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Biomedical subjects

Donald Schopflocher

Publications and source records attributed to Donald Schopflocher.

11 recordsLinked to original sources
PubMed2006

A population-based survey of back pain beliefs in Canada.

STUDY DESIGN: Population-based survey. OBJECTIVES: To assess the back pain beliefs in 2 provinces in Canada to inform a population-based educational campaign. SUMMARY OF BACKGROUND DATA: Beliefs, attitudes, and recovery expectations appear to influence recovery from back pain, yet prevailing public opinions about the condition have been little studied. METHODS: Telephone surveys were conducted with 2400 adults in 2 Canadian provinces. Surveys included the Back Beliefs Questionnaire, and additional questions concerning age, gender, recent and lifetime back pain, coping strategies for back pain, and awareness and persuasiveness of media information concerning back pain. RESULTS: A high prevalence of back pain was reported, with a lifetime prevalence of 83.8%, and 1-week prevalence of 34.2%. Generally, a pessimistic view of back pain was held. Most agreed that back pain makes everything in life worse, will eventually stop one from working, and will become progressively worse with age. Mixed opinions were observed regarding the importance of rest and staying active. A significant minority (12.3%) reported taking time off from work for their last back pain episode. Those individuals taking time off from work held more negative back pain beliefs, including the belief that back pain should be rested until it gets better. CONCLUSIONS: Public back pain beliefs in the 2 Canadian provinces sampled are not in harmony with current scientific evidence for this highly prevalent condition. Given the mismatch between public beliefs and current evidence, strategies for reeducating the public are needed.

Adolescent↗
PubMed2006

The Alberta Ambassador Program: delivering Health Technology Assessment results to rural practitioners.

BACKGROUND: The purpose of Health Technology Assessment (HTA) is to make the best possible summary of the evidence regarding specific health interventions in order to influence health care and policy decisions. The need for decision makers to find relevant HTA data when it is needed is a barrier to its usefulness. These barriers are highest in rural areas and amongst isolated practitioners. METHODS: A multidisciplinary team developed an interactive case-based instructional strategy on the topic of chronic non-cancer pain (CNCP) management using clinical evidence derived by HTA. The evidence for each of 18 CNCP interventions was distilled into single-sheet summaries. Clinicians and HTA specialists ('Ambassadors') conducted 11 two-hour interactive sessions on CNCP in eight of Alberta's nine health regions. Pre- and post-session evaluations were conducted. RESULTS: The sessions were attended by 130 individuals representing 14 health and administrative disciplines. The ambassador model was well received. The use of content experts as ambassadors was highly rated. The educational strategy was judged to be effective. Awareness of the best evidence in CNCP management was increased. Although some participants reported practice changes as a result of the workshops, the program was not designed to measure changes in patient outcome. CONCLUSION: The ambassador program was successful in increasing awareness of the best evidence in CNCP management, and positively influenced treatment decisions. Its teaching methods were felt to be unique and innovative by participants. Its methods could be applied to other clinical content areas in order to increase the uptake of the results of HTA.

Alberta↗
PubMed2006

Development and validation of a surname list to define Chinese ethnicity.

OBJECTIVE: Surnames have the potential to accurately identify ancestral origins as they are passed on from generation to generation. In this study, we developed and validated a Chinese surname list to define Chinese ethnicity. METHODS: We conducted a literature review, a panel review, and a telephone survey in a randomly selected sample from a Canadian city in 2003 to develop a Chinese surname list. The list was then validated to data from the Canadian Community Health Survey. Both surveys collected information on self-reported ethnicity and surname. RESULTS: Of the 112,452 people analyzed in the Canadian Community Health Survey, 1.6% were self-reported as Chinese. This was similar to the 1.5% identified by the surname list. Compared with self-reported Chinese ethnicity (reference standard), the surname list had 77.7% sensitivity, 80.5% positive predictive value, 99.7% specificity, and 99.6% negative predictive value. When stratifying by sex and marital status, the positive predictive value was 78.9% for married women and 83.6% for never married women. CONCLUSIONS: The Chinese surname list appears to be valid in identifying Chinese ethnicity. The validity may depend on the geographic origins and Chinese dialects in given populations.

Adolescent↗
PubMed2006

A population-based analysis of health behaviours, chronic diseases and associated costs.

Health behaviours influence the future incidence of certain common chronic diseases and thus have an impact on health status and utilization of health care services and costs. We analyzed person-level data of the Albertan adult population from the Canadian Community Health Survey, Cycle 1.1 (2000) to determine health care costs associated with specific health behaviours (smoking, sub-optimal diet, physical inactivity) and chronic disease states (heart disease, diabetes, COPD). We found that 74.7 percent of the population exhibited one or more risk behaviours, while 10.5 percent had one or more of the chronic diseases of interest. Greater health care utilization and costs were noted in groups exhibiting risk behaviour and chronic disease states. Approximately 31 percent of health care costs in Alberta were attributable to people having one or more of the three chronic diseases. Our findings of higher health care costs incurred by those exhibiting unhealthy behaviour prior to development of disease, as well as by those with multiple co-existent diseases, are important indicators to guide future prevention and treatment strategies of chronic illness.

Adult↗
PubMed2006

Statistical disease cluster surveillance of medically treated self-inflicted injuries in Alberta, Canada.

Routine surveillance of cases of disease can highlight geographic regions that need further study and intervention. Statistical disease cluster detection methods are one way to statistically assess the number of cases in administrative areas. Traditionally, disease cluster detection methods are used to monitor the incident cases of disease. We review a statistical cluster detection method that is applicable for regions with diverse administrative area population sizes. We apply the method to assess clustering of self-inflicted injury presentations to emergency departments in Alberta, Canada. Analyses focus on the pediatric population and are adjusted by the age and gender distributions of subregional health authorities. Fifteen clusters of self-inflicted injuries are identified and, based on age and gender distributions, the clusters are not likely chance occurrences. We believe that these clusters represent areas of excessive self-inflicted injury and that special intervention programs should be considered.

Adolescent↗
PubMed2004

A health production function for persons with back problems: results from the Canadian Community Health Survey of 2000.

STUDY DESIGN: A retrospective, population-based analysis. OBJECTIVES: To analyze the relation between health outcomes and resources used by persons with back problems in an everyday setting. SUMMARY OF BACKGROUND DATA: The Canadian Community Health Survey (2000) contains self-reported variables on change in health status, use of health resources, and socioeconomic characteristics of a population sample. METHODS: We use a health production function approach, in which we explore the association between change in health status and a series of utilization variables for persons with a single diagnosis of back pain using a regression equation. The independent variables include use of family physicians, chiropractors, physiotherapists, and exercise. RESULTS: Change in health status was negatively and significantly associated with family practice, chiropractic, and physiotherapy visits and positively associated with physical activity. The magnitudes of the results were small. CONCLUSIONS: Our results indicate that exercise is an important factor in back problems, while persons who seek formal care do not improve.

Adult↗
PubMed2004

Long term medical costs of motor vehicle casualties in Alberta (1999): a population-based, incidence approach.

The purpose of this paper is to estimate the long term medical costs attributable to motor vehicle accidents (MVAs) for all persons in Alberta, Canada in 1999, primarily using observational data. Injury claims with personal identifiers for 1999 were reported by the automobile insurance companies. These records were linked to the provincial health registry which covers the entire population. The registry is linked to databases which identify all inpatient and outpatient (including emergency room) visits, physician services, and other health records. Utilization and costs were derived for all casualties who were admitted to hospital or seen in an emergency room, and for a large sample of other (low severity) cases; a sample of matched controls was derived and their costs were also estimated. Actual costs were obtained for 3 years, and longer term costs were projected for subsequent years. Total costs attributable to MVAs were estimated at over $117 million for 1999. Average net costs per casualty, reported by severity group, were: $22.9 thousand for hospital cases; $3.6 thousand for emergency room-only cases; and $157 for other cases. Long term costs were 65% of first year costs for hospitalized cases and 250% for emergency room cases. Overall, aggregate costs for all non-hospital cases exceeded those for hospitalized cases.

Accidents, Traffic↗
PubMedDate not supplied

Alcohol problems and interest in self-help: a population study of Alberta adults.

BACKGROUND: We quantified the prevalence of alcohol problems among Alberta adults and determined relationships between sociodemographic characteristics, problem drinking status, and interest in self-help materials to reduce alcohol use. METHODS: A computer-aided telephone interview was administered to a stratified random sample of 10,014 Albertans, 18 years of age or older (5,621 women and 4,393 men; M age = 43.3 years, SD = 16.0), with a response rate of 65.4%. Measures included: 1) current drinking status, 2) prior alcohol treatment, 3) problem drinking status (using the Alcohol Use Disorders Identification Test; AUDIT), and 4) interest in receiving free self-help materials to encourage safe drinking. Data were weighted to reflect age, sex, and regional Alberta population. RESULTS: Of the total sample, 19.3% abstained from drinking in the past year, 4.2% had received treatment for alcohol problems at some point in their lives, and 80.7% were current drinkers (i.e., consumed alcohol in the previous year). Some 15.2% (n = 1,193) of current drinkers were classified as having a drinking problem. Logistic regression analyses showed that problem drinkers had 3.5 times greater odds of being male and 2.3 times greater odds of being interested in self-help interventions, compared to other current drinkers. Being single, of younger age, and not being exposed to post-secondary education also significantly predicted problem drinking status. INTERPRETATION: Alcohol misuse is common among Alberta drinkers, but many of them are interested in receiving brief public health interventions designed to help them assert control over their behaviour.

Adolescent↗
PubMedDate not supplied

Potential factors that may affect acceptance of routine prenatal HIV testing.

BACKGROUND: Despite increasing advocacy for an "opt-out" strategy in routine prenatal HIV screening programs in Canada, no published studies have examined factors that may affect acceptance of prenatal HIV testing. METHODS: We included all pregnant women in Alberta who received prenatal care (N = 38,712) and their caregivers (N = 2,007) between January 1 and November 30, 2000. Factors associated with non-acceptance of HIV testing in both pregnant women and their caregivers were assessed using multivariate logistic regression. RESULTS: Overall, 1.5% of women declined HIV testing. First Nations women were about twice as likely to decline the test (adjusted odds ratio [OR(adj)] 1.91, 95% CI [1.42-2.58]) compared to non-First Nations women (p < 0.001). The proportion also increased with age (chi2 trend p < 0.001) in the general population. In First Nations women, however, most (3.2%) declined in the 20-24 year age group. No significant effect was seen for a socio-economic status marker or for the place of residence. The caregivers of women who declined HIV testing were more likely to be female (OR(adj) 1.56 [1.28-1.89]), midwives (OR(adj) 140.65 [58.61-337.49]), other non-obstetrical medical specialties (OR(adj) 4.92 [1.94-12.47]), and general practitioners (OR(adj) 3.44 [1.87-6.33]). CONCLUSION: In an "opt-out" routine prenatal HIV screening program, the characteristics of both the pregnant women and their caregivers may contribute to the non-acceptance of HIV testing. A higher likelihood of declining HIV testing among First Nations pregnant women and other pregnant women under the care of midwives and female physicians warrants further study.

AIDS Serodiagnosis↗
PubMedDate not supplied

Public investment in providing information for chronic disease prevention for adults in Alberta.

BACKGROUND: The World Health Organization in 2000 cited specific chronic diseases (chronic obstructive pulmonary disease, heart disease, diabetes and certain cancers) as major and preventable health hazards. There have subsequently been calls for increased investment in prevention activities. Currently there is no information on the economic magnitude of these promotion activities. In this study, we present an estimate of the investment in Alberta, by public organization, for chronic disease prevention activities which provide information that promotes behaviour changes in adults at risk. METHODS: We surveyed board members of the Alberta Healthy Living Network (AHLN) to obtain economic data and information on activities related to chronic disease (primary) prevention. We also asked for further contacts on programs in other agencies. We continued the ("snowball") process until no new agencies were identified. Agencies provided the information on a survey form. RESULTS: In 2003 in Alberta, the cost of publicly provided information to change risk behaviours related to chronic diseases for persons over 20 was dollars 24.9 million. This investment was diffused over a large number of bodies. Anti-smoking programs used the largest proportion of the money. The total cost per person at risk was about dollars 15. Regional Health Authorities spend about 1/10th of 1% of their budget on these activities. DISCUSSION: There are difficulties in collecting and organizing society-level data on chronic disease prevention. Nevertheless, all indications are that the amount of resources devoted in this area is small, and much smaller than has been suggested.

Adult↗