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OBJECTIVE: The Respiratory Health Strategic Clinical Network (RHSCN) was launched to facilitate respiratory and sleep health through implementation of innovative, patient-centred, evidence-informed coordinated services in Alberta. In collaboration with project partners, the RHSCN aimed to determine the respiratory research priorities for Alberta. DESIGN: The four phases of this research prioritisation project were (1) identifying research questions from stakeholders, (2) determining which research questions had been answered in existing literature, (3) prioritising unanswered questions and (4) finalising the priorities through an inperson workshop. SETTING: The study occurred in Alberta, Canada over a 2-year period beginning in March 2017. PARTICIPANTS: A total of 448 patients, clinicians and other stakeholders consented to participate in the survey. RESULTS: A total of 595 possible questions were submitted, with 343 unique questions identified. Of the questions, 94 were out of scope, 155 answered by existing literature and 10 were combined with others, while 83 were determined to be unanswered in the literature. Stakeholders were surveyed again to prioritise the remaining 83 questions and they were reviewed by the project's Steering Committee (clinicians and patients). At the inperson workshop, the Steering Committee identified 17 research topics as priority areas for respiratory and sleep research in Alberta. CONCLUSION: A stakeholder-led research prioritisation process identified optimal clinical management/follow-up, equitable access to services, and management of social, psychological and mental health issues related to respiratory/sleep health as priority research areas.

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The patient engagement (PE) platform staff of Alberta Strategy for Patient Oriented Research Support for People and Patient Oriented Research Trials Unit developed a patient-powered PE network called Albertans for Health Research Network (AB4HR); an enhanced tool to better connect patient partners and researchers online. AB4HR was developed in response to an identified need-a user-friendly online forum for both patient partners and researchers to access, so that they can better work together, as partners, in health research. We codesigned AB4HR and identified ways to improve the form, fit, and function of an existing registry through discussion groups with patient partners and researchers. We found 3 main themes derived from the perspective shared by patient partners and researchers. Patient partners and researchers agreed that the existing registry provides a forum to connect with one another in an easy, low-barrier way. However, there were opportunities for improvement with AB4HR, including possibilities for greater interaction between patient partners and researchers to promote more collaborative partnerships.

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PLAIN ENGLISH SUMMARY: The Alberta Depression Research Priority Setting Project aimed to meaningfully involve patients, families and clinicians in determining a research agenda aligned to the needs of Albertans who have experienced depression. The project was modeled after a process developed in the UK by the James Lind Alliance and adapted to fit the Alberta, Canada context. This study describes the processes used to ensure the voices of people with lived experience of depression were integrated throughout the project stages. The year long project culminated with a facilitated session to identify the top essential areas of depression research focus. People with lived experience were engaged as part of the project's Steering Committee, as survey participants and as workshop participants. It is hoped this process will guide future priority setting opportunities and advance depression research in Alberta. ABSTRACT: Background The Depression Research Priority Setting (DRPS) project has the clear aim of describing the patient engagement process used to identify depression research priorities and to reflect on the successes of this engagement approach, positive impacts and opportunities for improvement. To help support patient-oriented depression research priority setting in Alberta, the Patient Engagement (PE) Platform of the Alberta Strategy for Patient Oriented Research Support for People and Patient-Oriented Research and Trials (SUPPORT) Unit designed, along with the support of their partners in addictions and mental health, an explit process to engage patients in the design and execution of the DRPS. Methods The UK's James Lind Alliance (JLA) Priority Setting Partnership (PSP) method was adapted into a six step process to ensure voices of "people with lived experience" (PWLE) with depression were included throughout the project stages. This study uses an explicit and parallel patient engagement process throughout each estage of the PSP designed by the PE Platform. Patient engagement was divided into a five step process: i) Awareness and relationship building; ii) Co-designing and co-developing a shared decision making process; iii) Collaborative communication; iv) Collective sensemaking; and v) Acknowledgement, celebration and recognition. A formative evaluation of the six PE processes was undertaken to explore the success of the parallel patient engagement process. Results This project was successful in engaging people with lived depression experience as partners in research priority setting, incorporating their voices into the discussions and decisions that led to the top 25 depression research questions. Conclusions The DRPS project has positively contributed to depression research in Canada by identifying the priorities of Albertans who have experienced depression for depression research. Dissemination activities to promote further knowledge exchange of prioritized research questions, with emphasis on the importance of process in engaging the voices of PWLE of depression are planned.

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BACKGROUND: To support patient-oriented setting of priorities for depression research in Alberta, the Patient Engagement Platform of the Alberta Strategy for Patient Oriented Research's Support for People and Patient-Oriented Research and Trials Unit and Alberta Health Services' Addiction and Mental Health Strategic Clinical Network, along with partners in addictions and mental health, designed the Alberta Depression Research Priority Setting Project. The aim of the project was to survey patients, caregivers and clinicians/researchers in Alberta about what they considered to be the most important unanswered questions about depression. METHODS: The project adapted the James Lind Alliance Priority Setting Partnership method into a 6-step process to gather and prioritize questions about depression posed by people with lived depression experience, which included patients, caregivers, clinicians and health care practitioners. RESULTS: Implementation of the project, from initial data collection to final priority setting, took 10 months (August 2016 to June 2017). A total of 445 Albertans with lived experience of depression participated, ultimately identifying 11 priority depression research questions spanning the health continuum, life stages, and treatment and prevention opportunities. INTERPRETATION: This project is a fundamental step that has the potential to positively influence depression research. Including the voices of Albertans with lived experience will create advantages for depression research for Albertans, researchers and research funders, and for patient engagement in the research enterprise overall.

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BACKGROUND: Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify 'high-level' priorities in health ecosystem priority setting, and at the preparation phase for health research. OBJECTIVE: The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. DATA SOURCES: HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar's Portal. STUDY ELIGIBILITY CRITERIA: i) published in English; ii) published within the timeframe of 2007-Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. STUDY APPRAISAL AND SYNTHESIS: i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. RESULTS: Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1-Deliberative and Tier 2-Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). LIMITATIONS: The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. CONCLUSION: The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered.

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It has been highlighted that the original manuscript [1] contains a typesetting error in the surname of Virginia Vandall-Walker. This was incorrectly captured as Virgnia Vandall-Walker in the original manuscript which has since been updated.

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BACKGROUND: Over the last 10 years, patient engagement in health research has emerged as the next evolution in healthcare research. However, limited evidence about the clear role and scope of patient engagement in health research and a lack of evidence about its impact have influenced the uptake, implementation and ongoing evolution of patient engagement. The present study aims to conduct a scoping review to identify methods for and outcomes of patient engagement in health research. METHODS: An adaptation of the scoping review methodology originally described by Arksey and O'Malley and updated by Levac, Colquhoun and O'Brien was applied. Sources from a formal database search and relevant documents from a grey literature search were compiled into data extraction tables. Articles were synthesised into key themes according to the (1) methods and (2) outcomes of patient engagement in health research. RESULTS: The total yield for the scoping review was 55 records from across Canada, the United Kingdom and the United States. While evidence about the methods used to engage patients in health research is increasing, stronger evidence of specific patient and healthcare system outcomes is required. This necessitates further mobilisation of research that explores outcomes and that validates specific tools to evaluate engagement. Additionally, theoretical frameworks that can better inform and sustain patient engagement across the lifecycle of health research are lacking. CONCLUSION: Further increasing the volume and reach of evidence about patient engagement in health research will support the paradigmatic shift needed to normalise the patient's role in research beyond 'subject' or 'participant', so as to ultimately improve patient health outcomes and better address healthcare reform in Canada.

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INTRODUCTION: To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions (SDs): Healthy Food Access, and Food Literacy and Skills. METHODS: The OFNS Indicators Advisory Group used a five-step process to select indicators: (1) potential indicators from national and provincial data sources were identified; (2) indicators were organized by SD, action area and data type; (3) selection criteria were identified, pilot tested and finalized; (4) final criteria were applied to refine the indicator list; and (5) indicators were prioritized after reapplication of selection criteria. RESULTS: Sixty-nine potential indicators were initially identified; however, many were individual-level rather than system-level measures. After final application of the selection criteria, one individual-level indicator and six system-level indicators were prioritized in five action areas; for six of the action areas, no indicators were available. CONCLUSION: Data limitations suggest that available data may not measure important aspects of the food environment, highlighting the need for action and resources to improve system-level indicators and support monitoring of the food environment and health in Ontario and across Canada.

INTRODUCTION: Une approche intergouvernementale multilatérale globale en matière d'élaboration de politiques est essentielle pour permettre aux Canadiens et aux Canadiennes de faire face aux défis que pose leur environnement alimentaire. Des indicateurs de l'environnement alimentaire sont nécessaires pour évaluer l'état et l'évolution de la population. La Stratégie sur l'alimentation et la nutrition de l'Ontario (SANO), qui regroupe les secteurs de l'alimentation, de l'agriculture et de la nutrition, vise à améliorer la santé de la population ontarienne par des interventions favorisant des systèmes et des environnements alimentaires sains. Cet article décrit le processus d'établissement d'indicateurs pour 11 secteurs d'intervention de la SANO dans deux orientations stratégiques : l'accès à des aliments sains et l'alphabétisme et les compétences alimentaires. MÉTHODOLOGIE: Le groupe consultatif sur les indicateurs de la SANO a suivi un processus en cinq étapes pour choisir les indicateurs : 1) choix des indicateurs potentiels dans les sources de données provinciales et nationales, 2) catégorisation des indicateurs par orientation stratégique, par secteur d'intervention et par type de données, 3) établissement, essai pilote et finalisation des critères de sélection, 4) application des critères finaux pour améliorer la liste des indicateurs et 5) établissement des indicateurs prioritaires après cette application finale des critères de sélection. RÉSULTATS: Soixante-neuf indicateurs potentiels ont été recensés au départ, mais un grand nombre d'entre eux offraient des mesures individuelles et non collectives. Après l'application finale des critères de sélection, ont été jugés prioritaires un indicateur individuel et six indicateurs collectifs associés à cinq secteurs d'intervention, aucun indicateur n'étant disponible pour les six autres secteurs d'intervention. CONCLUSION: Les limites des données existantes laissent penser qu'on ne peut sans doute pas qualifier certaines caractéristiques importantes de l'environnement alimentaire, d'où l'importance de prendre des mesures et d'allouer des ressources pour améliorer les indicateurs collectifs et d'appuyer le suivi de l'environnement alimentaire et de la santé alimentaire tant en Ontario que dans le reste du Canada.

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OBJECTIVE: An absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy. DESIGN: A scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand. RESULTS: The search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between 'healthy' and 'unhealthy' foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one's capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model. CONCLUSIONS: The lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps.

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Health literacy has the potential to improve an individual's capacity to access, understand, evaluate, and communicate basic health information and services in order to make appropriate health decisions. We developed a research agenda to help older adults become aware of health literacy and its function in promoting their nutritional health and well-being. A key activity is the development, implementation, and evaluation of an eHealth literacy tool, eSEARCH, targeted at older adults to help improve their eHealth literacy skills. Before consultations were held with this subpopulation to assess their eHealth literacy needs and abilities, key informant interviews were conducted with eight experts in the field of health literacy, the older adult population, and/or online communications. Some experts were identified from the relevant literature; others were identified by informants who had already been interviewed. Informants were asked nine questions about the perceived importance of health literacy in Canada, key considerations in developing an eHealth literacy tool, and supporting resources for advancement of the eHealth literacy tool. Informants agreed that health literacy is a key concept and stressed that key considerations for development of the eSEARCH tool are identifying the target population's needs, focusing on health promotion, and increasing confidence in information-seeking behaviours. Identified challenges are ensuring accessibility, applicability to older adults, and adoption of the tool by dietetic and other health care professionals.

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Better Living Health and Community Services developed a 12-week community-based nutrition information series (NIS) for people aged 55 or older. The purpose of this feasibility study was to describe briefly the process of developing and implementing the 12-week NIS and to identify the practicality and plausibility of the program in terms of its process and content attributes, using Thorncliffe Park community as the test site. A pre- and post-test design was used to identify changes in participants' perception of their nutritional and overall well-being. Twenty-four participants who completed at least four sessions participated in the post-evaluation follow-up. Only participants' perception of their eating habits demonstrated a significant, positive improvement (t24=2.1, P<0.05). The results suggest that the NIS has the potential to promote the health and well-being of community-living seniors. The development and implementation of the NIS provided considerations for program practicality. However, additional work is needed to examine the plausibility of the program in meeting its stated objective to promote awareness of nutrition as an important concept for healthy aging. Community-practising dietitians are instrumental in providing credible nutrition information to facilitate healthy eating in older Canadians.

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CONTEXT: Funding for transdisciplinary chronic disease prevention research has increased over the past decade. However, few studies have evaluated whether networking and knowledge exchange activities promote the creation of transdisciplinary teams to successfully respond to requests for proposals (RFPs). Such evaluations are critical to understanding how to accelerate the integration of research with practice and policy to improve population health. OBJECTIVE: To examine (1) the extent of participation in pre-RFP activities among funded and nonfunded transdisciplinary coalitions that responded to a RFP for cancer and chronic disease prevention initiatives and (2) levels of agreement in proposal ratings among research, practice, and policy peer reviewers. DESIGN/SETTING: Descriptive report of a Canadian funding initiative to increase the integration of evidence with action. PARTICIPANTS: Four hundred forty-nine representatives in 41 research, practice, and policy coalitions who responded to a RFP and whose proposals were peer reviewed by a transdisciplinary adjudication panel. INTERVENTION: The funder hosted 6 national meetings and issued a letter of intent (LOI) to foster research, practice, and policy collaborations before issuing a RFP. RESULTS: All provinces and territories in Canada were represented by the coalitions. Funded coalitions were 2.5 times more likely than nonfunded coalitions to submit a LOI. A greater proportion of funded coalitions were exposed to the pre-RFP activities (100%) compared with coalitions that were not funded (68%). Overall research, practice, and policy peer reviewer agreement was low (intraclass correlation 0.12). CONCLUSIONS: There is widespread interest in transdisciplinary collaborations to improve cancer and chronic disease prevention. Engagement in networking and knowledge exchange activities, and feedback from LOIs prior to submission of a final application, may contribute to stronger proposals and subsequent funding success. Future evaluations should examine best practices for transdisciplinary peer review to facilitate funding of proposals that on balance have both scientific rigor and are relevant to the real world.

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Older adults make up the fastest growing age group in North America. This has demanded increased attention in supporting the health and well-being of this population and, in particular, the role of health information in promoting the health and well-being of older adults. Increased availability and accessibility of information as well as a greater emphasis on self-management and care have raised concern about an individual's health literacy skills. The purpose of this study is to conduct a systematic literature review using explicit systematic literature review methodology. This includes a detailed online search process of recent publications on programs that focus on health literacy in the older adult population using the Rychetnik et al. guiding questions and the Population Intervention Comparison Outcome framework. The search yielded nine articles describing functional (n = 4) and interactive (n = 5) health literacy programs. Overall, the selected articles demonstrated positive outcomes in supporting the health literacy skills of older adults. However, there are limitations in study designs and evaluation measures and outcomes of the programs remain unknown in demonstrating long-term impact in supporting health literacy skills. Further high quality studies with clear and strong research methodology are needed to develop and evaluate evidence-based interactive health literacy programs targeted specifically to older adults.

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OBJECTIVE: To explore older adults' (55-70 years) health information-seeking behaviors. METHODS: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts were analyzed using a qualitative thematic coding framework. RESULTS: Twenty participants were interviewed, at which point theoretical saturation of data was achieved. Three themes describing older adults' health information-seeking behaviors emerged. This article will focus on one theme: the enabling and disabling experience of seeking nutrition and health information to support an understanding of successful aging in this population. CONCLUSIONS AND IMPLICATIONS: These findings are framed within the context of supporting older adults' information-seeking behaviors to contribute to their health and well-being. This is a relevant issue to public health professionals given the global emphasis on successful aging strategies.

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OBJECTIVE: To describe the development stages of the Coalitions Linking Action and Science for Prevention (CLASP) initiative of the Canadian Partnership Against Cancer to support research, practice, and policy coalitions focused on cancer and chronic disease prevention in Canada. DESIGN: Coalitions Linking Action and Science for Prevention was implemented in 3 stages. This article describes Stage 1 that consisted of an online concept-mapping consultation process, 3 topic specific networking and consultation workshops, and 3 context-specific networking, coalition development, and planning meetings. These were all completed using a participatory engagement approach to encourage knowledge exchange across jurisdictions and sectors in Canada. SETTING: Toronto, Ontario; Calgary, Alberta; Montreal, Québec; and Ottawa, Ontario. PARTICIPANTS: More than 500 researchers, practitioners, and policy specialists were invited to take part in the first stage activities. MAIN OUTCOME MEASURES: (1) Participant-identified high-priority opportunities for strategic collaboration; (2) Cross-jurisdictional and cross-sector representation; and (3) Participant feedback on the CLASP processes and activities. RESULTS: Participants from Stage 1 activities were distributed across all provinces/territories; 3 jurisdictional levels; and research, practice, and policy sectors. Ninety priority opportunities for strategic collaboration were identified across all 3 workshops. Participants provided detailed feedback about transparency of the RFP (Request for Proposals) application process, support needed to level the playing field for potential applicants, and valuable suggestions for the adjudication process. CONCLUSIONS: Coalitions Linking Action and Science for Prevention engaged hundreds of research, practice, and policy experts across Canada focusing social-behavioral, clinical, and environmental and occupational opportunities for cancer and chronic disease prevention. Given the extent of expert and jurisdictional engagement, the substantial Partnership investment in a participatory engagement approach to RFP development and potential applicant response suggests that efforts to link cancer and chronic disease prevention efforts across jurisdictions and through research, practice, and policy collaboration may require this type of a priori investment in networking, communication, coordination, and collaboration.

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