CAN-ADAPTT AGM 2010 : Population Approaches to Smoking Cessation in Canada

1. CAN-ADAPTT AGM 2010:Population Approaches to Smoking Cessation in Canada October 1st, 2010 Ottawa, Ontario

2. Welcome/Bienvenue While we wait to get started • Tell people who you are • What ‘hat’ you are wearing • What you hope to get out of today • Favourite vacation location • Name your table……a Fall theme…..

3. Introduction: CAN-ADAPTT Team • Jess Rogers – Manager • Rosa Dragonetti – Clinic manager • Janet Ngo – Coordinator, Western Canada • Tamar Meyer – Coordinator, Ontario • Katie Hunter – Coordinator, Atlantic Canada • Stephanie Elliott – Administrative Secretary • Dr. Peter Selby – Principal Investigator • Dr. John Garcia –Lead, system level interventions for cessation

4. Team Members • Executive Committee • Evaluation Committee • Opportunity to get involved • Guideline Development Group • Professional Advisory Committee • Opportunity to get involved

5. AGENDA 9:00-9:20 Introduction 9:20-10:00 Overview of CAN-ADAPTT progress 10:00-10:15 Setting the Stage - P.Selby 10:15-10:45 “Population approaches to tobacco use cessation programming and current capacity in Canada”- J.Garcia 10:45-11:00 Break 11:00-12:00 Small group discussion

6. AGENDA 12:00-12:30 Report back 12:30-1:30 Networking Lunch 1:30-1:45 Where do we go next? – J.Garcia 1:45-3:45 Small group discussion and report back 3:45-4:00 Closing remarks, Next steps - P.Selby and J. Rogers 4:30-6:00 Networking Reception

7. Objectives for Today • Learn about current status of CAN-ADAPTT project: • Engagement/Network Membership • Dissemination/Implementation Highlights • Version 2.0 Launch/Wiki Contribute to development of CAN-ADAPTT’s population/systems level standards for tobacco use cessation systems

8. CAN-ADAPTT • Unique guideline development and dissemination project • Practice informed approach • Practice Based Research Network (PBRN) • Dynamic • Online

9. Practice-informed • Research Agenda • Seed grants • Discussion board • AGM • National Network • Practitioners • Researchers • Policy-makers RESEARCH PRACTICE Canadian Clinical Practice Guideline • Knowledge Translation • Seed grants • Discussion board • Dissemination • & Engagement • Stakeholders • Professional Advisory Groups

10. Health Canada Funding • Funding provided by the Drugs and Tobacco Initiatives Program, Health Canada • 3 year funding • March 20, 2008 - March 31, 2011

11. Overview of CAN-ADAPTT Progress • Engagement and Network Membership • Dissemination/Implementation Highlights • Seed Grants and Research Agenda • Version 2.0 Launch

12. 1. Engagement and Network Membership

13. Timeline/Work Plan • March 2008: Focus on provider and practitioner organizations • March, 2009: Ontario coordinator • October, 2009: Western and Eastern coordinators • Spring, 2010: Engagement beyond providers • Fall, 2010: Quebec Coordinator

14. Network Membership • Multi-sectoral • Multi-disciplinary • National

15. Network Membership • Multi-sectoral • Multi-disciplinary • National Psychologist Physician OT/PT/Chiropractor Counselor/Therapist/Social Worker Respiratory Therapist/Asthma Educator Pharmacist Dental professional Nurse professional Number of Network Members • >700 members across Canada

16. Network Membership • Multi-sectoral • Multi-disciplinary • National

17. Member Survey: Reason for Joining the Network To gain access to CAN-ADAPTT’s guideline To get updates on tobacco control news and events To build relationships/collaboration with tobacco control professionals To contribute to promoting the adoption of the guideline To provide input into identifying knowledge gaps To conduct practice-informed research to address gaps % of participants who identified this reason as their reason for joining “to a great extent” (n=141)

18. Moving forward (targets for next 7 months) • Increase Network Membership • Professional representation • Increase regional reach • Launch Version 2.0 on Wiki Platform • Translate Version 2.0 in French and launch • Launch Version 3.0 • Engage Partners, Stakeholders in dissemination plan • Build sustainability around the Network, guideline and research agenda

19. 2. Dissemination/ Implementation Highlights

20. Dissemination/Implementation • National and provincial conferences • Exhibits, poster and oral presentations, workshops • Stakeholder engagement • Regional teleconferences, meetings, committee/coalition membership • Communications • Stakeholder articles, e-blasts, journals, listservs

21. Some sense of numbers….. 26Oral and poster presentations: To a variety of practitioner and academic audiences 17Exhibit tables: At a variety of practitioner conferences across Canada 5Workshops: Integrating CAN-ADAPTT guideline in practice/identifying barriers to implementation Plus, many upcoming dissemination opportunities confirmed and in development…

22. CAN-ADAPTT TRAVELS

23. Western Canada - Highlights Successes: • College of Registered Dental Hygienists of Alberta (CRDHA) • University of Alberta Dental Hygiene program Next steps: • engagement on applying the guideline

24. Key Successes Canadian and Ontario Association of Public Health Dentistry conference keynote, workshop Ontario Respiratory Care Society keynote, workshop Ontario - Highlights

25. Atlantic Canada – Highlights Key successes: • Significant increase in Atlantic Canada representation • Numerous collaborations/ connections established • across provinces/disciplines Next Steps: • Pursue workshop opportunities

26. Benefits of Joining Individuals & organizations Access to up-to-date clinical practice guideline Opportunities to contribute to the development of Canada’s first national CPG Links to a variety of resources including websites, projects, literature reviews and articles Updates on meetings/conferences A discussion board to connect with colleagues, share resources and comment on the guideline Disseminate and Implement the guideline

27. 3. Seed Grants and Research Agenda

28. CAN-ADAPTT Seed Grants • 23 applications received from across Canada; 12 funded • Applicants: researchers, practitioners, and collaborations of both. Topic Themes Disciplines Proposed Products • Optometry • Women’s • health • Addictions • Mental health/ • psychiatry • Health • sciences • Specific • populations • Role of HCPs • Counselling • Capacity and • theory building • Scientific publications • Academic posters • Grant proposals • Collaborative • meetings

29. Development of a Practice-Informed Research Agenda • CAN-ADAPTT Executive committee • September 2010 • February 2011 CAN-ADAPTT Network feedback Existing guidelines* • April 2010 (member survey) • October 2010 (AGM) • Ongoing (discussion board) Comprehensive literature search* • Feedback from stakeholders and collaborating organizations • Ongoing Research Agenda Organizational reports* CAN-ADAPTT network feedback* Health Canada submission March 2011 Summer 2010 version Fall 2010 version Winter 2011 version March 2009-June 2010 June 2010- March 2011 * Details in following section www.can-adaptt.net Updated: June 30, 2010

30. 4. Version 2.0 Launch

31. Scope of CAN-ADAPTT

32. Clinical Practice Guideline • Sections Launched • Counselling • Hospital based populations • Youth (Child and Adolescents) • Pregnant and Breastfeeding Women • Mental Health and Other Addictions • Aboriginal Peoples • Upcoming Launches • Pharmacotherapy • Levels of evidence/grade of recommendation

33. Guideline Development Group • Gerry Brosky, MD (Counselling) • Alice Ordean, MD (Pregnant and Breastfeeding Women) • Peter Selby, MBBS/ Charl Els, MBChB (Mental Health and Addictions) • Sheila Cote-Meek, PhD (Aboriginal) • Bob Reid, PhD (Hospital-based) • Jennifer O’Loughlin, PhD (Youth) • Paul McDonald, PhD (Pharmacotherapy)

34. Guideline Development Process

35. Guideline Development Process • Applied principles of ADAPTE….. • Review existing smoking cessation CPGs (internationally and across disciplines) • CPGs rated using the AGREE instrument • Highest-scoring CPGs were used • Sections subject to ongoing input by CAN-ADAPTT network (PBRN, partners etc.)

36. Version 2.0 TODAY Version 2.0

37. Structure of the guideline • Background and Evidence Overview • Summary Statements • Clinical Considerations • Tools and Resources • Future Research Suggestions for Review Suggestions for Review CAN-ADAPTT Network Direct input Direct input Direct input

38. Levels of Evidence/Grade of Recommendations • Summary statements are rated based on the GRADE system • Required consensus of the Guideline Development Group GRADE system of Ratings High Grade of Recommendation Low Weak Strong Level of Evidence

39. Next Steps for the guideline • Continue to build clinical considerations • Use of a wiki platform • GDG and network involvement • Continue engagement and dissemination • Integrate outcomes of today’s workshop to create Version 3.0 • Launch date: January 2011

40. 2.2 Next Steps: Online engagement Website New (internal) provider New website – launching winter 2010 Wiki platform Launched for AGM (Oct 1) Twitter Launching in October

41. Objective for today…. Inform CAN-ADAPTT’s guideline on population level approaches for tobacco use cessation

42. “Setting the Stage” Dr. Peter Selby Principal Investigator, CAN-ADAPTT

43. Setting the Stage… • Opportunity for collaborative approach in developing key principles for an effective smoking cessation system in Canada • Identifying gaps and ways to work together

44. Society Behaviour and Biology: Making the Case for EBB interventionsT.A. Glass, M.J. McAtee / Social Science & Medicine 62 (2006) 1650–1671

45. The Smoking Environment in Canada • About one in five Canadians (5.7 million) 12yrs or older, are daily or occasional smokers* • Average cigarettes smoked per day = 13.3** • 37,000 Canadians die from smoking per year • 100 infants/year • 1 in 5 deaths are due to smoking • 1 in 2 smokers die from smoking-related diseases * Canadian Community Health Survey (Statistics Canada), 2010 **CTUMS 2009

46. Burden of Addiction • Smoking rates are higher among: • Young adults • Less than high school education • Blue collar • Mentally ill • Aboriginal • Poor

47. Never too late to Quit Quitting smoking at any age may increase life expectancy • Quitting smoking before age 30 = normal life expectancy

48. Hard things to do….large benefits to doing them…. “Smoking cessation is a critical aspect of the management of many chronic diseases, both in terms of treatment outcome, progression of disease, comorbidities, quality of life, and survival.” (Gritz et al., 2007)

49. Providing Smoking Cessation • Many Providers • Physicians, RNs, NPs, Dental Hygenist, Assistants, Opthalmologists, Chiropractors, Pharmacists, Social Workers, Mental Health Counselors, RTs, etc…. • Many Settings • Hospital, Primary Care, Community, Long term care, Specialty Care, etc. • Opportunities!!!!

50. Levers and Opportunities Training of HCPs Research Funding: programs Mass Media Guidelines Provider tools/resources Engage community Policy Patient/client tools Incentives Clinical Strategies (5A’s, Ottawa Model) Priority Setting Public/Consumers Funding: pharmacotherapy Existing programming Partnerships Opinion leaders/Champions