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3. Challenges and Strategies for Promoting Health Equity in Virtual Care: Protocol for a Scoping Review of Reviews

Author

Fujioka, Jamie Keiko, Budhwani, Suman, Thomas-Jacques, Tyla, De Vera, Kristina, Challa, Priyanka, Fuller, Kaitlin, Hogeveen, Sophie, Gordon, Dara, Shahid, Simone, Seto, Emily, and Shaw, James

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundThe rapid virtualization of health services during the COVID-19 pandemic has drawn increasing attention to the impact of virtual care technologies on health equity. In some circumstances, virtual care initiatives have been shown to increase health disparities, as individuals from underserved communities are less likely to benefit from such initiatives. ObjectiveThe purpose of this paper is to describe a protocol for a scoping review of reviews that aims to map review-level evidence that describes challenges and strategies for promoting effective engagement with virtual care technologies among underserved communities. MethodsOur methodology was adapted from seminal scoping review guidelines provided by Arksey and O’Malley, Levac at al, Colquhoun et al, and the Joanna Briggs Institute. Our search strategy was developed for the following databases: MEDLINE (on Ovid), EMBASE (on Ovid), CINAHL (on EBSCO), Scopus, and Epistemonikos. Supplementary searches will include the use of Google Scholar and reference tracking. Each citation will be independently screened by 2 researchers at the title and abstract level, and full-text screening will be performed in accordance with our eligibility criteria. The eligibility criteria focused on the inclusion of methods-driven reviews (ie, systematic reviews, scoping reviews, meta-analyses, realist reviews, and critical interpretative syntheses) to enhance rigor and quality. Other inclusion criteria included a focus on virtual care services that facilitate bidirectional patient-provider communication (ie, video, telephone, and asynchronous messaging visits) for underserved populations (ie, those who experience social disadvantage due to race, age, income, and other factors related to the social determinants of health). ResultsThis scoping review of reviews will provide a broad overview of identified challenges associated with the accessibility of virtual health care services among underserved communities. In addition, strategies for improving the access to, uptake of, and engagement with virtual care technologies among underserved communities will be identified. The knowledge synthesized from this review will aid in developing and implementing virtual services that acknowledge the unique needs of populations who experience barriers to care and disproportionately worse health outcomes. The results will also inform gaps in current research. ConclusionsThe rapid shift toward virtual health services has highlighted the urgent need to critically examine the intersection of virtual care and health equity. Although technology-driven innovations in health care generally aim to improve access, quality, and health outcomes, it is also possible for these innovations to produce intervention-generated inequities. Assessing current review-level evidence on the key challenges and strategies for improving the application of virtual care in underserved communities is imperative for ensuring that virtual care benefits all populations. International Registered Report Identifier (IRRID)PRR1-10.2196/22847

Published
2020
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13. Leveraging Community Support Services to Support an Integrated Health and Social System Response to COVID-19: A Mixed Methods Study

Author

Northwood, Melissa, Kalles, Elizabeth, Harrington, Cathy, Hogeveen, Sophie, and Heckman, George

Abstract

The COVID-19 pandemic restricted access to health and social care for older adults. In response, a standardized, self-report instrument, the interRAI COVID-19 Vulnerability Screener (CVS), was developed. In collaboration with a community support service organization, this project aimed to evaluate a surveillance process to identify those at risk and triage them to health- or social-care services. A convergent, mixed methods design was used. Virtual focus groups were conducted with partner staff. The clinical, social, and functional characteristics of screened clients were analyzed descriptively. The mixed methods analysis generated implementation considerations. Participants successfully utilized the CVS to identify and support vulnerable clients who may have otherwise been overlooked. Most screened clients were not experiencing COVID-19 symptoms, yet had elevated mortality risk should they become infected, and were negatively impacted by social isolation. Findings support the use of the CVS by community support services during the pandemic or other disasters to identify those at risk due to frailty and social or economic vulnerability. Implementation requirements include a knowledgeable workforce, active facilitation, and incorporation of the CVS into existing workflows. Health- and social-care integration would be enhanced by the development of updated privacy policies and shared digital infrastructure.

Published
2023
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14. Evaluation of a Student-Older Adult Telephone Befriending Program to Reduce Social Isolation during the COVID-19 Pandemic: A Pilot Evaluation

Author

Ahuja, Manan, Lewis, Kaitlin, Kim, Leanne, Owais, Sawayra, Compagnone, Jordana, Fallico, Laura, Fishbein, Francine, Stefanova, Isabella, Xu, Kai Man, Boulos, Mary, Gui, Shannon, Basu, Monisha, Cooper, Tracy, Kay, Kelly, Hogan, David B., Morais, José A., Molnar, Frank, Lam, Robert E., Borrie, Michael J., Koerber, Raphaelle, Vaccarello, Linh, Ho, Allan, MacKay, Scott, Ebert, Patricia, Harbridge, Cathy, Hogan, David, Mukharyamova, Alfiya, Foster, Nicoda, Wang, Irene, Kabitsis, Pauline P., Hamelin, Mary Ann, Troung, Nga, Lee, Janny, Sinha, Samir K., Thompson, Cody, Bharadia, Morgan, Sadowski, Cheryl, Chuen, Victoria, Chan, Adrian, Alibhai, Shabbir, Chau, Vicky, Dholakia, Saumil, Bagheri, Alireza, Simpson, Alexander (Sandy), Hewitt, David, Ratcliffe, Michael, Booth, Dr Malcolm, Lafleur, Benoit, Jibb, Samantha, Gingrich, Shaen, Lane, Susan, Clarke, Jo-Anne, Fat, Guillaume Lim, Gopaul, Aquila, Pananos, Demetri, Taabazuing, Mary-Margaret, Schnarr, Lindsay, Bater, Marilyn, Dai, Serina, Freedman, Amy, Degan, Sophie Del, Forget, Marie-France, Leblanc, Julie, Desjardins, Michaël, Durand, Madeleine, Vu, Thien Tuong Minh, Nguyen, Quoc Dinh, Desmarais, Philippe, Miles, Amy, Norris, Mireille, Reppas-Rindlisbacher, Christina, Finlay, Jessica M, Mahar, Alyson, Siddhpuria, Shailee, Hallet, Julie, Rochon, Paula, Kobayashi, Lindsay C, Wong, Eric, Gormley, Jessica, Lee, Justin, Conroy, Maeve, Patterson, Christopher, Xu, Victoria YY, Sham, Rosalind, Moy, Sally, Naglie, Gary, Smith, Jagger, Mahon, Joel, Almeida, Quincy, Bherer, Louis, Burhan, Amer, Liu-Ambrose, Teresa, Middleton, Laura, Nagamatsu, Lindsay, Speechley, Mark, Montero-Odasso, Manuel, Osman, Abdelhady, Ali, Shehzad, Payen, Anaïs, Beuscart, Jean-Baptiste, Soula, Julien, Verloop, David, Defebvre, Marguerite-Marie, Dambre, Delphine, Godard-Sebillotte, Claire, Pieruccini-Faria, Frederico, Haddad, Seyyed, Cornish, Ben, McIlroy, Bill, Bartha, Rob, Investigators, All ONDRI, Searle, Samuel, Walsh, Steve, Davis, Giselle, Mercier, Tara, Rockwood, Kenneth, Davis, Daniel, Haroon, Babar, Sultana, Munira, Campbell, Karen, Jennings, Morgan, Orange, Joseph B., Knowlton, Jill, George, Armin St., Bryant, Dianne, Akter, Ripa, Kim, Kristine, Huang, Allen, Arsenault-Lapierre, Geneviève, Bui, Tammy, Sourial, Nadia, Quesnel-Vallée, Amélie, Massamba, Victoria, Rochette, Louis, Morgan, Debra, Kosteniuk, Julie, Vedel, Isabelle, Aubin, Vincent, Paquet, Steve, Durand, Pierre J., Pageau, Félix, Bharaj, Neetika, Suárez, Pablo Solla, Obrand, Jeremy, Chetrit, Jessica, Ahmad, Fayeza, Lantagne, Sarah, Morrison, David, Xue, Xiaoqing, Afilalo, Marc, Richards, Brent, Afilalo, Jonathan, Bray, Nick W, Witt, Suzanne T, Bartha, Robert, Doherty, Timothy J, Nagamatsu, Lindsay S, Almeida, Quincy J, Arsenault-Lapierre, Genevieve, Cameron, Julie, Kolomitro, Klodiana, Dalgarno, Nancy, Turnnidge, Jennifer, Pelland, Lucie, Auais, Mohammad, Carr, Frances, Morgan, Angela, Devapura, Shehani, Williams, Christina, Symon, Jennifer, Howe-Riddell, Carolyn, Miller, Angela, Boone, Jennifer, Ebbage, Kevin, Jadaviji, Shalmin, Mathura, Pamela, Charles, Lesley, Parmar, Jasneet, Suzette, Brémault-Phillips, Pike, Ashley, Dobbs, Bonnie, Tian, Peter George, Piazza, Nicolo, Goldfarb, Michael, Martucci, Giuseppe, Rudski, Lawrence, Spaziano, Marco, Morin, Jean-Francois, Lachapelle, Kevin, Langlois, Yves, D’Amico, Danielle, Yusupov, Iris, Zhu, Lynn, Lass, Jordan W., Levine, Brian, Vandermorris, Susan, Troyer, Angela K., Ewa, Vivian, Lee, Jennifer, Jones, Chris, Gutscher, Abram, Feng, Chengying, Adebero, Tony, DePaul, Vincent, Vafaei, Afshin, Norman, Kathleen, Gallibois, Molly, Rogers, Kyle, Folkins, Chris, Jarrett, Pamela, Magalhaes, Sandra, Gibson, Kirstian, Gao, Yuchen, Ottley, Katherine M., Qiao, Thomas, Myge, Ivy, Compton, Roslyn M., Wickson-Griffiths, Abigail, Hunter, Paulette V., Network, Saskatchewan Long-Term Care, Gill, Navjot, Connelly, Denise, Godwin, Bradley, Hanson, Natasha, Kervin, Emily, Skerry, Leanne, McCloskey, Rose, Hassanabadi, Nazila, Berger, Claudie, Papaioannou, Alexandra, Cheung, Angela M, Rahme, Elham, Leslie, William D, Goltzman, David, Morin, Suzanne, Hogeveen, Sophie, Heckman, George, Milne, Kelly, Hirdes, John, Horne, Natalie, Marshall, Emily, Andrew, Melissa, Hunter, Susan, Somerville, Lyndsay, Lanting, Brent, Ivo, Jessica, Pitre, Teresa, Faisal, Sadaf, Antunes, Kristen, Oda, Kasumi, Patel, Tejal, Jacob, Gabriella, Sherwood, Malcolm, Malik, Shabhaz, Baker, Jacquie, Bhangu, Jaspreet, Khoury, Lara, Moors, Joy, Lampron, Jacynthe, Figueira, Sonshire, Nemnom, Marie-Joe, Eagles, Debra, Koop, Jennifer, Lee, Linda, Hillier, Loretta M., Gregg, Susie, Hickman, Kathy, Agla, Caitlin, Carducci, Jillian, Skimson, Kara, Dillon-Martin, Sharon, Kuzych, Lissa, Beuermann, Lindsay, Parikh, Ruchi, Lee, Catherine, Lee, Ahreum, McArthur, Caitlin, Ioannidis, George, Adachi, Jonathan D, Griffith, Lauren E, Thabane, Lehana, Giangregorio, Lora, Morin, Suzanne N, Madden, Kenneth, Feldman, Boris, Arishenkoff, Shane, Meneilly, Graydon, Mah, Jasmine, Godin, Judith, Stevens, Susan, Keefe, Janice, Sun, Michael, Goodwin, Josh, Cheung, Bonnie, von Maltzahn, Maia, Mailhot, Tanya, Clausen, Christina, Crump, Laura, Leblanc, Marie-Eve, Sanzone, Lia, Marr, Sharon, Doherty, Michelle, Siemon, Jennifer, Hillier, Loretta, Milroy, Desmond, Marrone, Erica, Maalouf, Mona, Moorhouse, Paige, Shetty, Nabha, Mallery, Laurie, Miller, Ashley, VonMaltzahn, Maia, Naug, Anne Marie Krueger, Tinning, Amanda, Buckler, Melissa, Stasiulis, Elaine, Sandhu, Harvir, Brookes, Jahnel, Vrkljan, Brenda, Mariano, Claudia, Gélinas, Isabelle, Byszewski, Anna, Rapoport, Mark J., Sanford, Sarah, Bédard, Michel, Belchior, Patricia, Crizzle, Alexander, Marshall, Shawn, Rapoport, Mark, Nene, Sofia, Bennett, Roxanne, Morin, Suzanne N., Nixon, Lara, Sampson, Megan, Punungwe, Fadzai Moreblessing, Kelly, Martina, Nuique, Kate, Papillon-Ferland, Louise, Castonguay, Valérie, Anderson, Sharon, Pollard, Cheryl, Poole, Lisa, Leslie, Myles, McGhan, Gwen, Weir, Carolyn, Pooler, Charlotte, Stickney-Lee, Jennifer, Shapkin, Kimberly, Peyrusqué, Eva, Kergoat, Marie-Jeanne, Bolduc, Aline, Buckinx, Fanny, Law, Caroline, Veillette, Nathalie, Fonseca, Raquel, Aubertin-Leheudre, Mylène, Quan, Samuel, Menec, Verena, O’Connell, Megan, Cloutier, Denise, Newall, Nancy, Tate, Robert, John, Philip St., Qureshi, Natasha, Djekic-Ivankovic, Maria, Wall, Michelle, Berry, Gregory, Mayo, Nancy, Gélinas, Céline, Funnell, Larry, Racey, Megan, Markle-Reid, Maureen, Fitzpatrick-Lewis, Donna, Ali, Muhammad Usman, Gagné, Hélène, Ploeg, Jenny, Sztramko, Richard, Harrison, Lisa, Sherifali, Diana, Sacco, Veronica, Stolee, Paul, Boscart, Veronique, MacEachen, Ellen, Malik, Shabaz, Borrie, Micheal, Fogarty, Jennifer, Savage, Rachel, Sirisegaram, Luxey, Thain, Jenny, Diachun, Laura, Lingard, Lorelei, Cristancho, Sayra, Triscott, Jean, Huang, James, Moores, David, Tian, Peter George Jaminal, and Cerna, Judith

Subjects
Abstracts, Eligible for the Edmund V. Cowdry Award, Finalists for the Willard and Phoebe Thompson Award, Posters, Eligible for the Réjean Hébert Canadian Institutes of Health Research - Institute on Aging Prize, Eligible for the Dr. Jack & Dr. ASA Award
Published
2021

21. Challenges and strategies for promoting health equity in virtual care: findings and policy directions from a scoping review of reviews

Author

Budhwani, Suman, primary, Fujioka, Jamie, additional, Thomas-Jacques, Tyla, additional, De Vera, Kristina, additional, Challa, Priyanka, additional, De Silva, Ryan, additional, Fuller, Kaitlin, additional, Shahid, Simone, additional, Hogeveen, Sophie, additional, Chandra, Shivani, additional, Bhatia, R Sacha, additional, Seto, Emily, additional, and Shaw, James, additional

Published
2022
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30. Identifying knowledge-translation opportunities in the treatment of locally advanced breast cancer.

Author

Rajmohan, Yanchini, primary, Leonard, Robyn, additional, Hogeveen, Sophie, additional, Ebrahim, Jalal, additional, Han, Dolly, additional, Wong, Audrey, additional, Boileau, Jean-Francois, additional, Gandhi, Sonal, additional, Lee, Justin, additional, Dinniwell, Robert Edward, additional, Brackstone, Muriel, additional, and Simmons, Christine E., additional

Published
2013
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32. Development of a practice consensus statement of the management of locally advanced breast cancer: Expert consensus and systematic review.

Author

Leonard, Robyn, primary, Hogeveen, Sophie, additional, Han, Dolly, additional, Wong, Audrey, additional, Ebrahim, Jalal, additional, Rajmohan, Yanchini, additional, Boileau, Jean-Francois, additional, Gandhi, Sonal, additional, Lee, Justin, additional, Dinniwell, Robert Edward, additional, Brackstone, Muriel, additional, and Simmons, Christine E., additional

Published
2013
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33. Identification of knowledge translation opportunities in the treatment of locally advanced breast cancer: Results of a national survey of physicians.

Author

Rajmohan, Yanchini, primary, Leonard, Robyn, additional, Hogeveen, Sophie, additional, Ebrahim, Jalal, additional, Han, Dolly, additional, Wong, Audrey, additional, Boileau, Jean-Francois, additional, Gandhi, Sonal, additional, Lee, Justin, additional, Dinniwell, Robert Edward, additional, Brackstone, Muriel, additional, and Simmons, Christine E., additional

Published
2013
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40. Integrating a Standardized Self-Report Tool into Geriatric Medicine Practice during the COVID-19 Pandemic: A Mixed-Methods Study.

Author

Northwood M, Didyk N, Hogeveen S, Nova A, Kalles E, and Heckman G

Subjects
Humans, Aged, Self Report, Pandemics, Caregivers psychology, COVID-19, Frailty
Abstract

Specialized geriatric services care for older adults (≥ 65 years of age) with dementia and other progressive neurological disorders, frailty, and mental health conditions were provided both virtually and in person during the pandemic. The objective of this study was to implement a software-enabled standardized self-report instrument - the interRAI Check-Up Self-Report - to remotely assess patients. A convergent, mixed-methods research design was employed. Staff found the instrument easy to use and the program-level metrics helpful for planning. Most patients urgently needed a geriatrician assessment (72%) and had moderate to severe cognitive (34%) and functional impairments (34%), depressive symptoms (53%), loneliness (57%), daily pain (32%), and distressed caregivers (46%). Implementation considerations include providing ongoing support and facilitating intersectoral collaboration. The Check Up enhanced the geriatric assessment process by creating a system to track all needs for immediate and future care at both the patient and program level.

Published
2024
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41. Applicant and Match Trends to Geriatric-Focused Postgraduate Medical Training in Canada: A Descriptive Analysis.

Author

Correia RH, Dash D, Hogeveen S, Woo T, Kay K, Costa AP, and Siu HY

Subjects
Humans, Aged, Canada, Retrospective Studies, Physicians, Family, Geriatrics education, Internship and Residency
Abstract

Physicians with postgraduate training in caring for older adults-geriatricians, geriatric psychiatrists, and Care of the Elderly family physicians (FM-COE)-have expertise in managing complex care needs. Deficits in the geriatric-focused physician workforce coupled with the aging demographic necessitate an increase in training and clinical positions. Descriptive analyses of data from established matching systems have not occurred to understand the preferences and outcomes of applicants to geriatric-focused postgraduate training. This study describes applicant and match trends for geriatric-focused postgraduate training in Canada. In this retrospective cohort study, data from the Canadian Resident Matching Service and FM-COE program directors were analysed to examine program quotas, applicants' preferences, and match outcomes by medical school and over time. Based on their first-choice specialty ranking, applicants to geriatric medicine and FM-COE signalled a preference to pursue these programs and tended to match successfully. The proportion of unfilled training positions has increased in recent years, and the number of applicants has not increased consistently over time. There is a disparity between applicants to geriatric-focused training and the health human resources to meet population-level needs. Garnering interest among medical trainees is essential to address access and equity gaps.

Published
2023
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42. Adverse Events in Home Care: Identifying and Responding with interRAI Scales and Clinical Assessment Protocols.

Author

Sinn CJ, Betini RSD, Wright J, Eckler L, Chang BW, Hogeveen S, Turcotte L, and Hirdes JP

Subjects
Aged, Aged, 80 and over, Aging, Algorithms, Cross-Sectional Studies, Female, Humans, Male, Ontario, Risk Factors, Decision Support Techniques, Geriatric Assessment methods, Home Care Services statistics & numerical data, Outcome Assessment, Health Care
Abstract

Outcomes of adverse events in home care are varied and multifactorial. This study tested a framework combining two health measures to identify home care recipients at higher risk of long-term care placement or death within one year. Both measures come from the Resident Assessment Instrument-Home Care (RAI-HC), a standardized comprehensive clinical assessment. Persons scoring high in the Method for Assigning Priority Levels (MAPLe) algorithm and Changes in Health, End-stage disease, Signs and Symptoms (CHESS) scale were at the greatest risk of placement or death and more than twice as likely to experience either outcome earlier than others. The target group was more likely to trigger mood, social relationship, and caregiver distress issues, suggesting mental health and psychosocial interventions might help in addition to medical care and/or personal support services. Home care agencies can use this framework to identify home care patients who may require a more intensive care coordinator approach.

Published
2018
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