Browsing by Author "Hanson, Heather M."

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    The Brain in Motion II Study: study protocol for a randomized controlled trial of an aerobic exercise intervention for older adults at increased risk of dementia
    (2021-06-14) Krüger, Renata L.; Clark, Cameron M.; Dyck, Adrienna M.; Anderson, Todd J.; Clement, Fiona; Hanly, Patrick J.; Hanson, Heather M.; Hill, Michael D.; Hogan, David B.; Holroyd-Leduc, Jayna; Longman, R. S.; McDonough, Meghan; Pike, G. B.; Rawling, Jean M.; Sajobi, Tolulope; Poulin, Marc J.
    Abstract Background There remains no effective intervention capable of reversing most cases of dementia. Current research is focused on prevention by addressing risk factors that are shared between cardiovascular disease and dementia (e.g., hypertension) before the cognitive, functional, and behavioural symptoms of dementia manifest. A promising preventive treatment is exercise. This study describes the methods of a randomized controlled trial (RCT) that assesses the effects of aerobic exercise and behavioural support interventions in older adults at increased risk of dementia due to genetic and/or cardiovascular risk factors. The specific aims are to determine the effect of aerobic exercise on cognitive performance, explore the biological mechanisms that influence cognitive performance after exercise training, and determine if changes in cerebrovascular physiology and function persist 1 year after a 6-month aerobic exercise intervention followed by a 1-year behavioural support programme (at 18 months). Methods We will recruit 264 participants (aged 50–80 years) at elevated risk of dementia. Participants will be randomly allocated into one of four treatment arms: (1) aerobic exercise and health behaviour support, (2) aerobic exercise and no health behaviour support, (3) stretching-toning and health behaviour support, and (4) stretching-toning and no health behaviour support. The aerobic exercise intervention will consist of three supervised walking/jogging sessions per week for 6 months, whereas the stretching-toning control intervention will consist of three supervised stretching-toning sessions per week also for 6 months. Following the exercise interventions, participants will receive either 1 year of ongoing telephone behavioural support or no telephone support. The primary aim is to determine the independent effect of aerobic exercise on a cognitive composite score in participants allocated to this intervention compared to participants allocated to the stretching-toning group. The secondary aims are to examine the effects of aerobic exercise on a number of secondary outcomes and determine whether aerobic exercise-related changes persist after a 1-year behavioural support programme (at 18 months). Discussion This study will address knowledge gaps regarding the underlying mechanisms of the pro-cognitive effects of exercise by examining the potential mediating factors, including cerebrovascular/physiological, neuroimaging, sleep, and genetic factors that will provide novel biologic evidence on how aerobic exercise can prevent declines in cognition with ageing. Trial registration ClinicalTrials.gov NCT03035851 . Registered on 30 January 2017
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    Understanding the Relationship Between Health Technology Reassessment and Knowledge Translation
    (2020-10-18) Esmail, Rosmin; Clement, Fiona M.; Hanson, Heather M.; Holroyd-Leduc, Jayna M.; Niven, Daniel J.
    Until now, it was not well understood how the field of Knowledge Translation (KT) would be applicable to Health Technology Reassessment (HTR). This thesis reports on three studies to determine how KT approaches are used to translate HTR outputs to achieve the desired outcomes. The first study was a scoping review of full-spectrum (phases of planning/design, evaluation, implementation, sustainability/scalability) KT Theories, Models, Frameworks (KT TMFs). Thirty-six KT TMFs were identified and categorized according to five approaches: process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. It provided a starting point for the selection of KT TMFs for HTR. The second study employed a modified Delphi process and expert survey to review the 36 full-spectrum KT TMFs and determined which may be suitable for HTR. The three-round modified Delphi process resulted in 16 KT TMFs. Twenty-two international experts (11 KT and 11 HTR) were surveyed. None of the 16 KT TMFs reached ≥ 70% agreement when ratings of “yes” were considered. However when ratings of “yes” and “partially yes” were combined, the Consolidated Framework for Implementation Research (CFIR) was considered the most suitable by both KT and HTR experts (86%). One additional KT TMF was selected by KT experts: the Knowledge-to-Action framework. HTR experts selected two additional KT TMFs: the co-KT framework and the Plan-Do-Study-Act cycle. The third study involved 13 one-to-one semi-structured interviews on characteristics of KT TMFs that were important to consider for the HTR outputs of decreased use or de-adoption of a technology. Four foundational principles, three levers of change, and five steps for knowledge to action emerged as KT TMF traits for HTR. From the KT TMFs that were mapped onto the characteristics, CFIR had the most characteristics (11/12) missing only the ability to map to the micro, meso, macro levels. This is the first body of work that examines the relationship between HTR and KT. The findings offer guidance to users on the application of KT TMFs to the HTR process and implementation of its outputs. Practical use of these KT TMFs to the HTR process will provide further advancement in this area.