditions using the Fortin list and Chronic Disease Management Program (CDMP) list of chronic conditions. Crude and standardised prevalence …

Primary Care Bonus Payments And Patient-Reported Access In Urban Ontario: A Cross-Sectional Study, Kamila Premji, Ewa Sucha, Richard H. Glazier, Michael E. Green, Walter P. Wodchis, William E. Hogg, Tara Kiran, Eliot Frymire, Thomas R. Freeman, Bridget L. Ryan

Family Medicine Publications

BACKGROUND: Rurality strongly correlates with higher pay-for-performance access bonuses, despite higher emergency department use and fewer primary care services than in urban settings. We sought to evaluate the relation between patient-reported access to primary care and access bonus payments in urban settings. METHODS: We conducted a cross-sectional, secondary data analysis using Ontario survey and health administrative data from 2013 to 2017. We used administrative data to calculate annual access bonuses for eligible urban family physicians. We linked this payment data to adult (≥ 16 yr) patient data from the Health Care Experiences Survey to examine the relation between access bonus …

Are Family Medicine Residents Trained To Counsel Patients On Physical Activity? The Canadian Experience And A Call To Action., Jane Thornton, Karim Khan, Richard Weiler, Christopher Mackie, Robert Petrella

Family Medicine Publications

Physical inactivity is a leading risk factor for non-communicable diseases (NCDs) and early mortality. Family physicians have an important role in providing physical activity counselling to patients to help prevent and treat NCDs. Lack of training on physical activity counselling is a barrier in undergraduate medical education, yet little is known regarding physical activity teaching in postgraduate family medicine residency. We assessed the provision, content and future direction of physical activity teaching in Canadian postgraduate family medicine residency programs to address this data gap. Fewer than half of Canadian Family Medicine Residency Programme directors reported providing structured physical activity counselling …

Environmental Scan Of Primary Care Needs In The Last Decade (2010-2020), Ravninder Bahniwal

Family Medicine Publications

No abstract provided.

Primary Care Informatics Response To Covid-19 Pandemic: Adaptation, Progress, And Lessons From Four Countries With High Ict Development, Siaw Teng Liaw, Craig Kuziemsky, Richard Schreiber, Jitendra Jonnagaddala, Harshana Liyanage, Aliasgar Chittalia, Ravninder Bahniwal, Jennifer W. He, Bridget L. Ryan, Daniel J. Lizotte, Jacqueline K. Kueper, Amanda L. Terry, Simon De Lusignan

Family Medicine Publications

OBJECTIVE: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned. METHODS: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives. RESULTS: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID …

Development Of A Primary Care Pandemic Plan Informed By In-Depth Policy Analysis And Interviews With Family Physicians Across Canada During Covid-19: A Qualitative Case Study Protocol, Maria Mathews, Sarah Spencer, Lindsay Hedden, Emily Gard Marshall, Julia Lukewich, Leslie Meredith, Dana Ryan, Richard Buote, Tiffany Liu, Emily Volpe, Paul S. Gill, Bridget Ryan, Gordon Schacter, Jamie Wickett, Thomas R. Freeman, Shannon L. Sibbald, Eric Wong, Maddi Mckay, Rita Mccracken, Judith Belle Brown

Family Medicine Publications

Introduction Given the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing pandemic plans in Canada, however, do not adequately incorporate family physicians' roles and perspectives. This policy and planning oversight has become increasingly evident with the emergence of the novel coronavirus disease, COVID-19, pandemic. This study is designed to inform the development of pandemic plans for primary care through evidence from four provinces in Canada: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario. Methods and analysis We will employ …

Systematic Review On The Instruments Used For Measuring The Association Of The Level Of Multimorbidity And Clinically Important Outcomes, Eng Sing Lee, Hui Li Koh, Elaine Qiao Ying Ho, Sok Huang Teo, Fang Yan Wong, Bridget L. Ryan, Martin Fortin, Moira Stewart

Family Medicine Publications

Objectives There are multiple instruments for measuring multimorbidity. The main objective of this systematic review was to provide a list of instruments that are suitable for use in studies aiming to measure the association of a specific outcome with different levels of multimorbidity as the main independent variable in community-dwelling individuals. The secondary objective was to provide details of the requirements, strengths and limitations of these instruments, and the chosen outcomes. Methods We conducted the review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number: CRD42018105297). We searched MEDLINE, Embase and CINAHL electronic databases …

The Prevalence Of Physical Multimorbidity Among People With Non-Affective Psychotic Disorders 10 Years After First Diagnosis: A Matched Retrospective Cohort Study, Myanca Rodrigues, Saverio Stranges, Bridget L. Ryan, Kelly K. Anderson

Family Medicine Publications

Aims: The higher prevalence of chronic physical health conditions among people with psychotic disorders may result in a reduced life expectancy as compared to the general population. More research is needed on the risk of multiple co-occurring chronic health conditions, known as multimorbidity, for people with psychotic disorders.

Methods: We conducted a matched retrospective cohort study to quantify the prevalence of multimorbidity and associated factors among people with psychotic disorders over the 10-year period following first diagnosis, relative to those without psychosis. Data from an early psychosis intervention program in London, Canada were linked to population-based health administrative data to …

Pilot Study Of Mental Health And Substance Use Of Detained Youths In Ontario, Canada, Evelyn R. Vingilis, Shannon Stewart, Hayley A. Hamilton, Jane Seeley, Kathleen M. Einarson, Nathan J. Kolla, Susan J. Bondy, Patricia G. Erickson

Family Medicine Publications

Detained youth display substantive mental health and substance use problems. However, Canadian information is limited. The purpose of this study was (1) to assess mental health and substance use problems of youth in residential detention/custody facilities in Ontario, Canada, at intake, using the interRAI Youth Justice in Custodial Facilities (YJCF), and (2) to explore the added value of using the YJCF in addition to the facilities’ standard intake tool. This paper presents the findings of this pilot study. Drawing on all 20 youth secure custody facilities in Ontario, Canada, two groups were created through stratified random group assignment: 10 intervention …

The Healthesteps™ Lifestyle Prescription Program To Improve Physical Activity And Modifiable Risk Factors For Chronic Disease: A Pragmatic Randomized Controlled Trial., Dawn P. Gill, W Blunt, N C Boa Sorte Silva, C Stiller-Moldovan, G Y Zou, R J Petrella

Family Medicine Publications

BACKGROUND: Our objective was to determine the influence of the HealtheSteps™ lifestyle prescription program on physical activity and modifiable risk factors for chronic disease in individuals at risk.

METHODS: One hundred eighteen participants were recruited from 5 sites in Southwestern Ontario, Canada and randomized to either the intervention (HealtheSteps™ program, n = 59) or a wait-list control group (n = 59). The study comprised three phases: an Active Phase (0 to 6 months) consisted of bi-monthly in-person lifestyle coaching with access to a suite of eHealth technology supports (Heathesteps app, telephone coaching and a private HealtheSteps™ social network) followed by …

Hockey Fans In Training (Hockey Fit) Pilot Study Protocol: A Gender-Sensitized Weight Loss And Healthy Lifestyle Program For Overweight And Obese Male Hockey Fans, Dawn P. Gill, Wendy Blunt, Ashleigh De Cruz, Brendan Riggin, Kate Hunt, Guangyong Zou, Shannon Sibbald, Karen Danylchuk, Merrick Zwarenstein, Cindy M. Gray, Sally Wyke, Christopher Bunn, Robert J. Petrella

Family Medicine Publications

Background:

Effective approaches that engage men in weight loss and lifestyle change are important because of worldwide increases, including in Canada, in obesity and chronic diseases. Football Fans in Training (FFIT), developed in Scotland, successfully tackled these problems by engaging overweight/obese male football fans in sustained weight loss and positive health behaviours, through program deliveries at professional football stadia.

Methods:

Aims: 1) Adapt FFIT to hockey within the Canadian context and integrate with HealtheSteps™ (evidence-based lifestyle program) to develop Hockey Fans in Training (Hockey FIT); 2) Explore potential for Hockey FIT to help overweight/obese men lose weight and improve other …

The Impact Of Childhood Symptoms Of Conduct Disorder On Driver Aggression In Adulthood, Christine Wickens, Evelyn R. Vingilis, Robert Mann, Patricia Erickson, Maggie Toplak, Natan Kolla, Jane Seeley, Anca Ialomiteanu, Gina Stoduto, Gabriela Ilie

Family Medicine Publications

Background: Despite limited empirical investigation, existing scientific literature suggests that individuals with a history or current diagnosis of conduct disorder (CD) may be more likely to demonstrate reckless and aggressive driving. Much of the limited research in this field examines the impact of childhood CD on driver behaviour and collision risk in young adults. Few, if any, studies assess the impact of this disorder on driver behaviour beyond age 21 years. The current research is a population-based study of the impact of CD symptoms during childhood on the risk of engaging in driver aggression during adulthood.

Methods: Data are based …

Public Health Guidelines For Physical Activity: Is There An App For That? A Review Of Android And Apple App Stores, Emily Knight, Melanie I Stuckey, Harry Prapavessis, Robert Petrella

Family Medicine Publications

BACKGROUND: Physical activity participation is an important behavior for modifying lifestyle-related disease risk. Mobile health apps for chronic disease management and prevention are being developed at a rapid rate. However, it is unclear whether these apps are evidence-based. Current public health recommendations for physical activity participation for adults highlight the importance of engaging in 150 minutes weekly of purposeful exercise, and muscle strengthening activities on at least 2 days of the week.

OBJECTIVE: The aims of the present review were to (1) identify available evidence-based physical activity apps, and (2) identify technological features that could be leveraged to improve health …

Attention Deficit Hyperactivity Disorder, Other Mental Health Problems, Substance Use And Driving: Examination Of A Population-Based, Representative Canadian Sample, Evelyn R. Vingilis, Robert Mann, Pat Erickson, Maggie Toplak, Nathan Kolla, Jane Seeley, Umesh Jain

Family Medicine Publications

Purpose: The purpose of this study is to examine the relationships among self-reported screening measures of ADHD, other psychiatric problems, and driving-related outcomes in a provincially

representative sample of adults 18 years and older living in the province of Ontario, Canada.

Methods: The study examined the results of the Centre for Addictions and Mental Health (CAMH) Ontario Monitor, an ongoing repeated cross-sectional telephone survey of Ontario adults over a two year period. Measures: ADHD measures (Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1), previous ADHD diagnosis, ADHD medication use); psychiatric distress measures (General Health Questionnaire (GHQ12), pain, anxiety and depression medication use); antisocial …