Using a participatory design when creating services and programs in partnership with Indigenous communities ensures the creation of resources that meet their needs, are culturally relevant, and align with cultural beliefs.
Background
The BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) intervention was designed to integrate the approach to chronic disease prevention and screening in primary care and demonstrated effective in a previous randomized trial.
Methods
We tested the effectiveness of the BETTER HEALTH intervention, a public health adaptation of BETTER, at improving participation in chronic disease prevention and screening actions for residents of low-income neighbourhoods in a cluster randomized trial, with ten low-income neighbourhoods in Durham Region Ontario randomized to immediate intervention vs. wait-list. The unit of analysis was the individual, and eligible participants were adults age 40–64 years residing in the neighbourhoods. Public health nurses trained as “prevention practitioners” held one prevention-focused visit with each participant. They provided participants with a tailored prevention prescription and supported them to set health-related goals. The primary outcome was a composite index: the number of evidence-based actions achieved at six months as a proportion of those for which participants were eligible at baseline.
Results
Of 126 participants (60 in immediate arm; 66 in wait-list arm), 125 were included in analyses (1 participant withdrew consent). In both arms, participants were eligible for a mean of 8.6 actions at baseline. At follow-up, participants in the immediate intervention arm met 64.5% of actions for which they were eligible versus 42.1% in the wait-list arm (rate ratio 1.53 [95% confidence interval 1.22–1.84]).
Conclusion
Public health nurses using the BETTER HEALTH intervention led to a higher proportion of identified evidence-based prevention and screening actions achieved at six months for people living with socioeconomic disadvantage.
Trial registration
NCT03052959, registered February 10, 2017.
Introduction Breastfeeding rates among young mothers are low and do not meet recommendations from health authorities, putting the health of young mothers and their infants at risk. Young mothers require breastfeeding support that meets their learning needs and preferred mode for accessing information. The objective of this study was to work collaboratively with young mothers in order to cocreate an eHealth breastfeeding resource. Methodology A three-phase exploratory study was conducted in Ontario, Canada. In Phases I and II, young mothers and health care providers (HCPs) were recruited and preferences for an eHealth breastfeeding resource were explored. In Phase III, feedback from young mothers and HCPs about the new resource was collected. Results Participants found the breastfeeding eHealth resource visually appealing, engaging, and informative. Discussion Cocreating a tailored breastfeeding eHealth resource with young mothers and HCPs using a participatory approach ensured that the resource design and content met the learning needs of young mothers.
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