Behavioural and Environmental Interventions for Personal and Community Cardiovascular Health Research Group

Health behaviours such as tobacco smoking, physical activity, sedentary behavior, and eating patterns are critical determinants of cardiovascular health. They influence the development of risk factors such as obesity, high blood pressure, diabetes, and blood lipids. Social and physical environments exert profound influence over health behaviours. Behavioural and environmental interventions can assist people to improve their cardiovascular health.

Goals of the Cluster

  • Developing and evaluating new interventions to help people improve and maintain personal health behaviours and self-management;
  • Translating knowledge about proven interventions to individuals, health care professionals and health care delivery systems;
  • Understanding how interventions interact with social and physical environments and genetic factors;
  • Understanding the unique underpinnings of women’s heart health and develop behavioural and environmental interventions to support women with heart disease, women at risk for heart disease, and women with families;
  • Developing and evaluating worksite programs to improve cardiovascular health;
  • Refining and evaluating technological innovations (e.g., health portals; phone apps; automated telephone, text-based and email contacts) and financial incentives to facilitate health behaviour change;
  • Examining the health services impacts and cost-effectiveness of behavioural and environmental interventions to improve cardiovascular health.

Innovation Cluster Scientists

Leads:
Robert D. Reid, PhD, MBA, University of Ottawa Heart Institute
Doug Manuel, MD, The Ottawa Hospital, Institute for Clinical Evaluative Sciences

Team members at the University of Ottawa Heart Institute:
Thais Coutinho, MD, George Fodor, MD, PhD, Peter Liu, MD, Amy Mark, PhD, Kerri-Anne Mullen, PhD, Andrew Pipe, MD, Stephanie Prince Ware, PhD, Jennifer Reed, PhD, Heather Tulloch, PhD, George A. Wells, PhD and Lisa McDonnell, MBA.

Other team members:

Kristi Adamo, PhD, Children’s Hospital of Eastern Ontario
Swapnil Hiremath, MD, The Ottawa Hospital
Elizabeth Kristjanssen, PhD, University of Ottawa
Julian Little, PhD, University of Ottawa
Kara Nerenberg, MD, University of Calgary
Sophia Papadakis, PhD, MHA, University of Crete

Partners:

Chris Blanchard, PhD, Dalhousie University
Sherry Grace, PhD, York University 

 Ongoing Pilot Projects

Nurses Health

The Nurses Health Study is a pilot project to assess determinants of moderate to vigorous intensity physical activity among hospital-employed nurses at 10 hospitals in the Champlain LHIN. Knowledge of the determinants is fundamental to identifying targets for new interventions. 500 nurses are participating. The dependent variable is physical activity measured objectively via accelerometer. Questionnaire measures of potential individual, social and environmental correlates of physical activity are being gathered.

Project Leads: Jennifer Reed, PhD, Robert Reid, PhD

Cardio Prevent Intervention to Improve Vascular Health in Post-Partum Women with a History of Pre-eclampsia

Pregnancy often reveals early signs of heightened vascular risk, particularly among women who develop gestational diabetes or eclampsia/pre-eclampsia. Fifty women with a history of pre-eclampsia during their most recent pregnancy are receiving a multi-factorial intervention called CardioPrevent to reduce their vascular risk during the post-partum period. The main outcome is vascular risk measured by pulse wave velocity.

Project Leads: Kara Nerenberg, MD, Lisa McDonnell, MBA

Pilot Cluster Randomized Trial of the Ottawa Model for Smoking Cessation in Diabetes Education Centres

A pilot cluster randomized controlled trial is being conducted among 18 diabetes education centres in Eastern Ontario. Matched pairs of diabetes education programs are being randomized to an Ottawa Model for Smoking Cessation practice change intervention group or a wait-list control group. Effects on patient-level cessation rates are being compared at 1-year follow-up. A total of 940 smoker-patients are being recruited.

Project Lead: Robert Reid, PhD, Andrew Pipe, MD

Adaptation of the Ottawa Model for Smoking Cessation to the Cancer Care Setting

We are conducting a mixed methods study to understand how the Ottawa Model for Smoking Cessation may need to be adapted for use in the cancer care setting. We have conducted stakeholder interviews with cancer care professionals and are conducting a pilot implementation of adapted program materials in a cancer-screening clinic in Ottawa.

Project Lead: Robert Reid, PhD, Roanne Segal, MD

Pilot RCT of Virtual Care Intervention in the Workplace

We have developed a virtual care intervention to improve vascular health among employee populations. We would like to test it in a definitive RCT. We need to pilot test the intervention for acceptability and produce a preliminary assessment of its effectiveness. This will inform development of the definitive trial. We are conducting a pilot RCT among nurses working in hospitals in the Ottawa area.

Project Leads: Robert Reid, PhD, Jennifer Reed, PhD, Thais Coutinho, MD

Selected Innovation Cluster Publications

Prince SA, Saunders TJ, Gresty K, Reid RD. A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: A systematic review and meta-analysis of controlled trials. Obesity Reviews 2014 (e-pub Aug 11).

McDonnell L, Pipe AL, Westcott C, Perron S, Younger-Lewis D, Elias N, Nooyen J, Reid RD. Perceived versus actual knowledge and risk of heart disease in women: Findings from a national survey on heart health awareness, attitudes, and behaviours. Can J Cardiol 2014; 30(7): 827-34.

Mullen KM; Coyle D; Manuel D; Nguyen HV; Pham B; Pipe AL; Reid RD. Economic evaluation of a hospital-initiated intervention for smokers with chronic disease in Ontario, Canada. Tobacco Control 2014 Jun 16.

Slovinec-D’Angelo ME, Pelletier LG, Huta V, Reid RD. The roles of self-efficacy and motivation in the prediction of short- and long-term adherence to exercise among patients with coronary heart disease. Health Psychol 2014;33(11):1344-53.

Reid RD, McDonnell L, Riley D, Mark A, Mosca L, Gagne L, Papadakis S, Blanchard C, Mochari-Greenberger H, O’Farrell P, Wells G, Slovinec D’Angelo M, Pipe AL. Effect of an Intervention to Improve the Cardiovascular Health of Family Members of Patients with Heart Disease: A Randomized Trial. Can Med Assoc J 2014; 186(1):23-30.

Reed JL, Mark AE, Reid RD, Pipe AL. The Effects of Regular Exercise Training in those with Atrial Fibrillation: A Systematic Review. Can J Cardiol 2013; 29(12):1721-1728.

Funding

Canadian Cancer Society, Knowledge to Action Grant ($100,000), “Translating knowledge about smoking cessation into cancer care treatment: the Ottawa Model for Smoking Cessation.” Project Lead: Dr. Robert Reid, PhD.

Pfizer Global Research Awards for Nicotine Dependence ($199,550), “A prospective cluster-randomized trial to implement the Ottawa Model for Smoking Cessation in diabetes education programs in Canada.” Project Leads: Drs. Robert Reid, PhD and Andrew Pipe, MD.

ORACLE Innovation Cluster Pilot Project Fund ($50,000), “E-health Interventions to Improve Vascular Health in Workplaces: Foundational Research Examining Physical Activity Among Nurses Working in Hospitals.” Project Leads: Drs. Jennifer Reed, PhD and Robert Reid, PhD.

Public Health Agency of Canada ($1.8 Million), “INSPIRE: Implementing a National Smoking Cessation Program In Respiratory Clinics.” Project Leads: Drs. Kerri-Anne Mullen, PhD and Robert Reid, PhD.

Ontario Ministry of Health and Long-Term Care ($2.0 Million), “The Ottawa Model for Smoking Cessation in Hospitals, Community Health Centres, and Primary Care Practices in Ontario.” Project Leads: Drs. Andrew Pipe, MD , Robert Reid, PhD, Kerri-Anne Mullen, PhD, Sophia Papadakis, PhD, MHA and Ms. Tracy Gierman.

Heart and Stroke Foundation ($274,824), “Ecologically Optimizing Exercise Maintenance in Men and Women Post-Cardiac Rehabilitation: A Randomized Controlled Trial of Efficacy with Economics (ECO-PCR). Project Leads: Drs. Robert Reid, PhD and Sherry Grace, PhD.

Heart and Stroke Foundation ($251,919), “Randomized Trial of Nordic Walking vs. Standard Cardiac Rehabilitation in Patients with Heart Failure.” Project Lead: Dr. Robert Reid, PhD.

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