Publications by authors named "Karen K Lee"

Article Synopsis
  • * Recently, there have been great breakthroughs for MS, with new medications being approved, but people with PD still have not gotten new treatments and only have old ones that don't work as well.
  • * Experts from around the world gathered in Toronto to discuss how to improve treatment for PD by learning from what worked for MS, focusing on things like better clinical trials and understanding the diseases better.
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We developed a Project ECHO® module to offer prenatal providers training on engaging in shared decision-making about hepatitis C virus (HCV) treatment during pregnancy. In this pilot program, the ECHO module addressing HCV during pregnancy and the potential benefits of treatment was associated with increases in self-efficacy scores among participants.

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Parkinson's disease (PD) and dementia with Lewy bodies (DLB) share underlying neuropathology. Despite overlapping biology, therapeutic development has been approached separately for these clinical syndromes and there remains no treatment to slow, stop or prevent progression of clinical symptoms and development disability for people living with PD or DLB. Recent advances in biomarker tools, however, have paved new paths for biologic definition and staging of PD and DLB under a shared research framework.

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Novel therapies with the ability to delay disease progression are a gap in the care of people living with Parkinson disease (PD) today. Clinical outcomes assessments (COAs) that are sensitive to the earliest clinical changes in PD are deemed essential for a successful therapeutic development. To understand the current landscape of COAs use in clinical trials in PD and define priorities for future research in the field, a stakeholder roundtable meeting was held in November 2022.

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Objectives: Diabetes and obesity care for ethnocultural migrant communities is hampered by a lack of understanding of premigration and postmigration stressors and their impact on social and clinical determinants of health within unique cultural contexts. We sought to understand the role of cultural brokering in primary healthcare to enhance chronic disease care for ethnocultural migrant communities.

Design And Setting: Participatory qualitative descriptive-interpretive study with the Multicultural Health Brokers Cooperative in a Canadian urban centre.

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Background: Migrants often face worse health outcomes in countries of transit and destination because of challenges such as financial constraints, employment problems, lack of a network of social support, language and cultural differences, and difficulties accessing health services. As understanding how the migrant context affects patient-provider engagement is critical to the provision of contextually appropriate care, this study aimed at understanding primary health care provider perspectives on challenges and opportunities of the intercultural care process for migrant patients with diabetes and obesity.

Methods: This qualitative study within a multimethod, participatory research project involved primary care providers in clinics and primary care networks in Edmonton, Alberta, between September 2019 and February 2020.

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To present the best and most up-to-date evidence on associations between built environment (BE) attributes and overall and specific domains of physical activity (PA) (i.e., leisure, transport, walking, and cycling) in older adults (≥60 years).

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Introduction: To mitigate the lack of specialty healthcare, Project ECHO (Extension for Community Health Outcomes) trains community-based primary care clinicians to better prevent the progression of, manage, and treat common health conditions. ECHO-Chicago launched in 2010 as the first urban-centered ECHO program, focusing on safety-net clinicians, and has trained over 5,175 community clinicians across 34 topic areas. This paper examines self-efficacy among ECHO-Chicago participants across 11 clinical series, including a novel use of qualitative themes from self-efficacy questions.

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Background: Obesity is increasingly prevalent worldwide and is becoming an epidemic in many countries, including Canada. We sought to describe and analyze temporal obesity trends in the Canadian adult population from 2005 through 2018 at the national and provincial or territorial levels.

Methods: We conducted a consecutive, cross-sectional study using data from 7 sequential Canadian Community Health Survey (CCHS) cycles (2005 to 2017/18).

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Background: Providing contextually appropriate care and interventions for people with diabetes and/or obesity in vulnerable situations within ethnocultural newcomer communities presents significant challenges. Because of the added complexities of the refugee and immigrant context, a deep understanding of their realities is needed. Syndemic theory sheds light on the synergistic nature of stressors, chronic diseases and environmental impact on immigrant and refugee populations living in vulnerable conditions.

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Background: In collaboration with building developers, the Housing for Health team is contributing to the design of community-based congregate living facilities to support healthy living in older adults. There may also be opportunities to improve the surrounding neighbourhoods by collaborating with the municipalities where the developments are located. We will evaluate whether one or more of these comprehensive interventions lead to changes in the perceived, microscale, and macroscale neighbourhood-built environment (BE) and amenities, and impacts on the physical activity (PA), healthy eating, and social connections of residents.

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Objective: Inactive lifestyles contribute to health problems and premature death and are influenced by the physical environment. The primary objective of this study was to quantify patterns of physical inactivity in New York City and the United States by combining data from surveys and accelerometers.

Methods: We used Poisson regression models and self-reported survey data on physical activity and other demographic characteristics to predict accelerometer-measured inactivity in New York City and the United States among adults aged ≥18.

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Stair climbing is a readily available form of vigorous-intensity physical activity. Evidence indicates that placing stair prompt signs at points-of-decision (e.g.

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This descriptive study explored pastors' beliefs about etiology and treatment of mental illness. Surveys were completed by mail by 202 Korean and Euro-American Presbyterian clergy. Nearly one-third of Korean pastors viewed bad parenting and demon possession as very important causes of mental illness, in contrast to the more than two-thirds of Euro-American pastors who viewed genetics and chemical imbalances as the most important causes.

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The CommunityRx system, a population health innovation, combined an e-prescribing model and community engagement to strengthen links between clinics and community resources for basic, wellness, and disease self-management needs in Chicago. The components of CommunityRx were a youth workforce, whose members identified 19,589 public-serving entities in the 106-square-mile implementation region between 2012 and 2014; community health information specialists, who used the workforce's findings to generate an inventory of 14,914 health-promoting resources; and a health information technology (IT) platform that was integrated with three electronic health record systems at thirty-three clinical sites. By mapping thirty-seven prevalent social and medical conditions to community resources, CommunityRx generated 253,479 personalized HealtheRx prescriptions for more than 113,000 participants.

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Spaces that encourage better health are increasingly seen as key to reducing the burden of chronic disease: many larger Canadian public health departments now include built environment (BE) teams, which work with municipalities and land use planners to promote and/or require the development of health-encouraging spaces. In many public health agencies, it is environmental health practitioners who have assumed the new healthy BE role, but at what cost to existing mandates? We argue that reinventing roles to increase BE capacities within environmental health practice would reinforce health protection mandates while building capacity in chronic disease prevention. Significant expansion into the design of healthier built environments may require some reallocation of resources.

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Objective: To illuminate the key components of multi-sector reform to address the obesogenic environment in New York City during the administration of Mayor Michael Bloomberg from 2002 to 2013, we conducted a case study consisting of interviews with and a critical analysis of the experiences of leading decision makers and implementers.

Method: Key informant interviews (N = 41) conducted in 2014 were recorded, transcribed, coded, and thematically analyzed. Participants included officials from the Health Department and other New York City Government agencies, academics, civil society members, and private sector executives.

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Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity.

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Introduction: Recent studies have demonstrated the negative health consequences associated with extended sitting time, including metabolic disturbances and decreased life expectancy. The objectives of this study were to characterize sitting time in an urban adult population and assess the validity of a 2-question method of self-reported sitting time.

Methods: The New York City Health Department conducted the 2010-2011 Physical Activity and Transit Survey (N = 3,597); a subset of participants wore accelerometers for 1 week (n = 667).

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Endorsement of psychotic symptoms serves as an indicator of significant health issues and interpersonal distress. Seeking services is the ultimate recourse for many individuals, yet few studies have assessed the help-seeking process in a nationally representative sample. This study, guided by Lewis-Fernández et al.

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At least 70 US cities have now introduced ciclovías-large-scale street closures to promote physical activity-joining numerous other cities worldwide that have implemented ciclovías in efforts to improve population health. We assessed the impact of Summer Streets, a New York City program in which 6.9 contiguous miles of urban streets were closed to traffic and opened for walking, cycling, and group activities, such as dancing and yoga, on population physical activity levels.

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Objective: Efforts to promote environmental designs that facilitate opportunities for physical activity should consider the fact that injuries are the leading cause of death for Americans ages 1 to 44, with transportation-related injuries the most common cause. Drawing on the latest research and best practices in the field of injury prevention, the purpose of this article is to provide those working to promote physical activity with evidence-based recommendations on building in safety while designing active environments.

Method: A systematic review of the peer-reviewed and grey literature published from 1995 to 2012 was conducted to identify injury prevention strategies applicable to objectives in the Active Design Guidelines (ADG), which present design strategies for active living.

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Objective: Family involvement is important in the recovery experience of culturally diverse adults with schizophrenia. However, little is known about the influence of family among consumers purported to have close family ties without regular contact. This study explored Asian American consumers' views about family relationships and participation in their recovery.

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Background: Cities across the U.S. and internationally are adopting Bus Rapid Transit to improve transit services for residents.

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