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Article: Balancing the needs of the population, profession, and self: aligning with the environment.

Harrison, Elizabeth L

Physiotherapy Canada. Physiotherapie Canada

2008 Volume 60, Issue 1, Page(s) 51–71

Language	French
Publishing date	2008-04-15
Publishing country	Canada
Document type	Journal Article
ZDB-ID	639189-8
ISSN	1708-8313 ; 0300-0508
ISSN (online)	1708-8313
ISSN	0300-0508
DOI	10.3138/physio/60/1/51
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Article ; Online: Assessing the implementation processes of a large-scale, multi-year quality improvement initiative: survey of health care providers.

Goodridge, Donna / Rana, Masud / Harrison, Elizabeth L / Rotter, Thomas / Dobson, Roy / Groot, Gary / Udod, Sonia / Lloyd, Joshua

BMC health services research

2018 Volume 18, Issue 1, Page(s) 237

Abstract: Background: Beginning in 2012, Lean was introduced to improve health care quality and promote patient-centredness throughout the province of Saskatchewan, Canada with the aim of producing coordinated, system-wide change. Significant investments have ... ...

Abstract	Background: Beginning in 2012, Lean was introduced to improve health care quality and promote patient-centredness throughout the province of Saskatchewan, Canada with the aim of producing coordinated, system-wide change. Significant investments have been made in training and implementation, although limited evaluation of the outcomes have been reported. In order to better understand the complex influences that make innovations such as Lean "workable" in practice, Normalization Process Theory guided this study. The objectives of the study were to: a) evaluate the implementation processes associated with Lean implementation in the Saskatchewan health care system from the perspectives of health care professionals; and b) identify demographic, training and role variables associated with normalization of Lean. Methods: Licensed health care professionals were invited through their professional associations to complete a cross-sectional, modified, online version of the NoMAD questionnaire in March, 2016. Analysis was based on 1032 completed surveys. Descriptive and univariate analyses were conducted. Multivariate multinomial regressions were used to quantify the associations between five NoMAD items representing the four Normalization Process Theory constructs (coherence, cognitive participation, collective action and reflexive monitoring). Results: More than 75% of respondents indicated that neither sufficient training nor resources (collective action) had been made available to them for the implementation of Lean. Compared to other providers, nurses were more likely to report that Lean increased their workload. Significant differences in responses were evident between: leaders vs. direct care providers; nurses vs. other health professionals; and providers who reported increased workload as a result of Lean vs. those who did not. There were no associations between responses to normalization construct proxy items and: completion of introductory Lean training; participation in Lean activities; age group; years of professional experience; or employment status (full-time or part-time). Lean leader training was positively associated with proxy items reflecting coherence, cognitive participation and reflexive monitoring. Conclusions: From the perspectives of the cross-section of health care professionals responding to this survey, major gaps remain in embedding Lean into healthcare. Strategies that address the challenges faced by nurses and direct care providers, in particular, are needed if intended goals are to be achieved.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Health Facility Administrators ; Health Personnel ; Humans ; Male ; Middle Aged ; Quality Improvement ; Quality of Health Care ; Saskatchewan ; Surveys and Questionnaires
Language	English
Publishing date	2018-04-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-018-3045-6
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Article: Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey.

Fisher, Koren L / Harrison, Elizabeth L / Reeder, Bruce A / Sari, Nazmi / Chad, Karen E

Journal of aging research

2015 Volume 2015, Page(s) 425354

Abstract: Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community ... ...

Abstract	Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50-65-year-old individuals were 27% less likely to report any GP consultations (ORadj = 0.73; P < 0.001) and had 8% fewer GP consultations annually (IRRadj = 0.92; P < 0.01) than their inactive peers. Active persons aged 65-79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj = 0.82, P < 0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.
Language	English
Publishing date	2015-08-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573906-2
ISSN	2090-2212 ; 2090-2204
ISSN (online)	2090-2212
ISSN	2090-2204
DOI	10.1155/2015/425354
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Article ; Online: Interprofessional Competency Toolkit for Internationally Educated Health Professionals: Evaluation and Pilot Testing.

Arain, Mubashir / Suter, Esther / Hepp, Shelanne / Nanayakkara, Shyama / Harrison, Elizabeth L / Mickelson, Grace / Bainbridge, Lesley / Grymonpre, Ruby E

The Journal of continuing education in the health professions

2017 Volume 37, Issue 3, Page(s) 173–182

Abstract: Introduction: Internationally Educated Health Professionals (IEHPs) constitute a major health care workforce in Canada. Interprofessional education is particularly important for IEHPs to integrate into the Canadian health care system. We designed an ... ...

Abstract	Introduction: Internationally Educated Health Professionals (IEHPs) constitute a major health care workforce in Canada. Interprofessional education is particularly important for IEHPs to integrate into the Canadian health care system. We designed an online interprofessional education curriculum for IEHPs. The curriculum is designed to cover the six interprofessional competency domains defined in the Canadian Interprofessional Health Collaborative National Interprofessional Competency Framework. In this article, we are presenting findings from the pilot testing of the curriculum with a cohort of IEHPs and educators. Methods: We conducted surveys and interviews with IEHPs and educators from four provinces (British Columbia, Alberta, Saskatchewan, and Manitoba). We aimed to include seven healthcare professionals: licensed practical nurses, registered nurses, registered psychiatric nurses, pharmacists, physicians, occupational therapists, and physical therapists. We also used a pre- post- self-assessment tool and a set of reflective questions to measure the effectiveness of the curriculum. Results: Thirty IEHPs and five educators reviewed the online curriculum and participated in this evaluation. Postintervention confidence scores for all items under the role clarification and patient-centered care domains increased significantly (P = <0.01) after module completion. The scores also increased for most questions in team functioning, collaborative leadership, and communication domains. The postassessment scores increased for only half of the questions in conflict management domains. Participants agreed with the appropriateness of the content in terms of language, scenarios, and cultural aspects covered in the online curriculum on interprofessional education. Discussion: The content of the curriculum improved IEHPs' understanding of interprofessional collaboration in Canada. The interprofessional curriculum is a creative and useful resource to improve collaborative practice among internationally educated health professionals in Canada.
MeSH term(s)	Adult ; Canada ; Communication ; Curriculum/standards ; Female ; Health Personnel/psychology ; Humans ; Internationality ; Interprofessional Relations ; Male ; Middle Aged ; Patient-Centered Care/manpower ; Patient-Centered Care/methods ; Pilot Projects ; Program Evaluation/methods ; Surveys and Questionnaires
Language	English
Publishing date	2017-08-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639445-0
ISSN	1554-558X ; 0894-1912
ISSN (online)	1554-558X
ISSN	0894-1912
DOI	10.1097/CEH.0000000000000160
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Article ; Online: Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework.

Fisher, Koren L / Harrison, Elizabeth L / Bruner, Brenda G / Lawson, Joshua A / Reeder, Bruce A / Ashworth, Nigel L / Sheppard, M Suzanne / Chad, Karen E

Journal of aging and physical activity

2017 Volume 26, Issue 1, Page(s) 114–120

Abstract: The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by ... ...

Abstract	The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors' housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors' housing units should be considered when developing PA programs for older adults.
MeSH term(s)	Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Exercise/psychology ; Female ; Housing ; Humans ; Independent Living/psychology ; Male ; Middle Aged ; Residence Characteristics ; Social Environment
Language	English
Publishing date	2017-11-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1543-267X
ISSN (online)	1543-267X
DOI	10.1123/japa.2016-0286
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Article: Exercise for fall risk reduction in community-dwelling older adults: a systematic review.

Arnold, Catherine M / Sran, Meena M / Harrison, Elizabeth L

Physiotherapy Canada. Physiotherapie Canada

2008 Volume 60, Issue 4, Page(s) 358–372

Abstract: Purpose: To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults.: Method: A ... ...

Abstract	Purpose: To evaluate the influence of exercise on falls and fall risk reduction in community-dwelling older adults and to present an updated synthesis of outcome measures for the assessment of fall risk in community-dwelling older adults. Method: A systematic review was performed, considering English-language articles published from 2000 to 2006 and accessible through MEDLINE, CINAHL, PEDro, EMBASE, and/or AMED. Included were randomized controlled clinical trials (RCTs) that used an exercise or physical activity intervention and involved participants over age 50. Screening and methodological quality for internal validity were conducted by two independent reviewers. Results: The search retrieved 156 abstracts; 22 articles met the internal validity criteria. Both individualized and group exercise programmes were found to be effective in reducing falls and fall risk. The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined. A variety of outcome measures have been used to measure fall risk, especially for balance. Conclusions: Falls and fall risk can be reduced with exercise interventions in the community-dwelling elderly, although the most effective exercise variables are unknown. Future studies in populations with comorbidities known to increase fall risk will help determine optimal, condition-specific fall-prevention programmes. Poor balance is a key risk factor for falls; therefore, the best measure of this variable should be selected when evaluating patients at risk of falling.
Language	English
Publishing date	2008-11-12
Publishing country	Canada
Document type	Journal Article
ZDB-ID	639189-8
ISSN	1708-8313 ; 0300-0508
ISSN (online)	1708-8313
ISSN	0300-0508
DOI	10.3138/physio.60.4.358
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Article ; Online: Structured approaches to promote patient and family engagement in treatment in acute care hospital settings: protocol for a systematic scoping review.

Goodridge, Donna / Henry, Chrysanthus / Watson, Erin / McDonald, Meghan / New, Lucia / Harrison, Elizabeth L / Scharf, Murray / Penz, Erika / Campbell, Steve / Rotter, Thomas

Systematic reviews

2018 Volume 7, Issue 1, Page(s) 35

Abstract: Background: While effective engagement of patients and families in treatment is increasingly viewed as a priority for many healthcare systems, much remains to be learned about the nature and outcomes of approaches that seek to accomplish this goal in ... ...

Abstract	Background: While effective engagement of patients and families in treatment is increasingly viewed as a priority for many healthcare systems, much remains to be learned about the nature and outcomes of approaches that seek to accomplish this goal in the acute care hospital setting. Wide variability in the implementation of practices designed to promote patient and family engagement in hospitals has been noted. Approaches aimed at promoting patient and family engagement in treatment share the over-arching goal of changing behaviors of patients, families, and healthcare providers and possibly administrators. Behavior change techniques (BCTs) can be a key element of patient and family engagement approaches. This scoping review will contribute to the development of an evidence base detailing that the BCTs have potential to be effective in patient and family engagement interventions. The specific objectives of this review are to (a) identify and classify approaches used in acute care hospitals to engage patient and families in treatment according to the behavior change technique taxonomy; and (b) evaluate and synthesize the outcomes for these approaches for patients and families, healthcare providers, and health administrators/funders. Methods: This systematic scoping review will allow us to determine the extent, range, and nature of research activity related to initiatives designed to promote patient and family engagement in care. A comprehensive electronic literature search will be conducted in MEDLINE, EMBASE, and CINAHL. Studies will be included if they report on outcomes of a structured or systematic approach to the promotion of adult inpatient and family engagement in treatment in acute care settings. Studies will be selected in a two-stage screening process (title and abstract; full text) and quality will be assessed using the mixed methods assessment tool. Data extraction will include narrative descriptions of the intervention and classification of the behavior change techniques employed. Discussion: This review aims to identify and classify the specific behavior change techniques underpinning patient and family engagement interventions used in acute care hospital settings. By identifying the "active ingredients" in these interventions, our findings will be transferable to a wide range of acute care hospital contexts and populations.
MeSH term(s)	Health Personnel ; Hospitals ; Humans ; Inpatients/psychology ; Organizational Innovation ; Patient Participation ; Patient-Centered Care/methods ; Patient-Centered Care/organization & administration ; Professional-Family Relations
Keywords	covid19
Language	English
Publishing date	2018-02-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2662257-9
ISSN	2046-4053 ; 2046-4053
ISSN (online)	2046-4053
ISSN	2046-4053
DOI	10.1186/s13643-018-0694-9
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Article ; Online: Comparing Class-Based and Home-Based Exercise for Older Adults With Chronic Health Conditions: 12-Month Follow-Up of a Randomized Clinical Trial.

Fisher, Koren L / Reeder, Bruce A / Harrison, Elizabeth L / Bruner, Brenda G / Ashworth, Nigel L / Pahwa, Punam / Sari, Nazmi / Sheppard, M Suzanne / Shields, Christopher A / Chad, Karen E

Journal of aging and physical activity

2018 Volume 26, Issue 3, Page(s) 471–485

Abstract: Objective: To assess the maintenance of physical activity (PA) and health gains among participants in a class-based (CB) or home-based (HB) PA intervention over a 12-month study period.: Methods: A total of 172 adults aged 50 years and older were ... ...

Abstract	Objective: To assess the maintenance of physical activity (PA) and health gains among participants in a class-based (CB) or home-based (HB) PA intervention over a 12-month study period. Methods: A total of 172 adults aged 50 years and older were randomly allocated to either a CB or an HB intervention, each involving an intensive 3-month phase with a 9-month follow-up period. Measures at baseline, 3, 6, and 12 months included self-reported PA and health, body mass index, waist circumference (WC), blood pressure, cardiovascular endurance (6-min walk test), physical function, and functional fitness (senior fitness test). Outcomes were analyzed using generalized estimating equations. Results: Maximum improvement was typically observed at 3 or 6 months followed by a modest diminution, with no differences between groups. For body mass index, waist circumference, 6-min walk test, and senior fitness test, there was progressive improvement through the study period. Greater improvement was seen in the CB group compared with the HB group on three items on the senior fitness test (lower body strength and endurance [29% vs. 21%, p < .01], lower body flexibility [2.8 cm vs. 0.4 cm, p < .05], and dynamic agility [14% vs. 7%, p < .05]). Conclusion: The interventions were largely comparable; thus, availability, preferences, and cost may better guide program choice.
MeSH term(s)	Aged ; Aged, 80 and over ; Body Mass Index ; Chronic Disease/therapy ; Exercise Test ; Exercise Therapy ; Female ; Follow-Up Studies ; Geriatric Assessment ; Humans ; Male ; Middle Aged ; Physical Fitness ; Waist Circumference
Language	English
Publishing date	2018-07-12
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ISSN	1543-267X
ISSN (online)	1543-267X
DOI	10.1123/japa.2016-0285
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Article: Saskatoon in motion: class- versus home-based exercise intervention for older adults with chronic health conditions.

Reeder, Bruce A / Chad, Karen E / Harrison, Elizabeth L / Ashworth, Nigel L / Sheppard, M Suzanne / Fisher, Koren L / Bruner, Brenda G / Quinn, Brian G / Pahwa, Punam / Hossain, M Alomgir

Journal of physical activity & health

2008 Volume 5, Issue 1, Page(s) 74–87

Abstract: Background: The study aimed to compare the effectiveness of a class-based (CB) and home-based (HB) exercise program for older adults with chronic health conditions.: Methods: 172 sedentary older adults with overweight or obesity, type 2 diabetes, ... ...

Abstract	Background: The study aimed to compare the effectiveness of a class-based (CB) and home-based (HB) exercise program for older adults with chronic health conditions. Methods: 172 sedentary older adults with overweight or obesity, type 2 diabetes, hypertension, dyslipidemia, or osteoarthritis were enrolled in a randomized controlled trial with a 3-month follow-up. Results: A significant increase was seen in the CB group in the Physical Activity Scale for the Elderly (PASE) scores and SF-12 Physical and Mental Health scores. In both groups, significant increases were seen in 6-minute walk distance, Physical Performance Test (PPT), and Functional Fitness Test (FFT), and significant reductions were seen in systolic and diastolic blood pressure but not body mass index or waist circumference. Except for a greater increment in the FFT in the CB group, the degree of improvement was not significantly different between the 2 groups. Conclusion: After a 3-month intervention, both the CB and HB program produced comparable significant improvements in outcome measures.
MeSH term(s)	Aged ; Chronic Disease ; Exercise/physiology ; Female ; Health Promotion/methods ; Humans ; Male ; Program Evaluation/methods ; Saskatchewan ; Surveys and Questionnaires
Language	English
Publishing date	2008-01-02
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ISSN	1543-3080
ISSN	1543-3080
DOI	10.1123/jpah.5.1.74
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Article: Profile of physical activity levels in community-dwelling older adults.

Chad, Karen E / Reeder, Bruce A / Harrison, Elizabeth L / Ashworth, Nigel L / Sheppard, Suzanne M / Schultz, Sandra L / Bruner, Brenda G / Fisher, Koren L / Lawson, Joshua A

Medicine and science in sports and exercise

2006 Volume 37, Issue 10, Page(s) 1774–1784

Abstract: Purpose: To examine relationships between selected sociodemographic, health-related and environmental factors and levels of physical activity in older adults across three age groups.: Methods: Seven hundred sixty-four older adults (mean age = 77.4 +/- ...

Abstract	Purpose: To examine relationships between selected sociodemographic, health-related and environmental factors and levels of physical activity in older adults across three age groups. Methods: Seven hundred sixty-four older adults (mean age = 77.4 +/- 8.6 yr) from a midsize Canadian city completed a self-administered questionnaire under researcher supervision. Level of physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Correlates of physical activity were examined using previously validated questionnaires. The findings pertaining to personal and environmental factors are presented. Results: Overall, significantly higher mean PASE scores were seen in those individuals in the following categories: male (P < 0.001), married or common-law (P < 0.001), not living alone (P < 0.001), not living in senior's housing (P < 0.001), higher levels of education (P < 0.001) and higher incomes (P < 0.001). Better physical health showed significant positive associations (P < 0.001) with PASE score. Individuals reporting at least four or more chronic health conditions had significantly lower PASE scores than those reporting no chronic conditions (P < 0.001). Significantly lower PASE scores were also reported in those using domestic services (P < 0.001). Higher PASE scores were related to the presence of hills, biking and walking trails, street lights, various recreation facilities, seeing others active and unattended dogs (P < 0.001 to P < 0.05). Conclusion: An understanding of the factors that influence physical activity behavior in older adults is critical to developing effective intervention strategies that will address the problem of physical inactivity in this population, and in doing so, improve the health status and quality of life of the older adult, while having a significant impact on healthcare expenditures.
MeSH term(s)	Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Geriatric Assessment ; Health Status ; Humans ; Male ; Middle Aged ; Physical Fitness ; Quality of Life
Language	English
Publishing date	2006-01-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603994-7
ISSN	1530-0315 ; 0195-9131 ; 0025-7990
ISSN (online)	1530-0315
ISSN	0195-9131 ; 0025-7990
DOI	10.1249/01.mss.0000181303.51937.9c
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