Prevention and screening of chronic diseases before they start has been identified as the best way to prevent this rise in disease, with primary care providing the greatest opportunity for impact as most prevention and screening actions are offered in these settings; However,in our current healthcare system, most primary care providers lack the time, resources and tools to address cancer and chronic disease prevention and screening, and to integrate the many guidelines and resources that are focused on one specific disease, organ system, or lifestyle risk.

Traditional models of health care focus on one disease, but to prevent chronic diseases we need a proactive, comprehensive approach, and this is where The BETTER Program™ comes in. We take a personalized, comprehensive approach, by carefully blending the best available clinical evidence to inform patients about their chronic disease risk and how to improve their overall health. BETTER is unique because it addresses the root causes of chronic diseases and common risk factors for heart disease, diabetes, and cancer.

We bring together Clinicians, Policy Makers, Researchers, and Patients to improve chronic disease prevention. Frontline health care professionals such as nurses, dietitians, and pharmacists are trained on the BETTER approach and tools, becoming experts in prevention and a resource to their practice setting.

While The BETTER Program™ has been demonstrated to have a positive impact on patients’ health through a cluster randomized controlled trial, which found a 37% improvement in the screening and prevention of chronic diseases such as blood pressure, cancer, smoking, alcohol consumption, diet, and physical activity, research involving the program is ongoing to continue to build evidence for the program with diverse patient populations (e.g. vulnerable populations, cancer survivors), health care settings (e.g. public health), and health conditions (e.g. secondary prevention of chronic disease)

Ongoing Initiatives

 

BETTER Life Study

The goal of the BETTER Life study is to learn if the BETTER HEALTH: Durham program which has been shown to help people 40-64 years take steps to prevent chronic disease, can be adapted for younger persons ages 18 to 39 years.

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2016 – 2022

The BETTER WISE Project

The BETTER approach to chronic disease prevention and screening transforms clinical practice, utilizing patient-level intervention conducted by a healthcare professional within the primary care practice setting.

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Completed Initiatives

2015 – 2020

BETTER HEALTH: Durham Study

Back to Evidence The BETTER HEALTH: Durham study, jointly funded by CIHR and the Canadian Cancer Society, is a study that  extends the BETTER Program approach. It consists of a supportive meeting to review chronic disease prevention and screening (CDPS) between a public health nurse taking on the role of Prevention Practitioner and a participant […]

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2015 – 2016

The TAP-BPS Project

The aim of this collaboration was to refine and integrate electronic versions of the BETTER Program tools (i.e. the BETTER App) into the TAPESTRY Application (or TAP-App) platform developed for use in the McMaster personal health record.

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2012 – 2015

The BETTER 2 Program

The BETTER 2 Program engaged patients, clinicians, researchers and policy-makers to develop an integrated, comprehensive, longitudinal and sustainable approach to chronic disease prevention and screening within the various settings.

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2009 – 2012

The BETTER Trial

The purpose of the BETTER Trial was to determine whether prevention and screening for cancer and other chronic diseases such as diabetes and heart disease could be improved in the family practice setting.

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The BETTER Mainpro+ Workshop

We can do BETTER – Building on Existing Tools to Improve Cancer and Chronic Disease Prevention and Screening in Primary Care Mainpro+ Workshop

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Publications

Journal Articles

Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial.

BMC Public Health 03 August 2021; 21(1496).

What is a prevention visit? A qualitative study of a structured approach to prevention and screening – the BETTER WISE project.

BMC Family Practice 19 July 2021; 22(153).

The effectiveness of a proven chronic disease prevention and screening intervention in diverse and remote primary care settings: an implementation study on the BETTER 2 Program.

British Journal of General Practice (BJGP) Open 17 September 2019; bjgpopen19X101656.

The BETTER WISE protocol: Building on existing tools to improve cancer and chronic disease prevention and screening in primary care for wellness of cancer survivors and patients – a cluster randomized control trial embedded in a mixed methods design.

BMC Cancer 2018: 18 (927)

BETTER HEALTH: Durham – protocol for a cluster randomized trial of BETTER in community and public health settings.

BMC Public Health 2017: 17(754).

Patients’ perspectives on BETTER prevention and screening: Qualitative findings from Newfoundland & Labrador.

British Journal of General Practice (BJGP) Open 8 August 2017; BJGP-2017-0061.

Moderate mental illness as a predictor of chronic disease prevention and screening.

BMC Family Practice 2017: 18(73).

Family history of chronic disease: prevalence, accuracy and utility in prevention and screening.

Canadian Family Physician 2017: 63(1)

Implementation of the BETTER 2 Program: A qualitative study exploring barriers and facilitators of a novel way to improve chronic disease prevention and screening in primary care.

Implementation Science 2016: 11(158)

Developing clinical decision tools to implement chronic disease prevention and screening in primary care: the BETTER 2 Program (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care).

Implementation Science 2015: 10 (107)

On the analysis of composite measures of quality in medical research.

Statistical Methods in Medical Research

Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

Implementation Science 2014: 9 (135)

Finding a BETTER Way: A qualitative study exploring the Prevention Practitioner intervention to improve chronic disease prevention and screening in family practice.

BMC Family Practice 2014: 15 (66)

Guideline Harmonization and Implementation Plan for the BETTER Trial (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice).

Canadian Medical Association Journal Open (CMAJOpen) : 2(1): E1-10.

Improving Chronic Disease Prevention and Screening in Primary Care: Results of the BETTER Pragmatic Cluster Randomized Controlled Trial.

BMC Family Practice 2013: 14 (175)

Current Use of Electronic Medical Records in primary care of chronic disease: the implications for clinical governance.

Clinical Governance: An International Journal 2011: 16(4); 353-363

Published Abstracts

PCR101: Qualitative evaluation of the BETTER HEALTH intervention: views of community residents living in low income neighborhoods.

Abstracts from the 48th NAPCRG Annual Meeting. November 20, 2020, Virtual.

OP223: The BETTER Program: from clinical trials to nation-wide implementation.

Abstracts from the 48th NAPCRG Annual Meeting. November 20, 2020, Virtual.

Patients’ perspectives of BETTER WISE a chronic disease prevention and screening project.

International Journal of Qualitative Methods 2020: 19: 1-92.

Abstract P-51: Facilitators and Barriers to the Implementation of the BETTER 2 Program: Qualitative Evaluation of a New Approach to Chronic Disease Prevention and Screening (CDPS).

Abstracts of the Cancer and Primary Care Research International (Ca-PRI) Network Seventh Annual Meeting: New Partnerships in Primary Care Research. June 10-13, 2014, Winnipeg, Manitoba, Canada. European Journal of Cancer Care 2014: 23 (Sup1): 1-23.

Abstract P-50: Finding a BETTER Way: A Chronic Disease Prevention and Screening Program.

Abstracts of the Cancer and Primary Care Research International (Ca-PRI) Network Seventh Annual Meeting: New Partnerships in Primary Care Research. June 10=13, 2014, Winnipeg, Manitoba, Canada. European Journal of Cancer Care 2014: 23 (Sup1): 1-23.

Family history in primary care: feasibility, accuracy and utility in chronic disease prevention and screening.

Canadian Family Physician 2014; 60 (Sup1): S1-S43

Finding a BETTER Way: A Program to Facilitate Chronic Disease Prevention ad Screening in Primary Care.

Canadian Family Physician 2014; 60 (Sup1): S1-S43

How can we do BETTER? Contrasting perspectives on a new approach to chronic disease prevention and screening (CDPS) in Newfoundland and Labrador.

a new approach to chronic disease prevention and screening (CDPS) in Newfoundland and Labrador. International Journal of Qualitative Methods 2014: 13(1): 589-627.

Evidence Synthesis, Translation, Tool Development and Implementation Plan for the BETTER 2 (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) Project.

Family Medicine Journal 2013: 45 (Sup4)

Doing it BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening): a qualitative evaluation of a personalized approach to prevention and screening.

Family Medicine Journal 2013: 45 (Sup4)

On the analysis of composite endpoints in primary care.

Family Medicine Journal. 2013; 45 (Sup2).

Building on Existing Tools to Improve Chronic Disease Prevention and Screening: Results of the BETTER Trial.

Family Medicine Journal. 2013; 45 (Sup2)

Development of Clinical Interventions for the Better Project (Building on Existing Tools to Improve Chronic Disease Prevention in Family Practice).

Family Medicine Journal. 2012; 44 (Sup1)

Screening And Primary Prevention In Primary Care In Patients With Co-morbid Depression: Evidence Review And Tool Identification for The Better Coalition.

Family Medicine Journal 2011; 43(Sup1)

Non-Peer Reviewed Publications

Cancer SCN Research.

Cancer SCN Quarterly Update. January – March 2019 Edition.

BETTER Recognized in PMH Implementation Kit.

Family Medicine Research Newsletter. October 2019 Edition.

BAP in Research: BETTER WISE.

CCMI BAP Community of Practice Newsletter. December 2018 Edition.

The BETTER Institute.

Family Medicine Research Newsletter. July 2018 Edition.

BETTER Program Receives CPAC Grant.

Family Matters: Your updates from the University of Alberta Department of Family Medicine. May/June 2018 Edition.

Exercise aids in treating illnesses

Alberta Health Services, Alberta Innovates, Issue 26.

CLASP 1 AND CLASP 1 Renewals – The BETTER 2 Program.

Cancerview website. August 17, 2016 Edition.

Improving cancer and chronic disease prevention and screening through the BETTER WISE Project

Cancer Cares, Alberta Health Services.

NWT BETTER Program

The Bear Facts: A Newsletter for Employees of the Government of the Northwest Territories

Assessing the cost of sitting: Study shows Canadians at higher risk of chronic conditions due to sedentary lifestyles.

Northern News Services

Making BETTER Choices.

The Bear Facts: A Newsletter for the Employees of the Government of the Northwest Territories

Putting science back into the Family Medicine Forum

College of Family Physicians of Canada website

Projects and Initiatives Around the North: NWT BETTER Program

The Canadian Circumpolar Health Newsletter

Improve your health.

The Labradorian. November 19, 2013 Edition.

Research Teams: The BETTER 2 Program

Covenant Health Research Publication (newsletter)

Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice: the BETTER Project

Covenant Health Research Publication (newsletter)

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