by Jack Quach, Dr. Olga Theou, Dr. Ulises Pérez-Zepeda, Dr. Judith Godin, Dr. Scott Kehler

Abstract: We examined the effect of a two-year physical activity (PA) intervention on frailty trajectory and on major mobility disability (MMD) across baseline frailty levels. We analyzed data from 1,635 community-dwelling participants from the Lifestyle Interventions and Independence Study who were 70-89 years old (mean baseline age [SD]: 78.9 [5.2 years], 67.0% female). Participants were randomized to either moderate intensity PA or health education (HE) groups. Frailty was measured with a 44-item frailty index (FI) created from the study questionnaires, using standardized procedures; scores range from 0 (healthy) to 1 (severely frail). MMD was determined by the inability to complete a 400m walk test within 15 minutes without sitting or person- or walking aid assistance. Linear mixed-effects models estimated frailty trajectory. Cox regression models were used, centering FI at 0.05 intervals, to determine if the effect of PA on MMD differed by baseline FI. The mean (SD) FI at baseline was 0.18 (0.10) for both groups. MMD rates were 28.3% (246/818) and 34.5% (290/817) for the PA and HE groups, respectively. Linear mixed-effects models showed that the FI trajectory was not different across interventions (p = 0.303). When FI was centered at 0.15 or higher, PA was associated with lower MMD risk when compared to HE (odds ratio range [95% CI]: 0.65-0.81 [0.43-0.98]). At lower FI (0-0.1), PA was not different than HE in regard to MMD risk. Frailty trajectory was similar across both PA and HE groups. PA intervention reduced the risk of MMD in those who were frailer. 

by Eve Justason, Dr. Shelley Doucet, Dr. Alison Luke, Dr. Lillian MacNeill and Jennifer Splane

Abstract: Access to primary care providers is a challenge in New Brunswick (NB). In response to this issue, the Government of NB recently announced the implementation of three nurse practitioner (NP)-staffed clinics in the three major cities in the province (Moncton, Saint John and Fredericton). The primary goal of this study is to evaluate the implementation of the Greater Moncton Health Centre, an NP-staffed clinic established in Moncton, in 2020. This process evaluation will determine whether the Greater Moncton Health Centre was implemented effectively and as originally planned. We are using a mixed-methods design to explore indicators related to both program coverage and program process. Coverage includes indicators related to client uptake (e.g., patient data), while program process includes indicators related to implementation (e.g., clinic planning documents; administrative files). Data collection will involve a retrospective audit of clinic planning documents and patient charts, as well as semi-structured interviews with relevant stakeholders to explore key poitns related to clinic implementation. Interview participants will include stakeholders from the NB Department of Health and Vitalité Health Network, clinic staff and a sample of clinic patients. This evaluation will provide a better understanding of the implementation process of the Greater Moncton Health Centre, which can inform the development and implementation of other NP-staffed clinics across the province and beyond.

by Naythah Thevathasan, Dr. Kerrie Luck, Dr. Alison Luke and Dr. Shelley Doucet

Abstract: NaviCare/SoinsNavi is a bilingual patient navigation centre for children and youth 25 years of age or younger with complex care needs in New Brunswick. This research-based center employs two bilingual patient navigators, one a registered nurse and the other a lay navigator, who assist children/youth, family members, and the care team by facilitating more convenient and integrated care using a personalized family-centred approach. The purpose of this study was to explore the perceptions and experiences of care providers who use NaviCare/SoinsNavi. This study builds on ongoing research exploring the experiences of children/youth and their families who are clients of NaviCare/SoinsNavi. Interviews were conducted with 10 care providers (N=10) from various sectors including social support services (n=6), primary care (n=2), mental health services (n=1), and acute care (n=1). Qualitative interviews were conducted and five themes related to the participants’ perceptions and experiences with NaviCare/SoinsNavi emerged, including a: 1) trusted source, 2) connector, 3) capacity builder, 4) partner, and 5) time saver. The overall impression of NaviCare/SoinsNavi was positive in the service’s ability to help support care providers and streamline the care they provide to their clients. It is within every healthcare provider’s scope of practice to provide navigational support to essential programs and services; however, due to limitations in time, resources, and capacity, novel services such as NaviCare/SoinsNavi can be used to help close gaps in care that exists for children/youth with complex care needs and their families. 

by Dr. Luke MacNeill, Dr. Alison Luke, Dr. Shelley Doucet

Abstract: Conversational agents are autonomous software programs that are designed to engage in conversation with people using humanlike speech or text. In recent years, researchers and companies have developed a number of conversational agents to deliver health care. To date, the views of health professionals toward these agents have received little attention in the literature. The purpose of this study is to learn more about how health professionals view conversational agents that are used for health care. A total of 18 to 24 participants will be recruited through newsletters, online advertisements, social media channels, and emails to relevant organizations. Participants will consist of physicians, nurses, and regulated mental health professionals (psychologists, psychotherapists, counsellors, and clinical social workers) who are currently practicing in Canada. Participants will be interviewed individually using Zoom video conferencing software. Interviews are expected to last approximately 20 minutes. Interviews will be transcribed verbatim and uploaded to NVivo (Version 12) for coding and analysis. Transcripts will be analyzed using Braun and Clarke’s (2006) six phases of thematic analysis. Participant recruitment and data collection are ongoing. Preliminary results will be presented. Although there is considerable promise surrounding the use of conversational agents for health care, these agents are encroaching on areas that traditionally have been the domain of health professionals. It seems unlikely that health organizations will promote or utilize conversational agents without the approval of the health professionals affiliated with these organizations. Therefore, capturing the opinions of these individuals is important. 

by Evan MacEachern, Dr. Scott Kehler

Abstract: Heart disease patients are living with more health problems. Multiple health problems can be expressed as frailty. Frailty is important in cardiac rehabilitation (CR); however, it is uncertain whether patient frailty affects CR goal achievement. CR patients underwent a frailty assessment upon admission to the program. A 25-item frailty index (FI) including health problems related to age determined patient frailty status (scores range from 0-1; higher scores indicate higher frailty). Patients were categorized by admission frailty score (<0.20, 0.20-0.30, 0.30-0.40, >0.40). CR goals (e.g., improve fitness) were determined by patients. Logistic regression analyses adjusted for age, sex, education, and diagnosis. Secondary analysis investigated if obtaining a clinically significant change in frailty score (a 0.03 improvement in the FI) from admission to graduation improved CR goal achievement. Of the 759 participants (age 59.5±9.8, 24% female), 607 (80%) patients achieved a CR goal at graduation. Lower levels of frailty were associated with CR goal achievement (FI<0.20: OR=4.06[1.83-9.01]; FI 0.20-0.30: OR=2.32[1.35-3.97]; FI 0.30-0.40: OR=1.19[0.764-1.86]; FI>0.40 = Reference). Every 1% increase in FI score revealed 1.2% reduced odds of achieving a CR goal (OR=0.98[0.95-0.98]). Clinical improvements in frailty during CR was not associated with CR goal achievement (OR=1.19[0.76-1.86]). Lower levels of admission frailty were associated with CR goal achievement. Additionally, every 1% increase in admission FI score resulted in 1.2% reduced odds of CR goal achievement. Patients who improved their frailty score during CR were not associated with achieving CR goals.  

by Isaac Cull

Abstract: Binge-watching television series’ is a sedentary behaviour that may have health implications. This study examines possible changes in binge-watching behaviour before, during and after the COVID-19 pandemic. An international cross-sectional survey was conducted online measuring self-reported binge-watching, sleep, physical activity, and overall sedentary behaviour across three time periods: one month before the COVID-19 pandemic; during the first month of the COVID-19 pandemic; and currently. Of the initial 707 responders, 385 participants provided complete responses that were included in the analysis. Participants were 28.0 (SD=11.5) years old; 76% were female. Before the pandemic, participants binge watched an average of 1.87 (SD=1.86) days per week for 259.05 (SD=344.33) minutes which significantly increased to 3.58 (SD=2.19) days per week for 781.97 (SD=746.20) minutes during the first month of the pandemic (ps<0.05). Currently, participants reported binge-watching an average of 3.26 (SD=2.17) days per week for 625.75 (SD=654.15). Binge-watching increased during the COVID-19 pandemic, with time spent binge-watching more than doubling during the height of the pandemic. Since the height of the COVID-19 pandemic, binge-watching has decreased, but currently remains more than double the time spent binge-watching before the start of the pandemic.  

by Christina Torrealba and Dr. Yukiko Asada

Abstract: Understanding health inequalities among older adults is imperative, especially as Canada’s population ages. Individuals in the lowest socioeconomic positions have the poorest health outcomes, and health outcomes improve in a stepwise fashion among those with higher socioeconomic positions – this is known as the social gradient of health. In health inequality research, self-rated health is a frequently used subjective measure of health that is strongly associated with future health outcomes. Objective measures of health, including physical capability measures such as chair rise time, which correlates with future mortality, may be a vital addition in studies of aging and health inequality. The overall goal of the proposed project is to explore the use of chair rise time as a measure of health in older adults. Specifically, we aim to investigate the association between self-rated health and chair rise times, and to assess whether the social gradient of health exists in chair rise times among older adults. Follow-up data from the Canadian Longitudinal Study on Aging (CSLA) Comprehensive, over 30,000 participants aged 45-85 at the baseline, who completed both computer-assisted interviews and clinical and physical examinations, including physical capability tests was used. This study will show the potential use of a simple physical performance measure – chair rise times – for the assessment of health inequalities in the aging Canadian population. 

 by Jamie Clark, Dr. Shelley Doucet and Dr. Alison Luke

Abstract: The concept of a memory clinic was first introduced in the 1980’s to address the needs of people with or at risk of dementia and their caregivers (Jolley, 2006). With the second highest elderly population in Canada (Statistics Canada, 2020), New Brunswick is preparing for a surge of dementia-related disorders to accompany their rapidly aging population (Government of New Brunswick, 2017). The purpose of this environmental scan is to identify memory clinic-type programs that currently exist in New Brunswick and to determine current practices, with respect to the structure, function, processes, and services being implemented within these programs to provide care for people with or at risk of dementia and their caregivers. The primary method of data collection was an electronic questionnaire sent via email to each participating memory clinic-type program. Completed questionnaires were analyzed using qualitative content analysis. New Brunswick is home to three memory clinic-type programs, with one in Saint John, Moncton, and Fredericton. Moncton and Fredericton provide both diagnostic and post-diagnostic services while Saint John only provides post-diagnostic services. Both Moncton and Fredericton believe that with adequate resources, their clinics could be run much more efficiently. Further research should aim to determine the effectiveness and efficiency of these programs through a program evaluation and their findings used to guide the development and implementation of existing and new memory clinic-type programs in New Brunswick.  

by Dr. Lillian MacNeill, Dr. Shelley Doucet and Dr. Alison Luke

Abstract: In Canada, young people aged 15-24 had the fastest growing rates of hospitalization for opioid poisoning in the last decade, compared to other age groups. This cross-sectional study examined non-medical prescription opioid (NMPO) use in youth and young adults in New Brunswick. Participants completed an online survey about motives for NMPO use, and knowledge and utilization of local resources. All participants (N = 108) were self-reported opioid users between the ages of 15-25 years. Mostparticipants had been prescribed an opioid by a physician in the past. Regression analysis showed that being older, having an opioid prescription, and using opioids for pain, coping, or enhancement reasons predicted higher levels of disordered opioid use. Pain was the most common motive for NMPO use and the strongest predictor of disordered opioid use. Most participants reported having limited knowledge about harm reduction resources in their communities. Although the opioid crisis is a wide-spread concern, understanding why youth and young adults engage in NMPO use in local contexts may facilitate the development and implementation of resources that are more useful for these individuals, which could be scalable to other regions across Canada and internationally.

by Jocelyn Paul, Dr. Amy Bombay and Dr. Robyn McQuaid

Abstract: Understanding health inequalities among older adults is imperative, especially as Canada’s population ages. Individuals in the lowest socioeconomic positions have the poorest health outcomes, and health outcomes improve in a stepwise fashion among those with higher socioeconomic positions – this is known as the social gradient of health. In health inequality research, self-rated health is a frequently used subjective measure of health that is strongly associated with future health outcomes. Objective measures of health, including physical capability measures such as chair rise time, which correlates with future mortality, may be a vital addition in studies of aging and health inequality. The overall goal of the proposed project is to explore the use of chair rise time as a measure of health in older adults. Specifically, we aim to investigate the association between self-rated health and chair rise times, and to assess whether the social gradient of health exists in chair rise times among older adults. We will use the most recently available, first follow-up data from the Canadian Longitudinal Study on Aging (CSLA) Comprehensive, over 30,000 participants aged 45-85 at the baseline, who completed both computer-assisted interviews and clinical and physical examinations, including physical capability tests. This study will show the potential use of a simple physical performance measure – chair rise times – for the assessment of health inequalities in the aging Canadian population.