Assessing the effectiveness of "BETTER Women", a community-based, primary care-linked peer health coaching programme for chronic disease prevention: protocol for a pragmatic, wait-list controlled, type 1 hybrid effectiveness-implementation trial.

Autor:	Kithulegoda N; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada.; Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Williams C; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada., Senthilmurugan A; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada., Aimola S; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada., Atkinson J; Ontario Public Health Association, Toronto, ON, Canada., Banerjee AT; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada., Bazeghi F; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada., Bender JL; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.; Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada., Flynn S; Canadian Cancer Society, Toronto, ON, Canada., Ghatage L; Canadian Cancer Society, Toronto, ON, Canada., Goulbourne E; Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada.; Women's College Hospital, Toronto, ON, Canada., Grunfeld E; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Ontario Institute for Cancer Research, Toronto, ON, Canada., Heisey R; Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada., Rao A; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada., Sutcliffe K; Canadian Cancer Society, Toronto, ON, Canada., Lofters A; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada aisha.lofters@wchospital.ca.; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Department of Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada., Ivers NM; Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada.; Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Department of Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jul 24; Vol. 14 (7), pp. e085933. Date of Electronic Publication: 2024 Jul 24.
DOI:	10.1136/bmjopen-2024-085933
Abstrakt:	Introduction: The Building on Existing Tools to Improve Cancer and Chronic Disease Prevention and Screening in Primary Care (BETTER) programme trains allied health professionals working in primary care settings to develop personalised chronic disease 'prevention prescriptions' with patients. However, maintenance of health behaviour changes is difficult without ongoing support. Sustainable options to enhance the BETTER programme and ensure accessibility to underserved populations are needed. We designed the BETTER Women programme, which uses a digital app to match patients with a trained peer health coach (PHC) who provides ongoing support for health behaviour change after receipt of a BETTER prevention prescription in primary care. Methods and Analysis: We will conduct a type 1 hybrid implementation-effectiveness patient-randomised trial. Interested women aged 40-68 years will be recruited from three large, sociodemographically distinct primary care clinics (urban, suburban and rural). Patients will be randomised 1:1 to intervention or wait-list control after receipt of their BETTER prevention prescription. We will aim to recruit 204 patients per group (408 total). Effectiveness will be assessed by the primary outcome of targeted behaviours achieved for each participant at 6 months, consisting of three cancer screening tests (cervical, breast and colorectal) and four behavioural determinants of cancer and chronic disease (diet, smoking, alcohol use and physical activity). Data will be collected through patient survey and clinical chart review, measured at 3, 6 and 12 months. Implementation outcomes will be assessed through patient surveys and interviews with patients, peer health coaches and healthcare providers. An embedded economic evaluation will examine cost per quality-adjusted life-year and per additional health behavioural targets achieved. Ethics and Dissemination: This study has been approved by Women's College Hospital Research Ethics Board (REB), the Royal Victoria Regional Health Centre REB and the University of Toronto REB. All participants will provide informed consent prior to enrolment. Participation is voluntary and withdrawal will have no impact on the usual care received from their primary care provider. The results of this trial will be published in peer-reviewed journals and shared via conference presentations. Deidentified datasets will be shared on request, after publication of results. Trial Registration Number: NCT04746859. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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