The Local Food Paradox: A Second Study of Local Food Affordability in Canada

The price of food has been affected in recent months in response to events such as the war in Ukraine, energy costs, inflation, the COVID-19 pandemic, and climate change. Indeed, supply problems, as well as the repercussions of global issues, have had an impact on grocery bills. Just between September and October 2022, the price of food increased by 11.4% and 11% year-to-year. In addition, with the pandemic, buying locally has become a key factor for some in choosing which products to consume. This second edition of the report aims to answer the question Does eating local in Quebec cost more? More precisely, our objective was to identify if local products in the food sector, especially in Quebec, were competitive in their price points compared to foods coming from other regions of the world. To answer this, we used AI and machine learning to harvest data from 99 local products and 335 comparable nonlocal products, totaling 198,990 data points and 3745 prices across six data collection dates. The results showed that a total of 25 categories displayed an advantage for the local product or a neutrality, out of a total of 45 categories identified. Our results demonstrated that 55.6% of the categories that contained the local foods analyzed were price competitive with comparable products or less expensive than them.

PFAB-driven clinical and patient education

Objective: We sought to study how an adult cystic fibrosis (CF) Patient Family Advisory Board (PFAB) can influence and co-produce patient and staff education in collaboration with their CF care team. Novel approaches in this study are: 1) learner needs analyses were driven by the PFAB, 2) study and abstract were created by patient PFAB member. Background: In addition to improving quality of care, patient safety, satisfaction, and engagement, the Institute for Patient and Family Centered Care (IPFCC) recommends the establishment of a PFAB to design patient-centric initiatives such as quality improvement, patient education, as well as healthcare provider and clinical staff education (Johnson, Abraham. 2012). Despite this recommendation, there are few studies on how patientdriven education is designed or implemented. The INOVA Adult CF Clinic PFAB articulated their perspective of clinical staff learner needs for Respiratory Therapy (RT), Emergency Department (ED), and Inpatient Nursing Teams (APU). They also helped to advise the need for and content of educational COVID-19 webinars to the patient population. Patients who were PFAB members provided educational content and the patient perspective in these workshops. Methods: Thematic analysis of educational sessions and PFAB meetings were used to study how PFABs can influence and co-produce clinical staff and patient education. Qualitative data were collected and analyzed from observation of 7 PFAB meetings and digital collaborative planning documents used by the PFAB to discuss patient-driven educational needs and session plans. Observational data were collected from 3 staff education sessions that were co-presented with a CF care team member and CF patient PFAB member who gave a short personal account of their experience with their disease. These included: one RT session, two inpatient nursing staff sessions. Plans were made for an ED session in August. Observational qualitative data was also collected from two COVID-19 webinars that were conducted with input and participation of the PFAB in sharing experiences and presenting content. Results: Thematic analysis showed that PFABs can increase engagement of clinical staff and augment educational opportunities for both patients and staff by addressing patient-centered learning needs. Patients who provided first-person accounts of their lived experience as part of a learning session promoted empathy and engagement amongst both staff and patients. Co-produced COVID webinars resulted in a 250% increase in attendance over a three-month period. Chat-box and verbal question participation of co-produced COVID webinars also increased. In addition, the PFAB-driven educational initiatives promoted psychological ownership (Avey, et al. 2009) within the PFAB itself. This has led to attitudes such as higher commitment, responsibility, and engagement of patient PFAB members and CF clinical staff. Opportunities for further research in this area include exploring the extent to which these themes are also promoted by administering formal pre- and post-intervention assessments to staff learners as well as PFAB members.

Patient-centered care of hospitalized adults with cystic fibrosis-a collaboration between the CF care team and the patient family advisory board

Background: The Inova Adult CF Program developed a Patient Family Advisory Board (PFAB) to facilitate patient and family centered care. The PFAB has been actively involved in providing input on multiple issues and expressed interest in initiating and actively participating in a quality improvement project related to CF care. Together with the CF care team, it was decided to focus on inpatient care. Methods: We identified inpatient respiratory care as an area of focus. For baseline data, we developed a survey regarding inpatient experience of respiratory care. Three primary observations emerged as common themes: 1. Desire for a more personalized airway clearance schedule 2. Desire to be more independent with airway clearance regimen 3. Concern that nebulizer sets were not consistently cleaned in accordance with CF guidelines Based on this, the PFAB and CF team evaluated ways to provide personalized scheduling and administration of respiratory medications and chest physiotherapy. A respiratory therapy preference card was created to address this. It includes 1) preferences of timing of airway clearance, 2) preferred nebulized medicines and airway clearance modalities, 3) preferred level of supervision with airway clearance. Next, a combined CF provider-patient in-service for respiratory therapists (RT) was conducted to facilitate an open dialogue with regards to integration of the preference card. Implementation of the preference card involves the following: the preference card is included in a customized CF admissions folder, which is given to the CF patient on admission. The CF patient fills out the card and gives it to the respiratory therapist, who incorporates these preferences into their workflow. For monitoring, we will check in with the patients during the hospitalization to determine if the protocol was followed and if the respiratory medications were administered as per the preferred schedule. A check-in with RT would also be completed to determine any barriers. Data: Baseline data were collected through a pre-intervention survey sent to all CF adults hospitalized in the prior two years. A post-intervention survey is planned after the intervention to asses for changes in respiratory care satisfaction scores. Unfortunately, implementation of our project has been delayed by the COVID-19 pandemic. Conclusions: Partnership between the PFAB and care team helps direct quality improvement initiatives. The PFAB provides unique insight and can be engaged to help develop, implement, and study quality improvement initiatives to help provide improved care.