Technology and Innovation

EU-GENIE is an online tool that volunteers can use with clients. It can help them describe their support network and can link them to relevant local community resources that are tailored to the interests of the client.

EU-GENIE is a UK-developed, evidence-based online intervention aimed to support self-management for adults living with long-term health and social conditions. It was adapted for use in Canada. It is currently being tested in a sub-group of TAPESTRY clients who are enroled in Health Links. Study Objectives include: 1.      To assess the usability, acceptability, and normalization of the EU-GENIE tool in a primary care environment that is used by providers, clients and volunteers. 2.      To explore if and how EU-GENIE can function as a collaborative practice tool to improve providers’ and clients’ understanding of personal support networks, as well as linkages among primary care team members and between primary care and community-based health and social services (team-based care), within the context of Health TAPESTRY and Health Links programs. 3.      To explore if and how clients perceive the use of EU-GENIE as a tool to support attainment of their health and life goals. 4.      To explore how the size, composition and function of clients’ social networks support attainment of self-identified health goals.    Our Canadian adatped version of EU-GENIE was presented at the EU-WISE Conference, Southhampton, England. November 23, 2015. (http://eu-wise.com/wp-content/uploads/2012/12/EU-WISE-Conference-Southampton-9-R.-Valaitis-21-Nov.pdf) 

Lead:

Ruta Valaitis, Cathy Risdon, Jenny Ploeg, Anita Kothari, Lisa Dolovich, Laura Cleghorn, Anne Kennedy, Anne Rogers, Ivo Vassilev, Dale Guenter, and James Gillett

Research Funding:

• Exploring the Use of Personal Network Mapping as a Component of the TAPESTRY Program

More Information:

• Website
• Conference

The objective of this study is to evaluate the implementation and effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach in older adults.

In our program, trained volunteers visit people where they live . In these visits, they learn about what matters most to that person and their health. They also learn more about a person’s health needs. The stories people tell our volunteers are recorded and sent to their health care team using special technology. This helps the team learn more about that person’s life, health needs, goals and how they can better work together to achieve goals and meet needs.

Co-author:

Dolovich, L., Oliver, D., Lamarche, L., Agarwal, G., Carr, T., Chan, D., Cleghorn, L., Griffith, L., Javadi, D., Kastner, M., Longaphy, J., Mangin, D., Richardson, J., Papaioannou, A., Ploeg, J., Raina, P., Risdon, C., Santaguida, P.L., Straus, S., Thabane, L., Valaitis, R., Price, D.

Research Funding:

• TAPESTRY: Teams Advancing Patient Experience: Strengthening Quality

More Information:

• Publication
• Health Tapestry Website

The objective of this study was to explore the use and perceptions of a local Severe Acute Respiratory Syndrome (SARS) Extranet and its potential to support future information and communication applications. The SARS Extranet was a single, managed electronic and limited access system to manage local, provincial and other SARS control information.

Despite higher rankings of various communication strategies during the SARS outbreak, such as email, meetings, teleconferences, and other web sites, users generally perceived a local Extranet as a useful support for the dissemination of local information during a public health emergency.

Co-author:

Valaitis, R., Akhtar-Danesh, N., Kealey, C., Brunetti, G., Thomas, H.

Research Funding:

More Information:

• Publication

This article reports on a usability study of remote noninvasive cardiac testing in homes. We studied the Vitaphone 3100BT (Bluetooth®) event loop recorder (Vitaphone GmbH, Mannheim, Germany) and paired BlackBerry® Curve™ 8520 smartphone (Research In Motion, Ltd., Waterloo, ON, Canada).

This application requires independent device set-up by patients in their own homes following receipt by mail out of the kit (instructions plus the event loop recorder and smartphone). The case studies of five participants, each with varying experience with technology, were documented as they interacted with the devices. Participants were videotaped following written instructions as they performed a "think aloud" procedure while completing 20 device set-up tasks. Interviews provided insight into how the independent device set-up and processes could be improved. This study concluded that gender, age, and familiarity with technology seemed to influence the participants' abilities to successfully set up these devices and that sending the kit by mail appeared to be an acceptable strategy to provide remote noninvasive cardiacdiagnostic services. This study provides a foundation for future research assessing usability of mobile healthcare technology.

Co-author:

Sparkes, J., Valaitis, R., McKibbon, A.

Students:

1. Jane Sparkes

Research Funding:

More Information:

• Publication

The research objective was to collaborate with frontline homecare workers (e.g. care coordinators, nurses, physiotherapists, occupational therapists, and personal support workers) and key stakeholders (e.g. Registered Nurses’ Association of Ontario, Heart and Stroke Foundation) to inform, design and build an innovative mobile health application to support communication and collaboration. A Webinar was given for the Ontario Home Care Association, January 27, 2016.

The end goals of the application are to promote evidence-informed care for older adults who have experienced a stroke and have multiple chronic conditions (MCC), and to provide a communication tool for all members of the homecare team, including healthcare providers, clients, and their family caregivers.

Co-researcher:

Matthew-Maich, N., Bender, D., Taberner, C., Markle-Reid, M., Ploeg, J., Gafni, A., Valaitis, R.

Research Funding:

More Information:

• Website
• News Story

The primary objective of this systematic review and meta-analysis was to examine the effect of caregiver-focused, Web-based interventions, compared with no or minimal Web-based interventions, on caregiver outcomes.

Background: Approaches to support the health and well-being of family caregivers of adults with chronic conditions are increasingly important given the key roles caregivers play in helping family members to live in the community. Web-based interventions to support caregivers have the potential to lessen the negative health impacts associated with caregiving and result in improved health outcomes. Objective: The primary objective of this systematic review and meta-analysis was to examine the effect of caregiver-focused, Web-based interventions, compared with no or minimal Web-based interventions, on caregiver outcomes. The secondary objective was to assess the effect of different types of Web-based interventions (eg, education, peer and professional psychosocial support, and electronic monitoring of the care recipient), compared with no or minimal Web-based interventions, on caregiver outcomes. Methods: MEDLINE, EMBASE, CIHAHL, PsychInfo, Cochrane, and AgeLine were searched from January 1995 to April 2017 for relevant randomized controlled trials (RCTs) or controlled clinical trials (CCTs) that compared caregiver-focused, Web-based intervention programs with no or minimal Web-based interventions for caregivers of adults with at least one chronic condition. Studies were included if they involved: adult family or friend caregivers (aged ≥18 years) of adults living in the community with a chronic condition; a caregiver-focused, Web-based intervention of education or psychosocial support or electronic monitoring of the care recipient; and general caregiver outcomes (ie, burden, life satisfaction, self-efficacy or mastery, reaction to problem behavior, self-esteem, strain, and social support). Title and abstract as well as full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for these caregiver outcomes were meta-analyzed. Results: The search yielded 7927 unique citations, of which 294 studies were screened at full text. Of those, 14 studies met the inclusion criteria; 12 were RCTs and 1 study was a CCT. One study used an RCT design in 1 country and a CCT design in 2 other countries. The beneficial effects of any Web-based intervention program, compared with no or minimal Web-based intervention, resulted in a mean increase of 0.85 points (95% CI 0.12 to 1.57) for caregiver self-esteem, a mean increase of 0.36 points (95% CI 0.11 to 0.62) for caregiver self-efficacy or mastery, and a mean decrease of 0.32 points (95% CI −0.54 to −0.09) for caregiver strain. However, the results are based on poor-quality studies. Conclusions: The review found evidence for the positive effects of Web-based intervention programs on self-efficacy, self-esteem, and strain of caregivers of adults living with a chronic condition. Further high-quality research is needed to inform the effectiveness of specific types of Web-based interventions on caregiver outcomes.

Co-author:

4. Ploeg, J., Usman Ali, M., Markle-Reid, M., Valaitis, R., Bartholomew, A., Fitzpatrick-Lewis, D., McAiney, C., Sherifali, D.

Research Funding:

More Information:

• Link to Paper

Youth are often disenfranchised in their communities and may feel they have little voice. Since computers are an important aspect of youth culture, they may offer solutions to increasing youth participation in communities. This study involved public health nurses to support the school-based community development project.

This qualitative case study investigated the perceptions of 19 (predominantly female) inner-city school youth about their use of computers and the Internet in a school-based community development project. Overall, youth perceived computers and the Internet to be empowering tools, and they should be encouraged to use such technology to support them in community initiatives related to health promotion.

Author:

Valaitis, R.

Research Funding:

More Information:

• Publication

The purpose of this study was to conduct a scoping review of current practices and recommendations for designing, implementing, and evaluating mHealth technologies to support the management of chronic conditions in community-dwelling older adults.

There is limited yet increasing use of mHealth technologies in home health care for older adults. A user-centered, collaborative, interdisciplinary approach to enhance feasibility, acceptability, and usability of mHealth innovations is imperative. Creating teams with the required pools of expertise and insight regarding needs is critical. The cyclical, iterative process of developing mHealth innovations needs to be viewed as a whole with supportive theoretical frameworks. Many barriers to implementation and sustainability have limited the number of successful, evidence-based mHealth solutions beyond the pilot or feasibility stage. The science of implementation of mHealth technologies in home-based care for older adults and self-management of chronic conditions are important areas for further research. Additionally, changing needs as cohorts and technologies advance are important considerations. Lessons learned from the data and important implications for practice, policy, and research are discussed to inform the future development of innovations.

Co-author:

Matthew-Maich, N., Harris, L., Ploeg, J., Markle-Reid, M., Valaitis, R., Ibrahim, S., Gafni, A., & Isaacs, S.

Students:

1. Sandra Isaacs

Research Funding:

• Centre for Research in Community Interventions to Promote Optimal Aging at Home

More Information:

• Publication
• Ontario Ministry of Health and Long-Term Care, Health System Research Fund ($445,194)

This scoping review was conducted in advance of our design and build of a mobile health app to support an interprofessional nurse-led team approach in the delivery of community-based stroke rehabilitation in home care.

We systematically mapped the breadth of research related to three topic areas: mobile and electronic devices, technology based healthcare delivery, and aging populations and/or chronic conditions. From the research question “What are the current practices and recommendations for designing, implementing and evaluating mHealth solutions to support older adults living in their homes?” we identified 42 studies. Report to the Ministry of Health and Long-Term Care, February 2016. To ensure success, a user-centered, collaborative, interdisciplinary and iterative approach is imperative to enhance feasibility, acceptability and usability of mHealth innovations. Implementation within systems or organizations requires a thorough understanding of culture, values and context readiness from researchers.

First Author:

Valaitis, R., Markle-Reid, M., Kelly Stradiotto, C., Archer, N., Bender, D., Brown, P., Chambers, T., Chang, K., Hillmer, M., Karimi, R., Kennedy, L., Magwood-Tye, R., Matthew-Maich, N., Murray, N., Ploeg, J., Taberner, C.

Students:

1. Kristina Chang
2. Rojin Karimi

Research Funding:

• Centre for Research in Community Interventions to Promote Optimal Aging at Home

To understand how and if information technology (IT) and decision-support systems (DSS) can be effective in detection, management, and communication during a bioterrorist event.

A systematic review was conducted to assess the evidence from peer reviewed evaluations of IT and DSSs for detection, diagnosis, management and communication. In addition, electronic surveillance systems were also evaluated.Rep. No. Evidence Report/ Technology Assessment: Number 59. Publication No. 02-E027). Rockville, MD: Agency for Health Care Research and Quality Publications.

Author:

Valaitis, R.

Research Funding:

More Information:

• Summary Statement

This review sought to answer the question: what is the use, nature and impact of electronic support groups in the prevention and promotion of health?

The findings indicate that social support can be successfully provided via a computer-mediated communication medium to support a broad range of populations and health conditions.

First Author:

Valaitis, R. Ciliska, D.

Research Funding:

More Information:

• Website
• Report

Schools are a main setting for health promotion for youth. A one year qualitative case study was undertaken in an inner-city, Canadian school. It explored factors that enabled and constrained youth in the process of a school-based computer-supported community development (CD) project. This paper reports on Dr. Ruta Valaitis' PhD thesis results.

Nineteen grade seven and eight students worked with four adult facilitators for 12 weeks. They completed a community assessment, planned and implemented actions to improve their school environment. Data were collected by: youth and adult interviews, participant observation, content analysis of online postings and two surveys. Constant comparison and triangulation from various data sources and methods were used to verify themes. Themes were categorized as intrinsic or extrinsic enabling and constraining factors. Intrinsic enabling factors were youth' s perceptions that they were making a difference, and feeling recognized for and having ownership of their work. Extrinsic enabling factors included flexibility inyouth's choice of activities, supportive adults and community members and the use of incentives. Intrinsic constraining factors were the perceived slow pace of the CD process, and difficulties in getting group consensus/decision-making. Extrinsic constraining factors included: school disruptions and schedules, a lack of 'buy-in' from teachers and parents, and resource demands-people and computers. Relationships between these factors are noted. Research and practice implications regarding school-based CD to promote youth resiliency are discussed.

First Author:

Valaitis, R., O’Mara, L.

Research Funding:

More Information:

• Publication

Tailoring Online Health Promotion: A Toolkit for Communities has been produced to share our learning and experiences in working to build a health promotion web site (www.youthspark.ca) to meet local needs by and for rural youth in Huron County, Ontario Canada.

Our project included an evaluation component, which helped us identify factors that enabled and hindered the process of creating, maintaining and sustaining the project. This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability.

First Author:

Valaitis, R., O’Mara, L., Bezaire, S., Savage R.

Research Funding:

• SPARK Youth Website Initiative

More Information:

• Report
• Website

This study describes the effectiveness, feasibility and effects of a volunteer program evaluation framework in primary care.

<p><span style="color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Volunteers support health and social care worldwide, yet there is little research on integrating these unpaid community members into primary care. ‘Health Teams Advancing Patient Experience, Strengthening Quality through Health Connectors for Diabetes Management’ (Health TAPESTRY‐HC‐DM) integrates volunteer ‘health connectors’ into a community‐ and primary care‐based program supporting client self‐management in Hamilton, Canada. Volunteers supported clients through goal setting, motivation, education and connections to community resources and primary care. This study aimed to create and apply a volunteer program evaluation framework to explore: (a) volunteer training effectiveness (learning online content, in‐person training, self‐efficacy in role tasks, training overall); (b) feasibility of program implementation (process measures, reflections on client encounters, understanding of volunteer roles/responsibilities, client perspectives on volunteer program); and (c) effects of volunteering on volunteers (health outcomes, self‐efficacy, value of volunteering). A concurrent triangulation, mixed‐methods design was used. Data were collected in 2016, sources included: volunteer online training quizzes, focus groups, self‐efficacy survey, Veterans RAND 12‐Item (VR‐12) survey, in‐person training feedback forms and narratives of client visits; client interviews; and quantitative implementation data. Quantitative data analysis included descriptive statistics, paired samples<span>&nbsp;</span></span><em style="box-sizing: border-box; color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial;">t</em><span style="color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span>&nbsp;</span>tests, and effect size (Cohen's<span>&nbsp;</span></span><em style="box-sizing: border-box; color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial;">d</em><span style="color: #1c1d1e; font-family: 'Open Sans', icomoon, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">). Qualitative data used descriptive thematic analysis. Nineteen volunteers and 12 clients participated in this evaluation. Findings demonstrate the volunteer program evaluation framework in action. Online training increased knowledge. In‐person training received largely positive evaluations. Self‐efficacy was high post‐training and higher after volunteering. VR‐12 sub‐scale means increased descriptively. Volunteers understood themselves as healthcare system connectors, feeling fulfilled with their contributions and learning new skills. They identified barriers including not having the resources and skills of healthcare professionals. Clients found volunteers were a major program strength, appreciating their company and regular goals follow‐up. Using a volunteer program evaluation framework generated rich and comprehensive data demonstrating the feasibility of bringing volunteers into primary care.</span></p>

https://onlinelibrary.wiley.com/doi/abs/10.1111/hs:

Lisa Dolovich, Jessica Gaber, Ruta Valaitis, Jenny PLoeg, Doug Oliver, Julie Richardson, Dee Mangin, Fiona Paeascandalo, & Gina Agarwal

Research Funding:

• TAPESTRY: Teams Advancing Patient Experience: Strengthening Quality

More Information:

• Link to paper

The objective of this systematic review and meta-analysis was to examine the impact of internet-based interventions on caregiver mental health outcomes and the impact of different types of internet-based intervention programs.

The review found evidence for the benefit of internet-based intervention programs on mental health for caregivers of adults living with a chronic condition, particularly for the outcomes of caregiver depression, stress and distress, and anxiety. The types of interventions that predominated as efficacious included information and education with or without professional psychological support, and, to a lesser extent, with combined peer and psychological support. Further high-quality research is needed to inform the effectiveness of interactive, dynamic, and multicomponent internet-based interventions. Team: Sherifali, D., Ali, M.U., Ploeg, J., Markle-Reid, M., Valaitis, R., Bartholomew, A., Fitzpatrick-Lewis, D., McAiney, C.  

co-author:

Sherifali, D., Ali, M.U., Ploeg, J., Markle-Reid, M., Valaitis, R., Bartholomew, A., Fitzpatrick-Lewis, D., McAiney, C.

Research Funding:

More Information:

• Link to paper

During 2005 - 2006, Dr. Ruta Valaitis served as an invited member of the E-Health Steering Committee for the Hamilton Niagara Haldimand Brant Norfolk Local Health Integrated Network (LHIN 4).

This report, submitted by the e-Health Steering Committee, is the culmination of the efforts that started with the priority planning process in November 2004, where the development of an e-Health strategy was identified as one of the LHIN’s key prioritis to promote system integration. The development of our e-Health strategy was actively supported by providers; they have demonstrated a tremendous enthusiasm for e-Health, and they are already leading and participating in a number of related initiatives.  The purpose of the 2006 document The Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN) e-Health Strategic Plan was a directional document to guide the implementation of e-Health initiatives in the LHIN. It encompasses the vision for e-Health and strategies which the LHIN will pursue over the next decade. It also emphasizes the objectives and clear benefits of those strategies.

E-Health Strategic Plan 2006:

Hamilton Niagara Haldimand Norfolk LHIN

Research Funding:

More Information:

• HNHB LHIN E-Health Strategic Plan 2006

During 2004 - 2007, Dr. Ruta Valaitis was a member of the Ministry of Health and Long-Term Care, E-Health Council for Public Health

E-Health Council for Public Health:

Ministry of Health and Long-Term Care

Research Funding:

More Information:

• Ministry of Health and Long-Term Care (Ontario)

During 2005 - 2006, Dr. Ruta Valaits was a member of the Canadian Nursing Association’s Nursing Portal Project- Evidenced Based Practice (EBP) Sub-group.

The Canadian Nurses Association (CNA) received funding from the First Nations and Inuit Health Branch (FNIHB) of Health Canada for a two-year project (2004-2006) to develop a nursing portal to support the on-going competence and professional development of nurses in Canada. A portal is a single-access gateway or entry point to a collection of resources and services via the Internet. As part of the Canadian Nurses Portal Project and to prepare nurses and the nursing environment for the Canadian Nurses Portal, now called NurseONE, CNA committed to creating an e-nursing strategy for Canadian nurses.

Nursing Portal Project- EBP Sub-group:

Canadian Nurses Association

Research Funding:

More Information:

• CNA e-Nursing Strategy October 2006

From 2005 – 2011, Dr. Ruta Valaitis was a member of the Registered Nurses’ Association of Ontario’s e-Health Advisory Committee

The RNAO Nursing and e-Health, which is funded by e-Health Ontario, is to facilitate the nursing profession’s involvement in the Ontario e-Health agenda and to support nurses to take a leadership role in the design, implementation, adoption and sustainability of integrated digital health systems (e.g. electronic medical records) in all health-care sectors and schools of nursing in Ontario.

e-Health & Technology:

RNAO

Research Funding:

More Information:

• RNAO e-Health Advisory Committee

This paper describes the methods, strategies and technologies used to conduct a scoping literature review examining primary care (PC) and public health (PH) collaboration. It presents challenges encountered as well as recommendations and 'lessons learned' from conducting the review with a large geographically distributed team comprised of researchers and decision-makers using an integrated knowledge translation approach.

Of 6125 papers identified, 114 were retained as relevant. Most papers originated in the United Kingdom (38%), the United States (34%) and Canada (19%). Of 80 papers that reported on specific collaborations, most were descriptive reports (51.3%). Research studies represented 34 papers: 31% were program evaluations, 9% were literature reviews and 9% were discussion papers. Key strategies to ensure rigor in conducting a scoping literature review while engaging a large geographically dispersed team are presented for each stage. The use of enabling technologies was essential to managing the process. Leadership in championing the use of technologies and a clear governance structure were necessary for their successful uptake.

First Author:

Valaitis, R., Martin-Misener, R., Wong, S.T., MacDonald, M., Meagher-Stewart, D., Austin, P., Kaczorowski, J., O’Mara, L., Savage, R.

Research Funding:

• Building Primary Health Care Nursing Leadership to Enhance Collaboration between Primary Health Care and Public Health

More Information:

• Publication

In this study nursing faculty perceptions of the implementation of simulation in schools of nursing across Ontario, Canada, were explored using the Q-methodology technique. Building on her secondary interest in the use of appropriate technologies (a principle of primary health care), this work was conducted during Dr. Valaitis' short term role as the Director of Learning Technologies for the Faculty of Health Sciences, McMaster University.

Results revealed four major viewpoints held by faculty including: (a) Positive Enthusiasts, (b) Traditionalists, (c) Help Seekers, and (d) Supporters. In conclusion, simulation was perceived to be an important element in nursing education. Overall, there was a belief that clinical simulation requires (a) additional support in terms of the time required to engage in teaching using this modality, (b) additional human resources to support its use, and (c) other types of support such as a repository of clinical simulations to reduce the time from development of a scenario to implementation. Few negative voices were heard. It was evident that with correct support (human resources) and training, many faculty members would embrace clinical simulation because it could support and enhance nursing education.

Co-author:

Akhtar-Danesh, N., Baxter, P., Valaitis, R., Stanyon, W., Sproul, S.

Research Funding:

• Evaluation of the Use of Clinical Simulation in Ontario Nursing Programs

More Information:

• Publication

This study explored community health nurses' viewpoints about a Canadian online community of practice to support their practice with homeless or under-housed populations.

Generally, nurses viewed the community of practice as a place to share stories, validate practice and adapt best practices to their work context. Online communities of practice can be valuable to nurses in specialized fields with limited peer support and access to information resources. Tacit knowledge development is important to nurses working with homeless populations: this needs to be valued in conjunction with scientifically based knowledge.

First Author:

Valaitis, R., Akhtar-Danesh, N., Brooks, F., Binks, S., Semogas, D.

Research Funding:

• Creating a Virtual Community of Practice for Street Nursing

More Information:

• Publication

The Internet is an innovative strategy to increase public participation. It is important to include pregnant and parenting teens' perspectives when planning programs to meet their needs. This qualitative study explored online discussions as a strategy to enhance participation by this population.

Findings showed that online communication was preferred over face-to-face group discussions. Being anonymous online encouraged open and honest feedback. Participants experienced various forms of social support, however, there was an overall lack of teen involvement online. Strategies to engage adolescents in online discussions and reduce barriers are discussed. Strategies included the use of teen moderators, home computer access, technical support, and engagement in naturally flowing online discussions to meet social support needs. Blending researchers' with teens' needs for social support in an online environment is encouraged. With careful planning and design, online communications can result in mutual benefits for researchers, service providers, and pregnant and parenting adolescents.

First Author:

Valaitis R., Sword, W.

Research Funding:

More Information:

• Publication

Most health care for people with diabetes occurs in family practice, yet balancing the time and resources to help these patients can be difficult. An intervention empowering patients, leveraging community resources, and assisting self-management could benefit patients and providers. Thus, the feasibility and potential for effectiveness of “Health Teams Advancing Patient Experience, Strengthening Quality through Health Connectors for Diabetes Management” (Health TAPESTRY-HC-DM) as an approach supporting diabetes self-management was explored to inform development of a future large-scale trial.

This study of Health TAPESTRY-HC-DM, a complex intervention to help people with diabetes self-management, indicated feasibility and potential clinical benefit. Patient-reported outcome measures showed change in the hypothesized direction, notably with physical activity, which was also seen as a primary goal set by clients. However, we need a greater understanding of who this approach helped the most and more efficient recruitment processes in order to offer it on a larger scale to the most appropriate patient population.

Co-author:

Agarwal, G., Gaber, J., Richardson, J., Mangin, D., Ploeg, J., Valaitis, R., Reid, G.J., Lamarche, L., Parascandalo, F., Javadi, D., O’Reilly, D., Dolovich, L.

Research Funding:

More Information:

• Publication

Building on Dr. Valaitis' secondary interest in the use of appropriate technologies (a principle of primary health care), this work was conducted during her short term role as the Director of Learning Technologies for the Faculty of Health Sciences, McMaster University.

McMaster University Faculty of Health Sciences trialed Wimba's Live Classroom Web conferencing technology to support education and curriculum activities with students and faculty. The purpose of this study was to explore faculty, staff, and student perceptions of Web conferencing as a support for teaching and learning in health sciences. The Live Classroom technology provided features including real-time VoIP audio, an interactive whiteboard, text chat, PowerPoint slide sharing, application sharing, and archiving of live conferences to support student education and curriculum activities. Overall, all participants, including pragmatists who were more cautious about the technology, viewed Web conferencing as an enabler, especially when face-to-face meetings were not possible. Adequate technical support and training need to be provided for successful ongoing implementation of Web conferencing.

First Author:

Valaitis, R., Akhtar-Danesh, N., Eva, K., Levinson, A., Wainman, B.

Research Funding:

More Information:

• Publication

This qualitative study explored health sciences students' perceptions of their experiences in online problem based learning (PBL) and focused on their views about learning and group process in the online environment. Building on her secondary interest in the use of appropriate technologies (a principle of primary health care), this work was conducted during Dr. Valaitis' short term role as the Director of Learning Technologies for the Faculty of Health Sciences, McMaster University.

Results indicated that it is feasible to conduct PBL online. Students felt that it increased their flexibility for learning, enhanced their ability to deeply process content, and provided access to valuable learning resources. Students experienced a period of adaptation to the online environment, perceived a heavy workload, and had difficulties making group decisions online. In addition to using asynchronous communication, chats (synchronous communication) were valued to support group decision-making online. Students appreciated validation of their online contributions from their peers and wanted clear expectations of what constituted successful tutorial participation from their tutors. Although online PBL can work effectively, tutors and students need to develop online literacy skills to smooth their transition to an online PBL environment.

First Author:

Valaitis, R., Sword, W., Jones, B., Hodges, A.

Research Funding:

More Information:

• Publication

The use of mobile computing in healthcare practice has grown substantially in recent years, yet little is known about its impact.This descriptive, exploratory, qualitative study explored the perceptions of public health nurses (PHNs) in a school health program about their use of mobile computing.

This descriptive, exploratory, qualitative study explored the perceptions of public health nurses (PHNs) in a school health program about their use of MC. Public health nurses participated in focus group interviews and completed weekly reflections. They perceived that MC (a) increased PHNs' flexibility although they were constrained by work rules, (b) increased peer and employer connectedness yet increased isolation, (c) and increased PHNs' status while creating a wider gap between PHNs and their clients. Public health nurses described their practice as being more efficient and client-focused with MC. Over time, PHNs grew more comfortable with the tool, developed a dependence on it, and learned to deal with technological problems. Although this new technology shows promise, there is a need for further research to examine its impact as a tool to promote public health nursing practice.

First Author:

Valaitis, R., O’Mara, L.

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In 2002, Dr. Valaitis was a representative for CASN at the National Summit for Ontario Health Information Highway. This conference was related to health Informatics and held at the University of Victoria, British Columbia.

CASN/ACESI (Canadian Association of Schools of Nursing/Association canadienne des écoles de sciences infirmières) is the national voice for nursing education, research, and scholarship and represents baccalaureate and graduate nursing programs in Canada.

National Summit for ON Health Information Highway:

CASN

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• CASN/ACESI

This study explored nursing students' viewpoints about the use of simulation in their nursing programs. This work was conducted during Dr. Valaitis' short term as the Director of Learning Technologies for the Faculty of Health Sciences, McMaster University.

Q-methodology was the research approach used. In total, 24 students from 17 universities and colleges participated in thestudy. Although all students felt that simulated experiences could support learning overall, four groups of students were identified who had differing viewpoints. Described as reflectors, reality skeptics, comfort seekers, and technology savvies, these four groups of students require unique approaches to better engage them in learning with simulation. This study provides recommendations for faculty to consider, taking into account these varied viewpoints regarding simulation in nursing education.

Co-author:

Baxter, P., Akhtar-Danesh, N., Valaitis, R., Stanyon, W., Sproul. S.

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Tailoring Online Health Promotion: A Toolkit for Communities: This toolkit was produced based on our experience and evaluation of working with public health staff and youth in a rural community to build a health promotion website for youth by youth.

This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability.

Lead:

Ruta Valaitis, Linda O'Mara, Sherri Bezaire, Erica Horbaniuk, and Brian Gould

Research Funding:

• SPARK Youth Website Initiative

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• Tailoring Online Health Promotion: A Toolkit for Communities

Tailoring Online Health Promotion: A Toolkit for Communities has been produced to share our learning and experiences in working to build a health promotion web site (www.youthspark.ca) to meet local needs by and for rural youth in Huron County, Ontario Canada. The Toolkit is loosely organized according to the phases of project development that we experienced in the YouthSpark project.

Our project included an evaluation component, which helped us identify factors that enabled and hindered the process of creating, maintaining and sustaining the project. This Toolkit contains a compilation of our learning as a result of the evaluation and is presented using a step-by-step approach from the initial stages of developing a vision for the project, implementation, marketing, evaluation and sustainability. We used a participatory approach with our work with youth, which is reflected throughout this Toolkit. We believe this approach is essential for any successful youth-centred program. Produced by Huron Country Health Unit and McMaster University, School of Nursing. http://fhs.mcmaster.ca/OHPToolkit/index.html. 

First Author:

Valaitis, R., O’Mara, L., Bezaire, S.

Research Funding:

• SPARK Youth Website Initiative

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• Website

A technical report commissioned by the Public Health Agency of Canada to inform the 2014 Chief Public Health Officer’s (CPHO) Report on the State of Public Health in Canada.

First Author:

Valaitis, R. K., Hunter, D., Lam, A., Murray, N., Spark, R. & Valaitis R. F.

Students:

1. Danielle Hunter
2. Rebecca Spark

Research Funding:

• Literature Review: In What Ways and How Effectively is Technology Being Used to Support Health Behaviour Change

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• A technical report commissioned by the Public Health Agency of Canada

We conducted a mixed-methods case study to explore the perceptions of family caregivers and palliative cancer patients of home telehealth, and their experience with it.

Overall the patients, family caregivers and tele-nurses felt that home telehealth enabled family caregiving, citing increased access to care, and patient and family caregiver reassurance. Pain management was the most common reason for initiating contact with the nurse, followed by emotional support. Concerns included lack of integration of services, inappropriate timing of the intervention and technical problems. The case study confirmed the importance of timely and accessible care for a group of clinically vulnerable, dying cancer patients and their family caregivers.

Co-author:

Stern, A., Valaitis, R., Weir, R., Jadad, A.

Students:

1. Anita Stern

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Most adults with chronic conditions live at home and rely on informal caregivers to provide support. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community.

Study results suggest that Web-based interventions may result in reduced depressive symptoms, anxiety, and stress or distress among informal caregivers of adults with chronic conditions in the community.  This is the first review assessing the impact of Web-based technologies on mental health, general caregiving outcomes, and general health for caregivers of adults with chronic conditions living in the community. Further rigorous research is needed that includes adequately powered studies examining the critical components of the intervention and the dosage needed to have an effect.

Co-author:

Ploeg, J., Markle-Reid, M., Valaitis, R., McAiney, C., Duggleby, W., Bartholomew, A., Sherifali, D.

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• Link to paper