Implementing shared decision-making in nutrition clinical practice: a theory-based approach and feasibility study.

Background: There are a growing number of dietary treatment options to choose from for the management of many chronic diseases. Shared decision making represents a promising approach to improve the quality of the decision making process needed for dietary choices that are informed by the best evidence and value-based. However, there are no studies reporting on theory-based approaches that foster the implementation of shared decision making in health professions allied to medicine.

Health IT acceptance factors in long-term care facilities: a cross-sectional survey.

Background And Purpose: This study applied a modified version of the extended technology acceptance model (TAM2) to examine the factors determining the acceptance of health IT applications by caregivers in long-term care facilities. The antecedent variables, including social influence factors such as subjective norm and image were examined together with demographic variables including age, job level, long-term care work experience and computer skills in regard to their impact on caregivers' acceptance of health IT applications.

Methods: A self-administered questionnaire was developed based on the validated items from TAM2.

An integrated strategy of knowledge application for optimal e-health implementation: a multi-method study protocol.

Background: E-health is increasingly valued for supporting: 1) access to quality health care services for all citizens; 2) information flow and exchange; 3) integrated health care services and 4) interprofessional collaboration. Nevertheless, several questions remain on the factors allowing an optimal integration of e-health in health care policies, organisations and practices. An evidence-based integrated strategy would maximise the efficacy and efficiency of e-health implementation.

Competing norms: Canadian rural family physicians' perceptions of clinical practice guidelines and shared decision-making.

Objectives: Implementation of clinical practice guidelines (CPGs) and shared decision-making are both advocated in primary care. Some authors argue that CPGs can enhance informed decisions by patients and physicians, while others warn that a standardized implementation of CPGs could hinder patients' involvement in decision-making. Our objective was to explore rural family physicians' perception of the interaction between clinical practice guidelines and shared decision-making in medical practice.

Translating shared decision-making into health care clinical practices: proof of concepts.

Background: There is considerable interest today in shared decision-making (SDM), defined as a decision-making process jointly shared by patients and their health care provider. However, the data show that SDM has not been broadly adopted yet. Consequently, the main goal of this proposal is to bring together the resources and the expertise needed to develop an interdisciplinary and international research team on the implementation of SDM in clinical practice using a theory-based dyadic perspective.

Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol.

Background: Shared decision-making (SDM) is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofessional approach to SDM in primary healthcare.

A survey in Alberta and Quebec of the telehealth applications that physicians need.

We studied the utility of various telehealth applications to support practice in rural and remote regions from the physicians' point of view. A postal survey was conducted among physicians from rural and remote regions of Alberta and Eastern Quebec. A total of 321 questionnaires were returned (13% response rate), comprising 180 from Quebec (16%) and 141 from Alberta (11%).

Perceived barriers to completing an e-learning program on evidence-based medicine.

Purpose: The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program.

Telehealth and the recruitment and retention of physicians in rural and remote regions: a Delphi study.

Introduction: The availability of a medical workforce is a growing concern for rural and remote communities across Canada. In the last decade, various telehealth experiences have highlighted the potential impact of this technology on professional as well as organizational practices. But could telehealth be a strategy to attract and maintain physicians in rural and remote communities? The objective of this study was to identify a reliable list of recruitment and retention factors on which telehealth could have an impact.

Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions.

Background: The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions.

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

Background: Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes.

Telehomecare for vulnerable populations: The evaluation of new models of care.

The use of telehomecare has the potential to facilitate access to healthcare services for vulnerable populations. However, evidence on the implications of telehomecare on various aspects related to patients, healthcare professionals, organizations, and healthcare systems is still limited. Assessing the various effects of telehomecare for these different groups of stakeholders is thus an essential step to ensure future integration of this technology into mainstream healthcare services.

From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA) recommendations.

Background: Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. The selected recommendations were prioritisation systems for patients on waiting lists for two surgical procedures: hip and knee replacement and cataract surgery.

Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

Objectives: Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies.

Methods: Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted.

Striving for evidence in e-health evaluation: lessons from health technology assessment.

Evaluation is crucial to the integration of e-health applications into the health-care system and their ultimate sustainability. However, e-health evaluation is often criticized for the poor quality of research design, the lack of common outcome indicators and the absence of an agreed theory. Health technology assessment (HTA) could offer a sound methodological basis for e-health evaluation.

Telehealth to support practice in remote regions: a survey among medical residents.

Medical workforce distribution represents a particular challenge in Quebec, Canada. Telehealth is considered a promising tool to provide access to health care, but also to increase professional support in remote regions. This survey was aimed at exploring medical residents' perceptions toward telehealth and its potential impact on their intention to practice in remote regions.

Telehealth adoption in hospitals: an organisational perspective.

Purpose: The purpose of this study is to explore the influence of hospitals' organisational characteristics on telehealth adoption by health-care centres involved in the extended telehealth network of Quebec (French acronym RQTE) DESIGN/METHODOLOGY/APPROACH: The article is based on a review of the literature and a questionnaire, which was administered via telephone interviews to the 32 hospitals involved in the Extended Telehealth Network of Quebec. Contingency analyses were performed to determine which organisational factors have influenced telehealth adoption. Subsequently, a multiple case study was conducted among nine hospitals representative of different categories of telehealth adopters.

Quebec population and telehealth: a survey on knowledge and perceptions.

Telehealth is widely considered to be a promising tool that addresses many of the challenges currently facing the health care system in Canada. However, diffusion of telehealth will ultimately depend on its acceptance among health care professionals and the general population. This study explores public understanding and perceptions of telehealth in the Province of Quebec (Canada).

Evaluation of an HIV and STD prevention program for adolescents in juvenile rehabilitation centers.

The aim of this study was to evaluate a sexual and STD/AIDS prevention program tailored for adolescents with social adaptation difficulties in juvenile rehabilitation facilities. The impact of the intervention on the psychosocial determinants of condom use were assessed, using a pre-test post-test quasi-experimental design. A total of 296 adolescents participated in the program (experimental group) while 240 adolescents did not receive the intervention (control group).

An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians.

Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine.

Evaluation of a telemedicine demonstration project in the Magdalene Islands.

The Magdalene Islands are an archipelago located in the middle of the Gulf of St Lawrence, more than 1000 km away from supra-regional medical referral centres. We have implemented and evaluated a telemedicine network for the local hospital on the Magdalene Islands. During a 13-month study period, 118 transmissions were made.