Roy Cameron

Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada

Are you Roy Cameron?

Claim your profile

Publications (44)94.11 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Population-level intervention is required to prevent cancer and other chronic diseases. It also promotes health for those living with established risk factors and illness. In this article, the authors describe a vision and approach for continuously improving population-level programs and policies within and beyond the health sector. The vision and approach are anchored in contemporary thinking about what is required to link evidence and action in the field of population and public health. The authors believe that, as a cancer prevention and control community, organizations and practitioners must be able to use the best available evidence to inform action and continually generate evidence that improves prevention policies and programs on an ongoing basis. These imperatives require leaders in policy, practice, and research fields to work together to jointly plan, conduct, and act on relevant evidence. The Propel Center and colleagues are implementing this approach in Youth Excel-a pan-Canadian initiative that brings together national and provincial organizations from health and education sectors and capitalizes on a history of collaboration. The objective of Youth Excel is to build sustainable capacity for knowledge development and exchange that can guide and redirect prevention efforts in a rapidly evolving social environment. This goal is to contribute to creating health-promoting environments and to accelerate progress in preventing cancer and other diseases among youth and young adults and in the wider population. Although prevention is the aim, health-promoting environments also can support health gains for individuals of all ages and with established illness. In addition, the approach Youth Excel is taking to link evidence and action may be applicable to early intervention and treatment components of cancer control.
    Cancer 05/2011; 117(10 Suppl):2281-8. · 5.20 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: This randomized clinical trial was designed to test the efficacy of intensive versus brief smoking cessation interventions for hospital patients. The interventions included advice and pamphlets for Brief and bedside counselling, take-home materials, and 7 post-discharge telephone counselling calls over 2 months for Intensive. Confirmed 1-year abstinence was 28% for Intensive (85/301) and 24% for Brief (76/315). Abstinence was significantly higher for patients who did not use pharmacotherapy (36%) versus those who did (16%) and for patients with CVD (40%) versus other diagnoses (20%). Because this was a replication trial, benchmarks for planning can be suggested: 12% to 15% recruitment of identified smokers, 90% plus completion for Intensive, 15% drop-out, and 75% abstinence corroboration. The results consolidate findings for general inpatients, including expected absolute abstinence and treatment outcomes, the effect of CVD patients on outcomes, the reproducibility of high abstinence in a universal health-care system, and the need for more research to inform practice.
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 03/2011; 43(1):98-117.
  • [show abstract] [hide abstract]
    ABSTRACT: This randomized clinical trial was designed to test the efficacy of intensive versus brief smoking cessation interventions for hospital patients. The interventions included advice and pamphlets for Brief and bedside counselling, take-home materials, and 7 post-discharge telephone counselling calls over 2 months for Intensive. Confirmed 1-year abstinence was 28% for Intensive (85/301) and 24% for Brief (76/315). Abstinence was significantly higher for patients who did not use pharmacotherapy (36%) versus those who did (16%) and for patients with CVD (40%) versus other diagnoses (20%). Because this was a replication trial, benchmarks for planning can be suggested: 12% to 15% recruitment of identified smokers, 90% plus completion for Intensive, 15% drop-out, and 75% abstinence corroboration. The results consolidate findings for general inpatients, including expected absolute abstinence and treatment outcomes, the effect of CVD patients on outcomes, the reproducibility of high abstinence in a universal health-care system, and the need for more research to inform practice. French Cet essai clinique randomisé a été conçu pour évaluer, en cessation tabagique, l'efficacité des interventions intensives comparées aux interventions brèves, chez les patients hospitalisés. La prestation de conseils et la remise de dépliants figurent parmi les interventions brèves. Le counseling au chevet du patient, la remise de documentation à emporter et la prestation d'un couseling par la voie de sept appels téléphoniques à la suite d'un congé d'hôpital et s'échelonnant sur plus de deux mois figurent parmi les interventions intensives. Ces dernières ont généré une abstinence confirmée de 1 an chez 28 % de participants (85/301), alors que ce chiffre se situe à 24 % (76/315) pour les interventions brèves. Le taux d'abstinence était particulièrement élevé chez les patients qui n'ont pas eu recours à la pharmacothérapie (36 %), contrairement à ceux qui ont adopté cette approche (16 %). Tel était le cas aussi chez les patients atteints de maladies cardiovasculaires (40 %), par opposition aux personnes atteintes d'autres maladies (20 %). Puisqu'il s'agissait d'un essai clinique à répétition, des points de repères à des fins de planification ont été proposés : un recrutement de fumeurs identifiés de 12 % à 15 % ; une complétion de plus de 90 % pour les interventions intensives; 15 % d'impersévérance; et une corroboration d'abstinence de 75 %. Les résultats confirment les conclusions chez l'ensemble des patients hospitalisés, y compris celles portant sur l'abstinence absolue et les résultats de traitements anticipés, l'impact des patients atteints de maladies cardiovasculaires sur les résultats, la reproductibilité d'une abstinence élevée dans un système de soins de santé universels, et le besoin de poursuivre d'autres recherches pour éclairer la pratique.
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 02/2011; 43(1):98-117.
  • [show abstract] [hide abstract]
    ABSTRACT: There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.
    The European Journal of Public Health 10/2009; 20(2):195-201. · 2.52 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Significant resources and time are invested in the production of research knowledge. The primary objective of this randomized controlled trial was to evaluate the effectiveness of three knowledge translation and exchange strategies in the incorporation of research evidence into public health policies and programs. This trial was conducted with a national sample of public health departments in Canada from 2004 to 2006. The three interventions, implemented over one year in 2005, included access to an online registry of research evidence; tailored messaging; and a knowledge broker. The primary outcome assessed the extent to which research evidence was used in a recent program decision, and the secondary outcome measured the change in the sum of evidence-informed healthy body weight promotion policies or programs being delivered at health departments. Mixed-effects models were used to test the hypotheses. One hundred and eight of 141 (77%) health departments participated in this study. No significant effect of the intervention was observed for primary outcome (p < 0.45). However, for public health policies and programs (HPPs), a significant effect of the intervention was observed only for tailored, targeted messages (p < 0.01). The treatment effect was moderated by organizational research culture (e.g., value placed on research evidence in decision making). The results of this study suggest that under certain conditions tailored, targeted messages are more effective than knowledge brokering and access to an online registry of research evidence. Greater emphasis on the identification of organizational factors is needed in order to implement strategies that best meet the needs of individual organizations. The trial registration number and title are as follows: ISRCTN35240937 -- Is a knowledge broker more effective than other strategies in promoting evidence-based physical activity and healthy body weight programming?
    Implementation Science 09/2009; 4:61. · 2.37 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: A knowledge broker (KB) is a popular knowledge translation and exchange (KTE) strategy emerging in Canada to promote interaction between researchers and end users, as well as to develop capacity for evidence-informed decision making. A KB provides a link between research producers and end users by developing a mutual understanding of goals and cultures, collaborates with end users to identify issues and problems for which solutions are required, and facilitates the identification, access, assessment, interpretation, and translation of research evidence into local policy and practice. Knowledge-brokering can be carried out by individuals, groups and/or organizations, as well as entire countries. In each case, the KB is linked with a group of end users and focuses on promoting the integration of the best available evidence into policy and practice-related decisions. A KB intervention comprised one of three KTE interventions evaluated in a randomized controlled trial. KB activities were classified into the following categories: initial and ongoing needs assessments; scanning the horizon; knowledge management; KTE; network development, maintenance, and facilitation; facilitation of individual capacity development in evidence informed decision making; and g) facilitation of and support for organizational change. As the KB role developed during this study, central themes that emerged as particularly important included relationship development, ongoing support, customized approaches, and opportunities for individual and organizational capacity development. The novelty of the KB role in public health provides a unique opportunity to assess the need for and reaction to the role and its associated activities. Future research should include studies to evaluate the effectiveness of KBs in different settings and among different health care professionals, and to explore the optimal preparation and training of KBs, as well as the identification of the personality characteristics most closely associated with KB effectiveness. Studies should also seek to better understand which combination of KB activities are associated with optimal evidence-informed decision making outcomes, and whether the combination changes in different settings and among different health care decision makers.
    Implementation Science 05/2009; 4:23. · 2.37 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: The School Health Action, Planning, and Evaluation System (SHAPES) is a data collection and feedback system designed to support population-based intervention planning, evaluation, and field research related to youth. The Physical Activity Module of SHAPES consists of: (a) a machine readable questionnaire to collect physical activity data from all students (grades 6 to 12) in a school, (b) a school administrator questionnaire to assess school policies, programs, and resources related to physical activity, and (c) a school-specific feedback report documenting student behavior and school programs and policies. This SHAPES module provides schools with feedback that enables them to take stock of patterns of activity and obesity within their school, recognize what is (and what is not) in place to support physical activity, and how to plan and evaluate their own prevention efforts. SHAPES enables researchers and stakeholders to identify what interventions work, in what contexts, with what students.
    Health Promotion Practice 03/2008; 10(2):254-61.
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: : Research to investigate levels of organisational capacity in public health systems to reduce the burden of chronic disease is challenged by the need for an integrative conceptual model and valid quantitative organisational level measures. To develop measures of organisational capacity for chronic disease prevention/healthy lifestyle promotion (CDP/HLP), its determinants, and its outcomes, based on a new integrative conceptual model. Items measuring each component of the model were developed or adapted from existing instruments, tested for content validity, and pilot tested. Cross sectional data were collected in a national telephone survey of all 216 national, provincial, and regional organisations that implement CDP/HLP programmes in Canada. Psychometric properties of the measures were tested using principal components analysis (PCA) and by examining inter-rater reliability. PCA based scales showed generally excellent internal consistency (Cronbach's alpha = 0.70 to 0.88). Reliability coefficients for selected measures were variable (weighted kappa(kappa(w)) = 0.11 to 0.77). Indicators of organisational determinants were generally positively correlated with organisational capacity (r(s) = 0.14-0.45, p<0.05). This study developed psychometrically sound measures of organisational capacity for CDP/HLP, its determinants, and its outcomes based on an integrative conceptual model. Such measures are needed to support evidence based decision making and investment in preventive health care systems.
    Journal of Epidemiology &amp Community Health 08/2007; 61(8):742-9. · 3.39 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: The Canadian Cancer Society and the National Cancer Institute of Canada have charged their Centre for Behavioral Research and Program Evaluation with contributing to the development of the country's systemic capacity to link research, policy, and practice related to population-level interventions. Local data collection and feedback systems are integral to this capacity. Canada's School Health Action Planning and Evaluation System (SHAPES) allows data to be collected from all of a school's students, and these data are used to produce computer-generated school "health profiles." SHAPES is being used for intervention planning, evaluation, surveillance, and research across Canada. Strong demand and multipartner investment suggest that SHAPES is adding value in all of these domains. Such systems can contribute substantially to evidence-informed public health practice, public engagement, participatory action research, and relevant, timely population intervention research.
    American Journal of Public Health 05/2007; 97(4):648-54. · 3.93 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Municipal smoke-free spaces bylaws are a common population-level intervention to address the prominent health risks associated with exposure to second-hand smoke. In Canada, bylaw prevalence is increasing, but inequities in level of protection across communities remain as bylaws vary from place to place. Little is known about the role of place in this policy disparity. To address this gap, this study examined associations between community characteristics and municipal smoke-free spaces policy outcomes to elucidate how ecological conditions are associated with bylaw status and strength. Smoke-free public place and workplace bylaws were obtained from all municipalities with a population of >or=5000 in the provinces of Alberta (N=78) and Ontario (N=245), Canada. Bylaws were assigned a strength score (ranging 0-100) rating the degree of bylaw comprehensiveness, restrictiveness and enforcement provisions. These data were then linked to socio-demographic data from the Canadian Census (1996) and the Canadian Community Health Survey Cycle 1.1 (2000/2001). Logistic and multiple linear regression analyses were used to develop models for municipal bylaw status and strength using community factors including: socio-demographics, municipality type, health region smoking rates, and provincial tobacco control environment. Study findings suggest that community characteristics play a key role in the status and strength of municipal smoke-free bylaws. As smoking bans continue to emerge world-wide under the Framework Convention on Tobacco Control, knowledge about conditions that promote policy success will be critical for those in need of immediate information to maximize policy-making in their own settings. Use of community profiles that consider socio-demographics along with broader contextual factors can aid decision-makers, public health advocates, and researchers in identifying similar jurisdictions with a successful smoke-free spaces policy and communicating with them about their policy-making experiences. Knowledge about the conditions associated with municipal policy-development may be translated to other jurisdictions where information is sparse, or evidence is newly emerging.
    Health Policy 02/2007; 80(2):358-68. · 1.55 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: The purpose of this study was to examine how social models for smoking are related to smoking susceptibility among a sample of non-smoking elementary school students. The Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) was administered to 6,431 students (grades 6 to 8) in 57 elementary schools in the province of Ontario, Canada. Multi-level logistic regression analysis was used to examine how smoking friends, parents, and the prevalence of smoking among grade 8 students at a school were related to smoking susceptibility among the 2,478 non-smoking grade 6 and 7 students. Findings indicate that non-smoking grade 6 and 7 students are more likely to be susceptible to smoking if they have (a) smoking friends, (b) a mother who smokes, or (c) two or more close friends who smoke and attend a school with a relatively high smoking rate among the grade 8 students. Sub-populations of non-smoking youth may be at increased risk for smoking because of the elementary school they attend. Future school-based smoking prevention programs might benefit from targeting prevention programming activities to the schools that are putting students at the greatest risk for smoking.
    Prevention Science 01/2007; 7(4):397-402. · 2.63 Impact Factor
  • The European Journal of Public Health 05/2006; 16(2):223-4; author reply 225. · 2.52 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: This study examined how older smoking peers at school and the smoking behaviour of friends and family members are related to youth smoking. Multi-level logistic regression analysis was used to examine correlates of ever smoking in a sample of 4286 grade 6 and 7 students from 57 elementary schools in Ontario, Canada (2001). Each 1% increase in the smoking rate among grade 8 students increased the odds that a student in grades 6 or 7 was an ever smoker versus never smoker [OR 1.05, 95% CI 1.02 to 1.08]. A low-risk student (no family or friends who smoke) was almost three times more likely to try smoking if he/she attended an elementary school with a relatively high prevalence of senior students who smoke than if he/she attended a school with a low prevalence of senior students who smoke. Low-risk grade 6 and 7 students are at significantly greater risk of smoking if they attend an elementary school with a relatively high prevalence of smoking among senior students. Prevention programs should target both at-risk schools and at-risk students.
    Preventive Medicine 04/2006; 42(3):218-22. · 3.50 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Capacity building in health promotion has traditionally involved training interventions to support knowledge, skill and resource building for effective practice. However, there is a need to understand how research can be used to support capacity building and practice. Findings are based on a parallel case study comprising qualitative analysis of 66 key informant interviews from five provincial heart health projects (Manitoba, Prince Edward Island, Ontario, Saskatchewan, and Newfoundland and Labrador) as part of the Canadian Heart Health Dissemination Project. Results indicate research was used primarily to monitor and report results about health promotion capacity and dissemination to stakeholders, and contribute to participatory processes. Respondents noted that research as intervention had an influence on five areas of health promotion capacity and practice: increased heart health promotion knowledge/skills; improved programming, planning and prioritizing; increased motivation for (heart) health promotion initiatives; and cultivation of relationships as well as buy-in. Research was a complementary capacity-building activity, although it did not directly increase program implementation. These findings contribute to linking researchers, practitioners and community decision-makers in the process of enhancing health promotion practice.
    Canadian journal of public health. Revue canadienne de santé publique 01/2006; 97(4):291-5. · 1.02 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: The purpose of this paper is to examine the utility of linking systems between public health resource and user organizations for health promotion dissemination and capacity building, and to identify factors related to the success of linking systems. The design is a parallel-case study using key informant interviews and content analysis of project reports (synthesized qualitative and quantitative data) of three provincial dissemination projects of the Canadian Heart Health Initiative-Dissemination Phase. Each provincial project used linking activities with public health user groups including meetings, skill building, resources, collaboration, networking and research feedback to facilitate capacity building for and implementation of heart health promotion activities. This paper presents empirical examples of linking system designs, activities, and qualitative and quantitative changes in the public health user groups' health promotion capacity, program delivery and sustainability. The findings indicate enhanced health promotion skills, partnerships, resources, infrastructure, and increased programming and sustainability in the targeted public health organizations of all three provincial projects. Identified barriers to the success of linking systems included lack of appropriately skilled personnel, funds, buy-in and leadership. We conclude that linking systems can be flexibly used to build capacity and disseminate health promotion innovations, and suggest conditions for success.
    Health Education Research 11/2005; 20(5):499-513. · 1.66 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: To examine how social models in the school environment and individual student characteristics are related to smoking susceptibility. Using data from the School Smoking Profile Project, multi-level logistic regression analysis was used to identify school and student characteristics related to smoking susceptibility among 6679 never smokers from 29 secondary schools in Ontario, Canada. If a nonsmoking student attended a school where there was student smoking on the school periphery, he or she was less likely to be susceptible to smoking (OR 0.71, 95% CI 0.57-0.89). A significant contextual interaction between the smoking on the school periphery and friends' disapproval of smoking was identified (beta = 0.68 [0.23], p < .01]; students with friends who disapprove of smoking were more likely to be susceptible to smoking if they attended a school with student smoking on the school periphery. Nonsmoking students who attend a school with student smoking on the school periphery are at an increased risk for being susceptible to smoking if they have friends who disapprove of smoking. Future school-based smoking prevention programs might benefit from targeting both individual students and entire schools with programming activities.
    Journal of Adolescent Health 10/2005; 37(4):330-6. · 2.97 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Current research on the etiology of tobacco use has largely focused on identifying the influential psychosocial characteristics of individual students; the influences of characteristics in the school environment are generally ignored. The purpose of this study was to simultaneously examine how school and individual student characteristics were related to smoking onset. Multilevel logistic regression analysis was used to examine how the senior student smoking rate at a school and the psychosocial characteristics of students were able to differentiate tried-once smokers from experimental smokers in a sample of 4850 grade 9, 10, and 11 students from the School Smoking Profile (SSP) project. Each 1% increase in smoking rate among high school seniors increased the odds that a junior student was an experimental smoker vs. a tried-once smoker (OR 1.07, 95% CI 1.03-1.12). A significant contextual interaction was identified where the senior student smoking rate at a school moderates the negative influence of having close friends who smoke. Influential student characteristics were also identified. The smoking prevalence of older students at a school is directly related to smoking onset among younger students at that school. Prevention programs should target schools that put students at-risk.
    Preventive Medicine 07/2005; 40(6):853-9. · 3.50 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: We assessed the impact of graphic Canadian cigarette warning labels. We used a longitudinal telephone survey of 616 adult smokers. Approximately one fifth of participants reported smoking less as a result of the labels; only 1% reported smoking more. Although participants reported negative emotional responses to the warnings including fear (44%) and disgust (58%), smokers who reported greater negative emotion were more likely to have quit, attempted to quit, or reduced their smoking 3 months later. Participants who attempted to avoid the warnings (30%) were no less likely to think about the warnings or engage in cessation behavior at follow-up. Policymakers should not be reluctant to introduce vivid or graphic warnings for fear of adverse outcomes.
    American Journal of Public Health 09/2004; 94(8):1442-5. · 3.93 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: To assess the impact of graphic Canadian cigarette warning labels on current adult smokers. A random-digit-dial telephone survey was conducted with 616 adult smokers in south western Ontario, Canada in October/November 2001, with three month follow up. Smoking behaviour (quitting, quit attempts, and reduced smoking), intentions to quit, and salience of the warning labels. Virtually all smokers (91%) reported having read the warning labels and smokers demonstrated a thorough knowledge of their content. A strong positive relation was observed between a measure of cognitive processing-the extent to which smokers reported reading, thinking about, and discussing the new labels-and smokers' intentions to quit (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.07 to 1.16; p < 0.001). Most important, cognitive processing predicted cessation behaviour at follow up. Smokers who had read, thought about, and discussed the new labels at baseline were more likely to have quit, made a quit attempt, or reduced their smoking three months later, after adjusting for intentions to quit and smoking status at baseline (OR 1.07, 95% CI 1.03 to 1.12; p < 0.001). Graphic cigarette warning labels serve as an effective population based smoking cessation intervention. The findings add to the growing literature on health warnings and provide strong support for the effectiveness of Canada's tobacco labelling policy.
    Tobacco control 12/2003; 12(4):391-5. · 3.85 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: This study examined the context and processes in which health promotion policy and program decisions are made to ensure that an Internet-based information system on heart health promotion programs provides appropriate information for decision makers' needs and is compatible with their decision-making processes. Five focus groups and six individual interviews were conducted with potential users of and contributors to the G8 Heart Health Projects Database. Results suggest that Internet-based systems such as this are seen as useful tools, but will only be used at certain critical points in program development and then, only when they meet several rigorous criteria. Systems must be completely credible and up-to-date, providing instant answers to complex questions about program design, implementation, and effectiveness, with adequate qualitative information for assessing contextual applicability. Participants also provided information about the conditions required if they were to submit project information to the system.
    Health Promotion Practice 11/2003; 4(4):413-21.

Publication Stats

832 Citations
238 Downloads
2k Views
94.11 Total Impact Points

Institutions

  • 2011
    • Northern Ontario School of Medicine
      Thunder Bay, Ontario, Canada
  • 1987–2011
    • University of Waterloo
      • • Propel Centre for Population Health Impact
      • • Department of Statistics and Actuarial Science
      • • Department of Psychology
      Waterloo, Quebec, Canada
  • 2009
    • Université de Montréal
      • Public Health Research Institute
      Montréal, Quebec, Canada
  • 2008
    • Cancer Care Ontario
      Toronto, Ontario, Canada
  • 2003–2007
    • McGill University
      • Department of Epidemiology, Biostatistics and Occupational Health
      Montréal, Quebec, Canada
  • 2000
    • National Cancer Institute (USA)
      Maryland, United States