Reducing Risk with e-Based Support for Adherence to Lifestyle Changes in Hypertension: The REACH Trial
The main objective of the REACH trial is to assess whether preventive e-counselling (provided through a website of the Heart and Stroke Foundation of Canada) improves blood pressure and cardiovascular risk status over 12 months. REACH will also evaluate improvement in lifestyle behaviours that include diet, exercise, smoking, and adherence to prescribed medications. Finally, we will quantify the amount of e-counselling support that is required during REACH to evoke a significant reduction in blood pressure. It is hypothesized that e-Counselling (vs. Control+ usual care) will significantly improve blood pressure and lifestyle behaviours at the 12-month assessment. The findings of this trial will provide information that is critical to our understanding of how internet-based programs can help to improve blood pressure and to reduce the risk for cardiovascular disease.
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Canadian e-Platform to Promote Behavioural Self-Management in Chronic Heart Failure: The CHF-CePPORT Trial
Chronic Heart Failure (CHF) is a growing public health issue in Canada. Counselling by multidisciplinary health care teams helps CHF patients improve self-care behaviours (for medications, diet, exercise, smoking cessation and symptom monitoring), and this reduces the rate of death and CHF hospitalization. Without intervention, patient adherence to these behaviours is below recommended standards and quality of life. A major challenge is to make self-care counselling available without overtaxing health care resources.
This 3.5-year, multi-centre randomized control trial will establish and evaluate a Canadian e-platform that provides multidisciplinary e-counselling to help patients with CHF initiate and maintain recommended self-care behaviours. We will recruit CHF patients in Toronto, Montreal, Ottawa, and Vancouver. We hypothesize that a 12-month program of e-Counselling + usual care vs. general eInfo + usual care will improve quality of life, self-care behaviours, and heart health. This trial is based upon previous clinical trials in CHF, e-health, and preventive lifestyle counselling by our team. The novel contribution of this research is that it will establish an infrastructure for a pan-Canadian e-platform in preventive e-counselling for CHF and improve the quality of life of patients with CHF.
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A Qualitative Study on the Quality of Life in Heart Failure
Heart Failure (HF) is a growing public health issue in Canada. Hospital re-admission within 1-year after diagnosis is 25-40%, and the 5-year rate of HF death is 50%. Because there is no cure, quality of life has become a primary therapeutic goal for HF treatment. Although there are many ways to measure quality of life in HF, most of these do not distinguish the various dimensions of quality of life that are unique or important for each person. In addition, the available instruments fail to consider the relative importance of different dimensions to overall quality of life.
This study is a sub-study of the CHF-CePPORT trial. We will explore how patients with HF perceive their current quality of life and whether they deem it to be "good," to understand how they prioritize the different dimensions of quality of life. We will also investigate activities of participants that help to improve or maintain their quality of life. The findings of this study will be used to improve the next generation of the CHF-CePPORT e-counselling intervention, which is aimed to improve HF adjustment.
Quality of Life and Unmet Self-Care Information Needs of Heart Failure Patients: A Cross-Cultural Needs Assessment
Heart failure is a disease in which the heart is unable to pump oxygen-rich blood throughout the body during exercise or at rest. In addition to medical treatment, patients need to carry out self-care behaviours (e.g., heart healthy diet, daily exercise, weight monitoring, etc.) to maintain heart health and to improve quality of life. Yet, many fail to follow these self-care behaviours, especially among visible ethnic minorities.
We know little about why people from the largest visible ethnic minority populations in Canada (i.e., individuals who are of Chinese, South Asian, or African-American background) have difficulties following these self-care behaviours. Before we can help these patients better adopt these self-care behaviours, we need to find out what does "living well" with heart failure mean to visible ethnic minority patients and what are the major barriers to following these self-care behaviours. Findings will help us develop patient-education content that is relevant to the needs of patients from these populations.
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