Matthew Menear

• PhD in Public Health
• Professor at Université Laval

Background: Interest in value-based healthcare, generally defined as providing better care at lower cost, has grown worldwide, and learning health systems (LHSs) have been proposed as a key strategy for improving value in healthcare. LHSs are emerging around the world and aim to leverage advancements in science, technology and practice to improve...

Background: Patients and families are often referred to as important partners in collaborative mental health care (CMHC). However, how to meaningfully engage them as partners remains unclear. We aimed to identify strategies for engaging patients and families in CMHC programs for depression and anxiety disorders. Methods: We updated a Cochrane re...

Introduction: Depression is a mental disorder that is common and chronic, especially if it is initially undertreated. It is now widely recognized that primary care providers have an important role to play in the detection and treatment of depression. However, ensuring quality depression care remains a challenge. Quality indicators for the treatment...

Objective: Self-management support is recognized as an important component of the management of mood and anxiety disorders. The goal of this feasibility study was to evaluate the acceptability, implementation and perceived usefulness of a new comprehensive self-management tool (Getting better my way) in four care settings in Quebec, Canada. Metho...

Background: The Decisional Conflict Scale (DCS) measures 5 dimensions of decision making (feeling: uncertain, uninformed, unclear about values, unsupported; ineffective decision making). We examined the use of the DCS over its initial 20 years (1995 to 2015). Methods: We conducted a scoping review with backward citation search in Google Analytic...

Background People with common mental disorders (CMD) are prone to experience work disabilities, which can lead to sick leave. To support their recovery and return to work, evidence recommends providing a combination of primary care services including psychological and work rehabilitation interventions. Furthermore, interventions to coordinate retur...

Symptoms of the Post-COVID-19 Condition are often non-specific making it a challenge to distinguish them from symptoms due to other medical conditions. In this study, we compare the proportion of emergency department patients who developed symptoms consistent with the World Health Organization’s Post-COVID-19 Condition clinical case definition betw...

Background: This study aims to describe the main type 2 diabetes mellitus (T2DM) quality improvement (QI) challenges identified by primary care teams in the province of Quebec who participated in the COMPAS+ QI collaborative. Methods: A qualitative descriptive design was used to analyse the results of 8 COMPAS+ workshops conducted in 4 regions of t...

Background For more than a decade, the Patient-Centered Medical Home model has been a guiding vision for the modernization of primary care systems. In Canada, Ontario’s Family Health Teams (FHTs) were designed in the mid-2000s with the medical home model in mind. These primary care clinics aim to provide accessible, comprehensive, and person-center...

Context Best practice guidelines for the recovery and return to work (RTW) of people with mental disorders recommend access to the services of an interdisciplinary team combining pharmacological, psychological and work rehabilitation interventions. In the Canadian context, primary healthcare services are responsible for providing these services for...

Introduction Mental disorders are common in adult patients with traumatic injuries. To limit the burden of poor psychological well-being in this population, recognised authorities have issued recommendations through clinical practice guidelines (CPGs). However, the uptake of evidence-based recommendations to improve the mental health of trauma pati...

Importance: Symptoms of Post-COVID-19 Condition (PCC) are non-specific and can occur due to other medical conditions, making it a challenge to distinguish PCC from other health conditions. Objective: To compare the proportion of emergency department (ED) patients who developed symptoms consistent with PCC between those who tested positive for Sever...

Introduction Despite efforts and repeated calls to improve the organisation and quality of healthcare and services, and in view of the many challenges facing health systems, the results and capacity to adapt and integrate innovations and new knowledge remain suboptimal. Learning health systems (LHS) may be an effective model to accelerate the appli...

Background Primary care and other health services have been disrupted during the COVID-19 pandemic, yet the consequences of these service disruptions on patients’ care experiences remain largely unstudied. People with mental-physical multimorbidity are vulnerable to the effects of the pandemic, and to sudden service disruptions. It is thus essentia...

This article examines how existing primary care services were transformed in Québec during COVID-19 to better serve the most vulnerable individuals for whom inequities and access difficulties increased during the pandemic. In the context of a research project, six particularly promising practices to respond to these challenges were identified withi...

Background Collaborative care is an evidence-based approach to improving outcomes for common mental disorders in primary care. Efforts are underway to broadly implement the collaborative care model, yet the extent to which this model promotes person-centered mental health care has been little studied. The aim of this study was to describe practices...

In its Strategic Plan 2021-2026, the Canadian Institutes of Health Research - Institute of Health Services and Policy Research (IHSPR) convincingly expresses its desire to expand capacity for applied health services and policy research (HSPR) and better mobilize research results for health system transformation geared toward the Quadruple Aim and h...

Introduction: The COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and social services to reorganise. This unprecedented crisis forces individuals to make considerable efforts to adapt and will have...

BACKGROUND Strong evidence supports beginning stroke rehabilitation as soon as the patient’s medical status has stabilized and continuing following discharge from acute care. However, adherence to rehabilitation treatments over the rehabilitation phase has been shown to be suboptimal. OBJECTIVE Objective: The aim of this study is to assess the imp...

Background Strong evidence supports beginning stroke rehabilitation as soon as the patient’s medical status has stabilized and continuing following discharge from acute care. However, adherence to rehabilitation treatments over the rehabilitation phase has been shown to be suboptimal. Objective The aim of this study is to assess the impact of a te...

Background Strengthening capacity for mental health in primary care improves health outcomes by providing timely access to coordinated and integrated mental health care. The successful integration of mental health in primary care is highly dependent on the foundation of the surrounding policy context. In Ontario, Canada, policy reforms in the early...

Background Our team has developed a decision aid to help pregnant women and their partners make informed decisions about Down syndrome prenatal screening. However, the decision aid is not yet widely available in Quebec’s prenatal care pathways. Objective We sought to identify knowledge translation strategies and develop an implementation plan to p...

Background Widespread policy reforms in Canada, the United States and elsewhere over the last two decades strengthened team models of primary care by bringing together family physicians and nurse practitioners with a range of mental health and other interdisciplinary providers. Understanding how patients with depression and anxiety experience newe...

Background Widespread policy reforms in Canada, the United States and elsewhere over the last two decades strengthened team models of primary care by bringing together family physicians and nurse practitioners with a range of mental health and other interdisciplinary providers. Understanding how patients with depression and anxiety experience newer...

Objective: To describe Blueprint 2 (2018-2023), the 5-year strategic plan launched in 2018 by the Section of Researchers (SOR), as well as its guiding principles and the process used to develop it. Composition of the committee: Blueprint 2 was co-created by many stakeholders from across Canada and led by the SOR Council (SORC). The process start...

Background Older adults hospitalized following a fall often encounter preventable adverse events when transitioning from hospital to home. Discharge planning interventions developed to prevent these events do not all produce the expected effects to the same extent. This realist synthesis aimed to better understand when, where, for whom, why and how...

Background The COVID-19 pandemic and the isolation measures taken to control it has caused important disruptions in economies and labour markets, changed the way we work and socialize, forced schools to close and healthcare and social services to reorganize in order to redirect resources on the pandemic response. This unprecedented crisis forces in...

Background: Chronic conditions such as diabetes and chronic obstructive pulmonary disease (COPD) are common and burdensome diseases primarily managed in primary care. Yet, evidence points to suboptimal quality of care for these conditions in primary care settings. Quality improvement collaboratives (QICs) are organized, multifaceted interventions...

Training in shared decision-making (SDM) often focuses solely on dyadic relationships between one healthcare provider and one patient. However, many healthcare decisions often involve two or more health professionals. These decisions warrant utilizing an interprofessional shared decision-making (IP-SDM) approach which enables patients and their car...

Background: We explored decisional conflict as measured with the 16-item Decisional Conflict Scale (DCS) and how it varies across clinical situations, decision types, and exposure to decision support interventions (DESIs). Methods: An exhaustive scoping review was conducted using backward citation searches and keyword searches. Eligible studies...

Policy-makers worldwide are increasingly interested in scaling up evidence-based interventions (EBIs) to larger populations, and implementation scientists are developing frameworks and methodologies for achieving this. But scaling-up does not always produce the desired results. Why not? We aimed to enhance awareness of the various pitfalls to be an...

Plain English summary Patient-oriented research (POR) has received increasing attention in recent years. In this approach, patients’ experiential knowledge, derived from their experiences of living with a condition or illness and of interacting with the healthcare system, is recognized, valued, and seen as complementary to scientific knowledge. Ear...

Background Little is known about the decision-making experiences of seniors and informal caregivers facing decisions about seniors’ housing decisions when objective decision making measures are used. Objectives To report on seniors’ and caregivers’ experiences of housing decisions. Design A cross-sectional study with a quantitative approach suppl...

Quantitative data for caregivers. (XLSX)

Quantitative data for seniors. (XLSX)

Background: For pregnant women and their partners, the decision to undergo Down syndrome prenatal screening is difficult. Patient decision aids (PtDA) can help them make an informed decision. We aimed to identify behaviour change techniques (BCTs) that would be useful in an intervention to promote the use of a PtDA for Down syndrome prenatal scree...

Background: Despite growing recognition that shared decision making (SDM) is central for patient-centred primary care, adoption by physicians remains limited in routine practice. Objective: To examine the characteristics of physicians, patients and consultations associated with primary care physicians' SDM behaviours during routine care. Method...

Aim: To synthesize the evidence on the effectiveness of interventions aiming to promote or improve the mental health of primary care nurses. Background: Primary care nurses have been found to have high levels of emotional exhaustion and to be at increased risk of suffering from burnout, anxiety and depression. Given the increasingly critical rol...

Mobile health (mHealth) applications intended to support shared decision making in diagnostic and treatment decisions are increasingly available. In this paper, we discuss some recent studies on mHealth applications with relevance to shared decision making. We discuss the potential advantages and disadvantages of using mHealth in shared decision ma...

L’intégration des soins de santé mentale dans les soins primaires est une stratégie importante pour améliorer la santé mentale et le bien-être des populations. Dans la dernière décennie, le Québec a adopté plusieurs mesures pour renforcer les soins de santé mentale primaires, mais certains problèmes d’intégration persistent. Cette synthèse a été ré...

This study aims at assessing the relative contribution of employment specialist competencies working in supported employment (SE) programs and client variables in determining the likelihood of obtaining competitive employment. A total of 489 persons with a severe mental illness and 97 employment specialists working in 24 SE programs across three Ca...

Background: Patient decision aids aim to present evidence relevant to a health decision in understandable ways to support patients through the process of making evidence-informed, values-congruent health decisions. It is recommended that, when developing these tools, teams involve people who may ultimately use them. However, there is little empiric...

Background Many elders struggle with the decision to remain at home or to move to an alternative location of care. A person’s location of care can influence health and wellbeing. Healthcare organizations and policy makers are increasingly challenged to better support elders’ dwelling and health care needs. A summary of the evidence that examines ho...

Introduction There is strong consensus that prevention and management of common mental disorders (CMDs) should occur in primary care and evidence suggests that treatment of CMDs in these settings can be effective. New interprofessional team-based models of primary care have emerged that are intended to address problems of quality and access to ment...

Background We sought to estimate the extent of decision regret among primary care patients and identify risk factors associated with regret. Methods Secondary analysis of an observational descriptive study conducted in two Canadian provinces. Unique patient-physician dyads were recruited from 17 primary care clinics and data on patient, physician...

Introduction: Collaborative mental healthcare (CMHC) has garnered worldwide interest as an effective, team-based approach to managing common mental disorders in primary care. However, questions remain about how CMHC works and why it works in some circumstances but not others. In this study, we will review the evidence on one understudied but poten...

Plain English summary For the elderly to get the care and services they need, they may need to make the difficult decision about staying in their home or moving to another home. Many other people may be involved in their care too (friends, family and healthcare providers), and can support them in making the decision. We asked informal caregivers of...

Introduction Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn’s theory of scientific revolutions to reflect on how an i...

To update an environmental scan of training programs in SDM for health professionals. We searched two systematic reviews for SDM training programs targeting health professionals produced from 2011 to 2015, and also in Google and social networks. With a standardized data extraction sheet, one reviewer extracted program characteristics. All complete...

Background: People often face difficult decisions about their health and may later regret the choice that they made. However, little is known about the extent of decision regret in health care or its predictors. We systematically reviewed evidence about the extent of decision regret and its risk factors among individuals making health decisions....

Participant recruitment in clinical trials is often challenging. Building partnerships with healthcare organizations during proposal development facilitates access to the community and may influence its subsequent organization participation and participant recruitment. We aimed to assess how pre-engaging directors of homecare organizations influenc...

To evaluate the mental health care needs perceived as unmet by adults in Quebec who had experienced depressive and (or) anxious symptomatology (DAS) in the previous 2 years and who used primary care services, and to identify the reasons associated with different types of unmet needs for care (UNCs) and the determinants of reporting UNCs. Longitudin...

Objective This study aimed to identify primary care practice characteristics associated with the quality of depression care in patients with comorbid chronic medical and/or psychiatric conditions. Method Using data from cross-sectional organizational and patient surveys conducted within 61 primary care clinics in Quebec, Canada, the relationships...

Anxiety disorders are common mental health problems in the community, and primary care has a predominant role in the diagnosis and treatment of these conditions. While most patients are treated with pharmacotherapy, clinical practice guidelines recommendations also comprise psychotherapy interventions. The aims of this study were: (a) to examine ac...

Objective: Providing comprehensive care to people with severe mental illness (SMI) involves moving beyond pharmacological treatment and ensuring access to a wide range of evidence-based psychosocial services. Numerous initiatives carried out in North America and internationally have promoted the widespread adoption of such services. Objectives of...

Objective: In North America and internationally, efforts have been made to reduce the gaps between knowledge of psychosocial evidence-based practices (EBPs) and the delivery of such services in routine mental health practice. Part 2 of this review identifies key issues for stakeholders to consider when implementing comprehensive psychosocial EBPs...

Over the past decade, substantial global investment has been made to support health systems and policy research (HSPR), with considerable resources allocated to training. In Canada, signs point to a larger and more highly skilled HSPR workforce, but little is known about whether growth in HSPR human resource capacity is aligned with investments in...

BACKGROUND: The aims of this study were to: (1) evaluate the psychometric properties of a French Canadian version of the Hospital Anxiety and Depression Scale (HADS-FC) in a large population of primary care patients in Quebec, Canada; (2) conduct a transcultural validation of the original HADS in a subsample of English-speaking patients; (3) explor...

Intensified knowledge translation (KT) efforts are considered important in the field of mental health in order to accelerate the implementation of various developments in research, policy and practice. A scoping review of KT focused on the field of mental health was undertaken to help inform development of a Knowledge Exchange Centre being initiate...

Supported employment (SE) is widely considered to be the most effective intervention for helping people with psychiatric disabilities integrate into the competitive workforce. While fidelity to principles and standards of evidence-based SE, i.e., the Individual Placement and Support model, is positively associated with vocational outcomes, studies...

People with schizophrenia consistently show memory impairment on varying tasks including item recognition memory. Relative to the correct rejection of distracter items, the correct recognition of studied items consistently produces an effect termed the old/new effect that is characterized by increased activity in parietal and frontal cortical regio...

Memory is one of the cognitive functions most affected in schizophrenia, but the severity of deficits varies from one task to another. In particular, greater impairments have been reported for pair recognition than item recognition. However, decision biases and how they could affect memory dysfunction in schizophrenia have received scant attention....

Supported employment (SE) is an evidence-based practice that helps people with severe mental disorders obtain competitive employment. The implementation of SE programs in different social contexts has led to adaptations of the SE components, therefore impacting the fidelity/quality of these services. The objective of this study was to assess the im...

We recently showed that, in healthy individuals, emotional expression influences memory for faces both in terms of accuracy and, critically, in memory response bias (tendency to classify stimuli as previously seen or not, regardless of whether this was the case). Although schizophrenia has been shown to be associated with deficit in episodic memory...

Dopamine (DA) modulates working memory. However, the relation between DA systems and episodic (declarative) memory is less established. Frontal lobe DA function may be involved. We were interested in assessing whether apomorphine (Apo), a drug used extensively in clinical research as a probe of DA function, has an effect on episodic memory test per...

We used an event-related functional Magnetic Resonance Imaging (fMRI) approach to examine the neural basis of the selective associative memory deficit in schizophrenia. Fifteen people with schizophrenia and 18 controls were scanned during a pair and item memory encoding and recognition task. During encoding, subjects studied items and pairs of visu...

Memory dysfunction is an important feature in the clinical presentation of Huntington's disease (HD) and may precede the onset of motor symptoms. Although several studies have contributed to the quantitative and qualitative description of memory impairments in HD, the characterization of episodic memory impairments has varied considerably. Whereas...

Recent decades have seen tremendous growth in our understanding of the cognitive dysfunctions observed in Huntington's disease (HD). Advances in neuroimaging have contributed greatly to this growth. We reviewed the role that structural and functional neuroimaging techniques have played in elucidating the cerebral bases of the cognitive deficits ass...

Artículo original RESUMEN Objetivo: estudios previos han mostrado que el rendimiento de los pacientes con enfermedad de Huntington (EH) en pruebas del recuerdo es normal o afectado de manera mínima en comparación al rendimiento en pruebas de reconocimiento. Este patrón neuropsicológico ha sido interpretado como el resultado de un proceso de recuper...

Objective: some previous studies indicate that HD patients' performance on tests of recognition memory is normal or less impaired than their performance on tests of free recall, and have interpreted this pattern as evidence for retrieval-based episodic memory impairment. The present study assessed associative recognition memory in a group of patien...

Studies of schizophrenia suggest a specific impairment in binding different parts of a memory event into a cohesive whole, a finding that may account for the reported preferential deficits in associative recognition memory relative to item recognition. As a further test of this hypothesis and to exert greater control over task differences, we used...

Retrieval of information from memory often involves the selection of an event among competing related events, a process that frequently gives rise to interference effects. The present study used a forced-choice recognition test to identify neural correlates of the interfering effect of related events on recognition memory discriminability. Particip...