Browsing by Author "Hanson, Heather"
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- ItemOpen AccessKnowledge translation and health technology reassessment: identifying synergy(2018-08-30) Esmail, Rosmin; Hanson, Heather; Holroyd-Leduc, Jayna; Niven, Daniel J; Clement, FionaAbstract Background Health Technology Reassessment (HTR) is an emerging field that shifts the focus from traditional methods of technology adoption to managing technology throughout its lifecycle. HTR is a mechanism to improve patient care and system efficiency through a reallocation of resources away from low-value care towards interventions and technologies that are high value. To achieve this, the outputs of HTR and its recommendations must be translated into practice. The evolving field of knowledge translation (KT) can provide guidance to improve the uptake of evidence-informed policies and recommendations resulting from the process of HTR. This paper argues how the theories, models and frameworks from KT could advance the HTR process. Discussion First, common KT theories, models and frameworks are presented. Second, facilitators and barriers to KT within the context of HTR are summarized from the literature. Facilitators and barriers to KT include ensuring a solid research evidence-base for the technology under reassessment, assessing the climate and context, understanding the social an political context, initiating linkage and exchange, having a structured HTR Process, adequate resources, and understanding the roles of researchers, knowledge users, and stakeholders can enhance knowledge translation of HTR outputs. Third, three case examples at the individual (micro), organizational (meso), and policy (macro) levels are used to illustrate to describe how a KT theory, model or framework could be applied to a HTR project. These case studies show how selecting and applying KT theories, models and frameworks can facilitate the implementation of HTR recommendations. Conclusion HTR and KT are synergistic processes that can be used to optimize technology use throughout its lifecycle. We argue that the application of KT theories, models and frameworks, and the assessment of barriers and facilitators to KT can facilitate translation of HTR recommendations into practice.
- ItemOpen AccessSocial participation of older people in urban and rural areas: Canadian Longitudinal Study on Aging(2023-07-18) Jones, C. A.; Jhangri, Gian S.; Yamamoto, Shelby S.; Hogan, David B.; Hanson, Heather; Levasseur, Mélanie; Morales, Ernesto; Légaré, FranceAbstract Background and objectives Although the positive influence of social activity on health is now well-established, a complex relationship exists among social participation, personal, social and the environment. Social participation of older adults was examined in rural and urban settings to identify features of the built-environment and perception of neighborhood specific to the locale. Research Design and methods Using cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA), we examined social participation and health of older people (65 + yrs) in relation to the built environment and sociocultural contexts for urban and rural areas. A social participation index was derived from responses on the frequency of participating in 8 social activities over the past 12 months. Personal, household and neighborhood indicators were examined to develop multivariable regression models for social participation in urban and rural cohorts. Results No meaningful differences were seen with the frequency of social participation between rural and urban settings; however, the type of community-related activities differed in that a greater proportion of urban participants reported sports and educational/cultural events than rural participants. Service club activities were greater for rural than urban participants. Different neighborhood features were statistically significant factors in explaining social participation in rural than in urban locales, although transportation was a significant factor regardless of locale. Trustworthiness, belonging and safety were perceived factors of the neighborhood associated with higher social participation for rural participants. Discussion and implications The relationship between home and health becomes stronger as one ages. Social and physical features of built environment specific to urban and rural settings need to be considered when implementing appropriate social activities for older people.
- ItemOpen AccessUnderstanding How to Care about Indifference: A Multistep Approach to Apathy in Parkinson’s Disease(2018-06-08) Mele, Bria; Holroyd-Leduc, Jayna M.; Goodarzi, Zahra S.; Hanson, Heather; Pringsheim, Tamara M.; Ismail, ZahinoorBackground: Apathy is a complex and heterogeneous symptom in Parkinson’s disease (PD). It is present in 17 – 70% of persons with PD. Limited information is available on how to define, diagnose, and subsequently manage apathy in PD. Objectives: To firstly synthesize all available knowledge on apathy in PD to assess what is currently known and where gaps exist. Secondly, we aimed to assess barriers and facilitators to the use of this knowledge clinically. Methods: A scoping review based on literature from six databases and extensive grey literature search was completed, examining the diagnosis, treatment, and management of apathy in PD. In focus groups and interviews with stakeholders, we assessed barriers and facilitators to the use of this knowledge. Results: A large body of literature exists on apathy in PD, however key gaps limit the use of knowledge. Gaps include the lack of an accepted apathy definition and limited treatment options. Health care practitioners feel limited in their ability to diagnose apathy without validated screening–tools. Patients and caregivers identified awareness of apathy and planning their days as key facilitators to diagnosis and management. Conclusions: Our findings highlight the importance of developing a broad understanding of available literature and the associated gaps, and the key role that stakeholders play in identifying where further research is required most. Our findings will aid in future research directed at the development of an apathy definition and management focused on non-pharmacological interventions.
- ItemOpen AccessUnderstanding the Barriers to Guideline Use for Depression & Anxiety in Patients with Parkinson's Disease and Dementia.(2016) Goodarzi, Zahra; Holroyd-Leduc, Jayna M.; Hanson, Heather; Jette, Nathalie; Patten, Scott; Pringsheim, TamaraBackground: Depression or anxiety are under-diagnosed and under-treated in those with dementia or Parkinson’s disease (PD). Objectives: The objectives of this thesis were to first understand what high quality guideline recommendations exist for depression or anxiety in dementia or PD. Secondly to explore the barriers and facilitators to implementing these guidelines. Methods: A systematic review of guidelines was completed, following the PRISMA statement and using the AGREE II tool to assess quality. In focus groups with stakeholders, we assessed the barriers and facilitators to guideline use and implementation. Results: Guideline quality scores were lowest for stakeholder involvement, applicability, and editorial independence. Major barriers to use included a lack of evidence, lack of applicability to the practice population, impractical or out of date recommendations. Conclusions: There are guideline recommendations for depression or anxiety in dementia and PD. However, practitioners have difficulty with implementation due to a lack of evidence and applicability.