Beyond BMI: a feasibility study implementing NutriSTEP in primary care practices using electronic medical records (EMRs). / Au-delà de l'IMC : étude de faisabilité de la mise en oeuvre de NutriSTEP dans les établissements de soins primaires au moyen des dossiers médicaux électroniques (DME).

INTRODUCTION: Primary care providers have a role to play in supporting the development of healthy eating habits, particularly in a child's early years. This study examined the feasibility of implementing the NutriSTEP® screen-a 17-item nutrition risk screening tool validated for use with both toddler and preschooler populations-integrated with an electronic medical record (EMR) in primary care practices in Ontario, Canada, to inform primary care decision-making and public health surveillance. METHODS: Five primary care practices implemented the NutriSTEP screen as a standardized form into their EMRs. To understand practitioners' experiences with delivery and assess factors associated with successful implementation, we conducted semi-structured qualitative interviews with primary care providers who were most knowledgeable about NutriSTEP implementation at their site. We assessed the quality of the extracted patient EMR data by determining the number of fully completed NutriSTEP screens and documented growth measurements of children. RESULTS: Primary care practices implemented the NutriSTEP screen as part of a variety of routine clinical contacts; specific data collection processes varied by site. Valid NutriSTEP screen data were captured in the EMRs of 80% of primary care practices. Approximately 90% of records had valid NutriSTEP screen completions and 70% of records had both valid NutriSTEP screen completions and valid growth measurements. CONCLUSION: Integration of NutriSTEP as a standardized EMR form is feasible in primary care practices, although implementation varied in our study. The application of EMR-integrated NutriSTEP screening as part of a comprehensive childhood healthy weights surveillance system warrants further exploration.

"Thinking outside the pack": examining physically active smokers and implications for practice among Ontario residents.

INTRODUCTION: It is estimated that tobacco use kills more than 5 million people annually; it is the leading cause of preventable deaths. Recent public health interventions have likely contributed to a steady decline in rates of smoking over the past decade. Nevertheless, innovative and cost-effective approaches to smoking cessation remain a public health priority. The purpose of this study was to profile physically active smokers. METHOD: Data from the Canadian Community Health Survey 2007-2008-Ontario Sharing File were used. Responses from 41,800 persons aged 12 years and older were assessed to compare (a) the sociodemographic characteristics of physically active smokers to physically active nonsmokers in Ontario and (b) the types of leisure-time physical activities that are more commonly practiced among active Ontario smokers to active nonsmokers. RESULTS: Pearson χ(2) and independent samples t tests revealed that active smokers were more likely to be male, younger, single, and less educated and to have lower income than active nonsmokers. Active smokers were also more likely to report inexpensive, low-intensity, and solitary leisure-time physical activities. CONCLUSION: Our findings have important implications for physical activity promotion among smokers. Physical activity interventions for smokers need to be tailored differently than for nonsmokers.

Women with postpartum depression: "my husband" stories.

BACKGROUND: The research on Postpartum Depression (PPD) to date suggests that there is a knowledge gap regarding women's perception of their partners' role as carer and care activities they perform. Therefore, the purpose of this study was to describe women's understanding of their partners' or husbands' involvement in the midst of PPD. METHODS: This study used interview data from a larger study of northern and rural Ontario women's stories of help-seeking for PPD. The interpretive description approach was used to illustrate the complexity of women's spousal connections in PPD. Data from a purposive community sample of 27 women who self-identified as having been diagnosed with PPD was used. From the verbatim transcribed interviews a number of data excerpts were identified and labeled as "my husband" stories. Narrative analysis was employed to examine these stories. RESULTS: During this time of vulnerability, the husbands' physical, emotional and cognitive availability positively contributed to the women's functioning and self-appraisals as wife and mother. Their representations of their husbands' 'doing for' and/or 'being with' promoted their well-being and ultimately protected the family. CONCLUSION: Given that husbands are perceived to be central in mitigating women's suffering with PPD, the consistent implementation of a triad orientation, that includes woman, child and partner rather than a more traditional and convenient dyadic orientation, is warranted in comprehensive postpartum care. Finally, this study contributes a theoretical understanding of responsive as well as reactive connections between women and family members during the postpartum period.