Browsing by Author "Folkins, Chris"

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    NB-IRDT chronic obstructive pulmonary disease research program – Report two: Investigation of the Canadian Chronic Disease Surveillance System (CCDSS) and the New Brunswick COPD Health Information Platform (NB-CHIP)
    (New Brunswick Institute for Research, Data and Training, 2023-04) Rogers, Kyle; Folkins, Chris; McDonald, Ted
    Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable chronic lung condition that causes airflow limitation and is characterized by persistent symptoms such as shortness of breath and excessive coughing with or without the production of phlegm. A common inflammatory disease, COPD is primarily caused by exposure to gases and particulates, with tobacco smoke being the most common source of exposure. COPD has significant effects on the quality of life, morbidity, and mortality of individuals living with it. For example, regarding quality of life, Canadians living with COPD have reported limitations to their daily activities, their ability to work outside the home, and even socialization. Between 2015 and 2019, COPD was the 4th/5th leading cause of death in Canada and the 2nd leading cause (after childbirth) of hospitalizations. During the same period, the province of New Brunswick (NB) had very similar mortality and morbidity effects to those seen across Canada: COPD was the 3rd/4th leading cause of death in the province and the 3rd leading cause of hospitalizations. A previous report from the New Brunswick Institute for Research, Data and Training (NB-IRDT) utilizing Statistics Canada Public Use Microdata Files of the Canadian Community Health Survey (CCHS) data demonstrated the effect COPD can have on quality of life. New Brunswickers who reported a diagnosis of COPD had increased rates of indicators associated with reduced quality of life when compared against the general population in NB. While the downstream effects of COPD are well documented, obtaining accurate estimations of the population burden can be difficult due to discrepancies that result from differences in the methodologies used to obtain them. This research report examines the prevalence of COPD based on the Canadian Chronic Disease Surveillance System case identification algorithm and compares it to clinical measurements from the pulmonary function testing data derived from the NB COPD Health Information Platform. By exploring how the data sources relate to and are consistent with one another, we can improve our understanding of the COPD disease burden and clinical practices surrounding how COPD is diagnosed in the province.
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    Projected outcomes of an expanded role for pharmacy professionals in the provision of publicly funded immunization services in New Brunswick
    (New Brunswick Institute for Research, Data and Training, 2021-10) Folkins, Chris; Gorman-Asal, Madeleine; Magalhaes, Sandra; Brewster, Clark; Gulliver, Adrienne; Singh, Paramdeep; Foster, Rebecca; Miah, Pablo; Thomson, Emily; McDonald, Ted
    New Brunswick (NB) legislation permits pharmacy professionals (pharmacists, and as of 2021, registered pharmacy technicians) to administer a wide range of immunizations to their patients. Many vaccines in New Brunswick are publicly funded and available at no charge to patients when administered by a physician or nurse practitioner; however, the majority of these vaccines are not publicly funded when administered by pharmacy professionals, even though legislation permits their administration. Currently, only vaccines against influenza and COVID-19 are publicly funded when administered by pharmacy professionals in NB. This creates a scenario in which patients wishing to take advantage of the convenience and accessibility offered by pharmacy-based vaccination services must pay for most vaccinations (including drug costs and service administration fees) out of pocket – even when, in the case of publicly funded vaccines, these same vaccinations are available through a physician at no cost to the patient. This situation represents a barrier to accessible health services, particularly for NB residents who do not have access to a primary care provider, and a missed opportunity to take advantage of the full scope of practice of NB’s pharmacy professionals. By expanding the repertoire of publicly funded vaccinations that can be administered by pharmacy professionals, it is hypothesized that cost savings, improved health outcomes, and improved access to care could be realized in New Brunswick. The main objective of this study is to understand how expanding the number of publicly funded vaccines pharmacy professionals can administer would impact provincial spending, access to care, and health outcomes in New Brunswick.
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    Répercussions à court et à long terme du volet de visites postnatales à domicile du programme Familles en santé, bébés en santé (FSBS) sur les résultats sur la santé et le développement des enfants au Nouveau-Brunswick
    (l’Institut de recherche, de données et de formation du Nouveau-Brunswick, 2023-04) Magalhaes, Sandra; Cameron, Jillian; Cookson, Samuel; Folkins, Chris; Gorman-Asal, Sadie; Somayaji, Chandy
    Le développement de la petite enfance est un déterminant social de la santé de premier plan. Les visites à domicile constituent une stratégie de santé publique visant à atténuer les répercussions néfastes de la pauvreté et de l’adversité dans la petite enfance, habituellement offertes aux familles présentant un risque élevé de résultats moins favorables. Les familles sont inscrites avant ou après la naissance de bébé, et suivies tout au long de la grossesse et lors des premières années de vie de l’enfant. Les programmes de visites à domicile se sont montrés bénéfiques pour les participants et les fournisseurs de services, mais leurs répercussions à long terme n’ont pas fait l’objet d’une évaluation adéquate au sein des populations canadiennes. Chaque province et territoire du Canada offre un programme de visites à domicile qui, chez plusieurs, fait actuellement l’objet d’un examen continu. De plus amples recherches sont nécessaires pour éclairer ces efforts. L’objectif global de la présente étude consiste à évaluer les répercussions à court et à long terme d’une participation aux services ciblés de visites postnatales à domicile sur l’attitude face à l’allaitement maternel et le développement de l’enfant. Les résultats qui en découleront serviront à un examen du volet de visites postnatales à domicile ciblées du programme FSBS, au Nouveau-Brunswick. Une étude de cohorte rétrospective appariée comprenant toutes les naissances vivantes ayant eu lieu au Nouveau-Brunswick (Canada) entre le 1er avril 2012 et le 31 mars 2014 dans des familles qui accueillaient leur premier enfant a été élaborée au moyen de données administratives axées sur la population fournies par l’Institut de la recherche, des données et de la formation du Nouveau-Brunswick (IRDF-NB). Plusieurs ensembles de données administratives couplables ont servi à déterminer la cohorte de l’étude, la participation postnatale au programme FSBS, la durée de l’allaitement maternel et les résultats sur le développement infantile des trottineurs et des enfants d’âge préscolaire, de même que le nombre de variables de confusion. Une méthode d’appariement par scores de propension a permis de sélectionner un groupe de familles n’ayant pas participé semblables aux familles participantes. L’application d’un modèle de régression multivariable a permis de dégager des estimations statistiques des écarts de résultats entre les groupes, tout en tenant compte des variables de confusion pertinentes. Une cohorte de naissances de 6 096 familles accueillant leur premier enfant, ainsi établie, a fait l’objet d’un suivi longitudinal, de la naissance à l’âge scolaire; 1 211 familles ont participé au programme de visites postnatales à domicile et 1 366 autres ont été appariées aux familles participantes.
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    Short- and longer-term impacts of the Healthy Families Healthy Babies (HFHB) postnatal home visiting program on child health and developmental outcomes in New Brunswick
    (New Brunswick Institute for Research, Data and Training, 2023-04) Magalhaes, Sandra; Cameron, Jillian; Cookson, Samuel; Folkins, Chris; Gorman-Asal, Sadie; Somayaji, Chandy
    Early childhood development is a fundamental social determinant of health. Home visiting is a public health strategy to mitigate negative impacts from poverty and early childhood adversity, typically offered to families at high risk of poorer outcomes. Families are enrolled prenatally or postnatally and followed through pregnancy and the first years of the child’s life. Home visiting programs are shown to have benefits for both program participants and service providers; however, their longer-term impacts have not been properly evaluated among Canadian populations. Each Canadian province and territory offers a home visiting program, with several currently undergoing program review. More research is needed to inform these efforts. The overall goal of this study is to evaluate the short- and longer-term impacts of participation in targeted postnatal home visiting services on breastfeeding behaviour and child development, and results will inform a review of the Healthy Families, Healthy Babies (HFHB) targeted postnatal home visiting program in New Brunswick. A matched retrospective cohort study of all live births in New Brunswick, Canada, between April 1, 2012, and March 31, 2014, among families parenting for the first-time was developed using population-based administrative data accessible at the New Brunswick Institute for Research, Data and Training (NB-IRDT). Several linkable administrative data sets were used to define the study cohort, HFHB postnatal program participation, breastfeeding duration, and child developmental outcomes in toddlers and preschoolers, as well as a number of confounding variables. A propensity score matching methodology was used to select a group of families that did not participate who were similar to those who participated. Multivariable regression models were used to provide statistical estimates of the differences in outcomes between groups while accounting for relevant confounding variables. A birth cohort of 6096 families parenting for the first time was established and followed longitudinally from birth to school age; 1211 participated in the postnatal home visiting program, and 1366 non-participating families were matched to participants.
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    Summary Report: NB-IRDT chronic obstructive pulmonary disease research program – Report two: Investigation of the Canadian Chronic Disease Surveillance System (CCDSS) and the New Brunswick COPD Health Information Platform (NB-CHIP)
    (New Brunswick Institute for Research, Data and Training, 2023-04) Rogers, Kyle; Folkins, Chris; McDonald, Ted
    Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable chronic lung condition that causes airflow limitation and is characterized by persistent symptoms such as shortness of breath and excessive coughing with or without the production of phlegm. A common inflammatory disease, COPD is primarily caused by exposure to gases and particulates, with tobacco smoke being the most common source of exposure. COPD has significant effects on the quality of life, morbidity, and mortality of individuals living with it. For example, regarding quality of life, Canadians living with COPD have reported limitations to their daily activities, their ability to work outside the home, and even socialization. Between 2015 and 2019, COPD was the 4th/5th leading cause of death in Canada and the 2nd leading cause (after childbirth) of hospitalizations. During the same period, the province of New Brunswick (NB) had very similar mortality and morbidity effects to those seen across Canada: COPD was the 3rd/4th leading cause of death in the province and the 3rd leading cause of hospitalizations. A previous report from the New Brunswick Institute for Research, Data and Training (NB-IRDT) utilizing Statistics Canada Public Use Microdata Files of the Canadian Community Health Survey (CCHS) data demonstrated the effect COPD can have on quality of life. New Brunswickers who reported a diagnosis of COPD had increased rates of indicators associated with reduced quality of life when compared against the general population in NB. While the downstream effects of COPD are well documented, obtaining accurate estimations of the population burden can be difficult due to discrepancies that result from differences in the methodologies used to obtain them. This research report examines the prevalence of COPD based on the Canadian Chronic Disease Surveillance System case identification algorithm and compares it to clinical measurements from the pulmonary function testing data derived from the NB COPD Health Information Platform. By exploring how the data sources relate to and are consistent with one another, we can improve our understanding of the COPD disease burden and clinical practices surrounding how COPD is diagnosed in the province.
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    Summary Report: Short- and longer-term impacts of the Healthy Families Healthy Babies (HFHB) postnatal home visiting program on child health and developmental outcomes in New Brunswick
    (New Brunswick Institute for Research, Data and Training, 2023-04) Magalhaes, Sandra; Cameron, Jillian; Cookson, Samuel; Folkins, Chris; Gorman-Asal, Sadie; Somayaji, Chandy
    Early childhood development is a fundamental social determinant of health. Home visiting is a public health strategy to mitigate negative impacts from poverty and early childhood adversity, typically offered to families at high risk of poorer outcomes. Families are enrolled prenatally or postnatally and followed through pregnancy and the first years of the child’s life. Home visiting programs are shown to have benefits for both program participants and service providers; however, their longer-term impacts have not been properly evaluated among Canadian populations. Each Canadian province and territory offers a home visiting program, with several currently undergoing program review. More research is needed to inform these efforts. The overall goal of this study is to evaluate the short- and longer-term impacts of participation in targeted postnatal home visiting services on breastfeeding behaviour and child development, and results will inform a review of the Healthy Families, Healthy Babies (HFHB) targeted postnatal home visiting program in New Brunswick. A matched retrospective cohort study of all live births in New Brunswick, Canada, between April 1, 2012, and March 31, 2014, among families parenting for the first-time was developed using population-based administrative data accessible at the New Brunswick Institute for Research, Data and Training (NB-IRDT). Several linkable administrative data sets were used to define the study cohort, HFHB postnatal program participation, breastfeeding duration, and child developmental outcomes in toddlers and preschoolers, as well as a number of confounding variables. A propensity score matching methodology was used to select a group of families that did not participate who were similar to those who participated. Multivariable regression models were used to provide statistical estimates of the differences in outcomes between groups while accounting for relevant confounding variables. A birth cohort of 6096 families parenting for the first time was established and followed longitudinally from birth to school age; 1211 participated in the postnatal home visiting program, and 1366 non-participating families were matched to participants.
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    Technical Appendix: NB-IRDT chronic obstructive pulmonary disease research program – Report two: Investigation of the Canadian Chronic Disease Surveillance System (CCDSS) and the New Brunswick COPD Health Information Platform (NB-CHIP)
    (New Brunswick Institute for Research, Data and Training, 2023-04) Rogers, Kyle; Folkins, Chris; McDonald, Ted
    Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable chronic lung condition that causes airflow limitation and is characterized by persistent symptoms such as shortness of breath and excessive coughing with or without the production of phlegm. A common inflammatory disease, COPD is primarily caused by exposure to gases and particulates, with tobacco smoke being the most common source of exposure. COPD has significant effects on the quality of life, morbidity, and mortality of individuals living with it. For example, regarding quality of life, Canadians living with COPD have reported limitations to their daily activities, their ability to work outside the home, and even socialization. Between 2015 and 2019, COPD was the 4th/5th leading cause of death in Canada and the 2nd leading cause (after childbirth) of hospitalizations. During the same period, the province of New Brunswick (NB) had very similar mortality and morbidity effects to those seen across Canada: COPD was the 3rd/4th leading cause of death in the province and the 3rd leading cause of hospitalizations. A previous report from the New Brunswick Institute for Research, Data and Training (NB-IRDT) utilizing Statistics Canada Public Use Microdata Files of the Canadian Community Health Survey (CCHS) data demonstrated the effect COPD can have on quality of life. New Brunswickers who reported a diagnosis of COPD had increased rates of indicators associated with reduced quality of life when compared against the general population in NB. While the downstream effects of COPD are well documented, obtaining accurate estimations of the population burden can be difficult due to discrepancies that result from differences in the methodologies used to obtain them. This research report examines the prevalence of COPD based on the Canadian Chronic Disease Surveillance System case identification algorithm and compares it to clinical measurements from the pulmonary function testing data derived from the NB COPD Health Information Platform. By exploring how the data sources relate to and are consistent with one another, we can improve our understanding of the COPD disease burden and clinical practices surrounding how COPD is diagnosed in the province.