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Study 13 – Funded by CIHR

ACHRU Community Partnership Program for Diabetes Self-management for Older Adults – Canada

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Study 1 Co-Leads: Andrea Gruneir and Kathryn  Fisher

This population-based analysis aims to identify the socio-demographic, health and health service use characteristics associated with high use of the emergency department among our target population. The analysis uses administrative data from the provinces of Ontario and Alberta. Study 1 results will provide a better understanding of the target population’s impact on resources, provincial and regional differences in impact, utilization patterns, and potential drivers of high emergency department use. This information in turn informs the recruitment of participants into the RCT (Study 2) as well as the analysis of the effects of the CPP and issues relating to the strategy for scaling up the intervention.

This cross-jurisdictional, multi-site pragmatic randomized controlled trial (RCT) will concurrently evaluate the implementation and effectiveness of the CPP in new settings and subgroups of the target population in Ontario, Quebec and Prince Edward Island. The goal is to demonstrate widespread effectiveness and ways to adapt the CPP for diverse population subgroups and primary and community care contexts.

This program of research was designed from the beginning with scale-up in mind, with the ultimate goal of developing a plan that provides a systematic and detailed strategy for large-scale implementation of the Community Partnership Program in each study province.
The plan will map the social, political and organizational environments in which the ACHRU-CPP can be scaled-up in each province. Ultimately, the scale-up plan will serve as a guidance document. Decisions regarding locations and organizations selected for early ACHRU-CPP adoption rest with policy- and decision-makers and organizations implementing the program. The scale-up plan will provide information to make initial scale-up decisions, tools to evaluate progress as scaling-up occurs, and activities that need to be undertaken to enhance and sustain future scale-up. The plan is the foundation to begin the scale-up process, recognizing that strategic planning will adjust as factors affecting scale-up are identified, implementation experience accumulates across settings and populations, and as health and social systems/structures change.