3 November


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New TREC newsletter

November 2017

New TREC articles from TREC researchers

Prevalence and Determinants of Poor Food Intake of Residents Living in Long-Term Care Canada-flat-icon
Non UofA Access

Keller HH, Carrier N, Slaughter SE, Lengyel C, Steele CM, Duizer L, Morrison J, Brown KS, Chaudhury H, Yoon MN, Duncan AM, Boscart V, Heckman G, Villalon L.
J Am Med Dir Assoc [Internet]. 2017 Nov 1;18(11):941-7

OBJECTIVE: Poor food intake is known to lead to malnutrition in long-term care homes (LTCH), yet multilevel determinants of food intake are not fully understood, hampering development of interventions that can maintain the nutritional status of residents. This study measures energy and protein intake of LTCH residents, describes prevalence of diverse covariates, and the association of covariates with food intake.

The Care of Older Adults Experiencing Cognitive Challenges: How Interprofessional Teams Collaborate Canada-flat-icon
Non UofA Access

Dahlke S, Meherali S, Chambers T, Freund-Heritage R, Steil K, Wagg A.
Can J Aging [Internet]. 2017 Sep 18:1-16

Abstract: We conducted a scoping study to examine how interprofessional health care teams improve the outcomes of older adults experiencing cognitive challenges. We searched Ovid, Medline 1946, and MEDLINE In-Process and other non-indexed citations, using the concepts multi or interdisciplinary care teams, confusion or cognitive impairment, and elderly adults. Of 4,554 articles the review yielded, 34 relevant to our inquiry, using Arksey and O’Malley’s methodological framework. Twenty-nine per cent of authors reported on the processes interprofessional teams use to achieve positive outcomes for older adults. They highlighted the importance of communication, staff strategies, and education interventions in achieving outcomes with older adults and in supporting interprofessional collaboration. The review revealed knowledge gaps about the processes teams use to collaborate in caring for older adults experiencing cognitive challenges, and how to best incorporate older adults and their families’ perspectives in team decisions. More research to understand processes interprofessional teams use is needed.

New articles from TREC researchers

Persistence and adherence with mirabegron vs antimuscarinics in overactive bladder: Retrospective analysis of a UK General Practice prescription database
Non UofA Access

Wagg AS, Foley S, Peters J, Nazir J, Kool-Houweling L, Scrine L.
Int J Clin Pract [Internet]. 2017 Oct;71(10):10.1111/ijcp

INTRODUCTION AND OBJECTIVES: Persistence with antimuscarinic (AM) drugs prescribed for overactive bladder (OAB) is poor. This study aimed to compare persistence and adherence with the beta-3-adrenoceptor agonist mirabegron (MIR) vs AMs over 12 months.

Improving measurement-invariance assessments: correcting entrenched testing deficiencies
Non UofA Access

Hayduk LA.
BMC Med Res Methodol [Internet]

BACKGROUND: Factor analysis historically focused on measurement while path analysis employed observed variables as though they were error-free. When factor- and path-analysis merged as structural equation modeling, factor analytic notions dominated measurement discussions – including assessments of measurement invariance across groups. The factor analytic tradition fostered disregard of model testing and consequently entrenched this deficiency in measurement invariance assessments.

Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups
Non UofA Access

Roberts JL, Din NU, Williams M, Hawkes CA, Charles JM, Hoare Z, Morrison V, Alexander S, Lemmey A, Sackley C, Logan P, Wilkinson C, Rycroft-Malone J, Williams NH.
BMJ Open [Internet]. 2017 Oct 11;7(10):014362

OBJECTIVES: To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.

Survey participation

Training needed to help improve care of older Canadians living with frailty

Canadian Frailty Network
Deadline: 6 November 2017

We want to understand what you think will help trainees with future professional or academic work, or employment in a field related to care of older adults living with frailty. Your input will help ensure our training program provides experiential learning outside of normal academic or clinical channels.
In particular we are interested in hearing from students and post-docs, and those working in industry or for care providers.

Calls for Abstracts

International Federation on Aging 14th Global Conference on Ageing Canada-flat-icon

8-10 August 2018, Toronto, ON
Deadline: 1 December 2017

The conference themes and sub-themes are aligned with the World Health Organization (WHO) World Report on Ageing and Health and the WHO Global Strategy and Action Plan (GSAP). The WHO Global Strategy is a significant step toward establishing a framework for member states, and focuses on five strategic objectives: committing to action on healthy ageing in every country, developing age-friendly environments, aligning health systems with the needs of older populations, developing sustainable and equitable systems of long-term care, and improving the measurement and monitoring of healthy ageing.

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Grants & Awards

Education Fund for Personal Support Workers in Long-Term Care Canada-flat-icon

Ontario Personal Support Worker Education Fund

Ontario long-term care homes can now apply for tuition and backfill funding to train Personal Support Workers (PSW) in Excellence in Resident-Centred Care (ERCC) courses. The Ministry of Health and Long-Term Care has launched a new education fund in collaboration with the Ontario Centres for Learning, Research and Innovation in Long-Term Care to deliver ERCC in partnership with Conestoga College. Up until March 31, 2018, long-term care homes have the opportunity to train all PSWs working in their home on practical, person-centred approaches to care that may improve quality of care for residents. The train-the-trainer approach allows homes to build capacity for ongoing learning and provides opportunities for training for 2 years.

Pre-announcement: SPOR Network in Primary and Integrated Health Care Innovation (PIHCI) – Knowledge Synthesis Canada-flat-icon

CIHR
Expected funding opportunity launch: November 2017
Expected full application deadline: February 2018

In November 2017, the Canadian Institutes of Health Research, will launch the SPOR Network in Primary and Integrated Health Care Innovation (PIHCI) – Knowledge Synthesis funding opportunity through the Strategy for Patient-Oriented Research (SPOR), with scientific leadership shared across the CIHR Institute of Health Services and Policy Research, the CIHR Institute of Population and Public Health, the CIHR Institute of Human Development, Child and Youth Health, the CIHR Institute of Aging, in collaboration with the CIHR Institute of Nutrition, Metabolism and Diabetes.
The specific objective of this funding opportunity is to support cross-jurisdictional teams of researchers and knowledge users to produce knowledge syntheses or scoping reviews relevant to the priorities of the Primary and Integrated Health Care Innovations (PIHCI) Network, contributing to the use of synthesized evidence in decision-making and practice across multiple jurisdictions.
Please contact support@cihr-irsc.gc.ca for more information. Visit ResearchNet for the official funding opportunity launch.

NCCPH KT awards for graduate students Canada-flat-icon

National Collaborating Centre for Methods and Tools
Deadline: 12 December 2017

The objective of the NCCPH Knowledge Translation Awards is to recognize the work of graduate students in Canada. The Canadian Institutes of Health Research define knowledge translation as a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.
Up to three awards will be given at Public Health 2018, this year’s annual Canadian Public Health Association conference. Travel, accommodation and registration fees to attend Public Health 2018, will be covered up to a maximum of $1,500. Following the conference, the award winners will be required to give a webinar on their topic as an opportunity to make their work known within public health networks in Canada.

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Publications

KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Research Practice and Methodology
Aging

KT

Addressing the Practice Context in Evidence-Based Practice Implementation: Leadership and Climate

Clayton Shuman, PhD diss., University of Michigan, 2017

Opportunities and challenges in conducting community-engaged dissemination/implementation research
Non UofA Access

No abstract available.

Training in dissemination and implementation research: a field-wide perspective
Non UofA Access

Proctor EK, Chambers DA.
Transl Behav Med [Internet]. 2017 Sep;7(3):624-35

Abstract: We report outcomes of an NIH-convened meeting on training for dissemination and implementation (D&I) research, focused on accelerating translation of research to healthcare practice. Participants included leaders of current trainings, center directors, and those trained in existing programs. Given the large proportion of D&I research focused on cancer control, mental health, and substance abuse, participants overwhelmingly reflected the experiences and challenges of gaining capacity in behavioral health-related D&I research. The 2-day meeting required participants to draw upon their experiences to help build a field-wide perspective for D&I research training, identify resources needed to support this perspective, and brainstorm gaps in training that needed to be filled. Questions were sent to participants in advance, and responses were synthesized and presented to discuss during the meeting. A preliminary “field-wide” perspective emerged, spanning multiple disciplines, training models, and career levels. Current programs face high demand, need for continued evolution to reflect field advances, and sustainability challenges. Current gaps include implementation practice and predoctoral training. Federal funding is key to D&I research training, be it through grants or agency-led training programs, in order to span and address specialized disease and disorder foci and career tracks.

Mapping training needs for dissemination and implementation research: lessons from a synthesis of existing D&I research training programs
Non UofA Access

Chambers DA, Proctor EK, Brownson RC, Straus SE.
Transl Behav Med [Internet]. 2017 Sep;7(3):593-601

Abstract: With recent growth in the field of dissemination and implementation (D&I) research, multiple training programs have been developed to build capacity, including summer training institutes, graduate courses, degree programs, workshops, and conferences. While opportunities for D&I research training have expanded, course organizers acknowledge that available slots are insufficient to meet demand within the scientific and practitioner community. In addition, individual programs have struggled to best fit various needs of trainees, sometimes splitting coursework between specific D&I content and more introductory grant writing material. This article, stemming from a 2013 NIH workshop, reviews experiences across multiple training programs to align training needs, career stage and role, and availability of programs. We briefly review D&I needs and opportunities by career stage and role, discuss variations among existing training programs in format, mentoring relationships, and other characteristics, identify challenges of mapping needs of trainees to programs, and present recommendations for future D&I research training.

Fostering integrated approaches to dissemination and implementation and community engaged research
Non UofA Access

Blachman-Demner DR, Wiley TRA, Chambers DA.
Transl Behav Med [Internet]. 2017 Sep;7(3):543-6

No abstract provided.

The Diffusion of Evidence-Based Practice: Reviewing the Evidence-Based Practice Networks in the United States and German-Speaking Countries
Non UofA Access

Ghanem C, Lawson TR, Pankofer S, Maragkos M, Kollar I.
J Evid Inf Soc Work [Internet]. 2017;14(2):86-118

Abstract: Evidence-based practice (EBP) has had a major influence on U.S. social work while it has rarely been adapted in German-speaking countries. This study investigates how knowledge about EBP is diffused within and across geographical contexts. Network analysis methods reveals different diffusion patterns and provide reasons for these differences. For example, the U.S. discourse is self-contained and based on a more homogeneous knowledge base, while the German discourse is more heterogeneous and focuses on a notion of reflexive professionalism. The different conceptual influences within the U.S. and German discourses are discussed in light of future directions of disciplinary social work.

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Health Care Administration and Organization

Enabling at-homeness for residents living in a nursing home: Reflected experience of nursing home staff
Non UofA Access

Saarnio L, Boström A, Hedman R, Gustavsson P, Öhlén J.
Journal of Aging Studies [Internet]. 2017;43(Supplement C):40-5

Abstract: Older people are often living the last period of their lives in institutions such as nursing homes. Knowledge of this period, specifically related to at-homeness which can be described as wellbeing in spite of illness and has been regarded as one of the goals in palliative care, has been very little researched in the context of nursing homes and the experience of nursing home staff. The aim of this study was to explore the experiences of nursing home staff of how to enable at-homeness for residents. Qualitative interpretive description methodology guided the design. The data generation was conducted in winter 2014–2015, when seven repetitive reflective group discussions with staff in a nursing home were held. The results show five patterns for how healthcare staff enabled at-homeness for the residents: Striving to know the resident, Showing respect for the resident’s integrity, Creating and working in family-like relationships, Helping to find a new ordinariness and Preparing and making plans to ensure continuity. Nursing home staff seem to have collegial knowledge of how to enable at-homeness for the residents in a nursing home. Close relationships with respect for the resident’s integrity stand out as enabling at-homeness.

Perceptions of Communication and Respect Among Coworkers: a Comparison of Employees with and Without Experience in Long-Term Care Environments
Non UofA Access

Cox L, Mainiero F.
J Hum Rights Soc Work [Internet]

Abstract: The aim of this study was to evaluate how the work experiences of employees in long-term care affected their perceptions and levels of respect and communication. Content considers the effects of professional and non-professional long-term care (LTC) staff’s previous work experience, training, and supervision. The notion of hierarchy is raised in the context of its relationship to human rights, because where human right-based care helps to fulfill the humanity of people, the outcome tends to benefit both service users and care providers. As LTC environments continue to expand and reform, they employ a wide range of professional and non-professional staff who have varied educational levels, skill sets, and job responsibilities. Staff burnout and high turnover rates concern LTC administrators and federal and state policies do not require much training or continuing education for certified nursing assistants and other non-professional staff. Relationship issues and experience are important considerations because they connect to staff retention and quality patient care. Herein, a sample of 119 LTC employees was divided into two groups, those with prior LTC experience and those without any prior LTC work experience. Four research questions were tested and limitations and implications for future research are discussed. Findings revealed differences between the two groups; employees who had prior LTC experience perceived higher levels of respect toward residents and toward each other than those employees with no prior experience.

Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project
Non UofA Access

Ersek M, Hickman SE, Thomas AC, Bernard B, Unroe KT, Meeks S.
Gerontologist [Internet]

Background and Objectives: The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders’ perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption.

Nursing Home Use Across The Spectrum of Cognitive Decline: Merging Mayo Clinic Study of Aging With CMS MDS Assessments
Non UofA Access

Emerson JA, Smith CY, Long KH, Ransom JE, Roberts RO, Hass SL, Duhig AM, Petersen RC, Leibson CL.
J Am Geriatr Soc [Internet]. 2017 Oct;65(10):2235-43

BACKGROUND/OBJECTIVES: Objective, complete estimates of nursing home (NH) use across the spectrum of cognitive decline are needed to help predict future care needs and inform economic models constructed to assess interventions to reduce care needs.

What works in implementation of integrated care programs for older adults with complex needs? A realist review Canada-flat-icon
Non UofA Access

Kirst M, Im J, Burns T, Baker GR, Goldhar J, O’Campo P, Wojtak A, Wodchis WP.
J Qual Health Care [Internet]. 2017 Oct 1;29(5):612-24

PURPOSE: A realist review of the evaluative evidence was conducted on integrated care (IC) programs for older adults to identify key processes that lead to the success or failure of these programs in achieving outcomes such as reduced healthcare utilization, improved patient health, and improved patient and caregiver experience.

Impact of Nursing Home Palliative Care Teams on End-of-Life Outcomes: A Randomized Controlled Trial
Non UofA Access

Temkin-Greener H, Mukamel DB, Ladd H, Ladwig S, Caprio TV, Norton SA, Quill TE, Olsan TH, Cai X.
Med Care [Internet]

BACKGROUND: Deficits in end-of-life care in nursing homes (NHs) are reported, but the impact of palliative care teams (PCTeams) on resident outcomes remains largely untested.
OBJECTIVE: Test the impact of PCTeams on end-of-life outcomes.

Development and pilot testing of a decision aid for the initiation of antipsychotic medications in persons with dementia in long-term care using a systematic approach: a study protocol Canada-flat-icon
Non UofA Access

Malloy-Weir LJ, Kirk A.
BMJ Open [Internet]. 2017 Oct 25;7(10):018769

INTRODUCTION: Antipsychotic medications are commonly used in long-term care to treat neuropsychiatric symptoms of dementia despite concerns that their risks (eg, infection, falls, death) may outweigh their benefits. This study protocol outlines the development and pilot testing of a decision aid for antipsychotic medications that is tailored to the information needs of residents with dementia in long-term care and family caregivers (or decision makers). The goals of the decision aid are to help residents and caregivers (1) better understand the risks and benefits of antipsychotic medications in long-term care, and (2) make informed decisions about their use (or non-use).

Nurses and nurse assistants’ experiences with using a design thinking approach to innovation in a nursing home
Non UofA Access

AIM: The aim of this study was to evaluate nurses’ and nurse assistants’ experiences with a design thinking approach to innovation used in a nursing home in Norway.
BACKGROUND: A design thinking approach to innovation that focuses on users’ needs can be employed to address many of the challenges facing health care providers in a field facing a growing ageing population, complex diseases and financial shortfalls.

Nursing staff intentions towards managing deteriorating health in nursing homes: a convergent parallel mixed methods study using the Theory of Planned Behaviour
Non UofA Access

AIMS AND OBJECTIVES: To predict the factors that are most important in explaining nursing staff intentions towards early detection of the deteriorating health of a resident and providing subacute care in the nursing home setting.

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Health Care Innovation and Quality Assurance

Hearing the Voice of the Resident in Long-Term Care Facilities-An Internationally Based Approach to Assessing Quality of Life
Non UofA Access

Morris JN, Declercq A, Hirdes JP, Finne-Soveri H, Fries BE, James ML, Geffen L, Kehyayan V, Saks K, Szczerbinska K, Topinkova E.
J Am Med Dir Assoc [Internet]

OBJECTIVES: interRAI launched this study to introduce a set of standardized self-report measures through which residents of long-term care facilities (LTCFs) could describe their quality of life and services. This article reports on the international development effort, describing measures relative to privacy, food, security, comfort, autonomy, respect, staff responsiveness, relationships with staff, friendships, and activities. First, we evaluated these items individually and then combined them in summary scales. Second, we examined how the summary scales related to whether the residents did or did not say that the LTCFs in which they lived felt like home.

Characteristics of Quality Improvement Champions in Nursing Homes: A Systematic Review With Implications for Evidence-Based Practice
Non UofA Access

Woo K, Milworm G, Dowding D.
Evid Based Nurs [Internet]

BACKGROUND: Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality.

The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management
Non UofA Access

Reuben DB, Gazarian P, Alexander N, Araujo K, Baker D, Bean JF, Boult C, Charpentier P, Duncan P, Latham N, Leipzig RM, Quintiliani LM, Storer T, McMahon S.
J Am Geriatr Soc [Internet]

Abstract: In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients’ PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019.

Ethnographic Exploration of Empowerment to Improve Elderly Residents’ Quality of Life
Non UofA Access

Tabatabaei SZ, Ebrahimi F, Hamzah ABH, Rezaeian M, Kamrani MA.
Iran J Nurs Midwifery Res [Internet]. 2017;22(5):414-9

BACKGROUND: Evidence underscores that empowerment is central to improve the elderly residents’ quality of life. In truth, empowerment is a process through which individuals gain better control over their life. The aim of this study was to explore how perceived empowerment influence on the quality of life among elderly Malay residents.

The Influence of Thermal Comfort on the Quality of Life of Nursing Home Residents
Non UofA Access

Mendes A, Papoila AL, Carreiro-Martins P, Aguiar L, Bonassi S, Caires I, Palmeiro T, Ribeiro AS, Neves P, Pereira C, Botelho A, Neuparth N, Teixeira JP.
J Toxicol Environ Health A [Internet]. 2017;80(13-15):729-39

Abstract: Thermal comfort (TC) parameters were measured in 130 rooms from nursing homes (NH), following ISO 7730:2005 in order to evaluate the influence of winter season TC indices on quality of life (QoL) in older individuals. Mean radiant temperature (mrT), predicted mean vote (PMV) and predicted percent of dissatisfied people (PPD) indices, and the respective measurement uncertainties were calculated using Monte Carlo Method. The WHOQOL-BREF questionnaire was conducted from September 2012 to April 2013, during the winter season TC sampling campaign. Winter PMV and PPD indices showed significant differences between seasons in median values for comfort. There were also significant differences between seasons for air temperature, air velocity, mrT, and relative humidity. The winter PMV index displayed a “slightly cool” [≤-1] to “cool” [≤-2] in thermal sensation scale [-3 to 3]. PPD index reflected this discomfort as evidenced by a high rate of predicted dissatisfied occupants (64%). The influence of winter season TC on older individual QoL results demonstrated that values of PMV above -0.7 had higher mean score of QoL (coefficient estimate: 11.13 units) compared with values of PMV below -0.7. These findings are of relevance to public health and may be useful for understanding NH indoor environment variables thus implementing preventive policies in terms of standards and guidelines for these susceptible populations.

Changing Focus: End-of-Life Care in a New York State Managed Long-Term Care Program
Non UofA Access

Meeker MA, Waldrop DP.
J Appl Gerontol [Internet]

Abstract: In the United States, managed long-term care programs offer a noninstitutional approach to meeting the needs of increasing numbers of frail elders. Providing services that support both quality of life and quality of dying poses unique challenges. Using a qualitative descriptive design, we explored these challenges from the perspectives of care providers. Themes were identified using qualitative content analysis techniques applied to transcripts of 33 semistructured interviews. Professionals comprising an interdisciplinary care team and home health aide direct care providers described cues by which they identified movement into the end-of-life phase, their understandings of how care changed, and their concerns and recommendations for improvement. When the changing care needs could be met, a “good death” ensued, but that was not always possible. Managed long-term care programs are called upon to develop the capacity to integrate the phase of dying into the full story of each life for which they care.

Implementation and effects of Movement-oriented Restorative Care in a nursing home – a quasi-experimental study
Non UofA Access

Henskens M, Nauta IM, Scherder EJA, Oosterveld FGJ, Vrijkotte S.
BMC Geriatr [Internet]. 2017 Oct 23;17(1)

BACKGROUND: The prevalence of dementia is expected to increase rapidly, and institutionalization is a common consequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization and a determinant for the quality of life (QoL). A promising method to increase functional independence in nursing homes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) is derived from the concept of FFC and restorative care and focuses on the integration of physical activity in the daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective of this study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursing home residents with dementia.

Evaluation of data quality of interRAI assessments in home and community care Canada-flat-icon
Non UofA Access

Hogeveen SE, Chen J, Hirdes JP.
BMC Med Inform Decis Mak [Internet]. 2017 Oct 30;17(1):9

BACKGROUND: The aim of this project is to describe the quality of assessment data regularly collected in home and community, with techniques adapted from an evaluation of the quality of long-term care data in Canada.

Two Sides of Bipolar Disorder in Nursing Homes: Mental Healthcare and Quality Indicators
Non UofA Access

Kirkham JG, Seitz DP.
Am J Geriatr Psychiatry [Internet]

No abstract available.

Does Person-Centered Care Improve Residents’ Satisfaction With Nursing Home Quality?
Non UofA Access

Poey JL, Hermer L, Cornelison L, Kaup ML, Drake P, Stone RI, Doll G.
J Am Med Dir Assoc [Internet]. 2017 Nov 1;18(11):974-9

OBJECTIVE: Person-centered care (PCC) is meant to enhance nursing home residents’ quality of life (QOL). Including residents’ perspectives is critical to determining whether PCC is meeting residents’ needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents.

Implementation and effects of Movement-oriented Restorative Care in a nursing home – a quasi-experimental study
Non UofA Access

BACKGROUND: The prevalence of dementia is expected to increase rapidly, and institutionalization is a common consequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization and a determinant for the quality of life (QoL). A promising method to increase functional independence in nursing homes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) is derived from the concept of FFC and restorative care and focuses on the integration of physical activity in the daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective of this study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursing home residents with dementia.

Examining Racial and Ethnic Differences in Nursing Home Quality
Non UofA Access

BACKGROUND: Identifying racial/ethnic differences in quality is central to identifying, monitoring, and reducing disparities. Although disparities across all individual nursing home residents and disparities associated with between-nursing home differences have been established, little is known about the degree to which quality of care varies by race//ethnicity within nursing homes. A study was conducted to measure within-facility differences for a range of publicly reported nursing home quality measures.

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Research Practice and Methodology

How to increase the participation of older subjects in research: good practices and more evidence are needed!
Non UofA Access

Cherubini A, Gasperini B.
Age Ageing [Internet]. 2017 Nov 1;46(6):878-81

Key points:
– Older subjects are still under-represented in research studies.
– There are several barriers to recruitment and retention of older subjects in research studies.
– The evidence supporting effective strategies to promote recruitment and retention in this age group is limited.
– Researchers who plan research with older subjects should use multiple strategies.
– More research evaluating the methodology of performing studies with older subjects should be promoted.

Conducting and reporting trials for older people
Non UofA Access

Witham MD, Stott DJ.
Age Ageing [Internet]. 2017 Nov 1;46(6):889-94

Abstract: Randomised controlled trials provide the most rigorous test of efficacy and effectiveness for interventions used in healthcare. They underpin much of clinical practice, yet older people are often excluded from studies, resulting in uncertainty about risks and benefits of new treatments. Encouraging inclusion of older people in randomised controlled trials and reporting of trial results in a rigorous manner is a key function of clinical geriatrics journals such as Age and Ageing. This article provides practical advice on how to report randomised controlled trials that are targeted at older people. Some of these issues are generic, but there are specific requirements which apply to most studies of older people. Recording and reporting basic characteristics of recruits in terms of physical function, cognition, comorbidity and/or frailty is vital to allow proper interpretation of the external validity of the trial. Adverse effects should include consideration of common geriatric problems including falls. Authors should follow the CONSORT reporting guidelines (CONsolidated Standards Of Reporting Trials) to enhance the transparency and quality of their manuscript.

Bridging knowledge, policies and practices across the ageing and disability fields: a protocol for a scoping review to inform the development of a taxonomy Canada-flat-icon
Non UofA Access

Nalder EJ, Putnam M, Salvador-Carulla L, Spindel A, Batliwalla Z, Lenton E.
BMJ Open [Internet]. 2017 Oct 25;7(10):016741

INTRODUCTION: Bridging is a term used to describe activities, or tasks, used to promote collaboration and knowledge exchange across fields. This paper reports the protocol for a scoping review which aims to identify and characterise peer reviewed evidence describing bridging activities, between the ageing and disability fields. The purpose is to clarify the concepts underpinning bridging to inform the development of a taxonomy, and identify research strengths and gaps.

Enhancing patients’ autonomy by involving them in research ethics committees
Non UofA Access

OBJECTIVE: Although clinical trial participants are the most affected by research ethics committee’s decisions, they are not formally represented on Swiss committees. We aimed to find out what patients think about the idea of being members of such committees.

Ethical issues in palliative care for nursing homes: development and testing of a survey instrument
Non UofA Access

AIM: To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes.
BACKGROUND: Registered nurses (RNs) and healthcare assistants (HCAs) have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers.

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Aging

What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death
Non UofA Access

Bone AE, Gomes B, Etkind SN, Verne J, Murtagh FE, Evans CJ, Higginson IJ.
Palliat Med [Internet]

BACKGROUND: Population ageing represents a global challenge for future end-of-life care. Given new trends in place of death, it is vital to examine where the rising number of deaths will occur in future years and implications for health and social care.
AIM: To project where people will die from 2015 to 2040 across all care settings in England and Wales.

Dysphagia in Nursing Homes-Results From the NutritionDay Project
Non UofA Access

Streicher M, Wirth R, Schindler K, Sieber CC, Hiesmayr M, Volkert D.
J Am Med Dir Assoc [Internet]

OBJECTIVES: Dysphagia is a major healthcare problem as it increases the risk of malnutrition, dehydration, aspiration pneumonia, and death. The aims of this analysis of data from nursing homes (NHs) worldwide were to examine prevalence rates of dysphagia, to identify characteristics of residents with dysphagia, and to describe which type of nutrition residents with dysphagia receive.

Bipolar Disorder in Nursing Homes: Impact on Antipsychotic Use, Diagnosis Patterns, and New Diagnoses in People with Dementia
Non UofA Access

Carnahan RM, Letuchy EM.
Am J Geriatr Psychiatry [Internet]

OBJECTIVES: Nursing home quality measures include the proportion of residents who receive antipsychotics. Residents with bipolar disorder are included even though antipsychotics are FDA-approved for this indication. We evaluated how including residents with bipolar disorder impacted the antipsychotic use quality measure for long-stay residents. We evaluated the agreement of minimum data set (MDS) bipolar disorder diagnoses with Medicare data, whether dementia was diagnosed before bipolar disorder, and how less-specific bipolar disorder diagnoses impacted findings.

Oral health of older residents in care and community dwellers: nursing implications
Non UofA Access

Choi JS, Yi YJ, Donnelly LR.
Int Nurs Rev [Internet]

BACKGROUND: Poor oral health is associated with a reduced quality of life and serious illnesses. Consequently, nurses need to be more aware of oral health to improve the general health of residents in care.
AIM: To evaluate and compare oral health behaviours and levels of salivary haemoglobin and dental biofilm acidogenicity, which can be used to evaluate oral disease activity, between residents and community dwellers in South Korea.

The DE-PHARM Project: A Pharmacist-Driven Deprescribing Initiative in a Nursing Facility
Non UofA Access

Pruskowski J, Handler SM.
Consult Pharm [Internet]. 2017 Aug 1;32(8):468-78

OBJECTIVE: Many residents with life-limiting illnesses are being prescribed and taking potentially inappropriate medications (PIMs) and questionably beneficial medications either near or at the end of life. These medications can contribute to adverse drug reactions, increase morbidity, and increase unnecessary burden and cost. It is crucial that the process of deprescribing be incorporated into the care of these residents. After developing a clinical pharmacist-driven deprescribing initiative in the nursing facility, the objective of this project was to reduce the number of PIMs via accepted recommendations from the clinical pharmacist to the primary team.

Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors Canada-flat-icon
Non UofA Access

Rios S, Perlman CM, Costa A, Heckman G, Hirdes JP, Mitchell L.
BMC Geriatr [Internet]. 2017 Oct 23;17(1):8

BACKGROUND: Antipsychotic medications are not recommended for the management of symptoms of dementia, particularly among persons with no behavioral or psychological symptoms. We examine patterns of antipsychotic medication use among persons with dementia across health sectors in Canada, with a focus on factors related to use among those without behavioral or psychotic symptoms.

Discontinuing Inappropriate Medication Use in Nursing Home Residents: A Cluster Randomized Controlled Trial
Non UofA Access

Wouters H, Scheper J, Koning H, Brouwer C, Twisk JW, van der Meer H, Boersma F, Zuidema SU, Taxis K.
Ann Intern Med [Internet]

BACKGROUND: Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use.
OBJECTIVE: To examine successful discontinuation of inappropriate medication use and to improve prescribing in nursing home residents.

Association Between Malnutrition and Oral Health in Dutch Nursing Home Residents: Results of the LPZ Study
Non UofA Access

Huppertz VAL, van der Putten, G J, Halfens RJG, Schols, J M G A, de Groot, L C P G M.
J Am Med Dir Assoc [Internet]. 2017 Nov 1;18(11):948-54

INTRODUCTION: According to the World Health Organization (WHO) and FDI World Dental Federation (FDI), malnutrition and bad oral health are of great concern to global health, especially among the older population. This study aimed to assess the associations between oral health problems ([artificial] teeth problems, chewing problems, and xerostomia) and malnutrition in residents of somatic and psychogeriatric wards in Dutch nursing homes.

Successfully Reducing Hospitalizations of Nursing Home Residents: Results of the Missouri Quality Initiative
Non UofA Access

Rantz MJ, Popejoy L, Vogelsmeier A, Galambos C, Alexander G, Flesner M, Crecelius C, Ge B, Petroski G.
J Am Med Dir Assoc [Internet]. 2017 Nov 1;18(11):960-6

PURPOSE: The goals of the Missouri Quality Initiative (MOQI) for long-stay nursing home residents were to reduce the frequency of avoidable hospital admissions and readmissions, improve resident health outcomes, improve the process of transitioning between inpatient hospitals and nursing facilities, and reduce overall healthcare spending without restricting access to care or choice of providers. The MOQI was one of 7 program sites in the United States, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services (CMS) Innovations Center.

Caring for a Person With Dementia on the Margins of Long-Term Care: A Perspective on Burden From 8 European Countries
Non UofA Access

Sutcliffe C, Giebel C, Bleijlevens M, Lethin C, Stolt M, Saks K, Soto ME, Meyer G, Zabalegui A, Chester H, Challis D, RightTimePlaceCare Consortium
J Am Med Dir Assoc [Internet]. 2017 Nov 1;18(11):973.e1

OBJECTIVES: To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries.

Care Transitions Between Hospitals and Skilled Nursing Facilities: Perspectives of Sending and Receiving Providers
Non UofA Access

BACKGROUND: One in four Medicare patients hospitalized for acute medical illness is discharged to a skilled nursing facility (SNF); 23% of these patients are readmitted to the hospital within 30 days. The care transition from hospital to SNF is often marked by disruptions in care and poor communication among hospital and SNF providers. A study was conducted to identify the perspectives of sending and receiving providers regarding care transitions between the hospital and the SNF.

The Intersection of Intellectual Disability and Dementia: Report of The International Summit on Intellectual Disability and Dementia
Non UofA Access

Watchman K, Janicki MP, Asante C, Beránková A, Bishop K, Cadovius N, Cooper S, Coppus T, Crowe J, Dodd K, Fortea J, Gaertner C, Haksar K, Santos FH, Hogan M, Janicki MP, Jokinen N, Keller S, Larsen F, Lucchino R, McCallion P, McCarron M, Mittler P, Pearson J, Quinn S, Rebillat A, Reilly E, Service K, Splaine M, Stemp S, Strydom A, Tiziano G, Udell L, Watchman K.
Gerontologist [Internet]

Abstract: An International Summit on Intellectual Disability and Dementia, held in Glasgow, Scotland (October 13–14, 2016), drew individuals and representatives of numerous international and national organizations and universities with a stake in issues affecting adults with intellectual disability (ID) affected by dementia. A discussion-based consensus process was used to examine and produce a series of topical reports examining three main conceptual areas: (a) human rights and personal resources (applications of the Convention for Rights of People with Disabilities and human rights to societal inclusion, and perspectives of persons with ID), (b) individualized services and clinical supports (advancing and advanced dementia, post-diagnostic supports, community supports and services, dementia-capable care practice, and end-of-life care practices), and (c) advocacy, public impact, family caregiver issues (nomenclature/terminology, inclusion of persons with ID in national plans, and family caregiver issues). Outcomes included recommendations incorporated into a series of publications and topical summary bulletins designed to be international resources, practice guidelines, and the impetus for planning and advocacy with, and on behalf of, people with ID affected by dementia, as well as their families. The general themes of the conceptual areas are discussed and the main recommendations are associated with three primary concerns.

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Events

UofA

META Moving Evidence to Action Pragmatic Workshop Series

Alberta SPOR SUPPORT Unit Knowledge Translation Platform
Registration: 17 November 2017
21-23 November 2017

META provides a tailored, individualized learning experience. You have the flexibility to register for workshops that best meet your learning needs and interests. These are ‘how to’ workshops – bring your current or planned project to work on. META workshops will take place on the University of Alberta campus. Please see link for specific workshop details.
META pragmatic workshops are organized into two broad streams:
– knowledge synthesis
– knowledge translation

Human Centered Design

Guillermina Noel
9 November 2017, ECHA 4-099, 10:00-11:00

Knowledge Translation Canada in collaboration with the Knowledge Translation Platform and the Career Development Platform is hosting a speaker session for anyone with an interest in improving healthcare.
Available as a webinar through KT Canada.

Patient Engagement in Grant Proposals Drop-In Consultations

Alberta SPOR SUPPORT Unit

Drop by for a brief presentation by the Alberta SPOR SUPPORT Patient Engagement Platform about key things to consider when writing grant proposals that include patient engagement. Drop-in sessions are November 3 & 10 from 10:00 am – 12:00 pm in room 5-001 Edmonton Clinic Health Academy.

Non UofA

Spirituality and Aging Seminar Canada-flat-icon

Kristine Theurer, MA (Gerontology), PhD Candidate, University of British Columbia
17 November 2017, University of Waterloo, Waterloo, ON

Many older adults are socially isolated and lonely. This can have serious, even deadly, consequences for their well-being. The Toronto Globe and Mail describes loneliness as a public-health crisis in waiting. Loneliness has an associated stigma, a ‘whiff of failure’ that is difficult to speak about. And so, it remains an open secret— heartbreakingly apparent but often ignored or accepted as the cost of growing old. There is an urgent need for a spiritual revolution in residential care—an overturning of the entrenched long-standing tradition of ‘light’ social events, such as games and social gatherings, planned and implemented by staff. Although these activities provide enjoyment for some, social isolation and loneliness persists.
A spiritual revolution is a move from what we can do to and for residents, to what they can do for one another. Peer support—residents helping each other. How can we better engage community in meeting spiritual needs? How do we continue to have meaningful friendships/relationships into old age, and what structures might support that, in our churches, in retirement communities, and in long term care? Explore these questions in an interactive seminar dedicated to finding a new spiritual approach to overcome social isolation within residential care.

Ahead of the Curve Conference Canada-flat-icon

Ontario Long Term Care Association
27-29 November 2017, Toronto, ON

The Ontario Long Term Care Association’s annual This is Long Term Care conference profiles new and emerging research, innovation and quality initiatives in a unique forum designed for learning, networking and information sharing. It provides an unparalleled opportunity for our members to hear about existing best practice programs that have tools, resources, policies and procedures which can be implemented across the sector. Participants who attend will learn how a variety of innovative programs, that are already in use across Ontario, align with the current health care landscape, and the benefits that result.

A Spotlight on Young Carers Canada-flat-icon

The Change Foundation
20 November 2017, Toronto, ON

Join young carers, experts, policy makers, and influencers as we shine a light on this often invisible population of caregivers. This event will feature an Ontario young carer’s journey, lessons learned from overseas, as well as insights on the caregiver movement in Ontario from Janet Beed, Advisor at the Ontario Government’s Ontario Caregiver Initiative.
Presentations will be webcast live. Please register for more information.

Online

Canadian Frailty Priority Setting Partnership

Dr. Katherine McGilton, Dr. Jennifer Bethell
8 November 2017

The purpose of the Canadian Frailty Priority Setting Partnership was to involve individuals with direct experience of frailty in older adults, either personal or professional, in defining priorities for research. These research priorities will be shared with researchers and research funding organizations so that more research is carried out in these priority areas. The Canadian Frailty Priority Setting Partnership followed the methods of the James Lind Alliance.

Peer-to-Peer Webinar Series: Success Stories in EIDM

Peer-to-Peer Webinar Series: Success Stories in EIDM

Introduction to Patient Engagement & Integrated Knowledge Translation

Alberta SPOR SUPPORT Unit Knowledge Translation Platform, Lisa Petermann, Diane Duncan
7 November 2017

Learning Objectives:
Explain patient-oriented research(POR) in your own words
Compare patient engagement to integrated knowledge translation
Explain why patients and knowledge users should be engaged in patient-oriented research

Introduction to Knowledge Translation

Alberta SPOR SUPPORT Unit Knowledge Translation Platform, Dr. Gabrielle Zimmermann
8 November 2017

Learning Objectives:
Explain Knowledge Translation (KT) in your own words.
Explain when to use integrated KT and end-of-grant KT.
Describe to Knowledge-to-Action (KTA) process model.

Introduction to Knowledge Translation Evaluation

Alberta SPOR SUPPORT Unit Knowledge Translation Platform, Dr. Anne Bergen
15 November 2017

Learning Objectives:
Define basic evaluation terms (e.g., activity, output, outcome, impact; process and outcome evaluation).
Discuss how evaluation can be used across the KT project lifecycle (from planning to impact).
Identify barriers and enablers of KT evaluation.

Introduction to Knowledge Synthesis

Alberta SPOR SUPPORT Unit Knowledge Translation Platform, Dr. Meghan Sebastianski
16 November 2017

Learning Objectives:
Relate why evidence syntheses are important in evidence-based research
Summarize the steps involved in a systematic or scoping review
Explain the role of quality assessment
Outline possible analysis methods

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Courses

eHealth: Technology and Innovation Supporting Older Adults Canada-flat-icon

CIHR Summer Program in Aging
28 May-1 June 2018

This unique, interactive training program will run from May 28 – June 1, 2018 and will be held in Harrison Hot Springs, BC. Graduate students and post-doctoral fellows working in, or interested in learning about, research related to the area of eHealth and aging are encouraged to apply.
Trainees will have the opportunity to participate in advanced training that crosses disciplines and brings together trainees, researchers, and members of the public and private sector from Canada and abroad.
Networking opportunities will be offered throughout the week.
The program will be launched in December 2017 on the CIHR ResearchNet. More information will follow in the coming months.

UBC Care of the Elderly Intensive Review Course Canada-flat-icon

University of British Columbia
31 January-3 February 2018

This four day intensive course offers a unique small group learning opportunity for practitioners who wish to gain practical skills to take back to their communities. The days will include presentations from UBC faculty experts, case based discussions, interactive polls, self-reflection quizzes, and hands-on workshops. This course is limited to 100 participants.
Be sure to register early as we sold out in 2015 and 2017.

Online

Evidence-informed Public Health Practice Canada-flat-icon

National Collaborating Centre for Methods and Tools, Continuing Health Sciences Education (McMaster University)

The National Collaborating Centre for Methods and Tools (NCCMT) has partnered with McMaster University’s Continuing Health Sciences Education (CHSE) program to offer a new online learning certificate. This online program includes eight interactive learning modules to build your capacity for evidence-informed public health practice.
Fee: $200 for professionals, $100 for students
Register with McMaster University CHSE for access to the certified Learning Centre. Complete all eight learning modules to receive your personalized, McMaster University-endorsed certificate.

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News

Important changes for Postdoctoral Fellows and their supervisors at U of A

Beginning November 1, 2017, post-doctoral fellow appointments will be categorized into one of the following three categories: Employees, Trainees, or Guests.

Many Academics Are Eager to Publish in Worthless Journals

Universities, colleges, even community colleges insist that faculty publish scholarly research, and the more papers the better. Academics and the schools they teach at rely on these publications to bolster their reputations, and with an oversupply of Ph.D.’s vying for jobs, careers hang in the balance.
Competition is fierce to get published in leading journals. But what about the overworked professors at less prestigious schools and community colleges, without big grants and state-of-the-art labs? How do they get ahead? Predatory journals.

Bringing a Voice to Residential School Survivors with Dementia Canada-flat-icon

My dad, Duncan Harry, was from Ts’kw’ay’laxw First Nation in Pavilion BC. He was a skilled and proud ironworker—a foreman—who was well-liked and respected by his coworkers and bosses. In 1976, he suffered a workplace injury, falling 20 feet and landing on a concrete slab. Despite his accident, he continued to work until the injuries forced him to stop fourteen years later. In 2011, Dad was officially diagnosed with dementia.

Nursing homes ‘intending to leave’ Toronto over rebuilding costs Canada-flat-icon

The operators of eight long-term-care homes in Toronto with nearly 1,300 residents have told the province they intend to shut down and move their operations elsewhere, CBC News has learned.

VIDEO: The end-of-life conundrum

What does America need to grapple with most as the population ages? Our safety net has one great hole: Late-life care, the expensive middle ground between living independently at home, and Medicare-covered time in the hospital. Many families and shocked and blindsided by the costs when the need arises, and our policymakers just haven’t reckoned with the problem on a national scale.
What should we worry about? What should we be optimistic about? We put the questions to the expert participants at POLITICO’s recent panel on Aging in America.

One of the Greatest Threats to Our Lifespans Is Loneliness

What would society be like if health insurers and public bodies invested as much in encouraging social encounters as exercise and good diet?

Nova Scotia plans to publicly report long-term care abuse Canada-flat-icon

The province says it is working toward publicly reporting incidents of abuse in Nova Scotia long-term care homes.

Predatory conferences ‘now outnumber official scholarly events’

“Predatory” conferences now outnumber official events organised by scholarly societies following an explosion in the number of such symposia held across the world, a researcher has warned.

Nursing home group wants more beds, bigger construction subsidy Canada-flat-icon

Call for investment comes after CBC News reveals long-term care homes are threatening to leave Toronto

Why follow-up funding is important for translational research

This recommendation was born out of the observation that discontinuity in funding leads to losing trained personnel and trainees through dismantling of collaborations

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Resources

Preventing Ageing Unequally

OECD

This report examines how the two global mega-trends of population ageing and rising inequalities have been developing and interacting, both within and across generations. Taking a life-course perspective the report shows how inequalities in education, health, employment and earnings compound, resulting in large differences in lifetime earnings across different groups. It suggests a policy agenda to prevent, mitigate and cope with inequalities along the life course drawing on good practices in OECD countries and emerging economies.

Newsletters

KT Canada

1 November 2017

KT Canada

25 October 2017

KT Canada

18 October 2017

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Opportunities

CHAP Knowledge Broker

Cardiovascular Health Awareness Program (CHAP)
No deadline provided

Accountable to CHAP principal investigators, McMaster University and the University of Montreal Hospital Research Centre (CRCHUM), the Knowledge Broker is responsible for bridging the gap between research and decision-making to promote evidence-based practice and policy decisions. The CHAP Knowledge Broker initiates, develops and implements knowledge translation strategies to make research evidence available and accessible to key knowledge users for practice, planning and policy making. The Knowledge Broker identifies key stakeholders in the decision-making processes at national, provincial and local government levels, and develops and maintains relationships with them. S/he organizes meetings and workshops for diverse audiences, advocates for and represents CHAP at various events, platforms, and committees, and identifies and leverages new partnerships and funding opportunities. The Knowledge Broker will need to become familiar with results from CHAP studies and be up-to-date with CHAP current research projects. The Knowledge Broker will increase stakeholder knowledge about CHAP with a focus on stakeholders who have influence to fund or implement chronic disease prevention and management programs.

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