Publications by authors named "Rosa Dragonetti"
Unlabelled: Type 2 diabetes (T2D) is a complex chronic condition that requires ongoing self-management. Diabetes health coaching interventions provide personalized healthcare programming to address physical and psychosocial aspects of diabetes self-management.
Aims: This scoping review aims to explore the contexts and settings of diabetes health coaching interventions for adults with T2D, using the RE-AIM framework.
Introduction: Type-2 diabetes (T2D) is a complex chronic condition associated with a lower quality of life due to disease specific distress. While there is growing support for personalized diabetes programs, care for mental health challenges is often fragmented and limited by access to psychiatry, and integration of care. The use of communication technology to improve team based collaborative care to bridge these gaps is promising but untested.
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- - The "Picking up the PACE" study aimed to investigate the impact of physical activity and diet on smoking cessation, but the results showed no significant changes in these areas among participants.
- - A qualitative study involving interviews with 25 healthcare providers revealed that while many believed exercise and diet could help with quitting smoking, they faced challenges like social determinants of health and lack of time.
- - Healthcare providers emphasized the importance of training and collaboration with allied health professionals to effectively implement the intervention, but also noted the need for a personalized approach for patients.
Individuals seek help to stop their use of e-cigarettes from their healthcare practitioners. However, there is a paucity of published work addressing e-cigarette cessation methods empirically, and what evidence that is available is weak. Therefore, we developed an expert informed clinical resource to guide practitioners helping their clients quit using e-cigarettes.
View Article and Find Full Text PDFBackground: For individuals living with diabetes and its psychosocial comorbidities (eg, depression, anxiety, and distress), there remains limited access to interprofessional, integrated care that includes mental health support, education, and follow-up. Health technology, broadly defined as the application of organized knowledge or skill as software, devices, and systems to solve health problems and improve quality of life, is emerging as a means of addressing these gaps. There is thus a need to understand how such technologies are being used to support, educate, and help individuals living with co-occurring diabetes and mental health distress or disorder.
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- There is a lack of established guidelines for vaping cessation, particularly for users of e-cigarettes and those who also smoke traditional cigarettes (dual users).
- A review of current literature identified 13 relevant publications, with most focusing on youth and recommending behavioral counseling and nicotine replacement therapy as effective interventions.
- The findings suggest that there is minimal evidence to support existing vaping cessation strategies, emphasizing the need for well-designed clinical trials to explore effective interventions tailored for various user groups.
Background: Women experience greater difficulty achieving smoking abstinence compared to men. Recent evidence suggests that hormonal fluctuations during different phases of the menstrual cycle can contribute to lower smoking abstinence rates following a quit attempt among women. However, these findings are limited by small sample sizes and variability among targeted smoking quit dates.
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- The COVID-19 pandemic negatively affected diabetes care and mental health for type 2 diabetes (T2D) patients, especially those from disadvantaged backgrounds.
- The study aims to test a new Technology-Enabled Collaborative Care (TECC) model that combines digital support with health coaching to address these issues.
- The research involves 30 participants from Ontario, Canada, engaging in online health coaching and assessments over several weeks to evaluate the model's feasibility, acceptability, and impact on mental and physical health.
Article Synopsis
- A study was conducted to examine whether integrating a Clinical Decision Support System (CDSS) for physical activity and diet with smoking cessation programs could improve smoking quit rates among individuals who smoke.
- The trial involved over 5,300 participants from primary care practices in Ontario, and results showed only a slight difference in quit rates between the intervention group using the CDSS and the control group, with 29.7% and 27.3% reporting abstinence, respectively.
- Additionally, changes in physical activity levels and diet were minimal in both groups, indicating that the implementation of the CDSS did not significantly impact these health behaviors or smoking cessation outcomes.
Background: COVID-19 and its public health response are having a profound effect on people's mental health. To provide support during these times, Canada's largest mental health and addiction teaching hospital (Centre for Addiction and Mental Health [CAMH]) launched the Mental Health and COVID-19 Pandemic website on March 18, 2020. This website was designed to be a nonstigmatizing psychoeducational resource for people experiencing mild to moderate distress due to COVID-19 and the public health response to the pandemic.
View Article and Find Full Text PDFBackground: The emergence of the novel coronavirus (COVID-19) has introduced additional pressures on an already fragile mental health care system due to a significant rise in depression, anxiety, and stress among Canadians. Although cognitive behavioral therapy (CBT) is known to be an efficacious treatment to reduce such mental health issues, few people have access to CBT in an engaging and sustainable manner. To address this gap, a collaboration between the Centre for Addiction and Mental Health (CAMH) and the National Research Council of Canada (NRC) developed CBT-based self-led, online, clinician-tested modules in the form of a video game, named Legend of Evelys, and evaluated its usability in the attenuation of a COVID-19-related increase in stress.
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- The study aimed to improve health behaviors in youth (ages 16-29) with early psychosis through a Technology-Enabled Collaborative Care model, addressing factors like smoking, inactivity, and poor nutrition.
- Participants were randomly assigned to either high-intensity (health coach supervised) or low-intensity (self-directed) programs for 12 weeks, focusing on engagement and health behavior changes.
- Results indicated that high-intensity participants showed better engagement in physical activity and nutrition, but overall health behavior changes were not significant, and retaining participants over the 12 weeks proved difficult.
Article Synopsis
- Primary care organizations can effectively support patients in changing unhealthy behaviors through risk communication and self-monitoring strategies.
- The study aimed to create tailored resources for behavior change by involving patients with lived experiences, specifically those in smoking cessation programs.
- Participants expressed a preference for positive affirmation messages from practitioners and a unified self-report tracking sheet to monitor their health behaviors, which could guide healthcare providers in promoting healthier habits.
Introduction: Continuing education is essential to build capacity among health care providers (HCPs) to treat people with tobacco addiction. Online, interprofessional training programs are valuable; however, interpretation and comparison of outcomes remain challenging because of inconsistent use of evaluation frameworks. In this study, we used level 5 of Moore's evaluation framework to examine whether an online training program in intensive tobacco cessation counseling achieved sustained performance change among HCPs across multiple health disciplines.
View Article and Find Full Text PDFBackground: Modifiable risk factors such as tobacco use, physical inactivity, and poor diet account for a significant proportion of the preventable deaths in Canada. These factors are also known to cluster together, thereby compounding the risks of morbidity and mortality. Given this association, smoking cessation programs appear to be well-suited for integration of health promotion activities for other modifiable risk factors.
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- Individuals with psychotic disorders face worse health outcomes and earlier mortality due to cardiovascular diseases, influenced by factors like inactivity and poor diets. The study aims to test a Tech-Enabled Collaborative Care for Youth (TECC-Y) model to improve health behaviors among youth with early psychosis.
- A randomized controlled trial will involve youth aged 16-29 in Ontario, comparing two groups: one receiving health coaching from a virtual team and another using self-directed online resources.
- The goal is to see if the TECC-Y model effectively engages participants and improves their smoking habits, physical health, and nutrition over time.
Article Synopsis
- Smoking is a major factor in preventable diseases, healthcare costs, and lost productivity, often linked with other unhealthy behaviors like excessive drinking and poor diet.
- A rapid realist review was conducted to find effective contexts and mechanisms in interventions that target smoking and other risk behaviors, with 138 relevant studies included from a screening of over 20,000 articles.
- The review found that increasing external opportunities for healthy behaviors consistently aided in smoking cessation success, while enhancing individual capability or motivation was context-dependent, suggesting a need for broader public health strategies.
Objectives: Smoking remains a leading public health issue and health care practitioners (HCPs), who play an important role in supporting and promoting patients' cessation efforts, need educational initiatives that improve their ability to provide effective clinical care. The objective of this study was to compare patient-reported abstinence from smoking following treatment by HCPs trained in an intensive tobacco cessation program and those trained in less intensive programs.
Methods: A secondary data analysis of two overlapping samples of patients who received most of their treatment from one identifiable HCP (n = 26,590) or all of their treatment from one identifiable HCP (n = 20,986) was assessed.
Article Synopsis
- A novel outreach program was launched in Ontario to boost access to evidence-based smoking cessation treatment, particularly targeting disadvantaged groups who often face greater barriers to treatment.
- The program involved workshops offering standardized content and nicotine replacement therapy (NRT), and it was evaluated using the RE-AIM framework from 2007 to 2016, with high rates of adoption by Public Health Units (PHUs).
- Results showed over 26,000 enrollments, a significant portion of participants reported smoking abstinence after 6 months, and the program effectively reached individuals with higher smoking rates and lower socioeconomic status compared to the general smoking population in Ontario.
Article Synopsis
- Health behaviors significantly affect individual and population health, leading to community interventions targeting multiple unhealthy habits like smoking and poor diet together.* -
- The study utilizes a rapid realist review to identify factors that successfully lead to changes in tobacco use and other unhealthy behaviors, involving a thorough literature search and evaluation of selected studies.* -
- Findings from this review aim to inform a government-funded project in Canada, focusing on enhancing smoking cessation efforts by integrating strategies to address multiple health behaviors.*
Article Synopsis
- Standard Continuing Medical Education (CME) formats often fail to create lasting changes in medical practice; the study investigates how a Community of Practice (CoP) can effectively enhance competencies and support such changes in tobacco addiction treatment.
- Using a prospective cohort design, the study assessed TEACH-trained practitioners through surveys to evaluate their perceived competency, engagement in knowledge transfer (KT), and program development associated with CoP involvement.
- Results indicated that while initial competency scores were high post-training, long-term engagement in the CoP led to improved participation in KT and the implementation of new programs, highlighting the importance of integrating CoPs into CME programs for lasting practice enhancement.
Article Synopsis
- - The objective of the project was to create and encourage the use of clinical practice guidelines (CPGs) for smoking cessation in Canada by adapting existing high-quality guidelines using the ADAPTE framework and engaging stakeholders.
- - An expert body reviewed six existing CPGs, graded their recommendations, and formed a network of over 800 diverse stakeholders (clinicians, researchers, decision-makers) for collaborative input on the guidelines.
- - The final guidelines included 24 summary statements and were endorsed by various government and non-government organizations, demonstrating a successful model that could be replicated in other areas to enhance smoking cessation efforts.
Background: Many continuing professional development (CPD) Web-based programs are not explicit about underlying theory and fail to demonstrate impact.
Objective: The aim of this study was to develop and apply an aggregate mixed-methods evaluation model to describe the paradigm, theoretical framework, and methodological approaches used to evaluate a CPD course in tobacco dependence treatment, the Training Enhancement in Applied Cessation Counseling and Health (TEACH) project.
Methods: We evaluated the effectiveness of the 5-week TEACH Web-based Core Course in October 2015.
Qualitative evaluations of courses prove difficult due to low response rates. Online courses may permit the analysis of qualitative feedback provided by health care providers (HCPs) during and after the course is completed. This study describes the use of qualitative methods for an online continuing medical education (CME) course through the analysis of HCP feedback for the purpose of quality improvement.
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