Through the BETTER Trial, we developed and tested a unique, comprehensive and integrated approach to chronic disease prevention and screening at the patient level.

To assess the adaptability, sustainability and effectiveness of the Prevention Practitioner intervention in other settings, including rural and remote settings, the BETTER approach was expanded into the Northwest Territories and Newfoundland & Labrador, and disseminated in Alberta, Ontario and Nova Scotia.

The BETTER 2 Program engaged patients, clinicians, researchers and policy-makers to develop an integrated, comprehensive, longitudinal and sustainable approach to chronic disease prevention and screening within the various settings. The BETTER 2 team also adapted and refined the BETTER tools, maneuvers, and training resources in order to increase feasibility and sustainability of the approach.

The specific aims of the BETTER 2 Program were:

1. To expand the BETTER approach into three new jurisdictions and deepen the impact in the existing provinces by providing a framework, tools and resources to do chronic disease prevention and screening.
2. To further adapt, revise and tailor the BETTER individual patient-level chronic disease prevention and screening intervention including the survey, tools, maneuvers and resources to each setting including remote, rural and disadvantaged populations (such as aboriginal populations and populations with mental illness and substance abuse).
3. Evaluate the adapted BETTER individual patient intervention including a qualitative program evaluation of perceived effectiveness, facilitators and barriers, benefits and disadvantages in varied settings including remote, rural and disadvantaged populations.
4. Synthesize BETTER knowledge products for translation, dissemination and exchange.
5. To develop a sustainable coalition and linkages between primary care clinicians, researchers and policy-makers and evaluate the efforts of the Coalition for sustained work on chronic disease prevention and screening in primary care.

Each primary care setting wishing to implement the BETTER approach to chronic disease prevention and screening adapted the BETTER tools and approach to their setting and/or identified one or more personnel available to the practice to take on the role Prevention Practitioner. This individual:

• Developed skills in chronic disease prevention and screening
• Adapted the BETTER maneuvers and tools to their setting so that they are culturally relevant and sensitive
• Identified resources to integrate into the practice
• Developed a process within their setting for chronic disease prevention and screening
• Identified which patients are ideal to target in their setting
• Met with patients to develop individualized chronic disease prevention and screening prescriptions

More information about this implementation phase of the BETTER Program, can be found in our publications section.

For a downloadable version of the BETTER 2 Program Executive Summary, please click here.

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The BETTER 2 Program Team (2012 – 2015)

Principal Investigators: Dr. Donna Manca and Dr. Eva Grunfeld
Co-Investigators: Dr. Kris Aubrey-Bassler and Dr. Kami Kandola
Dissemination Leads: Dr. Catherine Cervin, Dr. Emily Marshall, Dr. Nandini Natarajan, Dr. Sarah Newbery.
Collaborators: P. Corcoran-Mooney, D. Gallant.
Methodology Working Group: E. Grunfeld (Co-Chair), D. Manca (Co-Chair), K. Aubrey-Bassler, V. Faria, K. Kandola, P. Krueger, C. Meaney, R. Moineddin, C. Nykiforuk, N. Sopcak.
Qualitative Methodology Working Group: N. Sopcak (Lead), C. Aguilar, L. Green, E. Grunfeld, P. Krueger, D. Manca, E. Marshall, C. Nykiforuk, M.A. O’Brien, G. Salvalaggio.
Clinical Working Group: D. Campbell-Scherer (Chair), K. Aubrey-Bassler, J. Carroll, V. Faria, E. Grunfeld, J. Inman, K. Kandola, D. Klein, C. Korownyk, L. Lyall, D. Manca, J. Mercer, J. Neudorf, G. Salvalaggio, G. Stagg-Sturge, M. Wilson.
Statistical Analysis: R. Moineddin, C. Meaney.
Program Coordination: C. Fernandes, J. Baxter, R. Cullen, V. Faria.
Research Assistant: M. Heatherington.
Students/Trainees: Y. Khakhuda, M. Lukasewich.