Case management in primary healthcare for people with complex needs to improve integrated care: a large-scale implementation study protocol.

Introduction: Case management (CM) is among the most studied effective models of integrated care for people with complex needs. The goal of this study is to scale up and assess CM in primary healthcare for people with complex needs.

Methods And Analysis: The research questions are: (1) which mechanisms contribute to the successful scale-up of CM for people with complex needs in primary healthcare?; (2) how do contextual factors within primary healthcare organisations contribute to these mechanisms? and (3) what are the relationships between the actors, contextual factors, mechanisms and outcomes when scaling-up CM for people with complex needs in primary healthcare? We will conduct a mixed methods Canadian interprovincial project in Quebec, New-Brunswick and Nova Scotia.

A scoping review of obesity education interventions for current and prospective medical professionals in Canada.

Background: Obesity is a prevalent chronic disease in Canada. Individuals living with obesity frequently interact with medical professionals who must be prepared to provide evidence-based and person-centred care options. The purpose of this scoping review was to summarize existing educational interventions on obesity in Canada for current and prospective medical professionals and to identify key future directions for practice and research.

Transforming the landscape of obesity education - The Canadian obesity education competencies.

Background: With ongoing gaps in obesity education delivery for health professions in Canada and around the world, a transformative shift is needed to address and mitigate weight bias and stigma, and foster evidence-based approaches to obesity assessment and care in the clinical setting. Obesity Canada has created evidence-based obesity competencies for medical education that can guide curriculum development, assessment and evaluation and be applied to health professionals' education programs in Canada and across the world.

Methods: The Obesity Canada Education Action Team has seventeen members in health professions education and research along with students and patient experts.

Virtual interprofessional (VIP) education, a family medicine-occupational therapy-physiotherapy collaborative experience: the perspectives of patients, learners and providers on the opportunities and challenges.

This study examined the experiences of patients, Occupational Therapy (OT), Physiotherapy (PT) and Medicine learners, Providers, and Faculty, in implementing a Virtual Interprofessional (VIP) education initiative in two academic Family Medicine (FM) collaborative clinics. A qualitative descriptive study drew on a strength-based approach as part of the evaluation of the interfaculty VIP initiative. Participants involved in VIP care were conveniently sampled.

Patient-Perceived Patient-Centeredness During Pregnancy.

Objectives: Although patient-centeredness is a pinnacle in high-quality healthcare, there is a lack of research measuring patient-centeredness from the perspective of the patient in the context of perinatal care. Therefore, the objectives of this study were to (1) measure patient-perceived patient-centeredness from pregnant people receiving prenatal care in Nova Scotia, and (2) explore potential correlates of patient-perceived patient-centeredness.

Methods: Participants completed an e-survey through REDCap software.

Comparison of patients' perceptions of family physicians' patient-centeredness between virtual and in-person clinical encounters: A cross-sectional study.

Introduction: A clinician's patient-centeredness is a core construct of quality healthcare and is associated with several positive patient outcomes. This study aimed to compare patient-perceived patient centeredness between in-person and virtual clinical encounters during the coronavirus pandemic.

Materials And Methods: Participants completed an online anonymous questionnaire pertaining to a recent clinical encounter.

The Prevalence of Pregnancy-Specific Perinatal Anxiety in Nova Scotia.

Objectives: Pregnancy-Specific Perinatal Anxiety (PSPA) is an understudied mental health condition of pregnancy that may affect maternal-fetal health outcomes. The purpose of this study was to determine the prevalence of PSPA among pregnant women in the province of Nova Scotia, Canada, as well as the factors associated with it.

Methods: A sample of 90 pregnant women provided data on PSPA symptomology and demographic co-variables via a self-report online survey.

SmartMoms Canada: An evaluation of a mobile app intervention to support a healthy pregnancy.

Background: There is a lack of cost-effective and readily available access to evidence-based information to manage healthy behaviours for pregnant individuals. Mobile health (mHealth) tools offer a cost-effective, interactive, personalized option that can be delivered anywhere at a time most convenient for the user. This study protocol was primarily developed to, i) assess the feasibility of the SmartMoms Canada intervention in supporting participants to achieve gestational weight gain (GWG) guidelines.

Exploring weight bias internalization in pregnancy.

Background: Recent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG.

Pregnant and Postpartum Women's Perceptions of Barriers to and Enablers of Physical Activity During Pregnancy: A Qualitative Systematic Review.

Introduction: Physical activity throughout pregnancy has been shown to have health benefits for the pregnant person, including reductions in the risk of preeclampsia and gestational weight gain and improvements in blood pressure regulation. Despite the benefits, many pregnant women do not meet the guidelines for physical activity throughout pregnancy. Therefore, it is important to determine what influences women's activity levels during pregnancy.

The relationship between skin-to-skin contact and rates of exclusive breastfeeding at four months among a group of mothers in Nova Scotia: a retrospective cohort study.

Objectives: Exclusive breastfeeding is the ideal source of nutrition for the first 6 months of life. Although skin-to-skin contact (SSC) has been shown to be associated with greater rates of exclusive breastfeeding, the results are heterogeneous. SSC involves placing a naked infant on its mother's bare chest immediately after birth.

Assessing the frequency with which primary care providers address sleep of infants and young children.

Sleep problems during early development are common and associated with negative health outcomes. Earlier recognition of poor sleep health permits earlier intervention and improved outcomes. This retrospective cohort study aimed to identify the frequency with which primary care providers assessed sleep health when completing the Rourke Baby Record for infants and young children during routine well-baby visits from 2002 to 2019.

Does prepregnancy weight change have an effect on subsequent pregnancy health outcomes? A systematic review and meta-analysis.

International guidelines recommend women with an overweight or obese body mass index (BMI) aim to reduce their body weight prior to conception to minimize the risk of adverse perinatal outcomes. Recent systematic reviews have demonstrated that interpregnancy weight gain increases women's risk of developing adverse pregnancy outcomes in their subsequent pregnancy. Interpregnancy weight change studies exclude nulliparous women.

Women's Views on Advice About Weight Gain in Pregnancy: A Grounded Theory Study.

Objectives: Pregnant women prioritize the health of their pregnancy, and weight gain contributes to the pregnancy's health. Women encounter different messages about gestational weight gain from various sources that can be confusing. This study aimed to increase our understanding of the processes influencing how women experience the gestational weight gain advice they receive.

Patient-centred innovation for multimorbidity care: a mixed-methods, randomised trial and qualitative study of the patients' experience.

Background: Patient-centred interventions to help patients with multimorbidity have had mixed results.

Aim: To assess the effectiveness of a provider-created, patient-centred, multi-provider case conference with follow-up, and understand under what circumstances it worked, and did not work.

Design And Setting: Mixed-methods design with a pragmatic randomised trial and qualitative study, involving nine urban primary care sites in Ontario, Canada.

The Relationship Between Pre-Pregnancy Attempts to Lose Weight and Gestational Weight Gain: An Exploratory Primary Care Prospective Cohort Study.

Objective: The primary objective of this study was to explore the association between weight cycling in the 6 months prior to pregnancy and gestational weight gain concordance with the 2009 Institute of Medicine guidelines for weight gain in pregnancy.

Methods: This was a prospective cohort study. Participants were women aged 18 years or older with a singleton pregnancy who had a prenatal appointment between April 1 and August 31, 2019.

Curbing excess gestational weight gain in primary care: using a point-of-care tool based on behavior change theory.

Introduction: Excess gestational weight gain (GWG) is a risk factor for several adverse outcomes for mothers and their offspring. In Nova Scotia, Canada, approximately 60% of women experience excess GWG. Outside the pregnancy arena, a patient-centered approach has been shown to promote increased patient adherence to clinician recommendations, and increased intentions for, and attempts at, behavior change.

Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform.

Background: Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes.

Objective: The aim of this study was to develop and evaluate a computerized decision support platform called "Diabetes Web-Centric Information and Support Environment" (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines-based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies.

Healthcare providers' gestational weight gain counselling practises and the influence of knowledge and attitudes: a cross-sectional mixed methods study.

Objective: To understand current gestational weight gain (GWG) counselling practices of healthcare providers, and the relationships between practices, knowledge and attitudes.

Design: Concurrent mixed methods with data integration: cross-sectional survey and semistructured interviews.

Participants: Prenatal healthcare providers in Canada: general practitioners, obstetricians, midwives, nurse practitioners and registered nurses in primary care settings.

Clinician self-efficacy in initiating discussions about gestational weight gain.

Objective: To compare prenatal care providers' perceived self-efficacy in starting discussions about gestational weight gain with pregnant women under a variety of conditions of gradated difficulty, when weight gain has been in excess of current guidelines.

Design: A 42-item online questionnaire related to the known barriers to and facilitators of having discussions about gestational weight gain.

Setting: Canada.