a1.2 what gets counted counts_catherine birken
DESCRIPTION
Prevent More to Treat Less | Public Health and Primary Health Care Together conference - PresentationTRANSCRIPT
TARGet Kids! Practice Based Primary Care Research Network
Catherine S Birken MD, MSc, FRCPC
Disclosure of Commercial Support CFPC Conflict of Interest
Presenter Disclosure Presenters: Catherine Birken, Richard Birtwhislte, Irfan Dhalla, Ruth Sanderson, Mari Teitelbaum, Karen Tu Relationships with commercial interests: • Grants/Research Support: None • Speakers Bureau/Honoraria: None • Consulting Fees: None • Other: None
Faculty/Presenter Disclosure
• Presenter: Catherine Birken
• Relationships with commercial interests: – None
CFPC CoI Templates: Slide 1
Practice Based Research Network www.targetkids.ca
Practice Embedded Data Collection
LABORATORY SERVICES Mount Sinai Services
DATA MANAGEMENT SYSTEM
Applied Health Research Centre
Secure web-based data management using
Medidata RAVE™ software
Primary Healthcare Practice Age newborn to 5 years
Height, weight, BMI waist circumference,
blood pressure, head circumference,
parent BMI
Questionnaires
Laboratory tests
A research assistant trained in phlebotomy is embedded in each practice site
Village Park Paediatrics Dr. Eddy Lau
Dr. Brian Chisamore Dr. Sharon Naymark
Tarandeep Malhi (RA)
Clairhurst Paediatrics
Dr. Michael Peer Dr. Sheila Jacobson Dr. Carolyn Taylor
Subitha Rajakumaran (RA)
Danforth Paediatrics A
Dr. Patricia Neelands Dr. Janet Saunderson
Dr. Anh Do Laurie Thompson (RA)
Danforth Paediatrics B
Dr. Marty Perlmutar Dr. Karoon Danayan Dr. Alana Rosenthal
Juela Sejdo (RA)
St Michael’s Hospital 410 Sherbourne Family Medicine
Clinic Dr. Susan Shepherd
Nadia Kabir (RA)
Research Leads: Dr. Patricia Parkin
Dr. Catherine Birken Dr. Jonathon Maguire
Research Managers/Coordinators:
Kanthi Kavikondala Matthew D’Ascanio
Steering Committee: Dr. Mark Feldman
Dr. Moshe Ipp Dr. Brian Chisamore Dr. Tony Barozzino
LABORATORY SERVICES Mount Sinai Services
Dr. Azar Azad
DATA MANAGEMENT Applied Health Research Centre
Dr. Muhammad Mamdani Magda Melo Kevin Thorpe
Dr. Gerald Lebovic Yang Chen
St Michael’s Hospital Pediatric Ambulatory
Clinic Dr. Tony Barozzino Dr. Michael Sgro
Dr. Sloane Freeman Tonya D’Amour (RA)
St Michael’s
Hospital 80 Bond Street
Family Medicine Clinic
Dr. Nav Persaud Richa Kukkar (RA)
Humber Paediatrics
Dr Peter Wong Dr Robert Lau
Dr Barbara Smiltnieks Dr Keewai Fung
Dr Michael Dorey
A Platform for Surveillance of Growth and Behaviour Trajectories
Time Gro
wth
and
Hea
lth B
ehav
iour
s
Building Linkages
Instrument Schedule NHQ NS IBQ ECBQ CBQ NDDS ITC PSI
0 weeks
1 month
2 months
4 months
6 months
9 months
12 months
15 months
18 months
2 years
3 years 4 years
5 years
6+ years
A Platform for Randomized Trials
rand
omize
Group A Group B
Total (N = 5062)
Demographics Frequency (N, %) Median (Range) Child’s age, months 0 - < 1 years 1 - < 3 years 3 - < 6 years
511 (10.1) 2441 (48.3) 2110 (41.7)
25 (0.2 – 72)
Child’s sex, male 2646 (52.3) Mother’s place of birth In Canada Outside of Canada Missing
3144 (62.1) 1707 (33.7) 211 (4.2)
Child Health Child’s zBMI Underweight (z < -1) Normal weight (-1≥ z ≤1)
681 (13.5) 3143 (62.1)
0.1 (-4.7 – 6.2)
Overweight (1> z ≤2) 708 (14.0) Obese (z > 2) 225 (4.4) Missing 305 (6.0)
Breastfeeding duration, months 10 (0 – 48) 0 – 6 months 901 (17.8) 6 – 12 months 2274 (44.9) 12 – 24 months 24 months + Never Missing
1103 (21.8) 149 (2.9) 353 (7.0) 282 (5.6)
Baseline Characteristics of TARGet Kids! Cohort
Cardiovascular risk associated with eating behaviours during early childhood
CMAJ, 2013
Intervention: 10 minute ‘doc talk’ at 3 year old visit reduce screen time remove screen from bedroom turn off TV during meals
Approaches to Data Collection
•
Characteristics
Canadian Health Measures Survey
Electronic Medical Records
Practice Based Research Network
Representative National ?RegionalNational LocalRegional National
Sample size Small Large Large
Age Excludes 0-3 All who attends All recruited
Design Cross-sectional Longitudinal Longitudinal
Measure Health outcomes
Yes Limited Yes
Evaluate Interventions
Limited Health system Interventions
Trials
Health behaviours
Yes Limited Yes
• Large sample young children • Embedded data collection and
knowledge translation • Platform for Surveillance and Trials • Scale up to sentinal sites • Complements other data sources
TARGet Kids! Summary
Practice Based Research Network www.targetkids.ca