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Background: Occupational therapists who work in hospitals need to assess patients’ home environment in preparation for hospital discharge in order to provide recommendations (eg, technical aids) to support their independence and safety. Home visits increase performance in everyday activities and decrease the risk of falls; however, in some countries, home visits are rarely made prior to hospital discharge due to the cost and time involved. In most cases, occupational therapists rely on an interview with the patient or a caregiver to assess the home. The use of videoconferencing to assess patients’ home environments could be an innovative solution to allow better and more appropriate recommendations. Objective: The aim of this study was (1) to explore the added value of using mobile videoconferencing compared with standard procedure only and (2) to document the clinical feasibility of using mobile videoconferencing to assess patients’ home environments. Methods: Occupational therapists assessed home environments using, first, the standard procedure (interview), and then, videoconferencing (with the help of a family caregiver located in patients’ homes, using an electronic tablet). We used a concurrent mixed methods design. The occupational therapist's responsiveness to telehealth, time spent on assessment, patient’s occupational performance and satisfaction, and major events influencing the variables were collected as quantitative data. The perceptions of occupational therapists and family caregivers regarding the added value of using this method and the nature of changes made to recommendations as a result of the videoconference (if any) were collected as qualitative data, using questionnaires and semistructured interviews. Results: Eight triads (6 occupational therapists, 8 patients, and 8 caregivers) participated. The use of mobile videoconferencing generally led occupational therapists to modify the initial intervention plan (produced after the standard interview

Bread is a highly consumed food and an important source of nutrients in the diet of Canadians, underlining the need to improve its nutritional quality. The Food Quality Observatory (Observatory) aimed to evaluate the nutritional value of the sliced bread products available in Quebec (Canada), according to their grain type and main flour. Analyses included comparing the bread’s sodium content to Health Canada’s daily values (DV) and sodium voluntary targets, comparing the bread’s fibre content thresholds with the source of fibre mentioned, and assessing whether the main flour was associated with the nutrient content. The nutritional values of 294 sliced breads available in Quebec were merged with sales data (from October 2016 to October 2017), with 262 products successfully cross-referenced. The results showed that 64% of the breads purchased were ‘low’ in fibre (i.e., below 2 g per two slices), while 47% were ‘high’ in sodium (i.e., above 15% DV per two slices). Attention should be paid to 100% refined grain bread and to bread with refined flour as the main flour, since they are great sellers, while showing a less favourable nutrient content. This study shows that there is room for improvement in the nutritional content of Quebec’s bread offer, particularly regarding sodium and fibre content.

Background: In Western societies, the acceptability of entomophagy is low despite the sustainable and nutritional benefits of insects. It is recognized that insect meals incorporated in into familiar foods increases willingness to eat insects. Chefs can offer positive culinary insect-based experiences to their customers which can then contribute to increasing the acceptability of entomophagy by consumers. However, little is known about chefs' perceptions of the use of insect-based ingredients. Objective: The aim of this study was to explore the reasons why innovative student chefs are willing (or not) to incorporate mealworms meals into their dishes. Methodology: Semi-structured interviews were conducted with 7 innovative student chefs at the Institut de tourisme et d'hôtellerie du Québec (ITHQ). Thematic analysis based on a priori Rogers' Diffusion of Innovation Theory was conducted using transcript verbatim. Results: Most participants had a past consumption experience with entomophagy and all of them had a positive attitude toward this practice. The main perceived disadvantages of mealworm meal was the texture (granular and uneven), the odor as well as the low acceptability by consumers. Despite that, student chefs were generally willing to use insect-based ingredients, but they thought that transparency and more opportunities for consumers to try good insect-based dishes are keys to enhancing the acceptability of insect consumption. Conclusion: Understanding perceptions of innovative chefs about the use of insect-based ingredients can help to promote their use in gastronomy and ultimately improve their acceptability by consumers.

Introduction : La prise de décision concernant le choix du milieu de vie à la sortie de l’hôpital est difficile et stressante pour plusieurs personnes ainées fragiles et proches aidantes. En effet, elle expose souvent les personnes impliquées à des situations complexes : la plupart des personnes aînées souhaite retourner à domicile malgré les risques, ce qui suscite souvent des divergences d’opinions avec leurs proches, plus particulièrement en présence de déclin cognitif. L’approche interprofessionnelle de prise de décision partagée (IP-PDP) aiderait à impliquer les personnes aînées fragiles et proches aidantes dans cette prise de décision. Son application en contexte de soins à domicile par le biais d’une aide à la décision (AD), initialement développée par Légaré et coll., a démontré des effets probants. Des adaptations ont récemment été apportées à cette AD pour qu’elle soit utilisée auprès des personnes aînées fragiles et proches aidantes lors du congé hospitalier et dans des situations complexes. Il importe ainsi de valider cette AD concernant le choix du milieu de vie au congé de l’hôpital et dans des situations complexes, notamment en documentant la perception des usagers potentiels. Cette étude cherche ainsi à initier la démarche de validation auprès d’usagers potentiels afin de répondre à ce besoin. Objectif : Évaluer la perception de personnes aînées fragiles et proches aidantes sur la pertinence, le contenu et le format de l’AD adaptée. Méthodologie : Des entrevues qualitatives semi-dirigées ont été menées avec des personnes aînées (n=5), notamment fragiles non-hospitalisées, et des personnes proches aidantes (n=3). Une analyse thématique de Paillé et Mucchielli (2012) combinée au modèle interactif de Miles et Huberman (2003) a été réalisée. Résultats : Les résultats révèlent que cette version adaptée de l’AD est perçue comme étant pertinente, en permettant aux personnes aînées et proches aidantes d’être bien informées, de favoriser la discussion, de con, Introduction: Making decisions about the living environment upon the discharge from hospital is difficult and stressful for many frail older adults and their caregivers. It often exposes people to complex situations: most older adults wish to return home despite the risks, which frequently results in differences in opinion with those close to them, especially in the presence of cognitive deficits. The interprofessional shared decision-making approach (IP-SDM) could help involve older adults and their caregivers in this decision-making. Its application in the context of home care through decision support (DA), initially developed by Légaré & al. demonstrated convincing effects. Adaptations have recently been made to this DA so that it can be used with frail older adults and caregivers during hospital discharge and in complex situations. It is therefore important to validate this DA concerning the choice of living environment at hospital discharge and in complex situations, particularly by documenting the perception of potential users. This study thus seeks to initiate the validation process with potential users to meet this need. Objective: This study aims to assess the perception of older adults and caregivers on the relevance, content and format of an adapted DA. Methodology: Semi-structured qualitative interviews were conducted with particularly frail, non-hospitalized older adults (n = 5), and family caregivers (n = 3) to document their perception of the usefulness of the DA, the relevance of its content and the accessibility of its format. A thematic analysis was conducted based on Paillé and Mucchielli (2012) combined with Miles and Huberman's (2003) interactive model. Results: The results show that this adapted version of the DA is relevant, provides appropriate information, knowledge of living options, professional support and facilitates discussion as well as decision-making. Participants noted that the information provided is comprehensive, clear

Introduction : La progression des troubles neurocognitifs majeurs limite la réalisation des occupations signifiantes de plusieurs personnes aînées vivant en ressource d’hébergement. Les micromilieux, un modèle novateur de ressource d’hébergement, favorisent le maintien de leur engagement occupationnel, en adaptant l’environnement physique, l’horaire quotidien et l’approche de soins à l’histoire de vie des résidents. Objectifs : Ce projet vise à adapter les micromilieux au contexte québécois en vue d’en faciliter l’implantation au sein de ressources d’hébergement pour des personnes aînées en vivant avec un trouble neurocognitif majeur. Méthodes : Des entrevues qualitatives auprès d’acteurs clés québécois et internationaux (n=7) ont permis de documenter les barrières et les facilitateurs rencontrés durant expérience d’implantation de micromilieux. Deux groupes de discussion focalisée (n=7 par groupe; personnes aînées, personne proche aidante, intervenants et gestionnaires de RH québécoises) ont permis d’explorer l’acceptabilité et l’applicabilité des micromilieux, puis de proposer des modifications afin de dégager des conditions gagnantes pour l’implantation. Résultats : Les quatre principaux facilitateurs relevés incluent : 1) l’acceptabilité de l’approche; 2) l’implication de figures de leadership au sein des équipes; 3) l’implication de membres de la direction, de gestionnaires ou de cadres; 4) le soutien d’institutions et acteurs clés ayant implanté des approches similaires. Les trois grandes barrières à l’implantation des micromilieux comprennent : 1) le changement de culture dans les pratiques actuelles; 2) les normes et règlementations; 3) le recrutement du personnel. Les adaptations proposées concernent entre autres l’accès sécurisé des citoyens de la communauté extérieure aux commerces au cœur des ressources d’hébergement et l’ajout de formations destinées aux intervenants pour pérenniser les changements proposés. Conclusion : L’implantation éventuelle des mi, Introduction: The progression of neurocognitive disorders limits the realization of meaningful occupations for many seniors living in residential resources. Small-scale approaches help maintain their occupational engagement by adapting the physical environment, daily schedule, and care approach to their residents’ life-story. Objectives: This project aims to adapt small-scale approaches to Quebec’s context to facilitate their implementation within residential resources for seniors with living with neurocognitive disorders. Methods: Qualitative interviews with Quebec and international key players (n=7) documented the facilitators and barriers encountered in their experience of implementing small-scale approaches. Two focus group discussions (n=7 per group; seniors, caregiver, care team members and managers from Quebec residential resources) explored the acceptability and applicability of small-scale approaches, then suggested adaptations to identify winning conditions for their implementation. Results: The four main facilitators identified include: 1) acceptability of small-scale approaches; 2) involvement of leadership figures within care teams; 3) involvement of directors, managers, or executives; 4) support from institutions and key actors that have implemented similar approaches. The three main barriers identified include: 1) change in the current culture of practice; 2) norms and regulations; 3) staff recruitment. The suggested adaptations entail secured access for citizens of the local community to businesses inside the residential resources and the addition of trainings for all practitioners to ensure the sustainability of the proposed changes. Conclusion: The eventual implementation of small-scale approaches will contribute to maintain the occupational engagement and well-being of Quebec seniors living with neurocognitive disorders.

Background: Co-design (or the participation of users) has shown great potential in the eHealth domain, demonstrating positive results. Nevertheless, the co-design approach cannot guarantee the usability of the system designed, and usability assessment is a complex analysis to perform, as evaluation criteria will differ depending on the usability framework (or set of criteria) used. ISO (International Organization for Standardization) on usability (ISO 9241-210), Nielsen heuristic, and Garrett element of user experience inform different yet complementary aspects of usability. Objective: This study aims to assess the usability and user experience of a co-design prototype by combining 3 complementary frameworks. Methods: To help caregivers provide care for functionally impaired older people, an eHealth tool was co-designed with caregivers, health and social service professionals, and community workers assisting caregivers. The prototype was a website that aims to support the help-seeking process for caregivers (finding resources) and allow service providers to advertise their services (offering resources). We chose an exploratory study method to assess usability in terms of each objective. The first step was to assess users’ first impressions of the website. The second was a task scenario with a think-aloud protocol. The final step was a semistructured interview. All steps were performed individually (with a moderator) in a single session. The data were analyzed using 3 frameworks. Results: A total of 10 participants were recruited, 5 for each objective of the website. We were able to identify several usability problems, most of which were located in the information design and interface design dimensions (Garrett framework). Problems in both dimensions were mainly coded as effectiveness and efficiency (ISO framework) and error prevention and match between the systemand the real world (Nielsen heuristic). Conclusions: Our study provided a novel contribution about usabil

Human–animal interactions may positively impact the health and well-being of older adults. Considering about one third of community-dwelling older adults report owning a pet, better understanding the benefits, challenges, and the role of pet ownership may help support the relationships between older adults and their pets. This case study aims to better understand the role of pet ownership in the daily lives of older adults and explore the benefits and the challenges of owning a pet for this population. Interviews were conducted with Violet, a 77-year-old dog owner and her healthcare provider. Qualitative data were analyzed by two evaluators and validated by the participants. Both participants agree that the benefits outweigh the challenges for both the older adult and her pet. The benefits and challenges were the following: Violet, taking care of her dog (Jack), (1) could provide Violet with a sense of safety and positively influence her mood; (2) may introduce a slight fall risk; (3) includes financial costs to consider. Ensuring Jack’s well-being is important for Violet and her dog benefits from Violet’s continual presence and care. The findings suggest that improving the fit between characteristics of the owner and their pet may support the meaningful role of pet ownership within the context of aging-in-place.

Objective: To characterise the nutritional quality of food products targeted to children, we aimed: (1) to determine if the nutritional composition of child-targeted food products is different from those for the general population and (2) to verify differences in the nutrient content of child-targeted food products between three selected food categories. Design: The present study is part of the work conducted by the Food Quality Observatory, created in 2016 in the province of Quebec (Canada). Ready-to-eat (RTE) breakfast cereals (n 331), granola bars (n 310) and yoghurts and dairy desserts (n 380) were the food categories analysed. Setting: Nutritional values and all packaging information were obtained by purchasing every product available in supermarkets, grocery stores and specialty grocery stores. Free sugars were manually differentiated from total sugars for each product. Products were classified according to two targeted consumer groups: children or general population. Results: The nutrient profile of RTE breakfast cereals, granola bars and yoghurts and dairy desserts targeted to children differed from that of products intended at the general population. Child-targeted RTE breakfast cereals had the least favourable nutritional composition, with significantly higher content of carbohydrates, total sugars, free sugars and Na compared with breakfast cereals for the general population as well as child-targeted granola bars and yoghurts and dairy desserts. All child-targeted products analysed contained free sugars. Conclusions: The current study supports the relevance to further regulate marketing to children on food product packages to ensure that such marketing is not present on food products with poor nutritional quality.

Objective: The Food Quality Observatory was created in the province of Quebec (Canada) in 2016. In this study, the Observatory aimed to generate a methodology to (1) test the use of sales data combined with nutrient values to characterise the nutritional composition of ready-to-eat (RTE) breakfast cereals offered and purchased in the province of Quebec (Canada) and (2) verify the extent to which a front-of-pack label based on the percentage of daily value (DV) for total sugar, as a strategy to improve the food supply, would be distributed in this food category. Design: Nutritional information were obtained by purchasing each RTE breakfast cereal available in the Greater Montreal area. Cereals were then classified according to their processing type. Setting: The nutritional values of 331 RTE breakfast cereals available in Quebec were merged with sales data covering the period between May 2016 and May 2017. A total of 306 products were successfully cross-referenced. Results: Granola and sweetened cereals were the most available (36·6 % and 19·6 %, respectively) and purchased (19·8 % and 40·9 % of sales, respectively). When compared with other types of cereals, granola cereals had a higher energy, fat, saturated fat, protein content and a lower Na content. A larger proportion of chocolate (65 %) and sweetened cereals (49 %) were above 15 % of the DV for sugar. Conclusions: This study showed that the methodology developed generates important data to monitor nutritional quality of the food supply and ultimately contribute to improve the nutritional quality of processed foods.

Bread is a highly consumed food and an important source of nutrients in the diet of Canadians, underlining the need to improve its nutritional quality. The Food Quality Observatory (Observatory) aimed to evaluate the nutritional value of the sliced bread products available in Quebec (Canada), according to their grain type and main flour. Analyses included comparing the bread’s sodium content to Health Canada’s daily values (DV) and sodium voluntary targets, comparing the bread’s fibre content thresholds with the source of fibre mentioned, and assessing whether the main flour was associated with the nutrient content. The nutritional values of 294 sliced breads available in Quebec were merged with sales data (from October 2016 to October 2017), with 262 products successfully cross-referenced. The results showed that 64% of the breads purchased were ‘low’ in fibre (i.e., below 2 g per two slices), while 47% were ‘high’ in sodium (i.e., above 15% DV per two slices). Attention should be paid to 100% refined grain bread and to bread with refined flour as the main flour, since they are great sellers, while showing a less favourable nutrient content. This study shows that there is room for improvement in the nutritional content of Quebec’s bread offer, particularly regarding sodium and fibre content.

The purpose of this study was to develop and validate a questionnaire assessing food liking in a French-Canadian population. A questionnaire was developed, in which participants were asked to rate their degree of liking of 50 food items. An expert panel evaluated the content validity. For the validation study, 150 men and women completed the questionnaire twice. An Exploratory Factor Analysis (EFA) was performed to assess the number of subscales of the questionnaire. Internal consistency and test-retest reliability of the subscales were evaluated. Concurrent validity was assessed through correlations between liking scores and self-reported frequencies of consumption. Comments from the experts led to changes in the list of foods included in the questionnaire. The EFA revealed a two-factor structure for the questionnaire (i.e., savory and sweet foods) and led to the removal of nine items, resulting in a 32-item questionnaire. The two subscales revealed good internal consistency (Cronbach alphas: 0.85 and 0.89) and test-retest reliability (p = 0.84 and 0.86). The questionnaire demonstrated adequate concurrent validity, with moderate correlations between food liking and self-reported frequency of consumption (r = 0.19–0.39, ps < 0.05). This new Food Liking Questionnaire assessing liking of a variety of savory and sweet foods demonstrated good psychometric properties in every validation step. This questionnaire will be useful to explore the role of food liking and its interactions with other factors in predicting eating behaviors and energy intake.

Objective: To verify the efficacy of school-based interventions aimed at reducing sugar-sweetened beverage (SSB) consumption among adolescents in order to develop or improve public health interventions. Design: Systematic review of interventions targeting adolescents and/or the school environment. Setting: The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL and EMBASE. Proquest Dissertations and Theses was also investigated for unpublished trials. Subjects: Adolescents were defined as individuals between the ages of 12 and 17 years. Results: A total of thirty-six studies detailing thirty-six different interventions tested among independent samples (n 152 001) were included in the review. Twenty interventions were classified as educational/behavioural and ten were classified as legislative/environmental interventions. Only six interventions targeted both individuals and their environment. Over 70 % of all interventions, regardless of whether they targeted individuals, their environment or both, were effective in decreasing SSB consumption. Legislative/environmental studies had the highest success rate (90·0 %). Educational/behavioural interventions only and interventions that combined educational/behavioural and legislative/environmental approaches were almost equally effective in reducing SSB consumption with success rates of 65·0 and 66·7 %, respectively. Among the interventions that had an educational/behavioural component, 61·5 % were theory-based. The behaviour change techniques most frequently used in interventions were providing information about the health consequences of performing the behaviour (72·2 %), restructuring the physical environment (47·2 %), behavioural goal setting (36·1 %), self-monitoring of behaviour (33·3 %), threat to health (30·6 %) and providing general social support (30·6 %). Conclusions: School-based interventions show promising results to reduce SSB consumption among adolescents. A number of recommendations are

Les personnes atteintes d’une maladie pulmonaire obstructive chronique (MPOC) doivent vivre avec des symptômes d’essoufflement devenant de plus en plus incapacitants avec la progression de la maladie1. Les maladies pulmonaires chroniques étaient la 5e cause de décès la plus importante en 2018 au Canada2 et pourraient devenir la 3e cause de décès au monde d’ici 20303. Les écrits scientifiques démontrent que la réadaptation pulmonaire (RP) améliore la capacité fonctionnelle et la qualité de vie des personnes ayant une MPOC4. La RP implique la promotion de l’activité physique au quotidien et l’autogestion de la maladie5. Toutefois, l’accès à la RP est limité6 et ses effets diminuent dans les 6 à 18 mois suivants7. Cette étude pilote à devis mixte a exploré les effets d’un programme novateur de chant choral (CC) bihebdomadaire de 12 semaines, incluant des exercices de rééducation respiratoire, et les a comparés à ceux obtenus à la RP. Dix-neuf personnes âgées de 50 ans et plus, atteintes de MPOC de modérée à très sévère ont participé à l’intervention de CC (n=11) ou de RP (n=8). En plus de l’assiduité, des mesures ont été effectuées avant, après l’intervention et 3 mois plus tard sur les fonctions pulmonaires, la capacité fonctionnelle, les fonctions cognitives, la participation sociale et la qualité de vie. Une entrevue semi-structurée au terme de l’intervention a permis de documenter la satisfaction, les barrières, les facilitateurs ainsi que les effets perçus des interventions. Les résultats révèlent une assiduité comparable (> 80%) entre les deux groupes. Les participants ont apprécié et recommanderaient tous leur programme. Des barrières (non-pérennité du programme, éloignement du site) et des facilitateurs (climat du groupe, approche personnalisée) ont été rapportés. Aucun changement significatif n’a été observé entre les mesures prises avant et après l’intervention pour les deux groupes, hormis des améliorations statistiquement et cliniquement significatives de l, People affected with a chronic obtrusive pulmonary disease (COPD) must endure breathlessness symptoms that become increasingly incapacitating as the disease progresses1. Chronic pulmonary diseases were the 5th cause of death in Canada in 20182 and could become 3rd cause of mortality in the world by 20303. Scientific literature shows that pulmonary rehabilitation (PR) can improve functional capacity and quality of life for people affected with COPD4. PR implies promoting daily physical activity and self-management of the disease5. However, PR access is limited6 and its effects are known to decrease in the following 6 to 18 months7. This mixed methods pilot feasibility study has explored the effects of an innovative group singing (GS) program, including breathing control exercises, and compared it to PR. Nineteen moderate to very severe COPD patients aged 50 and over participated either to GS (n=11) or PR (n=8). The repeated measures on both 12-week biweekly programs were assessed at baseline, post, and 3 months after on such variables as pulmonary function, functional capacity, cognitive functions, social participation, and quality of life, as well as attendance and were intercalated by an interview on satisfaction, barriers, facilitators, and perceived effects of the programs. The results show a comparable attendance (> 80%) for both groups. All participants appreciated and recommended their program. Some barriers (unsustainability, physical distance) and facilitators (group spirit, personalized approach) were noted. No significant changes were reported between baseline and post intervention, except for walking distance where PR obtained a significant improvement (6MWT + 53m, p=0,013). Better breathing and improvements in quality of life were perceived by most but more so by PR than GS. In between post intervention and 3 months later, the pulmonary function differed as PR declined (FEV6 (L), p=0,037; FEV (L), p=0,010), (FEV6/L, p=0,018). Larger scale repl

Introduction. Le milieu de vie est un déterminant important du bien-être. Le relogement des aînés est souvent réalisé en réactivité, n’offrant que peu de contrôle sur les décisions à prendre, générant stress et anxiété. La planification de la trajectoire domiciliaire, en proactivité, favoriserait une meilleure transition vers un nouveau milieu, en amorçant le processus de réflexions et d’actions en amont de la décision de relogement. Or, peu d’études ont cherché à comprendre cette planification de la perspective des aînés. Objectifs. 1) Dégager, à travers l’expérience d’aînés proactifs, les éléments narratifs et thématiques qui construisent les réflexions et les actions en planification de trajectoire domiciliaire. 2) Analyser ces éléments pour identifier les facteurs de succès qui influencent les phases subséquentes de la trajectoire. Méthodologie. Une étude de cas multiples (n=10) fut réalisée auprès d’aînés proactifs. Les récits d’expérience furent analysés thématiquement, puis illustrés schématiquement pour validation de leur part. Résultats. Les participants (6 femmes, 4 hommes ; âge moyen : 72,3 ans) présentaient en moyenne un niveau de scolarité universitaire. Selon les objectifs : 1) l’anticipation et le besoin de renouveau furent des moteurs à la réflexion. Des composantes personnelles ont soutenu la proactivité lors de la planification de la trajectoire domiciliaire, telles que le besoin de contrôle. Pour les actions, l’exploration d’options de milieu de vie débuta avec la détermination des critères de recherche ; 2) le temps, le soutien social et la réalisation d’un plan établi furent des facteurs de succès à la transition. Conclusion. Les résultats soutiendront le développement d’outils d’accompagnement et de formations valorisant la planification domiciliaire en vieillissant., Introduction. Home is an important determinant of well-being. Relocation of older adults is often done in a reactive manner, offering little control over the decision-making process, generating stress and anxiety. Proactive planning of home trajectory would promote a better home transition, by initiating reflections and actions processes before the relocation decision. However, few studies have sought to understand this planning from the older adults’ perspective. Goal. 1) bring out, through the experience of proactive older adults, narrative and thematic elements that build reflections and actions in home trajectory planning; 2) analyze these elements to identify the success factors which influence the subsequent phases of the trajectory. Methodology. A multiple case study (n=10) was carried out with 10 proactive older adults. Their narrative was thematically analyzed, then illustrated schematically for their validation. Results. Participants (6 women, 4 men; average age of 72,3 years old) had in average a level of university education. Following the objectives: 1) anticipation and a need for renewal drove reflections. Personal components supported proactivity in home trajectory planning, such as the need for control. For the actions, the exploration of home options began with the determination of search criteria; 2) time, social support, and the completion of an established plan are success factors in the transition. Conclusion. Results will support the development of guidance tools and training to enhance home planning as aging.

Objective: The present study aimed to develop and validate a questionnaire assessing social support for healthy eating in a French-Canadian population. Design: A twenty-one-item questionnaire was developed. For each item, participants were asked to rate the frequency, in the past month, with which the actions described had been done by family and friends in two different environments: (i) at home and (ii) outside of home. The content was evaluated by an expert panel. A validation study sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on items to assess the number of subscales. Internal consistency reliability was assessed using Cronbach's ɑ. Test-retest reliability was evaluated with intraclass correlations between scores of the two completions. Setting: Online survey. Subjects: Men and women from the Québec City area (n 150). Results: The content validity assessment led to a few changes, resulting in a twenty-two-item questionnaire. Exploratory factor analysis revealed a two-factor structure for both environments, resulting in four subscales: supportive actions at home; non-supportive actions at home; supportive actions outside of home; and non-supportive actions outside of home. Two items were removed from the questionnaire due to low loadings. The four subscales were found to be reliable (Cronbach's ɑ=0·82-0·94; test-retest intraclass correlation=0·51-0·70). Conclusions: The Social Support for Healthy Eating Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. This questionnaire will be useful to explore the role of social support and its interactions with other factors in predicting eating behaviours.

The objective of this study was to characterize the intakes of different types of sugars in an age- and sex-representative sample of French-speaking adults from five regions of the Province of Québec, Canada, enrolled in the cross-sectional PREDISE (PRÉDicteurs Individuels, Sociaux et Environnementaux) study (n = 1147, 18–65 years old; 50.2% women). Because only total sugar content of foods and beverages is available in the Canadian Nutrient File (CNF) 2015, the initial step of this study was thus to build a database of free and naturally occurring sugars content of each food item and recipe included in the R24W, which is an automated, self-administered, web-based, 24-h dietary recall validated to estimate nutrient intakes in French-speaking adults of the Province of Québec. Total sugars were manually differentiated into free and naturally occurring sugars using a systematic algorithm based on previously published systematic algorithms. The World Health Organization (WHO)’s free sugar definition was used to differentiate total sugars into free and naturally occurring sugars. Dietary intake estimates were assessed using three 24-h dietary recalls completed with the R24W. Mean total, free, and naturally occurring sugar intakes were 116.4 g (19.3% of daily energy intake (%E)), 72.5 g (11.7%E), and 44.0 g (7.5%E), respectively. Over half (57.3%) of the overall sample did not meet the WHO’s recommendation to consume less than 10%E from free sugars. Women had a higher %E from naturally occurring sugars than men and being younger was associated with a greater %E from free sugars. Sugar intakes among French-speaking adults from the Province of Québec were mainly in the form of free sugars, with the majority of the population exceeding the WHO recommendation regarding free sugar intake. This suggests that public health efforts towards reducing free sugar intake in this population are relevant and necessary, considering that overconsumption of free sugars negatively influence

Background: There is very limited knowledge on the magnitude to which foods with low nutritive value constitute the diet of adults from the province of Quebec. The extent to which these foods impact cardiometabolic risk is also poorly documented. The objective was to assess the contribution of low nutritive value foods to total energy intake (E) and to examine associations with cardiometabolic risk factors among French-speaking adults from 5 administrative regions of the Province of Quebec. Methods: As part of the cross-sectional PREDISE Study, 1147 adults (50.2% women; mean [SD] age, 43.2 [4.6] years) participated in a web-based investigation. Dietary intake data were obtained using a validated web-based selfadministered 24-h recall, the R24W, completed on three occasions. Foods with low nutritive value were defined as foods exceeding predetermined thresholds for the following nutrients: saturated fat, sugar or sodium as well as beverages and ingredients not recommended in Canada’s Food Guide 2019. A total of 1019 participants underwent on-site clinical assessment of cardiometabolic risk factors. Results: Participants consumed on average 29.0%E (95%CI, 28.2–29.7) as low nutritive value foods, to which pastries (18%), alcohol (15%), sweets (13%), chips/popcorn (6%) and sugar-sweetened beverages (6%) contributed the most. Low nutritive value foods contributed more to total E in men than in women (30.7%E vs. 27.5%E, respectively; P < 0.0001). In fully-adjusted linear regression models, increments of 250 kcal/d from low nutritive value foods were associated with higher body mass index (+ 1.7 kg/m2 ; 95%CI 1.2 to 2.2), higher waist circumference (+ 0.6 cm; 95%CI, 0.1 to 1.1), cholesterol: HDL cholesterol ratio (+ 0.12 mmol/L; 95%CI, 0.01 to 0.24 and triglycerides (+ 7.8%; 95%CI, 3.0 to 12.8). Conclusions: Low nutritive value foods contribute near 30% of total daily energy intake of French-speaking adults of the Province of Quebec and are associated with increased waist

The objectives were to assess whether social support for healthy eating and perceived food environment are associated with diet quality, and to investigate if sociodemographic characteristics moderate these associations. A probability sample of French-speaking adults from the Province of Québec, Canada, was recruited in the context of the PREDISE study. Participants reported their perceptions of supportive and non-supportive actions related to healthy eating from close others at home and outside of home (n = 952), and of the accessibility to healthy foods (n = 1035). The Canadian Healthy Eating Index (C-HEI) was calculated based on three Web-based 24 h food recalls. Multiple linear regression models showed that supportive (B = 1.50 (95% CI 0.46, 2.54)) and non-supportive (B = −3.06 (95% CI −4.94, −1.18)) actions related to healthy eating from close others at home were positively and negatively associated with C-HEI, respectively, whereas actions from close others outside of home were not. The negative association between non-supportive actions occurring at home and C-HEI was stronger among participants with lower (vs. higher) levels of education (p interaction = 0.03). Perceived accessibility to healthy foods was not associated with C-HEI (p > 0.05). These results suggest that the social environment may have a stronger influence on healthy eating than the perceived physical environment. This adds support for healthy eating promotion programs involving entire families, especially for more socioeconomically disadvantaged individuals, whose efforts to eat healthily may be more easily thwarted by non-supportive households

Le bien-être des aînés et leur possibilité de contribuer à la société requiert la mise en œuvre d’interventions adaptées aux collectivités. Visant à soutenir la participation sociale d’aînés ayant des incapacités grâce à un jumelage avec un citoyen encadré par des professionnels, l’Accompagnement-citoyen personnalisé d’intégration communautaire (APIC) est considéré prometteur et a été ciblé pour une première implantation dans un organisme communautaire d’une municipalité régionale de comté rurale avec des bénévoles. Or, dans ce nouveau contexte, les composantes s’avérant essentielles aux bienfaits pour les aînés et les enjeux influençant leur actualisation demeuraient inconnus. Cette étude visait donc à mieux comprendre l’émergence des bienfaits de l’APIC pour les aînés accompagnés. Une étude de cas multiples a été réalisée auprès de cinq cas, chacun formés autour d’une dyade incluant un accompagné et un accompagnateur totalisant 13 participants (6 accompagnateurs, 5 accompagnés, 1 proche, 1 responsable de l’implantation). Des données issues de questionnaires, de journaux de bord, de photovoix, d’observations et d’entretiens semi-dirigés ont fait l’objet d’une analyse de contenu thématique intra et inter-cas. Des composantes essentielles à l’émergence de bienfaits pour l’accompagné ont été mises en lumière, soit le plein engagement dans l’APIC, l’appréciation simultanée de l’expérience par les jumelés, le partage de l’appréciation, la personnalisation bidirectionnelle et la perception d’une progression chez l’accompagné. L’actualisation de ces composantes requiert que les dyades soient en mesure de communiquer efficacement; de gérer l’asymétrie dans la relation; de parvenir à un accord logistique et de concilier les attentes, les besoins et les intérêts de divers acteurs. L’émergence de bienfaits peut être favorisée en soutenant, à la fois chez les individus et dans le milieu d’implantation, la présence de caractéristiques propices à la résolution des tensions entre

Problématique : Les antipsychotiques sont prescrits chez près de 50 % des résidents vivant en centre d’hébergement de soins de longue durée (CHSLD) atteints de TNC majeurs. Or, les antipsychotiques ont des effets modestes pour traiter les symptômes comportementaux et psychologiques de la démence (SCPD), en plus d’être associés à des évènements indésirables sérieux. La démarche OPUS-AP a été développée afin d’aider les cliniciens à déprescrire les antipsychotiques en CHSLD, lorsqu’ils sont cliniquement non indiqués. Objectifs : Cette étude prospective vise à décrire et comparer entre le début du suivi (T0) et à 3 mois (T3), les changements dans (1) l’utilisation d’antipsychotique ; (2) dans l’utilisation des benzodiazépines, des antidépresseurs ainsi que la prévalence des SCPD et des chutes. Méthodologie : La démarche OPUS-AP a été mise en place dans 24 CHSLD du Québec. La comparaison entre T0 et T3 a été réalisée par le test de McNemar. Résultats : À T0, la cohorte de suivi comprenait 464 résidents avec un diagnostic de TNC majeurs et une prescription d’antipsychotique. À T3, 417 (89,9 %) résidents étaient toujours admis à la cohorte de suivi. Une déprescription a été possible chez 120 résidents (56,6 % de cessation complète et 43,3 % de diminution de dose) admissibles à la déprescription. Chez les résidents avec déprescription d’antipsychotique, une diminution de la prescription de benzodiazépine a été constatée. Parallèlement, la prescription d’antidépresseurs et la prévalence de SCPD n’ont pas augmenté, alors que les chutes n’ont pas diminué. Conclusion : OPUS-AP a permis aux cliniciens de déprescrire les antipsychotiques, sans augmenter l’usage de benzodiazépines et d’antidépresseurs. L’absence de recrudescence de SCPD suggère que la démarche OPUS-AP contribue à l’amélioration des soins des résidents., Problem: Antipsychotics are prescribed in 50% of residents of long-term care (CHSLD) living with major neurocognitive disorders (MNCD). However, antipsychotics show modest effects to treat the behavioral and psychological symptoms of dementia (BPSD), in addition of being associated with serious adverse events. The OPUS-AP approach was developed to allow clinicians to describe antipsychotics in CHSLD when clinically non-indicated. Objectives : This prospective study aims to describe and compare between baseline (T0) and at 3 months (T3) main changes (1) in antipsychotic use; (2) in benzodiazepines and antidepressants use, as well as the prevalence of BPSD and falls. Methodology: The OPUS-AP initiative was implemented in 24 long-term care facilities in Quebec. Changes between T0 and T3 were detected using the McNemar test. Results: At T0, the follow-up cohort included 464 residents with a diagnosis of MNCD and an antipsychotic prescription. At T3, 417 (89.9%) residents were still included in the follow-up cohort. Deprescription was possible in 120 residents (56.6% complete cessation and 43.3% dose reduction) eligible for deprescription. In residents with antipsychotic deprescription, a decrease in benzodiazepine prescription was observed. Moreover, BPSD or the prescription of antidepressants did not increase. No decrease in falls were observed. Conclusion : OPUS-AP has allowed clinicians to deprescribe antipsychotics without increasing the use of benzodiazepines and antidepressants. No worsening of BPSD outbreaks suggests that the OPUS-AP approach contributes to improving resident care.