Browsing by Author "Grindrod, Kelly"

Now showing 1 - 10 of 10

Acceptance of Commercially Available Wearable Activity Trackers Among Adults Aged Over 50 and With Chronic Illness: A Mixed-Methods Evaluation
(JMIR Mhealth Uhealth., 2016-01-27) Mercer, Kathryn; Grindrod, Kelly; Schneider, Eric; Li, Melissa; Chilana, Parmit; Giangregorio, Lora M.
Background: Physical inactivity and sedentary behavior increase the risk of chronic illness and death. The newest generation of “wearable” activity trackers offers potential as a multifaceted intervention to help people become more active. Objective: To examine the usability and usefulness of wearable activity trackers for older adults living with chronic illness. Methods: We recruited a purposive sample of 32 participants over the age of 50, who had been previously diagnosed with a chronic illness, including vascular disease, diabetes, arthritis, and osteoporosis. Participants were between 52 and 84 years of age (mean 64); among the study participants, 23 (72%) were women and the mean body mass index was 31 kg/m2 . Participants tested 5 trackers, including a simple pedometer (Sportline or Mio) followed by 4 wearable activity trackers (Fitbit Zip, Misfit Shine, Jawbone Up 24, and Withings Pulse) in random order. Selected devices represented the range of wearable products and features available on the Canadian market in 2014. Participants wore each device for at least 3 days and evaluated it using a questionnaire developed from the Technology Acceptance Model. We used focus groups to explore participant experiences and a thematic analysis approach to data collection and analysis. Results: Our study resulted in 4 themes: (1) adoption within a comfort zone; (2) self-awareness and goal setting; (3) purposes of data tracking; and (4) future of wearable activity trackers as health care devices. Prior to enrolling, few participants were aware of wearable activity trackers. Most also had been asked by a physician to exercise more and cited this as a motivation for testing the devices. None of the participants planned to purchase the simple pedometer after the study, citing poor accuracy and data loss, whereas 73% (N=32) planned to purchase a wearable activity tracker. Preferences varied but 50% felt they would buy a Fitbit and 42% felt they would buy a Misfit, Jawbone, or Withings. The simple pedometer had a mean acceptance score of 56/95 compared with 63 for the Withings, 65 for the Misfit and Jawbone, and 68 for the Fitbit. To improve usability, older users may benefit from devices that have better compatibility with personal computers or less-expensive Android mobile phones and tablets, and have comprehensive paper-based user manuals and apps that interpret user data. Conclusions: For older adults living with chronic illness, wearable activity trackers are perceived as useful and acceptable. New users may need support to both set up the device and learn how to interpret their data.
Appendix to "Characteristics, predictors, and reasons for regulatory body disciplinary action in health care: A scoping review"
(Journal of Medical Regulation, 2022-01) Foong-Reichert, Esther Ai-Leng; Fung, Ariane; Carter, Caitlin A.; Houle, Sherilyn; Grindrod, Kelly
In this appendix to the manuscript "Characteristics, predictors, and reasons for regulatory body disciplinary action in health care: A scoping review”, the studies included in the scoping review are summarized.
Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis
(JMIR mHealth and uHealth, 2016-04-27) Mercer, Kathryn; Burns, Catherine; Giangregorio, Lora M.; Li, Melissa; Grindrod, Kelly
Background: Wearable activity trackers are promising as interventions that offer guidance and support for increasing physical activity and health-focused tracking. Most adults do not meet their recommended daily activity guidelines, and wearable fitness trackers are increasingly cited as having great potential to improve the physical activity levels of adults. Objective: The objective of this study was to use the Coventry, Aberdeen, and London-Refined (CALO-RE) taxonomy to examine if the design of wearable activity trackers incorporates behavior change techniques (BCTs). A secondary objective was to critically analyze whether the BCTs present relate to known drivers of behavior change, such as self-efficacy, with the intention of extending applicability to older adults in addition to the overall population. Methods: Wearing each device for a period of 1 week, two independent raters used CALO-RE taxonomy to code the BCTs of the seven wearable activity trackers available in Canada as of March 2014. These included Fitbit Flex, Misfit Shine, Withings Pulse, Jawbone UP24, Spark Activity Tracker by SparkPeople, Nike+ FuelBand SE, and Polar Loop. We calculated interrater reliability using Cohen's kappa. Results: The average number of BCTs identified was 16.3/40. Withings Pulse had the highest number of BCTs and Misfit Shine had the lowest. Most techniques centered around self-monitoring and self-regulation, all of which have been associated with improved physical activity in older adults. Techniques related to planning and providing instructions were scarce. Conclusions: Overall, wearable activity trackers contain several BCTs that have been shown to increase physical activity in older adults. Although more research and development must be done to fully understand the potential of wearables as health interventions, the current wearable trackers offer significant potential with regard to BCTs relevant to uptake by all populations, including older adults.
Communicating health information in primary care: a multidisciplinary exploration of patient, pharmacist, and physician decision-making
(University of Waterloo, 2019-06-27) Mercer, Kathryn; Grindrod, Kelly
Research has yet to clearly define how health care professionals’ (HCPs) use and sharing of information influences how health decisions are made, both independently and collaboratively. Similarly, the manner in which patients use, interact with, and find health information is not fully, and how external influencers impact patient decision-making about health. The overall goal of this thesis is to examine how and what information is being shared among patients, pharmacists, and physicians and how this information is used in decision making. Using a variety of methodologies, this research examined five areas of communication and decision-making: 1) How patients, pharmacists, and physicians currently make decisions as a healthcare team; how this information influences shared decision-making about patients’ medications and health; and how this process can be improved through the use of electronic health records (EHRs); 2) How information is communicated among HCPs and between HCPs and patients; 3) What information patients seek out, collect and communicate to their HCPs; 4) How relationships influence professional collaboration and communication in healthcare; and 5) The scope of existing knowledge around including the reason for use on a prescription and how that influences the ways in which pharmacists make decisions. This thesis consists of four papers that describe two studies. Three of the papers use data from a qualitative examination of ethnographic observations and structured or semi-structured interview methods to examine: 1) patients’ medication decision-making with their pharmacists and physicians; 2) pharmacist and physician medication decision-making; and 3) how relationships between pharmacists and physicians influence collaboration. The final paper is a scoping review of the literature that characterizes the current body of research on how including the reason for use on a prescription impacts pharmacist decision making. The first study examines how patients make decisions with their health care team, how information influences decision-making and how the process can be improved through EHRs. It revealed that different people play different roles when it comes to helping patients make decisions. The first of three papers emerging from the first study determined that while EHRs can support decision-making, more research is needed to further clarify perceptions of role and how to develop EHRs that are adaptive to varying user information needs. The second paper focuses on physician-pharmacists medication decision-making and examined how physician and pharmacist relationships influence collaboration and communication. It concluded that there is limited communication and collaboration between physicians and pharmacists around managing medications. Further, this research saw an emerging result about how relationships influence how and when collaboration and communication occur, resulting in the third paper which examined the relationships more closely. The fourth paper emerged from the need to better understand the current scope of research about including reason for use on a prescription that is sent to a pharmacist--an emerging area of interest from the original study. Taken together, the chapters provide an emerging picture of how and what information is and should be communicated in healthcare and the factors that influence how information is shared. The findings reveal important common elements that have yet to be fully explored when it comes to information sharing, and these ultimately influence decision-making in health. The findings describe a complex environment of differing information needs among pharmacists, physicians, and patients and emphasize the importance of understanding specific knowledge that must be communicated. Future research should be designed to accommodate a robust multidisciplinary approach that allows us to examine how sharing and communicating health information changes as the influence of technology and the number of stakeholders involved in care increases. Future research should focus on helping HCPs develop multidisciplinary strategies for collaboration and information sharing, based on a shared understanding of each other’s roles, priorities, and values.
Evaluation of a microlearning module on hypertension in Canada
(University of Waterloo, 2023-02-20) Waked, Khrystine; Nagge, Jeff; Grindrod, Kelly
Objectives: To use a microlearning platform to evaluate pharmacists’ knowledge and behaviour related to hypertension. Methods: Pharmacy 5in5 is an online microlearning platform designed to help pharmacy professionals develop skills and acquire a deeper understanding of a variety of clinical and professional practice topics. Each topic includes a fact-based quiz, six case-based quizzes, six reflection questions, animated videos, infographics and flash cards. In April 2019, a hypertension module was released to engage pharmacists in managing hypertension and improving current practice behaviours. The module was developed using Canadian and American hypertension guidelines, landmark trials, and tertiary drug resources. The hypertension module was accessible on the Pharmacy5in5 website. Preliminary data were collected over 8 weeks between April-June 2019. User performance was analyzed with a binomial regression model. Results: Overall, 600 users accessed the Pharmacy 5in5 platform in the first two months, 81% of which were in Ontario. Licensed pharmacists performed significantly better than other registered users (β = −0.56, t (3362) =−2.15, p = 0.03), with users working in hospitals performing the best. The quiz resulting in the highest average focused on proper techniques for home blood pressure monitoring (mean score of 87%; SD 17%), while the quiz resulting in the lowest average focused on choosing medication therapy (mean score of 59%; SD 22%). In the reflection questions for behaviour in the last three months, 68% of users reported counselling a patient on home blood pressure monitoring and 62% had educated patients on their blood pressure targets, but only 18% had contacted a prescriber to optimize pharmacotherapy. Conclusion: The Pharmacy5in5 hypertension module is an engaging method of continuing education which can be used to rapidly reach many healthcare professionals in a short time. More education is needed to support pharmacists in working with prescribers to proactively optimize hypertension therapy.
“My pharmacist”: Creating and maintaining relationship between physicians and pharmacists in primary care settings
(Elsevier, 2020-01) Mercer, Kathryn; Neiterman, Elena; Guirguis, Lisa; Burns, Catherine; Grindrod, Kelly
Background Pharmacists and physicians are being increasingly encouraged to adopt a collaborative approach to patient care, and delivery of health services. Strong collaboration between pharmacists and physicians is known to improve patient safety, however pharmacists have expressed difficulty in developing interprofessional working relationships. There is not a significant body of knowledge around how relationships influence how and when pharmacists and physicians communicate about patient care. Objectives This paper examines how pharmacists and primary care physicians communicate with each other, specifically when they have or do not have an established relationship. Methods Thematic analysis of data from semi-structured interviews with nine primary care physicians and 25 pharmacists, we examined how pharmacists and physicians talk about their roles and responsibilities in primary care and how they build relationships with each other. Results We found that both groups of professionals communicated with each other in relation to the perceived scope of their practice and roles. Three emerging themes emerged in the data focusing on (1) the different ways physicians communicate with pharmacists; (2) insights into barriers discussed by pharmacists; and (3) how relationships shape collaboration and interactions. Pharmacists were also responsible for initiating the relationship as they relied on it more than the physicians. The presence or absence of a personal connection dramatically impacts how comfortable healthcare professionals are with collaboration around care. Conclusion The findings support and extend the existing literature on pharmacist-physician collaboration, as it relates to trust, relationship, and role. The importance of strong communication is noted, as is the necessity of improving ways to build relationships to ensure strong interprofessional collaboration.
Perspectives from Pharmacists, Prescribers and Patients on Sharing Medication Reason for Use
(University of Waterloo, 2020-05-05) Whaley, Colin; Grindrod, Kelly
Pharmacists rarely receive the reason a medication was prescribed, often referred to as reason for use (RFU). Pharmacists can use this information to better counsel patients, support patients in taking medications safely, and improve patient understanding of why they are taking their medications. RFU can also be added to medication labels, giving patients another tool in helping them stay informed and safe when taking their medications. A total of 60 semi-structured interviews were conducted with pharmacists, prescribers and patients. Twenty interviews were conducted with each group, and were analyzed using thematic analysis to determine the impact of adding RFU on prescriptions and medication labels. Specifically, the impact to clinicians’ workflows, on interprofessional communication and patient safety and privacy were examined. Additionally, aspects relating to the logistics of including RFU on prescriptions and medications were considered. Most participants identified a number of benefits to including RFU on prescriptions and medication labels and ensuring that pharmacists are made aware of RFU. Participants from all groups noted that some patients may not want RFU listed on their medication bottles for privacy reasons, especially for medications to treat sensitive illnesses. These results indicate a need to ensure all members of the healthcare team are informed about why a medication is being taken, and to support patients in taking their medications safely.
Pharmacy5in5: Evaluating a computer-based education platform to improve pharmacists’ knowledge and behaviour
(University of Waterloo, 2022-05-30) Hussein, Rand; Grindrod, Kelly
Background The pharmacist’s role continues to evolve and expand from the traditional role of dispensing to a more patient-centered model of care. However, many pharmacists still fall short in terms of their provision of full scope pharmacy services. A new behaviour change intervention is needed to help pharmacists adopt these pharmacy services. One such intervention is computer-based education. There is limited research exploring the effect of computer-based education on pharmacist knowledge, skills and behaviours. There is also a gap in literature on how to refine and design a computer-based educational platform targeting pharmacy professionals. Objectives The overall goal of this thesis is to provide step-wise guidance on how to design theory-based interventions and to provide outcome information on the effect of an educational platform on improving pharmacists’ knowledge. Methods This thesis is comprised of three studies. The first study was a scoping review that explored the current literature on how computer-based education affects healthcare professionals’ knowledge, skills and behaviour. The second study used a mixed methods approach which combined a self-reported survey with semi-structured interviews to explore barriers, facilitators and corresponding behaviour change techniques that are applicable to computer-based education. Based on these findings, the third study assessed the effect of one example of computer-based education on pharmacists’ knowledge using a randomized controlled trial. Results The scoping review showed that studies assessing the effect of computer-based education were mostly focused on user satisfaction, knowledge gain and self-reported behaviour. Moreover, few studies reported using a theoretical framework for the development of or to guide the selection of design features. Using the theoretical domains framework, a wide range of barriers and facilitators were identified for full scope services. Moreover, a total of 18 behaviour change techniques were identified which can be incorporated into computer-based education. The randomized controlled trial showed that computer-based education can significantly improve knowledge and is at least as effective as printed education material. Conclusion With the rapid transition to computer-based education due to the COVID-19 pandemic, a better understanding of computer-based education is critical. This thesis demonstrates the effectiveness of computer-based education in educating pharmacists, as well as its promising potential as a behaviour change intervention. More rigorous evaluation is needed to assess all possible learning outcomes including behaviour and practice change.
Professional regulation in healthcare: Exploring trends, predictors, and the disciplinary action process for health professionals in Canada
(University of Waterloo, 2024-09-03) Foong-Reichert, Esther; Grindrod, Kelly; Houle, Sherilyn
Background: Health professionals in Canada are governed by provincial regulatory bodies, whose mandate is to protect the public. Regulatory bodies license and register professionals, and handle complaints and disciplinary action processes when warranted. In recent years, jurisdictions internationally and in Canada have been undergoing regulatory reform. More research is needed on current processes to inform future improvements. Objectives: The overall goal of this thesis was to describe the disciplinary action process for health professionals in Canada. Methods: This thesis is comprised of five studies. The first study was a scoping review to describe the research on disciplinary action outcomes for health professionals, and to describe the research on characteristics or predictors of health professionals subject to disciplinary action. The next three studies reviewed disciplinary action outcomes for Canadian pharmacists, dentists, and nurse practitioners, respectively. Characteristics of professionals subject to disciplinary action were also studied. The fifth study sought to compare and contrast disciplinary action processes across professions and jurisdictions in Canada and to describe regulatory body perspectives of the disciplinary action process. Results: The scoping review found that most research focuses on physicians, originates from the USA, and has been conducted from 2010 – 2020. A variety of demographic factors and predictors of disciplinary action have been studied, including gender, age, years in practice, practice specialty, license type/profession, previous disciplinary action, board certification, and performance on licensing examinations. The reviews of pharmacist, dentist, and nurse practitioner disciplinary found differences in reasons for disciplinary action between professions. All professions had low rates of disciplinary action, with nurse practitioners being the lowest. In the final study, interviews with regulatory bodies identified possible explanations for the differences observed in the reviews of disciplinary action. Conclusion: This thesis has generated new knowledge about disciplinary action for Canadian health professionals. This research will guide regulators and other stakeholders in improving health regulation and ensuring protection of the public.
Using a collaborative research approach to develop an interdisciplinary research agenda for the study of mobile health interventions for older adults.
(JMIR Mhealth Uhealth., 2015-02-10) Grindrod, Kelly; Baskerville, Neill; Giangregorio, Lora M.; Tomasson Goodwin, Jill; Sadat Rezai, Leila; Mercer, Kathryn; Burns, Catherine; Chang, Feng
Background: Seniors with chronic diseases are often called on to self-manage their conditions. Mobile health (mHealth) tools may be a useful strategy to help seniors access health information at the point of decision-making, receive real-time feedback and coaching, and monitor health conditions. However, developing successful mHealth interventions for seniors presents many challenges. One of the key challenges is to ensure the scope of possible research questions includes the diverse views of seniors, experts and the stakeholder groups who support seniors as they manage chronic disease. Objective: Our primary objective was to present a case-study of a collaborative research approach to the development of an interdisciplinary research agenda. Our secondary objectives were to report on the results of a nominal group technique (NGT) approach used generate research questions and to assess the success of including non-academic researchers to enrich the scope, priority, and total number of possible research questions. Methods: We invited researchers and stakeholders to participate in a full day meeting that included rapid-style presentations by researchers, health care professionals, technology experts, patients and community groups followed by group discussions. An NGT was used to establish group consensus on the following question: In your opinion, what research needs to be done to better understand the effectiveness, usability and design of mobile health apps and devices for older adults? Results: Overall, the collaborative approach was a very successful strategy to bring together a diverse group of participants with the same end goal. The 32 participants generated 119 items in total. The top three research questions that emerged from the NGT were related to adoption, the need for high quality tools and the digital divide. Strong sub-themes included privacy and security, engagement and design. The NGT also helped us include the perspectives information from non-academic researchers that would not have been captured if the process had been limited to the research team. Conclusions: Developing ways for patients and other stakeholders to have a voice when it comes to developing patient awareness as related to mHealth may guide future research into engagement, ownership, usability and design. It is our intention that our paper be used and adapted by other researchers to engage small or vulnerable populations often excluded from mHealth research and design.