1
|
Groulx S, Limburg H, Doull M, Klarenbach S, Singh H, Wilson BJ, Thombs B. Guideline on screening for esophageal adenocarcinoma in patients with chronic gastroesophageal reflux disease. CMAJ 2021; 192:E768-E777. [PMID: 32631908 DOI: 10.1503/cmaj.190814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Stéphane Groulx
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Heather Limburg
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Marion Doull
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Scott Klarenbach
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Harminder Singh
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Brenda J Wilson
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Brett Thombs
- Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Public Health Agency of Canada (Limburg, Doull), Ottawa, Ont.; Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Community Health and Humanities (Wilson), Memorial University, St. John's, Nfld.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | | |
Collapse
|
2
|
Pottie K, Magwood O, Rahman P, Concannon T, Alonso-Coello P, Jaramillo Garcia A, Santesso N, Thombs B, Welch V, Wells GA, Saad A, Archibald D, Grad R, Moore A, Ximena Rojas M, Iorio A, Pinto N, Doull M, Morton R, Santesso N, Akl EA, Schünemann HJ, Tugwell P. GRADE Concept Paper 1: Validating the "F.A.C.E" instrument using stakeholder perceptions of feasibility, acceptability, cost, and equity in guideline implement. J Clin Epidemiol 2020; 131:133-140. [PMID: 33276054 DOI: 10.1016/j.jclinepi.2020.11.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/23/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE To present a structured approach for assessing stakeholder perceptions and implementing the approach in guideline development. METHODS This work was carried out by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Equity and Stakeholder Engagement Project Groups through brainstorming and iterative frameworks, stakeholder engagement, pilot testing, refinement of ideas, using input from workshops, and discussions at GRADE Working Group meetings to produce this document, which constitutes a GRADE conceptual article on implementation. RESULTS We introduce the FACE implementation criteria, feasibility, acceptability, cost, and equity; priority; and "intent to implement" criterion. We outline the implementation importance of networks and approaches to patient and other stakeholder engagement. Implementation is often highly contextual and can benefit from stakeholder engagement and other assessments. Our FACE approach provides stakeholder questions and language to inform guideline implementation and tools. CONCLUSION The FACE criteria propose a series of knowledge translation questions to guide the assessment of implementation for evidence-based guidelines. It is desirable for guideline developers to use a conceptual approach, such as FACE, to tailor implementation and inform end of guideline dissemination and knowledge translation activities.
Collapse
Affiliation(s)
- Kevin Pottie
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
| | - Olivia Magwood
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Prinon Rahman
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau-CIBERESP), Barcelona, Spain
| | | | - Nancy Santesso
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Brett Thombs
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Vivian Welch
- Centre for Global Health, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - George A Wells
- Ottawa Heart Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Ammar Saad
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Douglas Archibald
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Ainsley Moore
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Maria Ximena Rojas
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá,Colombia
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Pinto
- Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Marion Doull
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Rachael Morton
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nancy Santesso
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter Tugwell
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
3
|
Groulx S, Limburg H, Doull M, Klarenbach S, Singh H, Wilson BJ, Thombs B. Ligne directrice sur le dépistage de l’adénocarcinome œsophagien chez les patients atteints de reflux gastro-œsophagien chronique. CMAJ 2020; 192:E1597-E1607. [DOI: 10.1503/cmaj.190814-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
4
|
Reyes Domingo F, Avey MT, Doull M. Screening for thyroid dysfunction and treatment of screen-detected thyroid dysfunction in asymptomatic, community-dwelling adults: a systematic review. Syst Rev 2019; 8:260. [PMID: 31735166 PMCID: PMC6859607 DOI: 10.1186/s13643-019-1181-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/06/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This systematic review was conducted to inform the Canadian Task Force on Preventive Health Care recommendations on screening for thyroid dysfunction (TD). The review sought to answer key questions on the benefits and harms of screening for TD, patients' values and preferences for screening, and the benefits and harms of treating screen-detected TD. METHODS This review followed Canadian Task Force on Preventive Health Care methods, which include the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The search strategy used for benefits and harms of screening and treatment was an update to the 2014 review by the US Preventive Services Task Force and searched MEDLINE and the Cochrane Library. MEDLINE, Embase, ProQuest Public Health, and SCOPUS were searched for patients' values and preferences for screening. Outcomes of interest included all-cause mortality, deaths due to cardiovascular diseases, fatal and non-fatal cardiovascular events, atrial fibrillation, fractures, quality of life, cognitive function, and harms due to TD treatment. Two reviewers independently screened abstracts and full texts according to pre-determined inclusion criteria and assessed the risk of bias for each study included. Strength and quality of the evidence was assessed for each outcome. A narrative synthesis was conducted due to heterogeneity of the included studies. RESULTS No studies were found on screening for TD, treatment of subclinical hyperthyroidism, or patients' values and preferences for screening for TD. Twenty-two studies (from 24 publications) on the treatment of TD in patients with screen-detected subclinical hypothyroidism were included. Results from the included randomized controlled trials suggested no benefit of treatment for subclinical hypothyroidism for the large majority of outcomes. We found very low-quality evidence (from two cohort studies) for a small reduction in all-cause mortality among adults < 65 or 40-70 years who were treated for TD compared to those who were not. CONCLUSIONS This review found moderate to very low-quality evidence on the benefits and harms of treatment for subclinical hypothyroidism, with most of the evidence showing no benefit of treatment.
Collapse
Affiliation(s)
| | - Marc T Avey
- Public Health Agency of Canada, 785 Carling Ave, Ottawa, Ontario, Canada
| | - Marion Doull
- Public Health Agency of Canada, 785 Carling Ave, Ottawa, Ontario, Canada
| |
Collapse
|
5
|
Watson RJ, Rose HA, Doull M, Adjei J, Saewyc E. Worsening Perceptions of Family Connectedness and Parent Support for Lesbian, Gay, and Bisexual Adolescents. J Child Fam Stud 2019; 28:3121-3131. [PMID: 31649475 PMCID: PMC6812531 DOI: 10.1007/s10826-019-01489-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Lesbian, gay, and bisexual (LGB) adolescents often report compromised relations with their families. Given the recent changes in societal attitudes toward LGB individuals, in respect to rights for marriage and other legal statuses, we explore whether or not there has been a change in how LGB and heterosexual adolescents perceive their family relations over time. METHODS Using the British Columbia Adolescent Health Survey from British Columbia, Canada (N = 99,373; M age = 14.8), we investigated the trends and disparities in family connectedness and mother/father support in four data sets from 1998 to 2013. RESULTS We found that while levels of perceived family connectedness and parent support have increased for heterosexual adolescents since 1998, the same increases were not found for LGB adolescents. Among LGB participants, levels of perceived connectedness/support generally decreased in each survey waves, especially among females. Alarmingly, significant disparities in these perceptions remained for LGB youth over time. CONCLUSIONS Our findings have implications for supportive interventions focused on LGB adolescents and their families and in particular, the role of father support.
Collapse
Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | | | | | | | | |
Collapse
|
6
|
Klarenbach S, Sims-Jones N, Lewin G, Singh H, Thériault G, Tonelli M, Doull M, Courage S, Garcia AJ, Thombs BD. Recommendations on screening for breast cancer in women aged 40-74 years who are not at increased risk for breast cancer. CMAJ 2019; 190:E1441-E1451. [PMID: 30530611 DOI: 10.1503/cmaj.180463] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Scott Klarenbach
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Nicki Sims-Jones
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Gabriela Lewin
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Harminder Singh
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Guylène Thériault
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Marcello Tonelli
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Marion Doull
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Susan Courage
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Alejandra Jaramillo Garcia
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | - Brett D Thombs
- Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta.; Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Thériault), McGill University, Montréal, Que.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont.; Department of Psychiatry (Thombs), McGill University, Montréal, Que
| | | |
Collapse
|
7
|
Moore A, Doull M, Grad R, Groulx S, Pottie K, Tonelli M, Courage S, Garcia AJ, Thombs BD. Recommendations on screening for asymptomatic bacteriuria in pregnancy. CMAJ 2019; 190:E823-E830. [PMID: 29986858 DOI: 10.1503/cmaj.171325] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Ainsley Moore
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Marion Doull
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Roland Grad
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Stéphane Groulx
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Kevin Pottie
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Marcello Tonelli
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Susan Courage
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Alejandra Jaramillo Garcia
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | - Brett D Thombs
- Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Public Health Agency of Canada (Doull, Courage, Jaramillo Garcia), Ottawa, Ont.; Department of Family Medicine (Grad), McGill University, Montréal, Que.; Department of Community Health Sciences (Groulx), University of Sherbrooke, Sherbrooke, Que.; Department of Family Medicine (Pottie), University of Ottawa, Ottawa, Ont.; Department of Medicine (Tonelli), University of Calgary, Calgary, Alta.; Lady Davis Institute (Thombs), Jewish General Hospital and McGill University, Montréal, Que
| | | |
Collapse
|
8
|
Pillay J, Moore A, Rahman P, Lewin G, Reynolds D, Riva J, Thériault G, Thombs B, Wilson B, Robinson J, Ramdyal A, Cadieux G, Featherstone R, Burchell AN, Dillon JA, Singh A, Wong T, Doull M, Traversy G, Courage S, MacGregor T, Johnson C, Vandermeer B, Hartling L. Screening for chlamydia and/or gonorrhea in primary health care: protocol for systematic review. Syst Rev 2018; 7:248. [PMID: 30587234 PMCID: PMC6307186 DOI: 10.1186/s13643-018-0904-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis and Neisseria gonorrhoeae are the most commonly reported sexually transmitted infections in Canada. Existing national guidance on screening for these infections was not based on a systematic review, and recommendations as well as implementation considerations (e.g., population groups, testing and case management) should be explicit and reflect the quality of evidence. The aim of this systematic review is to synthesize research on screening for these infections in sexually active individuals within primary care. We will also review evidence on how people weigh the relative importance of the potential outcomes from screening, rated as most important by the Canadian Task Force on Preventive Health Care (CTFPHC) with input from patients and stakeholders. METHODS We have developed a peer-reviewed strategy to comprehensively search MEDLINE, Embase, Cochrane Library, CINAHL, and PsycINFO for English and French literature published 1996 onwards. We will also search trial registries and conference proceedings, and mine references lists. Screening, study selection, risk of bias assessments, and quality of findings across studies (for each outcome) will be independently undertaken by two reviewers with consensus for final decisions. Data extraction will be conducted by one reviewer and checked by another for accuracy and completeness. The CTFPHC and content experts will provide input for decisions on study design (i.e., when and whether to include uncontrolled studies for screening effectiveness) and for interpretation of the findings. DISCUSSION The results section of the review will include a description of all studies, results of all analyses, including planned subgroup and sensitivity analyses, and evidence profiles and summary of findings tables incorporating assessment based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods to communicate our confidence in the estimates of effect. We will compare our findings to others and discuss limitations of the review and available literature. The findings will be used by the CTFPHC-supplemented by consultations with patients and stakeholders and from other sources on issues of feasibility, acceptability, costs/resources, and equity-to inform recommendations on screening to support primary health care providers in delivering preventive care. SYSTEMATIC REVIEW REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018100733.
Collapse
Affiliation(s)
- Jennifer Pillay
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - Ainsley Moore
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Prinon Rahman
- Global Health and Guidelines Division, Public Health Agency of Canada, Edmonton, Canada
| | - Gabriel Lewin
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Donna Reynolds
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - John Riva
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | | | - Brett Thombs
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Brenda Wilson
- Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada
| | - Joan Robinson
- Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Amanda Ramdyal
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | | | - Robin Featherstone
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - Anne N. Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jo-Anne Dillon
- Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Canada
| | - Ameeta Singh
- Division of Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Tom Wong
- Public Health Agency of Canada, Edmonton, Canada
| | - Marion Doull
- Global Health and Guidelines Division, Public Health Agency of Canada, Edmonton, Canada
| | - Greg Traversy
- Global Health and Guidelines Division, Public Health Agency of Canada, Edmonton, Canada
| | - Susan Courage
- Global Health and Guidelines Division, Public Health Agency of Canada, Edmonton, Canada
| | - Tara MacGregor
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - Cydney Johnson
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - Ben Vandermeer
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| |
Collapse
|
9
|
Porta CM, Watson RJ, Doull M, Eisenberg ME, Grumdahl N, Saewyc E. Trend Disparities in Emotional Distress and Suicidality Among Sexual Minority and Heterosexual Minnesota Adolescents From 1998 to 2010. J Sch Health 2018; 88:605-614. [PMID: 29992605 DOI: 10.1111/josh.12650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/10/2017] [Accepted: 10/18/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sexual minority young people have demonstrated higher rates of emotional distress and suicidality in comparison to heterosexual peers. Research to date has not examined trends in these disparities, specifically, whether there have been disparity reductions or increases and how outcomes have differed over time by sex and sexual orientation group. METHODS Minnesota Student Survey data, collected from 9th and 12th graders in 3 cohorts (1998, 2004, 2010) were used to examine emotional distress and suicidality rates. Logistic regression analyses were completed to examine outcome changes over time within and across sexual orientation/sex groups. RESULTS With few exceptions, sexual minority youth are at increased risk of endorsing emotional distress and suicidality indicators in each surveyed year between 1998 and 2010. Young people with both-sex partners reported more emotional distress across all health indicators compared to their opposite-sex partnered peers. With a few exceptions, gaps in disparities between heterosexual and sexual minority have not changed from 2004 to 2010. CONCLUSIONS Disparities in emotional health persist among youth. Research is needed to advance understanding of mental health disparities, with consideration of sexual orientation differences and contextualized to sociocultural status and changes over time. Personalized prevention strategies are needed to promote adolescent mental health.
Collapse
Affiliation(s)
- Carolyn M Porta
- School of Nursing, University of Minnesota, 5-160 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455
| | - Ryan J Watson
- Department of Human Development and Family Studies, University of Connecticut, 348 Mansfield Road U1058, Storrs, CT, 06269, USA
| | - Marion Doull
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, T222-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414
| | - Nathan Grumdahl
- School of Nursing, University of Minnesota, 5-160 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455
| | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, T222-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
| |
Collapse
|
10
|
Doull M, Watson RJ, Smith A, Homma Y, Saewyc E. Are we leveling the playing field? Trends and disparities in sports participation among sexual minority youth in Canada. J Sport Health Sci 2018; 7:218-226. [PMID: 30356467 PMCID: PMC6180536 DOI: 10.1016/j.jshs.2016.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/24/2016] [Accepted: 08/09/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE Sports participation and physical fitness are widely beneficial for young people, yet activity levels among young people are declining. Despite growing popular media attention on the participation of sexual minority (e.g., lesbian, gay, and bisexual) youth in sports and various campaigns to improve the often homophobic climate of sports, there is limited evidence that sexual minority youth participate in sports. Our aim was to provide a current portrait of sports participation among 3 groups of sexual minority youth (e.g., lesbian, gay, and bisexual) in British Columbia, Canada, as well as to document population trends. METHODS Pooled population-level data from British Columbia, Canada (n = 99,373) were used to examine trends and disparities in sports participation among sexual minority and heterosexual youth. Age-adjusted logistic regression models were used to examine changes in participation over time and disparities in participation over time (1998-2013). RESULTS We found an overall decline in sports participation and physical activity (PA) for all youth. Sexual minority students were less likely to participate in formal sports (with a coach) and informal sports (without a coach) compared with their heterosexual peers. The disparity in participating in informal sports between heterosexual and sexual minority youth has narrowed over time for some sexual orientation groups, whereas the disparity in participating in formal sports has widened over time in some cases. CONCLUSION This study provides a comprehensive examination of sports participation among sexual minority youth over the past 15 years. Despite changing societal attitudes and laudable efforts to reduce homophobia in sports, results suggest that there are continued barriers to participation for sexual minority youth. Further research is needed to understand the factors that limit sports participation for these youth and to inform program development. PA is critical to lifelong health and well-being, and thus continued efforts are needed to increase the sports participation of sexual minority youth in particular.
Collapse
Affiliation(s)
- Marion Doull
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| | - Ryan J. Watson
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA
| | - Annie Smith
- McCreary Centre Society, Vancouver, British Columbia V5K2A7, Canada
| | - Yuko Homma
- School of Nursing, Mukogawa Women's University, Nishinomiya, Hyogo 663-8558, Japan
| | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| |
Collapse
|
11
|
Doull M, O'Connor AM, Wells GA, Tugwell P, Welch V. Peer-based interventions for reducing morbidity and mortality in HIV-infected women. Hippokratia 2017. [DOI: 10.1002/14651858.cd004774.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Marion Doull
- University of British Columbia; School of Population and Public Health; 2206 East Mall Vancouver BC Canada V6T 1Z3
| | - Annette M. O'Connor
- Senior Scientist, Clinical Epidemiology Program, Ottawa Health Research Institute; Professor, School of Nursing, Department of Epidemiology, University of Ottawa; 1053 Carling Avenue (ASB 2-008) Ottawa ON Canada K1Y 4E9
| | - George A Wells
- University of Ottawa; Department of Epidemiology and Community Medicine; Room H1281 40 Ruskin Street Ottawa ON Canada K1Y 4W7
| | - Peter Tugwell
- Faculty of Medicine, University of Ottawa; Department of Medicine; Ottawa ON Canada K1H 8M5
| | - Vivian Welch
- Bruyère Research Institute; Methods Centre; 85 Primrose Avenue Ottawa ON Canada
| |
Collapse
|
12
|
Welch V, Doull M, Yoganathan M, Jull J, Boscoe M, Coen SE, Marshall Z, Pardo JP, Pederson A, Petkovic J, Puil L, Quinlan L, Shea B, Rader T, Runnels V, Tudiver S. Reporting of sex and gender in randomized controlled trials in Canada: a cross-sectional methods study. Res Integr Peer Rev 2017; 2:15. [PMID: 29451565 PMCID: PMC5803639 DOI: 10.1186/s41073-017-0039-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/26/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Accurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants. METHODS We searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second. RESULTS The search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12-6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined "sex" and/or "gender." No publication carried out a comprehensive sex and gender analysis. CONCLUSIONS Findings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research.
Collapse
Affiliation(s)
- V. Welch
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - M. Doull
- School of Nursing, University of British Columbia, T223-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - M. Yoganathan
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
| | - J. Jull
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario Canada
| | - M. Boscoe
- Research Sex/gender, Health Equity, Primary Care Consultant, 906 Bowron Court, North Vancouver, BC V7H 2S7 Canada
| | - S. E. Coen
- Department of Geography and Planning, Queen’s University, Mackintosh-Corry Hall, Kingston, Ontario K7L 3 N6 Canada
| | - Z. Marshall
- Renison University College, University of Waterloo, 240 Westmount Road North, Waterloo, Ontario N2L 3G4 Canada
| | - J. Pardo Pardo
- Cochrane Musculoskeletal, University of Ottawa, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6 Canada
| | - A. Pederson
- B.C. Women’s Hospital + Health Centre, E305, 4500 Oak Street, Vancouver, BC V6H 3E1 Canada
| | - J. Petkovic
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - L. Puil
- Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, 2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - L. Quinlan
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
| | - B. Shea
- Bruyère Research Institute, Bruyère Continuing Care, 304b-85 Primrose Avenue, Ottawa, Ontario K1R 6 M1 Canada
- University of Ottawa, Ontario, Canada
| | - T. Rader
- Canadian Agency for Drugs and Technology in Health, 865 Carling Ave, Ottawa, Ontario Canada
| | - V. Runnels
- Globalization and Health Equity Research Unit, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 850 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3 Canada
| | - S. Tudiver
- Gender and Health Consultant, 161 Northwestern Avenue, Ottawa, Ontario K1Y 0 M1 Canada
| |
Collapse
|
13
|
Frohard-Dourlent H, Dobson S, Clark BA, Doull M, Saewyc EM. "I would have preferred more options": accounting for non-binary youth in health research. Nurs Inq 2016; 24. [PMID: 27653521 DOI: 10.1111/nin.12150] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 11/29/2022]
Abstract
As a research team focused on vulnerable youth, we increasingly need to find ways to acknowledge non-binary genders in health research. Youth have become more vocal about expanding notions of gender beyond traditional categories of boy/man and girl/woman. Integrating non-binary identities into established research processes is a complex undertaking in a culture that often assumes gender is a binary variable. In this article, we present the challenges at every stage of the research process and questions we have asked ourselves to consider non-binary genders in our work. As researchers, how do we interrogate the assumptions that have made non-binary lives invisible? What challenges arise when attempting to transform research practices to incorporate non-binary genders? Why is it crucial that researchers consider these questions at each step of the research process? We draw on our own research experiences to highlight points of tensions and possibilities for change. Improving access to inclusive health-care for non-binary people, and non-binary youth in particular, is part of creating a more equitable healthcare system. We argue that increased and improved access to inclusive health-care can be supported by research that acknowledges and includes people of all genders.
Collapse
Affiliation(s)
| | - Sarah Dobson
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Beth A Clark
- Interdisciplinary Studies, The University of British Columbia, Vancouver, BC, Canada
| | - Marion Doull
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth M Saewyc
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
14
|
Doull M, Haag D, Bondyra M, Lee C, Dinner K, Wong T, Gilbert M. P04.01 Similarities and differences in perceptions of models for online partner notification for sexually transmitted infections: potential users versus care providers. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
15
|
Doull M, Welch V, Puil L, Runnels V, Coen SE, Shea B, O’Neill J, Borkhoff C, Tudiver S, Boscoe M. Development and evaluation of 'briefing notes' as a novel knowledge translation tool to aid the implementation of sex/gender analysis in systematic reviews: a pilot study. PLoS One 2014; 9:e110786. [PMID: 25372876 PMCID: PMC4220945 DOI: 10.1371/journal.pone.0110786] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 09/17/2014] [Indexed: 12/12/2022] Open
Abstract
Background There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly ‘briefing note’ format and evaluate its potential in aiding the implementation of SGA in systematic reviews. Methods Our Sex/Gender Methods Group used an interactive process to translate knowledge about sex/gender into briefing notes, a concise communication tool used by policy and decision makers. The briefing notes were developed in collaboration with three Cochrane Collaboration review groups (HIV/AIDS, Hypertension, and Musculoskeletal) who were also the target knowledge users of the briefing notes. Briefing note development was informed by existing systematic review checklists, literature on sex/gender, in-person and virtual meetings, and consultation with topic experts. Finally, we held a workshop for potential users to evaluate the notes. Results Each briefing note provides tailored guidance on considering sex/gender to reviewers who are planning or conducting systematic reviews and includes the rationale for considering sex/gender, with examples specific to each review group’s focus. Review authors found that the briefing notes provided welcome guidance on implementing SGA that was clear and concise, but also identified conceptual and implementation challenges. Conclusions Sex/gender briefing notes are a promising knowledge translation tool. By encouraging sex/gender analysis and equity considerations in systematic reviews, the briefing notes can assist systematic reviewers in ensuring the applicability of research evidence, with the goal of improved health outcomes for diverse populations.
Collapse
Affiliation(s)
- Marion Doull
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
| | - Vivian Welch
- Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Lorri Puil
- Therapeutics Initiative, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vivien Runnels
- Globalization and Health Research Unit, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephanie E. Coen
- Department of Geography, Queen’s University, Mackintosh-Corry Hall, Kingston, Ontario, Canada
| | - Beverley Shea
- Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer O’Neill
- Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Cornelia Borkhoff
- Division of Pediatric Medicine, Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sari Tudiver
- Researcher/Consultant on Gender and Health, Ottawa, Ontario, Canada
| | - Madeline Boscoe
- Reach Community Health Centre, Vancouver, British Columbia, Canada
| |
Collapse
|
16
|
Abstract
BACKGROUND Systematic review methodology includes the rigorous collection, selection, and evaluation of data in order to synthesize the best available evidence for health practice, health technology assessments, and health policy. Despite evidence that sex and gender matter to health outcomes, data and analysis related to sex and gender are frequently absent in systematic reviews, raising concerns about the quality and applicability of reviews. Few studies have focused on challenges to implementing sex/gender analysis within systematic reviews. METHODS A multidisciplinary group of systematic reviewers, methodologists, biomedical and social science researchers, health practitioners, and other health sector professionals completed an open-ended survey prior to a two-day workshop focused on sex/gender, equity, and bias in systematic reviews. Respondents were asked to identify challenging or 'thorny' issues associated with integrating sex and gender in systematic reviews and indicate how they address these in their work. Data were analysed using interpretive description. A summary of the findings was presented and discussed with workshop participants. RESULTS Respondents identified conceptual challenges, such as defining sex and gender, methodological challenges in measuring and analysing sex and gender, challenges related to availability of data and data quality, and practical and policy challenges. No respondents discussed how they addressed these challenges, but all proposed ways to address sex/gender analysis in the future. CONCLUSIONS Respondents identified a wide range of interrelated challenges to implementing sex/gender considerations within systematic reviews. To our knowledge, this paper is the first to identify these challenges from the perspectives of those conducting and using systematic reviews. A framework and methods to integrate sex/gender analysis in systematic reviews are in the early stages of development. A number of priority items and collaborative initiatives to guide systematic reviewers in sex/gender analysis are provided, based on the survey results and subsequent workshop discussions. An emerging 'community of practice' is committed to enhancing the quality and applicability of systematic reviews by integrating considerations of sex/gender into the review process, with the goals of improving health outcomes and ensuring health equity for all persons.
Collapse
Affiliation(s)
- Vivien Runnels
- Globalization and Health Equity Research Unit, Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada
| | - Sari Tudiver
- Gender and Health Consultant/Researcher, 161 Northwestern Ave, Ottawa, ON K1Y 0M1, Canada
| | - Marion Doull
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, 414-2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Madeline Boscoe
- Reach Community Health Centre, 1145 Commercial Drive, Vancouver, BC V5L 3X3, Canada
| |
Collapse
|
17
|
|
18
|
Doull M, Runnels VE, Tudiver S, Boscoe M. Appraising the Evidence: Applying Sex- and Gender-Based Analysis (SGBA) to Cochrane Systematic Reviews on Cardiovascular Diseases. J Womens Health (Larchmt) 2010; 19:997-1003. [DOI: 10.1089/jwh.2009.1626] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Marion Doull
- Institute of Population Health, University of Ottawa, Ontario, Canada
| | - Vivien E. Runnels
- Institute of Population Health, University of Ottawa, Ontario, Canada
| | - Sari Tudiver
- Gender and Health Unit, Health Canada, Ottawa, Ontario, Canada
| | - Madeline Boscoe
- Canadian Women's Health Network & Women's Health Clinic, Winnipeg, Manitoba, Canada
| |
Collapse
|
19
|
Abstract
OBJECTIVE Abortion has been recognized internationally as an essential health service. The geographical distance to an abortion provider is acknowledged as a major barrier to access. This pilot study tracks women's journeys to the Toronto Morgentaler Clinic for abortion services. METHODS A questionnaire was developed specifically for this study and was administered over a four-month period to women using abortion services at the clinic. Questions asked for demographic information and details of the costs, distances, and women's experiences of their journeys to the clinic. RESULTS A total of 1022 of 1256 surveys were completed for an overall response rate of 81%. The majority of women in the sample (54%) were 21 to 30 years old, had a partner (55.8%), were employed full time (50.5%), and had an income of less than $30 000 per year (68.2%). Most women had travelled an hour or more to the clinic (73.5%), and the remainder had travelled for less than half an hour. Women reporting incomes of less than 30,000 dollars were more likely than wealthier women to have travelled from 200 km to more than 1000 km (OR 1.74; 95% CI 1.16-2.71). Women who were under the age of 30 were more likely to rate their journey as difficult or very difficult (OR 1.68; 95% CI 0.98-2.88). CONCLUSION More research is needed to determine how far women must travel for abortion services in Canada and to determine the wider health, political, and legal implications of these journeys.
Collapse
Affiliation(s)
- Christabelle Sethna
- Institute of Women's Studies, Faculty of Health Sciences, University of Ottawa, Ottawa ON, Canada
| | | |
Collapse
|
20
|
Robinson V, Tugwell P, Walker P, Ter Kuile AA, Neufeld V, Hatcher-Roberts J, Amaratunga C, Andersson N, Doull M, Labonte R, Muckle W, Murangira F, Nyamai C, Ralph-Robinson D, Simpson D, Sitthi-Amorn C, Turnbull J, Walker J, Wood C. Creating and testing the concept of an academic NGO for enhancing health equity: a new mode of knowledge production? Educ Health (Abingdon) 2007; 20:53. [PMID: 18058687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
CONTEXT Collaborative action is required to address persistent and systematic health inequities which exist for most diseases in most countries of the world. OBJECTIVES The Academic NGO initiative (ACANGO) described in this paper was set up as a focused network giving priority to twinned partnerships between Academic research centres and community-based NGOs. ACANGO aims to capture the strengths of both in order to build consensus among stakeholders, engage the community, focus on leadership training, shared management and resource development and deployment. METHODS A conceptual model was developed through a series of community consultations. This model was tested with four academic-community challenge projects based in Kenya, Canada, Thailand and Rwanda and an online forum and coordinating hub based at the University of Ottawa. FINDINGS Between February 2005 and February 2007, each of the four challenge projects was able to show specific outputs, outcomes and impacts related to enhancing health equity through the relevant production and application of knowledge. CONCLUSIONS The ACANGO initiative model and network has demonstrated success in enhancing the production and use of knowledge in program design and implementation for vulnerable populations.
Collapse
|
21
|
Doull M, O'Connor A, Jacobsen MJ, Robinson V, Cook L, Nyamai-Kisia C, Tugwell P. Investigating the decision-making needs of HIV-positive women in Africa using the Ottawa Decision-Support Framework: Knowledge gaps and opportunities for intervention. Patient Educ Couns 2006; 63:279-91. [PMID: 16982168 DOI: 10.1016/j.pec.2006.06.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 06/22/2006] [Accepted: 06/29/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine HIV-positive women's decision making in the context of pregnancy and HIV/AIDS and to explore interventions that may enhance and develop women's decision-making capacity in the sub-Saharan African context. METHODS The Ottawa Decision-Support Framework was used to assemble evidence of women's decision-making needs. Several electronic databases were searched and an Internet search of the World Wide Web was conducted to search grey literature sources. An evidence-based approach to assessing benefits, harms and current practices was employed. RESULTS Several gaps in our knowledge about women's decision making in the context of pregnancy and HIV were identified. The availability of evidence varied for each decision; however, significant gaps included: evidence around testing for ones status, advanced directives for self and child, disclosure (specifically, the impact of), others perceptions of antiretroviral use and data on termination of pregnancies. CONCLUSION Decision making as a concept was generally not addressed in the MTCT literature. Evidence regarding the perceptions of women and others regarding the various decisions was often not available and subsequently an important aspect of MTCT interventions neglected. PRACTICE IMPLICATIONS Incorporating a multi-disciplinary decision-support framework may prove useful to promote women's autonomy and involvement in MTCT-related decision making.
Collapse
Affiliation(s)
- Marion Doull
- Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Canada.
| | | | | | | | | | | | | |
Collapse
|
22
|
Doull M, O'Connor AM, Welch V, Tugwell P, Wells GA. Peer support strategies for improving the health and well-being of individuals with chronic diseases. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd005352] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|