Launching the Program
Developed for primary care settings, the BETTER Program is a proactive approach to cancer and chronic disease prevention and screening that can be adapted to diverse settings, from solo practitioners to large multi-disciplinary teams, and provides a framework for healthcare professionals to come together in the shared goal of improving prevention efforts.
The BETTER approach to chronic disease prevention and screening transforms clinical practice by providing evidence-based, comprehensive tools and resources that can be used to address the root causes of multiple chronic diseases, resulting in a shift from disease management to proactive prevention.
Frontline healthcare professionals such as nurses, dietitians, and pharmacists, and public health nurses work collaboratively with primary care providers to deliver the best care to patients. However, in health systems where the focus is chronic disease management, it is often difficult for primary care providers to address cancer and chronic disease prevention comprehensively due to a lack of time and resources.
A health care professional who is a member of the practice or linked in to the practice receives training in the BETTER approach, becoming your “prevention expert” or BETTER Prevention Practitioner™. Using the BETTER tools, which are based on the best available clinical evidence, the Prevention Practitioner meets with patients one-on-one, informs them about their chronic disease risk, and determines what their recommended prevention and screening action(s) are based on factors such as personal medical history, family history, and lifestyle behaviour.
Through shared decision-making and S.M.A.R.T. (specific, measurable, attainable, realistic, time-based) goal setting, the Prevention Practitioner develops a “Prevention Prescription” with each patient, tailored specifically to their needs and chronic disease risk. Links to other health care professionals, practice and community resources may be made to help patients achieve their health goals.
Communication between Prevention Practitioners and primary care providers is key to this approach since patients are referred back to their primary care provider as needed – in cases where possible elevated risk has been identified (e.g. first-degree relative with genetic mutation) or where follow-up is needed (e.g. elevated blood sugar levels). The Prevention Prescription also becomes a part of the patient’s chart so that it can inform the patient’s ongoing clinical care.
“I believe ongoing communication with the patient’s physician (or other primary health care provider, depending on the clinic setting) [is] key to the success of the program as the Prevention Practitioner and physician need to be on the ‘same page’ in order for the patient to continue to set health related goals and maintain healthy behaviours.”
Dawn Gallant RN, Prevention Practitioner
The Prevention Practitioner is an individual identified by a primary care setting, who receives training in the BETTER approach in order to become a cancer and chronic disease prevention and screening resource to their setting. Using the BETTER tools, Prevention Practitioners are able to engage patients as active participants in their health and create a personalized prevention plan with them that links them to resources in their community.
Completing the Training
To take on the role of BETTER Prevention Practitioner™, the chosen health care professional working in a primary care setting or linked with primary care would receive training on the BETTER approach to cancer and chronic disease prevention and screening. This involves 2-3 days of training led by a BETTER Master Trainer (13 hours of continuing education). Training provides an opportunity for health care providers to:
Develop an understanding of the BETTER approach to chronic disease prevention and screening and how it can be adapted.
Learn about the best available clinical evidence and how it determines the prevention and screening actions that should and should not be recommended for each patient using the BETTER Care Map.
Learn how to support patients in S.M.A.R.T. goal setting.
Role play the BETTER Prevention Practitioner™ role through patient cases.
Identify practice and community resources that could be used in your setting to help patients achieve their health goals.
Consider what outcome measures could be used to monitor and evaluate prevention and screening activities in your practice.
Sessions are available across Canada and can accommodate up to 8 trainees per session.Find out more
After the Training
Once your Prevention Practitioner has completed training, they will have the tools needed to start seeing patients one-on-one for prevention visits. However, in order to incorporate the BETTER Program into your current workflow, you may need to think about whether any changes will need to be made to accommodate this new resource.
You may choose to work with your Prevention Practitioner and other members of your team to decide how the Prevention Practitioner and their new expertise could best be used to enhance your cancer and chronic disease prevention and screening efforts. Some items to consider are:
Who is your target patient population (e.g. all 40-69 year olds, 40-69 year olds who smoke, etc.)?
How will you invite patients for prevention visits?
Are any adaptations needed for BETTER to work in your setting?