Publications by authors named "Christine Fahim"

Background: The Comparison of Outcomes and Access to Care for Heart Failure (COACH) trial demonstrated that use of a point-of-care risk assessment tool and a rapid ambulatory transitional heart failure clinic led to significant reductions in death and cardiovascular hospitalisation among patients with acute heart failure. We report a process evaluation of COACH intervention and strategy implementation.

Methods: We conducted longitudinal interviews with staff to assess barriers and facilitators to COACH implementation.

View Article and Find Full Text PDF

Pharmacogenetic (PGx) testing can enhance drug safety, improve efficacy, and reduce the risk of toxicity. However, the implementation of PGx testing in Canadian pediatric oncology centers has been limited. To address this gap, the aim of this study was to assess the barriers and facilitators to implementing PGx testing for three oncology drugs in eight Canadian pediatric oncology centers and identify strategies that could be used to support PGx testing implementation.

View Article and Find Full Text PDF

Background And Objective: Real-world evidence (RWE) can complement and fill knowledge gaps from randomized controlled trials to assist in health-technology assessment (HTA) for regulatory decision-making. However, the generation of RWE is an intricate process with many sequential decision points, and different methods and approaches may impact the quality and reliability of evidence. Standardization and transparency in reporting these decisions is imperative to appraise RWE and incorporate it into HTA decision-making.

View Article and Find Full Text PDF

Background: Theories, models and frameworks (TMFs) are useful when implementing, evaluating and sustaining healthcare evidence-based interventions. Yet it can be challenging to identify an appropriate TMF for an implementation project. We developed and tested the usability of an online tool to help individuals who are doing or supporting implementation practice activities to identify appropriate models and/or frameworks to inform their work.

View Article and Find Full Text PDF

Introduction: Incorporating shared decision-making (SDM) with children and families in hospitals was a top priority identified by patients, caregivers, and clinicians. Bronchiolitis, a common and costly reason for hospitalization in children, is an exemplar condition to study SDM in hospitals. Internationally, clinical practice guidelines differ when recommending intravenous (IV or parenteral) or nasogastric (NG or enteral) fluids for hospitalized infants with bronchiolitis who are unsafe to be fed orally.

View Article and Find Full Text PDF

Objective: To describe stakeholder characteristics and perspectives about experiences, challenges and information needs related to the use of environmental scans (ESs).

Design: Cross-sectional study.

Setting And Participants: A web-based survey platform was used to disseminate an online survey to stakeholders who had experience with conducting ESs in a health services delivery context (eg, researchers, policy makers, practitioners).

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates why fascia iliaca compartment nerve blocks (FICBs) are not consistently used in hip fracture treatment, focusing on barriers and facilitators to timely administration.
  • Researchers conducted interviews with 35 stakeholders and identified 18 barriers and 11 facilitators related to FICB use, categorizing them using implementation frameworks.
  • After applying evidence-based strategies, the study found a significant increase in FICB administration rates (from 48% to 65%) and a reduction in the time taken to administer (from 1.63 days to 0.81 days).
View Article and Find Full Text PDF

Background: The concept of intersectionality proposes that demographic and social constructs intersect with larger social structures of oppression and privilege to shape experiences. While intersectionality is a widely accepted concept in feminist and gender studies, there has been little attempt to use this lens in implementation science. We aimed to supplement the Consolidated Framework for Implementation Research (CFIR), a commonly used framework in implementation science, to support the incorporation of intersectionality in implementation science projects by (1) integrating an intersectional lens to the CFIR; and (2) developing a tool for researchers to be used alongside the updated framework.

View Article and Find Full Text PDF

Objectives: To identify candidate quality indicators from existing tools that provide guidance on how to practice knowledge translation and implemenation science (KT practice tools) across KT domains (dissemination, implementation, sustainability, and scalability).

Study Design And Setting: We conducted a scoping review using the Joanna Briggs Institute Manual for Evidence Synthesis. We systematically searched multiple electronic databases and the gray literature.

View Article and Find Full Text PDF

Background: Lung cancer resection is associated with high rates of prolonged hospital stay. It is presumed that preconditioning with aerobic exercise can shorten the postoperative duration of hospital stay, but this has not yet been demonstrated in trials after lung cancer surgery. The aim of this study was to perform a RCT to determine whether Move For Surgery (MFS), a home-based and wearable technology-enhanced preconditioning program before lung cancer surgery, is associated with a lower incidence of prolonged hospital stay when compared to usual preoperative care.

View Article and Find Full Text PDF

Background: Few training opportunities or resources for non-expert implementers focus on the "practice" as opposed to the "science" of knowledge translation (KT). As a guide for novice implementers, we present an open-access, fillable workbook combining KT theories, models, and frameworks (TMFs) that are commonly used to support the implementation of evidence-based practices. We describe the process of creating and operationalizing our workbook.

View Article and Find Full Text PDF

Background: The Canadian Task Force on Preventive Health Care (task force) develops evidence-based preventive health care guidelines and knowledge translation (KT) tools to facilitate guideline dissemination and implementation. We aimed to determine practitioners' awareness of task force guidelines and KT tools and explore barriers and facilitators to their use.

Methods: The task force's KT team completed annual evaluations using surveys and interviews with primary care providers in Canada from 2014 to 2020, to assess practitioners' awareness and determinants of use of task force guidelines and tools.

View Article and Find Full Text PDF
Article Synopsis
  • * 158 randomized controlled trials (RCTs) with over 973,000 participants were analyzed to assess the sustainability, adherence, and fidelity of these interventions.
  • * Results indicate that while KT interventions generally improve quality of life, only a small percentage were evaluated for sustainability, adherence, and fidelity, indicating a need for further research in these areas.
View Article and Find Full Text PDF

Background: Clear, accurate, and transparent risk communication is critical to providing policy makers and the public with directions to effectively implement public health strategies during a health emergency.

Objective: We aimed to explore the public's preferred sources of obtaining COVID-19 information, perceptions on the prevalence and drivers of misinformation during the pandemic, and suggestions to optimize health communications during future public health emergencies.

Methods: We administered a web-based survey that included Likert scale, multiple choice and open-ended response questions to residents of Ontario, Canada.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic accelerated the spread of misinformation worldwide. The purpose of this study was to explore perceptions of misinformation and preferred sources of obtaining COVID-19 information from those living in Canada. In particular, we sought to explore the perceptions of East Asian individuals in Canada, who experienced stigma related to COVID-19 messaging.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic has led to stigmatization of individuals based on race/ethnicity, age, gender, and occupation, among other factors. We canvassed Canadian residents to explore perceptions of and experiences with stigma during the COVID-19 pandemic.

Methods: We conducted an online survey between June 10 and December 31 2020.

View Article and Find Full Text PDF

Background: Stigmatisation, misinformation and discrimination have been magnified globally due to the COVID-19 pandemic. The healthcare sector was not spared from this. We conducted a transnational study, using the Health Stigma and Discrimination framework (HSDF) to explore public perception and reactions to the COVID-19 pandemic in a multicultural context.

View Article and Find Full Text PDF

Objective: To synthesise results of mental health outcomes in cohorts before and during the covid-19 pandemic.

Design: Systematic review.

Data Sources: Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints.

View Article and Find Full Text PDF

Context: The objective of CHOICES (Community Heart Outcomes Improvement and Cholesterol Education Study) is to understand how evidence-informed cholesterol management can prevent cardiovascular disease (CVD) in 14 health regions at higher risk in Ontario, Canada using a suite of educational interventions. An integrated knowledge translation (IKT) approach was used to co-create an educational tool on CVD risk, behaviour modifications for cholesterol management, and cholesterol-lowering medications. In order to further understand the needs of Ontario residents related to CVD prevention, a process evaluation was conducted through engagement with the public.

View Article and Find Full Text PDF

Person-level surveillance (N = 14 million) and neighborhood-level income data were used to explore magnitude of inequalities in COVID-19 hospitalizations and deaths over 5 waves in Ontario, Canada. Despite attempts at equity-informed policies alongside fluctuating levels of public health measures, the magnitude of inequalities in hospitalizations and deaths remained unchanged across waves.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic fueled stigmatization and discrimination, particularly towards individuals of Chinese or East Asian ethnicity. We conducted interviews with members of the public in Canada in order to describe and understand stigma perceptions and experiences during the COVID-19 pandemic.

Methods: We used a phenomenological approach to describe stigma experiences of Canadian residents during the COVID-19 pandemic and compared the stigma perceptions and experiences of East Asian and non-East Asian individuals.

View Article and Find Full Text PDF

Background: Patients with acute heart failure are frequently or systematically hospitalized, often because the risk of adverse events is uncertain and the options for rapid follow-up are inadequate. Whether the use of a strategy to support clinicians in making decisions about discharging or admitting patients, coupled with rapid follow-up in an outpatient clinic, would affect outcomes remains uncertain.

Methods: In a stepped-wedge, cluster-randomized trial conducted in Ontario, Canada, we randomly assigned 10 hospitals to staggered start dates for one-way crossover from the control phase (usual care) to the intervention phase, which involved the use of a point-of-care algorithm to stratify patients with acute heart failure according to the risk of death.

View Article and Find Full Text PDF

Objective: The objective of this scoping review is to identify and characterize relevant knowledge translation methods tools (those that provide guidance for optimized knowledge translation practice) to uncover candidate quality indicators to inform a future quality assessment tool for knowledge translation strategies.

Introduction: Knowledge translation strategies (defined as including knowledge translation interventions, tools, and products) target various knowledge users, including patients, clinicians, researchers, and policy-makers. The development and use of strategies that support knowledge translation practice have been rapidly increasing, making it difficult for knowledge users to decide which to use.

View Article and Find Full Text PDF

Governments can use social media platforms such as Twitter to disseminate health information to the public, as evidenced during the COVID-19 pandemic [Pershad (2018)]. The purpose of this study is to gain a better understanding of Canadian government and public health officials' use of Twitter as a dissemination platform during the pandemic and to explore the public's engagement with and sentiment towards these messages. We examined the account data of 93 Canadian public health and government officials during the first wave of the pandemic in Canada (December 31, 2019 August 31, 2020).

View Article and Find Full Text PDF

Background: Disproportionate risks of COVID-19 in congregate care facilities including long-term care homes, retirement homes, and shelters both affect and are affected by SARS-CoV-2 infections among facility staff. In cities across Canada, there has been a consistent trend of geographic clustering of COVID-19 cases. However, there is limited information on how COVID-19 among facility staff reflects urban neighborhood disparities, particularly when stratified by the social and structural determinants of community-level transmission.

View Article and Find Full Text PDF