Données et preuves scientifiques

La prévalence des maladies chroniques est en constante augmentation, ce qui entraîne des problèmes de santé, des coûts de santé élevés et des décès prématurés. Il s’agit d’un problème mondial. L’Organisation mondiale de la santé estime que 35 millions de décès sont attribuables aux maladies chroniques chaque année, et ce nombre ne cesse d’augmenter.

La prévention et le dépistage des maladies chroniques avant que celles-ci n’explosent demeure le meilleur moyen de freiner cette augmentation, les soins primaires offrant les meilleures possibilités d’améliorer la situation étant donné que la plupart des actions de prévention et de dépistage sont offertes dans ces contextes. Cependant, dans notre système de santé actuel, la plupart des prestataires de soins primaires manquent de temps, de ressources et d’outils pour aborder la prévention et le dépistage du cancer et des maladies chroniques, et pour intégrer les nombreuses directives qui sont généralement centrées sur une maladie, un système d’organe ou un facteur de risque spécifique.

Les modèles traditionnels de soins de santé sont centrés sur une seule maladie, mais pour prévenir les maladies chroniques, il est nécessaire d’avoir une approche globale et proactive, et c’est là qu’intervient le Programme BETTER™. Nous adoptons une approche personnalisée et globale, en intégrant les meilleures cliniques existantes pour informer les patients sur leurs risques de maladies chroniques et sur les façons d’améliorer leur état de santé global. L’approche BETTER est unique car elle s’attaque aux causes premières des maladies chroniques et aux facteurs de risque communs pour les maladies cardiovasculaires, le diabète et le cancer.

Nous réunissons des médecins, des preneurs de décisions et des responsables de politiques de santé et des chercheurs qui collaborent pour améliorer la prévention des maladies chroniques. Les professionnels de soins de santé de première ligne tels que les infirmières, les nutritionnistes et les pharmaciens reçoivent une formation sur l’approche et les outils BETTER, devenant des experts en prévention et pouvant ainsi agir à titre de personne-ressource dans leur milieu de pratique.

Bien que les études aient démontré un impact positif du Programme BETTER™ sur la santé des patients à travers un grâce à un essai contrôlé randomisé par groupes, qui a identifié une amélioration de 37% du dépistage et de la prévention des maladies chroniques telles que la pression artérielle, le cancer, le tabagisme, la consommation d’alcool, le régime alimentaire et l’activité physique, de nouvelles recherches portant sur le programme sont actuellement en cours afin de continuer à recueillir des données auprès d’autres populations de patients (par ex. populations vulnérables, survivants du cancer), milieux de soins de santé (par ex. santé publique) et conditions de santé (par ex. prévention secondaire des maladies chroniques).

Initiatives en cours

2020-2022

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.

2021-2024

BETTER Women

BETTER Women is a health promotion program that offers women free access to a volunteer peer health coach who is trained to help them reach and maintain their health and cancer screening goals. The goals are created by the participant and a peer health coach will be there along the participant’s journey to provide additional motivation and help them stay accountable.

2021-2022

Virtual BETTER

The goal of Virtual BETTER is to assess the accessibility and acceptability of three different methods of delivering a BETTER Prevention Visit: telephone, video and in-person. Results from this study will also be used to assess the feasibility of a non-inferiority randomized control trial to compare outcomes between patients experiencing visits using these modalities.

Initiatives Réalisées

2016 – 2022

Projet BETTER WISE

Bien que la plupart des patients présentent des risques multiples, la plupart des directives et ressources sont généralement centrées sur une maladie, un système d’organe ou un facteur de risque spécifique.

2015 – 2020

BETTER HEALTH : Étude Durham

Retour a Données et preuves scientifiques BETTER HEALTH: Étude Durham, financée conjointement par l’IRSC et la Société canadienne du cancer, est une étude qui étend l’approche du Programme BETTER. Cela consiste à faire une réunion de soutien pour réviser la prévention et le dépistage des maladies chroniques (CDPS), entre une infirmière de la santé publique, […]

2012 – 2015

BETTER 2

Le projet BETTER 2 va impliquer des patients, des cliniciens, des chercheurs et des responsables de politiques dans le développement d’une approche intégrée, globale, longitudinale et durable pour la prévention et le dépistage des maladies chroniques.

Le projet TAP-BPS

L’objectif de cette collaboration était d’affiner et d’intégrer les versions électroniques des outils du programme BETTER (c.-à-d. l’application BETTER) dans la plate-forme TAPESTRY Application (ou TAP-App) développée pour être utilisée dans le dossier de santé personnel de McMaster.

2009 – 2012

BETTER Essai Contrôlé Randomisé (ECR)

L’objectif du projet BETTER initial était de déterminer si la prévention et le dépistage du cancer et d’autres maladies chroniques telles que le diabète et les maladies cardiovasculaires pouvaient être améliorés dans le contexte de la médecine familiale.

Séminaire Mainpro+ BETTER

Nous pouvons faire MIEUX – Séminaire Mainpro+ BETTER – Building on Existing Tools to Improve Cancer and Chronic Disease Prevention and Screening in Primary Care

Publications

Articles de revue

2021

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

Lofters, A.K., O’Brien, M.A., Sutradhar, R., Pinto, A.D., Baxter, N.N., Donnelly, P., Elliott, R., Glazier, R.H., Huizinga, J., Kyle, R., Manca, D.M., Pietrusiak, M.A., Rabeneck, L., Riordan, B., Selby, P., Sivayoganathan, K., Snider, C., Sopcak, N., Thorpe, K., Tinmouth, J., Wall, B., Zuo, F., Grunfeld, E., Paszat, L.

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.

Sopcak, N., Fernandes, C., O’Brien, M.A., Ofosu, D., Wong, M., Wong, T., Kebbe, M., Manca, D.

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

2019

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.

Aubrey-Bassler, K., Fernandes, C., Penney, C., Cullen, R. M., Meaney, C., Sopcak, N., Campbell-Scherer, D., Moineddin, R., Baxter, J., Krueger, P., Wilson, M., Pike, A., Grunfeld, E., Manca, D.

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

2018

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.

Manca, D.P., Aguilar, C., Grunfeld, E., Aubrey-Bassler, K., Shea-Budgell, M., Lofters, A., Campbell-Scherer, D., Sopcak, N., O’Brien, M.A., Meaney, C., Moineddin, R., McBrien, K., Salvalaggio, G., Krueger, P.

BMC Cancer 2018: 18 (927)

2017

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

Paszat, L., Sutradhar, R., O’Brien, M.A., Lofters, A., Pinto, A., Selby, P., Baxter, N., Donnelly, P.D., Elliott, R., Glazier, R.H., Kyle, R., Manca, D., Pietrusiak, M.A., Rabeneck, L., Sopcak, N., Tinmouth, J., Wall, B., Grunfeld, E.

BMC Public Health 2017: 17(754).

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

Sopcak, N., Aguilar, C., Nykiforuk, C., O’Brien, MA., Aubrey-Bassler, K., Cullen, R., Heatherington, M., Grunfeld, E., Manca, D.

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.

Salvalaggio, G., Meaney, C., Moinnedin, R., Grunfeld, E., Manca, D.

BMC Family Practice 2017: 18(73).

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

Carroll, J.C., Campbell-Scherer, D., Permaul, J.A., Myers, J., Manca, D., Meaney, C., Moineddin, R., Grunfeld, E.

Canadian Family Physician 2017: 63(1)

2016

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.

Sopcak, N., Aguilar, C., O’Brien, MA., Nykiforuk, C., Aubrey-Bassler, K., Cullen, R., Grunfeld, E., Manca, D.

Implementation Science 2016: 11(158)

2015

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).

Manca, D., Campbell-Scherer, D., Kandola, K., Aubrey-Bassler, K., Aguilar, C., Baxter, J., Meaney, C., Nykiforuk, C., Grunfeld, E.

Implementation Science 2015: 10 (107)

2014

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

Moineddin, R., Meaney, C., Grunfeld, E.

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.

Manca, D.P., Aubrey-Bassler, K., Kandola, K., Aguilar, C., Campbell-Scherer, D., Sopcak, N., O’Brien, MA., Meaney, C., Faria, V., Baxter J., Moineddin, R., Salvalaggio, G., Green, L., Cave, A., Grunfeld, E.

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.

Manca, D.P., Greiver, M., Carroll, J.C., Salvalaggio, G., Cave, A., Rogers, J., Pencharz, J., Aguilar, C., Barrett, R., Bible, S., Grunfeld, E.

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).

Campbell-Scherer, D., Rogers, J., Manca, D., Lang-Robertson, K., Bell, S., Salvalaggio, G., Greiver, M., Korownyk, C., Klein, D., Carroll, J.C., Kahan, M.M., Meuser, J., Buchman, S., Barrett, R.M., Grunfeld, E.

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

2013

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

Grunfeld, E., Manca, D., Moineddin, R., Thorpe, K.E., Hoch, J.S., Campbell-Scherer, D., Meaney, C., Rogers, J., Beca, J., Krueger, P., Mamdani, M

BMC Family Practice 2013: 14 (175)

2011

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

Shaw, N.T., Aceti, V., Campbell-Scherer, D., Leyland, M., Mozgala, V., Patterson, L., Sunley, S., Manca, D., Grunfeld, E.

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

Résumés publiés

2020

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

O’Brien, M.A., Lofters, A., Grunfeld, E., Makuwaza, T., Riordan, B., Manca, D., Sopcak, N., Cornacchi, S., Siva, K., Selby, P., Rabeneck, L., Baxter, N.

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

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

Lofters, A., Grunfeld, E., Manca, D., Ivers, N., Paszat, L., Fernandes, C., O’Brien, M.A.

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

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

Sopcak, N., Kebbe, M., Fernandes, C., Manca, D.

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

2014

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).

Sopcak, N., Aguilar, C., Aubrey-Bassler, K., Cullen, R., Heatherington, M., Manca, D

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.

Manca, D., Grunfeld, E., Aubrey-Bassler, K., Kandola, K., Campbell-Scherer, D., Moineddin, R., Meaney, C., Sopcak, N., Aguilar, C.

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.

Carroll, JC., Campbell-Scherer, D., Permaul, J., Myers, J., Manca, D., Meaney, C., Moineddin, R., Grunfeld, E.

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

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

Manca, D., Aguilar, C., Baxter, J., Campbell-Scherer, D., Kandola, K., Aubrey-Bassler, K., Meaney, C., Grunfeld, E.

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.

Sopcak, N., Manca, D., Aguilar, C., O’Brien, M., Aubrey-Bassler, K., Cullen, R., Heatherington, M., Grunfeld, E.

International Journal of Qualitative Methods 2014: 13(1): 589-627.

2013

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.

Campbell–Scherer DL, Salvalaggio G, Aguilar C, Carroll J, Aubrey K, Rogers J, Meaney C, Korownyk C, Grunfeld E, Manca D.

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.

Manca, D., Aguilar, C., Carroll, J., Cave, A., Greiver, M., Patterson, L., Pencharz, J., Salvalaggio, G., Grunfeld, E

Family Medicine Journal 2013: 45 (Sup4)

On the analysis of composite endpoints in primary care.

Moineddin, R., Meaney, C., Grunfeld, E.

Family Medicine Journal. 2013; 45 (Sup2).

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

Manca, D., Rogers, J., Moineddin, R., Meaney, C., Campbell-Scherer, D., Thorpe, K., Mumdani, M., Hoch, J., Beca, J., Krueger, P., Patterson, L., Aguilar, C., Grunfeld, E. on behalf of the BETTER Trial Investigators.

Family Medicine Journal. 2013; 45 (Sup2)

The BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice) Project: A Qualitative Exploration of the Prevention Practitioner Role.

Manca, D., Aguilar, C., Sopcak, N.

International Journal of Qualitative Methods 2013: 12(1): 742-836.

2012

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

Campbell- Scherer, D., Rogers, J., Lang – Robertson, K., Bell, S., Grunfeld, E., Manca, D.

Family Medicine Journal. 2012; 44 (Sup1)

2011

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

Salvalaggio,G., Campbell-Scherer, D., Steele, L., Mozgala, V., Lang-Robertson, K., Bell, S.,Rogers, J., Manca, D., Grunfeld, E.

Family Medicine Journal 2011; 43(Sup1)

Publications sans comité de lecture

2020

Prevention before treatment: How an OICR investigator is shifting the paradigm of chronic disease in Canada.

Grunfeld, E.

OICR News. July 23, 2020 Edition.

2019

Cancer SCN Research.

Cancer Strategic Clinical Network (SCN).

Cancer SCN Quarterly Update. January – March 2019 Edition.

BETTER Recognized in PMH Implementation Kit.

Department of Family Medicine, University of Alberta.

Family Medicine Research Newsletter. October 2019 Edition.

2018

BAP in Research: BETTER WISE.

Centre for Collaboration, Motivation, and Innovation.

CCMI BAP Community of Practice Newsletter. December 2018 Edition.

New care model increases preventive behaviour in patients.

Young, L.

Folio website. July 4, 2018.

The BETTER Institute.

Department of Family Medicine, University of Alberta.

Family Medicine Research Newsletter. July 2018 Edition.

BETTER Program Receives CPAC Grant.

Department of Family Medicine, University of Alberta.

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

2017

Exercise aids in treating illnesses

Waldman, D.

Alberta Health Services, Alberta Innovates, Issue 26.

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

Access Improvement, Alberta Health Services. Volume 3.1.

2016

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

Canadian Partnership Against Cancer.

Cancerview website. August 17, 2016 Edition.

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

Cancer Cares, Alberta Health Services.

2015

NWT BETTER Program

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

2014

Empowering healthy lifestyle choices: NWT-specific videos being used in push to prevent chronic diseases.

Thompson, R.

Northern News Services. November 6, 2014 Edition.

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

Anselmi, E.

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

2013

Improve your health.

Dooley, D.

The Labradorian. November 19, 2013 Edition.

Research Teams: The BETTER 2 Program

Manca, D., Aguilar, C., Sopcak, N.

Covenant Health Research Publication (newsletter)

2011

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

Aguilar, C., Campbell-Scherer, D., Salvalaggio, G., Manca, D.

Covenant Health Research Publication (newsletter)