Please use this identifier to cite or link to this item:
http://hdl.handle.net/11375/14049
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.advisor | Thabane, Lehana | en_US |
dc.contributor.advisor | Papaioannou, Alexandra | en_US |
dc.contributor.advisor | Adachi, Jonathan D. | en_US |
dc.contributor.author | Kennedy, Courtney C. | en_US |
dc.date.accessioned | 2014-06-18T17:06:09Z | - |
dc.date.available | 2014-06-18T17:06:09Z | - |
dc.date.created | 2014-04-02 | en_US |
dc.date.issued | 2014-04 | en_US |
dc.identifier.other | opendissertations/8879 | en_US |
dc.identifier.other | 9957 | en_US |
dc.identifier.other | 5429161 | en_US |
dc.identifier.uri | http://hdl.handle.net/11375/14049 | - |
dc.description.abstract | <p><strong>Background:</strong> Despite strong evidence, strategies for improving bone health are underutilized. Knowledge translation (KT) interventions aim to improve uptake of evidence-based practices, however the feasibility and effectiveness of such strategies require further evaluation within Long-term Care (LTC). In this thesis, we examined the impacts of a province-wide osteoporosis strategy and a more intensive multifaceted KT strategy including expert-led educational meetings, audit/feed-back, and action planning for quality improvement. Both studies targeted interdisciplinary LTC teams (physicians, nurses, pharmacists, dietician, and other staff).</p> <p><strong>Methods: </strong>In the first thesis study, we examined the impact of the <em>Ontario Osteoporosis Strategy for LTC</em> by investigating changes in facility-level prescribing rates (vitamin D, calcium, osteoporosis medications) before and after its implementation (2007 versus 2012). The second study was a pilot cluster randomized trial evaluating the feasibility and effectiveness of a 12-month, multifaceted, interdisciplinary KT intervention [Vitamin D and Osteoporosis Study (ViDOS)]. Prescribing outcomes included: vitamin D ≥800 IU (primary), calcium ≥500 mg/day, and osteoporosis medications (high-risk residents only). Feasibility outcomes included recruitment, retention, data collection, intervention fidelity, and process changes. We analyzed resident level data using the generalized estimating equations (GEE) technique, adjusting for clustering.</p> <p><strong>Results:</strong></p> <p>In both studies, significant improvements were observed for vitamin D and calcium prescribing. In the first study, prescribing increased by 38% and 4%, respectively, between 2007 and 2012. In the ViDOS trial, the 12-month intervention resulted in an absolute improvement of 15% and 7%, respectively (intention to treat cohort). There was no significant effect for prescribing of osteoporosis medications in either study. In the ViDOS study, recruitment and retention rates were 22% and 63%, respectively; good intervention fidelity was achieved and intervention homes reported several process changes.</p> <p><strong>Conclusion:</strong></p> <p>This thesis study demonstrated that KT interventions targeting evidence-based osteoporosis and fracture prevention strategies were feasibly and effectively applied with interdisciplinary LTC teams.</p> | en_US |
dc.subject | Knowledge Translation | en_US |
dc.subject | Osteoporosis | en_US |
dc.subject | Fractures | en_US |
dc.subject | Prescribing | en_US |
dc.subject | Long-term Care homes | en_US |
dc.subject | Vitamin D | en_US |
dc.subject | Knowledge Translation | en_US |
dc.subject | Knowledge Translation | en_US |
dc.title | EVALUATING THE FEASIBILITY AND EFFECTIVENESS OF EVIDENCE-BASED KNOWLEDGE TRANSLATION INTERVENTIONS TARGETING OSTEOPOROSIS AND FRACTURE PREVENTION IN ONTARIO LONG-TERM CARE HOMES | en_US |
dc.type | thesis | en_US |
dc.contributor.department | Clinical Health Sciences (Health Research Methodology) | en_US |
dc.description.degree | Doctor of Philosophy (PhD) | en_US |
Appears in Collections: | Open Access Dissertations and Theses |
Files in This Item:
File | Size | Format | |
---|---|---|---|
fulltext.pdf | 8.42 MB | Adobe PDF | View/Open |
Items in MacSphere are protected by copyright, with all rights reserved, unless otherwise indicated.