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Developing integrative primary healthcare delivery: adding a chiropractor to the team.

https://arctichealth.org/en/permalink/ahliterature159348
Source
Explore (NY). 2008 Jan-Feb;4(1):18-24
Publication Type
Article
Author
Michael J Garner
Michael Birmingham
Peter Aker
David Moher
Jeff Balon
Dirk Keenan
Pran Manga
Author Affiliation
Carlington Community and Health Services, Ottawa, Ontario, Canada. michaelgarner@gmail.com
Source
Explore (NY). 2008 Jan-Feb;4(1):18-24
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chiropractic - organization & administration
Cooperative Behavior
Delivery of Health Care, Integrated - organization & administration
Female
Focus Groups
Humans
Interdisciplinary Communication
Interprofessional Relations
Male
Middle Aged
Ontario
Primary Health Care - organization & administration
Questionnaires
Referral and Consultation - statistics & numerical data
Abstract
The use of complementary and alternative medicine has been increasing in Canada despite the lack of coverage under the universal public health insurance system. Physicians and other healthcare practitioners are now being placed in multidisciplinary teams, yet little research on integration exists.
We sought to investigate the effect of integrating chiropractic on the attitudes of providers on two healthcare teams.
A mixed methods design with both quantitative and qualitative components was used to assess the healthcare teams. Assessment occurred prior to integration, at midstudy, and at the end of the study (18 months).
Multidisciplinary healthcare teams at two community health centers in Ottawa, Ontario, participated in the study.
All physicians, nurse practitioners, and degree-trained nurses employed at two study sites were approached to take part in the study.
A chiropractor was introduced into each of the two healthcare teams.
A quantitative questionnaire assessed providers' opinions, experiences with collaboration, and perceptions of chiropractic care. Focus groups were used to encourage providers to communicate their experiences and perceptions of the integration and of chiropractic.
Twelve providers were followed for the full 18 months of integration. The providers expressed increased willingness to trust the chiropractors in shared care (F value = 7.18; P = .004). Questions regarding the legitimacy (F value = 12.33; P
PubMed ID
18194787 View in PubMed
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Effectiveness of brief interventions as part of the screening, brief intervention and referral to treatment (SBIRT) model for reducing the non-medical use of psychoactive substances: a systematic review protocol.

https://arctichealth.org/en/permalink/ahliterature124367
Source
Syst Rev. 2012;1:22
Publication Type
Article
Date
2012
Author
Matthew M Young
Adrienne Stevens
Amy Porath-Waller
Tyler Pirie
Chantelle Garritty
Becky Skidmore
Lucy Turner
Cheryl Arratoon
Nancy Haley
Karen Leslie
Rhoda Reardon
Beth Sproule
Jeremy Grimshaw
David Moher
Author Affiliation
Canadian Centre on Substance Abuse (CCSA), 75 Albert Street, Ottawa, ON, K1P 5E7, Canada. myoung@ccsa.ca
Source
Syst Rev. 2012;1:22
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada - epidemiology
Child
Clinical Trials as Topic
Delivery of Health Care, Integrated - organization & administration
Early Medical Intervention - organization & administration
Female
Harm Reduction
Humans
Intervention Studies
Male
Mass Screening - organization & administration
Research Design
Review Literature as Topic
Substance-Related Disorders - epidemiology - prevention & control
Abstract
There is a significant public health burden associated with substance use in Canada. The early detection and/or treatment of risky substance use has the potential to dramatically improve outcomes for those who experience harms from the non-medical use of psychoactive substances, particularly adolescents whose brains are still undergoing development. The Screening, Brief Intervention, and Referral to Treatment model is a comprehensive, integrated approach for the delivery of early intervention and treatment services for individuals experiencing substance use-related harms, as well as those who are at risk of experiencing such harm.
This article describes the protocol for a systematic review of the effectiveness of brief interventions as part of the Screening, Brief Intervention, and Referral to Treatment model for reducing the non-medical use of psychoactive substances. Studies will be selected in which brief interventions target non-medical psychoactive substance use (excluding alcohol, nicotine, or caffeine) among those 12?years and older who are opportunistically screened and deemed at risk of harms related to psychoactive substance use. We will include one-on-one verbal interventions and exclude non-verbal brief interventions (for example, the provision of information such as a pamphlet or online interventions) and group interventions. Primary, secondary and adverse outcomes of interest are prespecified. Randomized controlled trials will be included; non-randomized controlled trials, controlled before-after studies and interrupted time series designs will be considered in the absence of randomized controlled trials. We will search several bibliographic databases (for example, MEDLINE, EMBASE, CINAHL, PsycINFO, CORK) and search sources for grey literature. We will meta-analyze studies where possible. We will conduct subgroup analyses, if possible, according to drug class and intervention setting.
This review will provide evidence on the effectiveness of brief interventions as part of the Screening, Brief Intervention, and Referral to Treatment protocol aimed at the non-medical use of psychoactive substances and may provide guidance as to where future research might be most beneficial.
Notes
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PubMed ID
22587894 View in PubMed
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