BETTER Life Study

Emerging evidence from the BETTER HEALTH: Durham study supports the need for exploration of adaptation of the BETTER HEALTH intervention for younger adults living with low income.   People with lower income are more likely to be smoking, physically inactive, and lacking in fruit and vegetable consumption than those with higher income and thus are more likely to develop multiple chronic conditions earlier.

The goal of the BETTER Life study is to learn if the BETTER HEALTH: Durham program, which has been shown to help people 40-64 years take steps to prevent chronic disease, can be adapted for younger persons ages 18 to 39 years.  We will focus on selected priority health neighbourhoods in the Durham Region of Ontario (identified by the Durham Region Health Department and community partners) and request feedback from eligible community residents.  We will also ask community residents to participate in adapted prevention practitioner visits to determine whether sessions are acceptable to them as a means of addressing chronic disease prevention and screening needs. The study builds on existing infrastructure of the BETTER program, the BETTER HEALTH: Durham research team, community advisory committee, and primary care group from the BETTER HEALTH: Durham study.

Specific study Objectives:

The BETTER Life study will:

  1. seek to understand individual, interpersonal and structural-level barriers to chronic disease prevention for younger adults living with low income using qualitative interviews and focus groups;
  2. adapt the BETTER HEALTH intervention based on these interviews and focus groups with younger adults as well as key stakeholders in multiple provinces (Ontario, Alberta, Newfoundland & Labrador;
  3. conduct acceptability testing of the adapted intervention with a small number of younger adults with low income in preparation for a future randomized trial.

Considerations          

Current restrictions from the COVID-19 pandemic may not allow for in-person recruitment strategies, data collection or prevention practitioner visits.  The BETTER Life research team will follow all Public Health guidelines for the Covid-19 pandemic and/or hold meetings virtually if in-person gatherings are not allowed.

Funding and timeline

This research is supported by a Canadian Institutes for Health Research (CIHR) catalyst grant and will be implemented between March 2020 and March 2022.

The BETTER Life is a study led by researchers at Women’s College Hospital, the University of Toronto, Sunnybrook Health Sciences Centre, St. Michael’s Hospital, University of Alberta, Memorial University, and Durham Region Health Department.

Learnings

The BETTER Life study’s timelines were shifted to accommodate emerging healthcare priorities during the COVID19 pandemic. As a result, the study’s research phases were completed between October 2021 and November 2023:

  • Phase 1 – Explore and learn: October 2021 to November 2022
  • Phase 2 – Adapt intervention: April 2022 to March 2023
  • Phase 3 – Test for acceptability: April 2023 to November 2023

To learn more about the learnings gleaned from this project, read the 2023 BETTER Life Acceptability Report: Views of Participating Community Residents and Prevention Practitioners.

For more information about the BETTER Life study, please contact project lead Dr. Aisha Lofters at Aisha.lofters@wchospital.ca