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During the COVID-19 pandemic, a Canadian recreation centre launched a community-based intervention to increase physical activity (PA) and reduce sedentary behaviour (SB). The Vivo Play Scientist (VPS) program provided a free wearable device (Garmin Vivofit4) that synchronized with a customized eHealth dashboard. Aim: The study investigated the feasibility and effectiveness of the VPS program through the participants' use and experiences of the device and dashboard using the Technology Acceptance Model (TAM). Method: We employed a concurrent mixed-methods approach of online surveys and semi-structured telephone interviews and estimated the device and dashboard's perceived usefulness and ease of use with TAM. Results: Of the 318 participants (mean age 39.8) 87 enrolled and completed the survey at baseline-T0, 4 wks-T1, and 8 wks-T2. Maximal-variation sampling was used to select 23 participants (78%, F) for interviews. We compared frequency of use, perceived usefulness and ease of use of the device and dashboard across all surveys using non-parametric statistical tests. A thematic analysis was used to analyze data. Participants had some experience using a wearable device (46%) or eHealth application (49%). A high use (≥4 d/wk.) of Vivofit4 at T1 (93%) and T2 (87%) occurred, but dashboard use was less frequent (≥1 d/wk. T1 54.0% and T2 47.1%). Average levels of perceived usefulness and ease of use for the Vivofit4 and dashboard remained constant from T1 to T2. Average daily PA scores decreased from T1 to T2 (4.9 to 4.5; p = 0.017). Conclusion: Participants were guarded about the value of the dashboard use and reported several challenges associated with the VPS program, but the free device and dashboard did provide PA support during the pandemic. [ABSTRACT FROM AUTHOR]

Play encourages physical and social activity creativity, and risk-taking. However, unstructured and risky play is on the decline. Our qualitative study explored the perspectives of Play Ambassadors, who faciliated a community-based loose parts play intervention ('play hubs') in Calgary parks during the COVID-19 pandemic. Using semi-structured interviews with 12 Play Ambassadors, four main topics emerged. Experiences Supporting Unstructured Play reflected how they supported play and their perceptions and observations of the play hubs. Learning to Take Risks in Play reflected how Play Ambassadors' views on risk and facilitating risky play evolved. Value of the Play Hubs reflected Play Ambassador perspectives on the community and personal impacts of the play hubs. Supporting Play during a Pandemic highlighted the challenges encountered in delivering the play hubs. Our findings suggest that community-based play programs in local parks may be a viable strategy for encouraging play, especially when traditional opportunities are restricted. [ABSTRACT FROM AUTHOR]

Unstructured play is characterized as play that is child initiated and determined, allowing children the freedom and flexibility to engage in activities, including taking risks, without adult intervention. However, playworkers and caregivers are important mediators of children's unstructured play. Studies have investigated playworker and caregiver perspectives regarding play, yet few have done so within the context of community based unstructured play interventions. Our qualitative study explored knowledge, attitudes and perspectives regarding play among playworkers ("play ambassadors") and caregivers exposed to a community based unstructured play intervention implemented in Calgary, Canada. The intervention aimed to encourage unstructured and risky play in local parks via loose parts. Between August and October 2020, ten caregivers and four play ambassadors completed individual semi-structured interviews. Using thematic analysis, we identified four overarching themes. The importance of play (theme 1) reflected play ambassador and caregiver perspectives about how unstructured and risky play promoted health and development and offered opportunities for enjoyment, exploration, and social interaction. Perceptions of the play environment (theme 2) reflected play ambassador and caregiver experiences of the play hubs including the role of loose parts in shaping play. Challenges and triumphs in promoting play (theme 3) reflected play ambassador experiences in facilitating play as well as interactions between caregivers and play ambassadors. Play hub impacts on the community (theme 4) reflected play ambassador and caregiver perspectives on the role of the play hubs in facilitating social interactions and community engagement. Play Ambassadors and caregivers shared common beliefs about the benefits of unstructured and risky play and about the play hubs affects on facilitating social interactions. Community based unstructured play interventions may support play and promote a sense of community. [ABSTRACT FROM AUTHOR]

BackgroundTransitions in care are vulnerable periods in health care that can expose patients to preventable errors due to incomplete or delayed communication between health care providers. Transitioning critically ill patients from intensive care units (ICUs) to other patient care units (PCUs) is particularly risky, due to the high acuity of the patients and the diversity of health care providers involved in their care. Instituting structured documentation to standardize written communication between health care providers during transitions has been identified as a promising means to reduce communication breakdowns. We developed an evidence-informed, computer-enabled, ICU-specific structured tool—an electronic transfer (e-transfer) tool—to facilitate and standardize the composition of written transfer summaries in the ICUs of one Canadian city. The tool consisted of 10 primary sections with a user interface combination of structured, automated, and free-text fields. ObjectiveOur overarching goal is to evaluate whether implementation of our e-transfer tool will improve the completeness and timeliness of transfer summaries and streamline communications between health care providers during high-risk transitions. MethodsThis study is a cluster-specific pre-post trial, with randomized and staggered implementation of the e-transfer tool in four hospitals in Calgary, Alberta. Hospitals (ie, clusters) were allocated randomly to cross over every 2 months from control (ie, dictation only) to intervention (ie, e-transfer tool). Implementation at each site was facilitated with user education, point-of-care support, and audit and feedback. We will compare transfer summaries randomly sampled over 6 months postimplementation to summaries randomly sampled over 6 months preimplementation. The primary outcome will be a binary composite measure of the timeliness and completeness of transfer summaries. Secondary measures will include overall completeness, timeliness, and provider ratings of transfer summaries; hospital and ICU lengths of stay; and post-ICU patient outcomes, including ICU readmission, adverse events, cardiac arrest, rapid response team activation, and mortality. We will use descriptive statistics (ie, medians and means) to describe demographic characteristics. The primary outcome will be compared within each hospital pre- and postimplementation using separate logistic regression models for each hospital, with adjustment for patient characteristics. ResultsParticipating hospitals were cluster randomized to the intervention between July 2018 and January 2019. Preliminary extraction of ICU patient admission lists was completed in September 2019. We anticipate that evaluation data collection will be completed by early 2021, with first results ready for publication in spring or summer 2021. ConclusionsThis study will report the impact of implementing an evidence-informed, computer-enabled, ICU-specific structured transfer tool on communication and preventable medical errors among patients transferred from the ICU to other hospital care units. Trial RegistrationClinicalTrials.gov NCT03590002; https://www.clinicaltrials.gov/ct2/show/NCT03590002 International Registered Report Identifier (IRRID)DERR1-10.2196/18675

Background: Health-promotion interventions incorporating wearable technology or eHealth apps can encourage participants to self-monitor and modify their physical activity and sedentary behavior. In 2020, a Calgary (Alberta, Canada) recreational facility developed and implemented a health-promotion intervention (Vivo Play Scientist program) that provided a commercially available wearable activity tracker and a customized eHealth dashboard to participants free of cost. Objective: The aim of this study was to independently evaluate the effectiveness of the Vivo Play Scientist program for modifying physical activity and sedentary behavior during the initial 8 weeks of the piloted intervention. Methods: Our concurrent mixed methods study included a single-arm repeated-measures quasiexperiment and semistructured interviews. Among the 318 eligible participants (≥18 years of age) registered for the program, 87 completed three self-administered online surveys (baseline, T0; 4 weeks, T1; and 8 weeks, T2). The survey captured physical activity, sedentary behavior, use of wearable technology and eHealth apps, and sociodemographic characteristics. Twenty-three participants were recruited using maximal-variation sampling and completed telephone-administered semistructured interviews regarding their program experiences. Self-reported physical activity and sedentary behavior outcomes were statistically compared among the three time points using Friedman tests. Thematic analysis was used to analyze the interview data. Results: The mean age of participants was 39.8 (SD 7.4) years and 75% (65/87) were women. Approximately half of all participants had previously used wearable technology (40/87, 46%) or an eHealth app (43/87, 49%) prior to the intervention. On average, participants reported wearing the activity tracker (Garmin Vivofit4) for 6.4 (SD 1.7) days in the past week at T1 and for 6.0 (SD 2.2) days in the past week at T2. On average, participants reported using the dashboard for 1.6 (SD 2.1) days in the past week at T1 and for 1.0 (SD 1.8) day in the past week at T2. The mean time spent walking at 8 weeks was significantly higher compared with that at baseline (T0 180.34 vs T2 253.79 minutes/week, P=.005), with no significant differences for other physical activity outcomes. Compared to that at baseline, the mean time spent sitting was significantly lower at 4 weeks (T0 334.26 vs T1 260.46 minutes/day, P<.001) and 8 weeks (T0 334.26 vs T2 267.13 minutes/day, P<.001). Significant differences in physical activity and sitting between time points were found among subgroups based on the household composition, history of wearable technology use, and history of eHealth app use. Participants described how wearing the Vivofit4 device was beneficial in helping them to modify physical activity and sedentary behavior. The social support, as a result of multiple members of the same household participating in the program, motivated changes in physical activity. Participants experienced improvements in their mental, physical, and social health. Conclusions: Providing individuals with free-of-cost commercially available wearable technology and an eHealth app has the potential to support increases in physical activity and reduce sedentary behavior in the short term, even under COVID-19 public health restrictions. [ABSTRACT FROM AUTHOR]

Introduction The challenge of implementing best evidence into clinical practice is a major problem in modern healthcare that can result in ineffective, inefficient and unsafe care. There is a growing body of literature which suggests that the removal or reduction of low-value care practices (ie, deadoption) is integral to the delivery of high-quality care and the sustainability of our healthcare system. However, currently very little is known about deadoption practices in Canada. We propose to map the current state of deadoption in Canadian intensive care units (ICUs). A key deliverable of this work will include development of an inventory of barriers, facilitators and potential implementation strategies for guiding the deadoption efforts. Methods and analysis We will use Canadian adult general systems ICUs as our laboratory of investigation and employ a two-phased sequential exploratory mixed-methods approach: (1) semi-structured interviews with critical care stakeholders to develop an understanding of the structure (ie, healthcare context), process (ie, actions and events in healthcare) and outcomes (ie, effects on health status, quality, knowledge or behaviour) of deadoption (phase I) and (2) surveys with a broader sample of critical care stakeholders to further identify important barriers and facilitators, as well as potential implementation strategies (phase II). Interview data will be analysed through qualitative content analysis and survey data will be analysed through quantitative analyses to identify top barriers and facilitators, as well as top rated strategies. Ethics and dissemination Ethical approval has been obtained through the University of Calgary Research Ethics Board (REB 17–2153). Participants involved will have the opportunity to provide feedback on the final written reports to support accurate representation of the data. The findings of this study will be disseminated through peer- reviewed publications and oral presentations with critical care stakeholders across Canada. Patient and family partners will receive an executive summary of the findings. [ABSTRACT FROM AUTHOR]

Background: Transitions in care are vulnerable periods in health care that can expose patients to preventable errors due to incomplete or delayed communication between health care providers. Transitioning critically ill patients from intensive care units (ICUs) to other patient care units (PCUs) is particularly risky, due to the high acuity of the patients and the diversity of health care providers involved in their care. Instituting structured documentation to standardize written communication between health care providers during transitions has been identified as a promising means to reduce communication breakdowns. We developed an evidence-informed, computer-enabled, ICU-specific structured tool—an electronic transfer (e-transfer) tool—to facilitate and standardize the composition of written transfer summaries in the ICUs of one Canadian city. The tool consisted of 10 primary sections with a user interface combination of structured, automated, and free-text fields. Objective: Our overarching goal is to evaluate whether implementation of our e-transfer tool will improve the completeness and timeliness of transfer summaries and streamline communications between health care providers during high-risk transitions. Methods: This study is a cluster-specific pre-post trial, with randomized and staggered implementation of the e-transfer tool in four hospitals in Calgary, Alberta. Hospitals (ie, clusters) were allocated randomly to cross over every 2 months from control (ie, dictation only) to intervention (ie, e-transfer tool). Implementation at each site was facilitated with user education, point-of-care support, and audit and feedback. We will compare transfer summaries randomly sampled over 6 months postimplementation to summaries randomly sampled over 6 months preimplementation. The primary outcome will be a binary composite measure of the timeliness and completeness of transfer summaries. Secondary measures will include overall completeness, timeliness, and provider ratings of transfer summaries; hospital and ICU lengths of stay; and post-ICU patient outcomes, including ICU readmission, adverse events, cardiac arrest, rapid response team activation, and mortality. We will use descriptive statistics (ie, medians and means) to describe demographic characteristics. The primary outcome will be compared within each hospital pre- and postimplementation using separate logistic regression models for each hospital, with adjustment for patient characteristics. Results: Participating hospitals were cluster randomized to the intervention between July 2018 and January 2019. Preliminary extraction of ICU patient admission lists was completed in September 2019. We anticipate that evaluation data collection will be completed by early 2021, with first results ready for publication in spring or summer 2021. Conclusions: This study will report the impact of implementing an evidence-informed, computer-enabled, ICU-specific structured transfer tool on communication and preventable medical errors among patients transferred from the ICU to other hospital care units. Trial Registration: ClinicalTrials.gov NCT03590002; https://www.clinicaltrials.gov/ct2/show/NCT03590002 International Registered Report Identifier (IRRID): DERR1-10.2196/18675 JMIR Res Protoc 2021;10(1):e18675 doi:10.2196/18675 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]