2015-03-10, Grégoire, Jean-Pierre, Guillaumie, Laurence, Giguère, Gabriel, Lauzier, Sophie, Moisan, Jocelyne, Guénette, Line

Purpose: The purpose of this study was to elicit patients' beliefs about taking their oral antidiabetic drugs (OADs) as prescribed to inform the development of sound adherence-enhancing interventions. Methods: A qualitative study was performed. Adults with type 2 diabetes who had been taking an OAD for >3 months were solicited to participate in one of six focus groups. Discussions were facilitated using a structured guide designed to gather beliefs related to important constructs of the theory of planned behavior. Four coders using this theory as the theoretical framework analyzed the videotaped discussions. Results: Forty-five adults participated. The most frequently mentioned advantages for OAD-taking as prescribed were to avoid long-term complications and to control glycemia. Family members were perceived as positively influential. Carrying the OAD at all times, having the OAD in sight, and having a routine were important facilitating factors. Being away from home, not accepting the disease, and not having confidence in the physician's prescription were major barriers to OAD-taking. Conclusion: This study elicited several beliefs regarding OAD-taking behavior. Awareness of these beliefs may help clinicians adjust their interventions in view of their patients' beliefs. Moreover, this knowledge is crucial to the planning, development, and evaluation of interventions that aim to improve medication adherence.

2020-03-14, Guillaumie, Laurence, Santina, Tania, Gagné, Camille, Beaulieu, Dominique

The present study aimed to evaluate the efficacy of a theory- and evidence-based intervention for promoting physical activity (PA) among children by changing PA-related psychosocial variables and reducing obesity and screen time outside school hours. A cluster randomised trial was conducted on two Lebanese elementary schools involving 374 children aged 10–12 years. While a control group received the standard curriculum, an intervention group received a 14-week school-based intervention comprising changes in the school environment, increased opportunities for PA provided by educational staff and PA-related learning activities. Measures included PA, psychosocial and obesity-related variables [body mass index (BMI), waist circumference and screen time outside school hours]. Measures were evaluated before the first week and in the last week of the intervention. Compared with the control group, significant increases were observed in the general PA levels and proportion of physically active children within 1 week. The proportion of children engaged in ≥30-min daily school-based moderate-to-vigorous PA MVPA increased from 0% to 67%. The intervention group showed significant improvement in almost all psychosocial variables. The children’s BMI class and waist circumference significantly reduced with the intervention. The intervention was effective in increasing the children’s general PA levels and school-based MVPA and in decreasing BMI and waist circumference.

2016-04-01, Grégoire, Jean-Pierre, Guillaumie, Laurence, Zomahoun, Hervé Tchala Vignon, Lauzier, Sophie, Moisan, Jocelyne, Guénette, Line

Understanding the process behind noninsulin antidiabetic drug (NIAD) nonadherence is necessary for designing effective interventions to resolve this problem. This study aimed to explore the ability of the theory of planned behavior (TPB), which is known as a good predictor of behaviors, to predict the future NIAD adherence in adults with type 2 diabetes. We conducted a prospective study of adults with type 2 diabetes. They completed a questionnaire on TPB variables and external variables. Linear regression was used to explore the TPB's ability to predict future NIAD adherence, which was prospectively measured as the proportion of days covered by at least 1 NIAD using pharmacy claims data. The interaction between past NIAD adherence and intention was tested. The sample included 340 people. There was an interaction between past NIAD adherence and intention to adhere to the NIAD (P = 0.032). Intention did not predict future NIAD adherence in the past adherers and nonadherers groups, but its association measure was high among past nonadherers (β = 5.686, 95% confidence interval [CI] -10.174, 21.546). In contrast, intention was mainly predicted by perceived behavioral control both in the past adherers (β = 0.900, 95% CI 0.796, 1.004) and nonadherers groups (β = 0.760, 95% CI 0.555, 0.966). The present study suggests that TPB is a good tool to predict intention to adhere and future NIAD adherence. However, there was a gap between intention to adhere and actual adherence to the NIAD, which is partly explained by the past adherence level in adults with type 2 diabetes.

2020-02-24, Guillaumie, Laurence, Boiral, Olivier, Yuriev, Alexander

Purpose – The aim of this study was to identify and quantitatively assess the importance of psychosocial and organizational factors that influence employees’ intentions to engage in pro-environmental behaviors at the workplace. Design/methodology/approach – A questionnaire based on the theory of planned behavior was completed by 318 employees. To validate three suggested hypotheses, a series of path analysis models were constructed using AMOS software. Findings – The theory of planned behavior explained 79 percent and 37.7 percent of variance in predicting intentions of employees to travel to work using alternative transportation and to make eco-suggestions directed toward the workplace, respectively. While organizational barriers did not play a significant role in predicting intentions to use alternative transportation, some organizational obstacles (opinion of colleagues, required paperwork) influenced workers’ intention to make eco-suggestions. Originality/value – This is one of the first articles in the field of pro-environmental workplace behaviors in which the theory of planned behavior is implemented in a systematic manner (qualitative exploration of beliefs followed by their quantitative evaluation). This article contributes to the existing literature by shedding light on the disproportionate influence of organizational and psychosocial factors on pro-environmental workplace behaviors

2020-05-08, Vézina-Im, Lydi-Anne, Guillaumie, Laurence, Turcotte, Stéphane, Boucher, Danielle, Douville, Frédéric, Beaulieu, Dominique

Objective: To identify correlates and underlying beliefs regarding the adolescents’ intention to abstain from consuming sugar-sweetened beverages (SSB) and the consumption of ≤1 daily portion of SSB. Design: Correlational study. Setting: Region of Chaudière-Appalaches in the province of Quebec, Canada. Participants: 311 adolescents aged 13–18 years completed a self-administrated online questionnaire based on the Reasoned Action Approach. Frequency and quantity of different types of SSB within the past month were measured. Results: Total mean SSB intake was 882·6 ml/d (654·0 kJ/d ). Only 11·3 % abstained from SSB within the last month. Intention to abstain from SSB was explained by identification as SSB abstainers ( β = 0·47), perceived norm ( β = 0·32), attitude ( β = 0·30), age 13–14 years ( β = –0·27) and perception of the school environment ( β = 0·14), which explained 66 % of the variance. Consumption of ≤1 daily portion of SSB was explained by the intention to abstain (OR = 1·55; 95 % CI 1·14, 2·11), perceived behavioural control to abstain (OR = 1·80; 95 % CI 1·29, 2·52), sex (girls v. boys: OR = 2·34; 95 % CI 1·37, 3·98) and socio-economic status (advantaged v. disadvantaged school: OR = 2·08; 95 % CI 1·21, 3·56). Underlying beliefs (i.e. more energy, decreased risk of addiction and friends’ approval) associated with intention as well as perceived barriers (e.g. access to SSB, after an activity that makes you thirsty), and facilitating factors (e.g. access to water) linked to SSB consumption were identified. Conclusions: The results can inform public health interventions to decrease SSB consumption and their associated health problems among adolescents.

2017-02-14, Guillaumie, Laurence, Boiral, Olivier, Heras-Saizarbitoria, Iñaki, Tayo Tene, Christian Valery

The objective of this paper is to analyze the adoption and outcomes of the ISO 14001 standard through a systematic review of the main studies on this issue published in peer-reviewed journals between 1996 and 2015. The 94 papers analyzed make it possible to paint a comprehensive picture of the effectiveness of ISO 14001 in environmental management practices, performance in this area and social aspects such as employee awareness. The systematic review also sheds more light on the main pitfalls and success factors of the standard. Nevertheless, the similarities and even redundancies of the literature in terms of objectives, approaches and methods used tend to produce quite predictable and optimistic results, which do not reflect the complexity of the impact of ISO 14001. The paper highlights the importance of more diverse and critical approaches that might challenge the successful rhetoric of the dominant literature, which tends to focus on positive aspects and be limited to a few countries that are not representative of the wide international distribution of certification. The findings of this systematic review can also help managers in making decisions on the adoption and renewal of certification.

2018-05-02, Grégoire, Jean-Pierre, Guillaumie, Laurence, Gagnon, Hélène, Villeneuve, Denis, Santina, Tania, Lauzier, Sophie, Moisan, Jocelyne

Objective: To describe the development of a community pharmacy-based intervention aimed at optimizing experience and use of antidepressants (ADs) for patients with mood and anxiety disorders. Methods: Intervention Mapping (IM) was used for conducting needs assessment, formulating intervention objectives, selecting change methods and practical applications, designing the intervention, and planning intervention implementation. IM is based on a qualitative participatory approach and each step of the intervention development process was conducted through consultations with a pharmacists’ committee. Results: A needs assessment was informed by qualitative and quantitative studies conducted with leaders, pharmacists, and patients. Intervention objectives and change methods were selected to target factors influencing patients’ experience with and use of ADs. The intervention includes four brief consultations between the pharmacist and the patient: (1) provision of information (first AD claim); (2) management of side effects (15 days after first claim); (3) monitoring treatment efficacy (30-day renewal); (4) assessment of treatment persistence (2-month renewal, repeated every 6 months). A detailed implementation plan was also developed. Conclusion: IM provided a systematic and rigorous approach to the development of an intervention directly tied to empirical data on patients’ and pharmacists’ experiences and recommendations. The thorough description of this intervention may facilitate the development of new pharmacy-based interventions or the adaptation of this intervention to other illnesses and settings.

2016-10-19, Grégoire, Jean-Pierre, Zongo, Arsène, Guillaumie, Laurence, Lauzier, Sophie, Moisan, Jocelyne, Guénette, Line

Objective: To assess the internal consistency and factorial validity of the adapted French 8-item Morisky Medication Adherence Scale in assessing adherence to noninsulin antidiabetic drug treatment. Study Design and Setting: In a cross-sectional web survey of individuals with type 2 diabetes of the Canadian province of Quebec, self-reported adherence to the antidiabetes drug treatment was measured using the Morisky Medication Adherence Scale-8. We assessed the internal consistency of the Morisky Medication Adherence Scale-8 with Cronbach’s alpha, and factorial validity was assessed by identifying the underlying factors using exploratory factor analyses. Results: A total of 901 individuals completed the survey. Cronbach’s alpha was 0.60. Two factors were identified. One factor comprised five items: stopping medication when diabetes is under control, stopping when feeling worse, feeling hassled about sticking to the prescription, reasons other than forgetting and a cross-loading item (i.e. taking drugs the day before). The second factor comprised three other items that were all related to forgetfulness in addition to the cross-loading item. Conclusion: Cronbach’s alpha of the adapted French Morisky Medication Adherence Scale-8 was below the acceptable value of 0.70. This observed low internal consistency of the scale is probably related to the causal nature of the items of the scale but not necessarily a lack of reliability. The results suggest that the adapted French Morisky Medication Adherence Scale-8 is a two-factor scale assessing intentional (first factor) and unintentional (second factor) non-adherence to the noninsulin antidiabetes drug treatment. The scale could be used to separately identify these outcomes using scores obtained on each of the sub-scales.

2019-01-01, Vermette, Sarah, Bujold, Louise, Guillaumie, Laurence, Bujold, Mathieu, Pelletier, Jérôme, Lauzier, Sophie, Martin, Elisabeth

Background and Purpose: The increasing prevalence of chronic diseases is driving health care systems to rethink their operations. Despite numerous studies supporting the advantages of primary health care nurse practitioners (PHCNPs) in chronic disease management, implementing practices that fully utilize the skills of these practitioners seems impeded in the Canadian province of Québec. This study explores the views of leaders involved in primary health care regarding the contributions PHCNPs can make in chronic disease management and the challenges they face in doing so. Methods: Through semi-structured interviews, an exploratory descriptive qualitative study was conducted with 20 key informants across Québec who hold a variety of professional positions connected to PHCNPs. Conclusions: PHCNPs were perceived to be able to improve self-management support for chronic diseases. In reality, however, PHCNPs are mainly devoting their time to clientelein acute care, and current regulations governing their practices limit their involvement in chronic disease management.Implications for Practice: Integrating PHCNPs offers a unique opportunity for health care settings to redefine the roles of family physicians and registered nurses and to restructure practices toward a chronic disease-oriented system. A clinical manager should be designated to monitor this re-structuring process and ensure its success.

2018-02-09, Grégoire, Jean-Pierre, Guillaumie, Laurence, Ndayizigiye, Alice, Lauzier, Sophie, Beaucage, Clément, Villeneuve, Denis, Moisan, Jocelyne

Objectives : Patients prescribed antidepressant drug treatment (ADT) for major depression report several needs in relation to their treatment, and a large proportion of these patients will end ADT prematurely. Community pharmacists may play an important role in monitoring ADT and supporting these patients. However, little is known about patient experiences of the services provided in community pharmacies. The objectives of this study were to 1) explore patients’ experiences with the services community pharmacists provide for ADT and 2) identify potential avenues for improvement of pharmacists’ services within the context of ADT. Methods : A qualitative descriptive exploratory study was conducted among individuals diagnosed with major depression who had initiated ADT at some point in the 12 months prior to their participation in the study. A total of 14 persons recruited in a local health centre and a community-based organization participated in individual interviews. A thematic analysis of the interview transcripts was conducted. Results : Pharmacists tend to concentrate their involvement in treatment at initiation and at the first refill when questions, uncertainties and side effects are major issues. Patients felt that the pharmacists’ contributions consisted of providing information and reassurance; in these respects, their needs were met. Participants had few ideas as to what additional services pharmacists could implement to improve patients’ experience with ADT. Patients’ sole expectations were that pharmacists extend this information role to the whole length of the treatment and enhance the confidentiality of discussions in pharmacy. Conclusion : Pharmacists should provide counselling throughout the entire treatment rather than passively waiting for patients to ask their questions. However, facilitation of open discussions may not be achieved unless confidentiality at pharmacies is secured.