Chronic Diseases in Canada

Volume 27, No. 2, 2006

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Titles of Feature Articles

1. Population-based cohort development in Alberta, Canada: A feasibility study - View Abstract
   Heather Bryant, Paula J Robson, Ruth Ullman, Christine Friedenreich and Ursula Dawe

2. Patients' opinions on privacy, consent and the disclosure of health information for medical research - View Abstract
   Stacey A Page and Ian Mitchell

3. Statistical disease cluster surveillance of medically treated self-inflicted injuries in Alberta, Canada - View Abstract
   Rhonda J Rosychuk, Cynthia Yau, Ian Colman, Don Schopflocher and Brian H Rowe

4. The impact of a quit smoking contest on smoking behaviour in Ontario - View Abstract
   Fredrick D Ashbury, Cathy Cameron, Christine Finlan, Robin Holmes, Ethylene Villareal, Yves Décoste, Tanya Kulnies, Claudia Swoboda-Geen and Boris Kralj

5. Trends in mortality from ischemic heart disease in Canada, 1986–2000 - View Abstract
   Jinfu Hu, Chris Waters, Ann-Marie Ugnat, Jonathan Horne, Ian Szuto, Marie Desmeules and Howard Morrison

Chronic Diseases in Canada (CDIC) is a quarterly scientific journal focussing on current evidence relevant to the control and prevention of chronic (i.e. non-communicable) diseases and injuries in Canada. Since 1980 the journal has published a unique blend of peer-reviewed feature articles by authors from the public and private sectors and which may include research from such fields as epidemiology, public/community health, biostatistics, the behavioural sciences, and health services or economics. Only feature articles are peer reviewed. Authors retain responsibility for the content of their articles; the opinions expressed are not necessarily those of the CDIC editorial committee nor of the Public Health Agency of Canada.

Abstracts from Feature Articles in Chronic Diseases in Canada Volume 27, No 2, 2006

Article 1: Population-based cohort development in Alberta, Canada: A feasibility study

Authors: Heather Bryant, Paula J Robson, Ruth Ullman, Christine Friedenreich and Ursula Dawe

Abstract:

In a climate of increasing privacy concerns, the feasibility of establishing new cohorts to examine chronic disease etiology has been debated. Our primary aim was to ascertain the feasibility of enrolling a geographically dispersed, population-based cohort in Alberta. We also examined whether enrolees would grant access to provincial health care utilization data and consider providing blood for future analysis. Using random digit dialling, 22,652 men and women aged 35 to 69 years, without diagnosed cancer, were recruited. Of these, 52.4 percent (N=11,865) enrolled; 84 percent of Alberta communities were represented. Approximately 97 percent of enrolees consented to linkage with health care data, and 91 percent indicated willingness to consider future blood sampling. Comparisons between the cohort and the Canadian Community Health Survey (Cycle 1.1) for Alberta demonstrated similarities in marital status and income. However, the cohort had a smaller proportion who had not finished high school, a greater proportion of nonsmokers and a higher prevalence of obesity. These findings indicate that establishment of a geographically dispersed cohort is feasible in the Canadian context, and that data linkage and biomarker studies may be viable.

Article 2: Patients' opinions on privacy, consent and the disclosure of health information for medical research

Authors: Stacey A Page and Ian Mitchell

Abstract:

A structured survey of patients in three illness groups (acquired immune deficiency syndrome, multiple sclerosis and mental disorders) was undertaken to describe patients' perspectives on privacy, consent and the use of their health information for medical research. The survey was distributed by mail to subjects in the AIDS and MS groups and was completed in a clinic waiting room by people in the mental disorders group. Of the 478 patients approached for participation, 235 returned completed surveys (response rate 49.2 percent). Most subjects were concerned about privacy and they valued opportunities to provide consent for the use of their personal health information for research. Contextual factors, such as identification, type of illness and who was conducting the research, were important to individuals' preferences in granting consent. When health information was used specifically for research, the majority of subjects wanted to be asked for their consent unless anonymity was assured. Privacy and control over personal health information were important to patients in these groups. Patients prefer to be asked for research access to their health information.

Article 3: Statistical disease cluster surveillance of medically treated self-inflicted injuries in Alberta, Canada

Authors: Rhonda J Rosychuk, Cynthia Yau, Ian Colman, Don Schopflocher and Brian H Rowe

Abstract:

Routine surveillance of cases of disease can highlight geographic regions that need further study and intervention. Statistical disease cluster detection methods are one way to statistically assess the number of cases in administrative areas. Traditionally, disease cluster detection methods are used to monitor the incident cases of disease. We review a statistical cluster detection method that is applicable for regions with diverse administrative area population sizes. We apply the method to assess clustering of self-inflicted injury presentations to emergency departments in Alberta, Canada. Analyses focus on the pediatric population and are adjusted by the age and gender distributions of subregional health authorities. Fifteen clusters of self-inflicted injuries are identified and, based on age and gender distributions, the clusters are not likely chance occurrences. We believe that these clusters represent areas of excessive self-inflicted injury and that special intervention programs should be considered.

Article 4: The impact of a quit smoking contest on smoking behaviour in Ontario

Authors: Fredrick D Ashbury, Cathy Cameron, Christine Finlan, Robin Holmes, Ethylene Villareal, Yves Décoste, Tanya Kulnies, Claudia Swoboda-Geen and Boris Kralj

Abstract:

Community-based smoking cessation initiatives target large numbers of people, are highly visible and have the potential for great impact. Ontario's Quit Smoking (2002) Contest was evaluated one year after its implementation to measure behaviour change among adult smokers participating in the contest. The registration database of 15,521 contest participants provided the basis for a random sample of 700 participants throughout Ontario who were contacted for a follow-up telephone survey. A total of 347 surveys were completed, of which 60 percent were women. Almost one third (31.4 percent) of the survey respondents reported that they had not smoked since the start of the contest. Participation in the contest also may have delayed relapse by as much as five months for 31.3 percent of respondents who resumed smoking. Older respondents, men, those who had previously attempted to quit and people who said their cessation “buddy” was helpful were more likely to stop smoking.

Article 5: Trends in mortality from ischemic heart disease in Canada, 1986–2000

Authors: Jinfu Hu, Chris Waters, Ann-Marie Ugnat, Jonathan Horne, Ian Szuto, Marie Desmeules and Howard Morrison

Abstract:

This study examined trends in ischemic heart disease (IHD) mortality rates in Canada from 1986 to 2000, including analyses at the county level. The study population comprised Canadians aged 35 and over. Age-standardized mortality rates (ASMRs) were computed. Linear regression and Poisson regression were used to calculate average annual percentage change (AAPC) by age, sex, county and province. A substantial decrease in mortality rates was observed in those aged 35 and over for both sexes; the AAPC indicated a decline of 3.44 percent for males and 3.42 percent for females. The ASMRs were plotted for three time periods; the rates increased with each successive age group and decreased with each consecutive time period for both sexes. A significant decline in the IHD mortality rate was found in 47.2 percent and 46.9 percent of the counties among males and females, respectively; those counties had a statistically significant lower prevalence of daily smoking in both genders, and obese in females only. Only two counties showed a significant increase in the ASMRs of IHD in males and females, respectively. Enhanced prevention and control strategies should be considered to address IHD in countries where more modest decreases (or no decrease at all) in IHD mortality have been observed.