KNOWLEDGE
TRANSLATION

INTERVENING PSHYCHOSIS

Three to five years. This is considered to be the critical period following the first symptoms of psychosis, when recognition, intervention and timely treatments may have the most impact on a patient’s future.


“Evidence shows that early treatment of psychosis, from the first symptoms or episode, is very important in improving long-term outcomes,” explained Kelly Anderson, PhD, assistant professor with the Departments of Epidemiology and Biostatistics and Psychiatry at Schulich Medicine & Dentistry.


As an epidemiologist, Anderson is looking at mental health services from a population health perspective. Working with research collaborators at the Institute for Clinical Evaluative Sciences (ICES), she found that specialized programs for early psychosis can substantially reduce patient mortality.


She led a recent study, published in The American Journal of Psychiatry, which examined health administrative data for patients treated between 1997 and 2013 at the Prevention and Early Intervention Program for Psychoses (PEPP) at London Health Sciences Centre.


PEPP was one of North America’s first early psychosis intervention (EPI) programs, which use specialized care models that focus on early detection of psychosis to provide intensive treatment during the first two or three years of illness.


The study compared early psychosis patients at PEPP to those who were not treated through an early intervention program, focusing on patient outcomes within the first two years of diagnosis.


The research team found that patients being treated at PEPP experienced a four-fold reduction in risk of mortality. In addition, patients had rapid access to their first appointment with a psychiatrist, and experienced fewer emergency department visits and involuntary hospitalizations.


The findings demonstrate the importance of early intervention programs for patients.


“The aim of our study was to examine ‘real-world’ effectiveness of EPI programs in the context of the Ontario health care system,” said Anderson.


Anderson now hopes to expand her research beyond London, Ontario, and confirm the study’s findings across the province. “Our findings suggest clues on how we can make EPI programs even more effective in the future,” she said.


With continued focus on improving mental health services, Anderson and her research team are committed to translating knowledge for patient and community impact.

...Evidence shows that early treatment of psychosis, from the first symptoms or episode, is very important in improving long-term outcomes.

GETTING HOCKEY FIT

Dr. Rob Petrella has deployed a new system with the goal of getting men excited about being active.

Using fan culture around junior hockey to motivate men to exercise and eat healthy, the 12-week pilot program, Hockey Fans in Training (Hockey FIT), led to significant weight loss and improvements in the health of its participants.

...featured ‘off-ice’ hockey style drills to engage men through a strong sense of fandom.

Dr. Petrella teamed up with the Ontario Hockey League’s Sarnia Sting and London Knights to give participants access to arena facilities, and featured ‘off-ice’ hockey style drills to engage men through a strong sense of fandom.

Hockey FIT’s approach to change participant behaviours, such as inactivity and unhealthy eating, proved successful in the pilot project. A study of the results indicated that the 80 men in the program were 10 times more likely to achieve at least a five per cent weight loss versus the comparator group, and were more likely to improve their physical activity and healthy eating habits.

TRACKING TRANSMISSION

Art Poon, PhD, is combining approaches from mathematics, epidemiology, evolutionary biology and computer science to track HIV-1 transmission rates and detect outbreaks.

His pioneering computer system analyzes ‘genetic clusters’ and is able to generate outbreak management reports and data visualizations in almost real-time within days of a new diagnosis. Due to the ability of viruses like HIV-1 to rapidly evolve, Poon developed a program that is able to track changes in HIV transmission in different populations by detecting the various mutations.

If genetic clustering is done right it can improve public health responses, streamline costs and mobilize resources to high-risk areas in a timely manner. Poon’s automated system was used to monitor an HIV population treatment database in British Columbia, and the system recently detected an outbreak of transmitted HIV drug resistance, which led to a subsequent targeted public health response.

This work has allowed Poon to strengthen research knowledge implementation, and achieve an immediate impact on the health of individuals and populations.

...able to generate outbreak management reports and data visualizations in almost real-time within days of a new diagnosis.

IMPROVING CARE PATHWAYS

Lloy Wylie, PhD, and her team are advancing compassionate care for marginalized populations by creating educational initiatives and providing supports for health care staff.

Wylie received a grant from AMS Phoenix to scale up a project across Southwestern Ontario. Her team is specifically looking at improving equity in health care delivery for underserviced populations, including Indigenous, immigrant and refugee communities, as well as patients with mental illness.

They are creating a series of training tools and ways to engage health care providers to give them the skills necessary to ensure they feel confident in providing compassionate care to all patients.

Many immigrants, refugees and Indigenous people are reluctant to access health care services and instead use the emergency room as the point of entry once in a crisis. This work aims to create a more welcoming and compassionate hospital experience so these underserved populations will be more inclined to access appropriate health care at the right time.

looking at improving equity in health care delivery for underserviced populations...