Rosa Dragonetti

Centre for Addiction and Mental Health · Addictions Research Group

Type 2 diabetes (T2D) is a complex chronic condition that requires ongoing self‐management. Diabetes health coaching interventions provide personalized healthcare programming to address physical and psychosocial aspects of diabetes self‐management. Aims This scoping review aims to explore the contexts and settings of diabetes health coaching inter...

Introduction: Type-2 diabetes (T2D) is a complex chronic condition associated with a lower quality of life due to disease specific distress. While there is growing support for personalized diabetes programs, care for mental health challenges is often fragmented and limited by access to psychiatry, and integration of care. The use of communication t...

Introduction In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression,...

Background Post-smoking-cessation weight gain can be a major barrier to quitting smoking; however, adding behavior change interventions for physical activity (PA) and diet may adversely affect smoking cessation outcomes. The “Picking up the PACE (Promoting and Accelerating Change through Empowerment)” study assessed change in PA, fruit/vegetable co...

Individuals seek help to stop their use of e-cigarettes from their healthcare practitioners. However, there is a paucity of published work addressing e-cigarette cessation methods empirically, and what evidence that is available is weak. Therefore, we developed an expert informed clinical resource to guide practitioners helping their clients quit u...

Background: For individuals living with diabetes and its psychosocial comorbidities (eg, depression, anxiety, and distress), there remains limited access to interprofessional, integrated care that includes mental health support, education, and follow-up. Health technology, broadly defined as the application of organized knowledge or skill as softw...

Background: Although evidence-based smoking cessation guidelines are available, the applicability of these guidelines for the cessation of electronic cigarette and dual e-cigarette and combustible cigarette use is not yet established. In this review, we aimed to identify current evidence or recommendations for cessation interventions for e-cigaret...

Background: The COVID-19 pandemic disrupted the delivery of diabetes care and worsened mental health among many patients with type 2 diabetes (T2D). This disruption puts patients with T2D at risk for poor diabetes outcomes, especially those who experience social disadvantage due to socioeconomic class, rurality, or ethnicity. The appropriate use o...

BACKGROUND For individuals living with diabetes and its psychosocial comorbidities (eg, depression, anxiety, and distress), there remains limited access to interprofessional, integrated care that includes mental health support, education, and follow-up. Health technology, broadly defined as the application of organized knowledge or skill as softwar...

BACKGROUND COVID 19 and its public health response are having a profound effect on people’s mental health. In order to provide supports during these times Canada’s largest mental health and addiction teaching hospital (CAMH) launched the Mental Health and the COVID-19 Pandemic website on March 18, 2020. This website was designed to be a non-stigmat...

Background: COVID 19 and its public health response are having a profound effect on people's mental health. To provide supports during these times Canada's largest mental health and addiction teaching hospital (CAMH) launched the Mental Health and the COVID-19 Pandemic website on March 18, 2020. This website was designed to be a non-stigmatizing p...

Background People who smoke have other risk factors for chronic diseases, such as low levels of physical activity and poor diet. Clinical decision support systems (CDSSs) might help health care practitioners integrate interventions for diet and physical activity into their smoking cessation programming but could worsen quit rates. Objective The ai...

BACKGROUND People who smoke also have other risk factors for chronic disease such as sedentary behaviours and poor diet. Usual practice is to address smoking with the exclusion of these other behaviours. Clinical decision support systems (CDSS) are a promising resource to effectively support health care practitioners integrate interventions for die...

Background: The emergence of novel coronavirus (COVID-19) has introduced additional pressures on an already fragile mental healthcare system due to significant rise in depression, anxiety and stress among Canadians. While Cognitive Behavioural Therapy (CBT) is known to be an efficacious treatment to reduce such mental health issues, few people hav...

BACKGROUND The emergence of the novel coronavirus (COVID-19) has introduced additional pressures on an already fragile mental health care system due to a significant rise in depression, anxiety, and stress among Canadians. Although cognitive behavioral therapy (CBT) is known to be an efficacious treatment to reduce such mental health issues, few pe...

Aim: Psychotic disorders are associated with excess morbidity and premature mortality. Contributing factors include tobacco smoking, low physical activity, and poor nutrition. This study tested a Technology-Enabled Collaborative Care model to improve health behaviours among youth with early psychosis. Methods: A feasibility study among youth (ag...

Background: Primary care organizations are well-suited to help patients change their unhealthy behaviors. Evidence shows that risk communication and self-monitoring of behavior are is an effective strategy practitioners can use to promote health behavior change with their patients. In order for this evidence to be actionable, it is important to und...

Settler introduction of tobacco to Inuit Nunangat (homeland of Inuit in Canada) has led to high tobacco use prevalence among Inuit. Inuit are moving from traditional territories to the province of Ontario to access resources, including health services. Indigenous-specific tobacco cessation approaches in Ontario lack cultural relevance among Inuit,...

Introduction: Continuing education is essential to build capacity among health care providers (HCPs) to treat people with tobacco addiction. Online, interprofessional training programs are valuable; however, interpretation and comparison of outcomes remain challenging because of inconsistent use of evaluation frameworks. In this study, we used lev...

Background: Modifiable risk factors such as tobacco use, physical inactivity, and poor diet account for a significant proportion of the preventable deaths in Canada. These factors are also known to cluster together, thereby compounding the risks of morbidity and mortality. Given this association, smoking cessation programs appear to be well-suited...

Aim Individuals with psychotic disorders have poorer health outcomes and die earlier due to cardiovascular diseases when compared to healthy populations. Contributing factors include low levels of physical activity, poor nutrition and tobacco smoking. Currently, patients navigate a fragmented health‐care system to seek physical and mental health se...

Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. Wh...

Objectives Smoking remains a leading public health issue and health care practitioners (HCPs), who play an important role in supporting and promoting patients’ cessation efforts, need educational initiatives that improve their ability to provide effective clinical care. The objective of this study was to compare patient-reported abstinence from smo...

BACKGROUND Modifiable risk factors, such as tobacco use, physical inactivity, and poor nutrition, account for a significant proportion of the preventable deaths in Canada. Given this association, smoking cessation programs appear to be well-suited for integration of health promotion activities for other modifiable risk factors. The Smoking for Onta...

Background Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. Whil...

Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. Whi...

Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. Whi...

Background: Multiple health risk behaviors have a synergistic negative influence on health resulting in higher rates of premature mortality and increased morbidity. Although there have been hundreds of interventions that address multiple health behaviors, much remains unknown about how to optimize these interventions. Realist synthesis is an approa...

Background Provision of evidence-based smoking cessation treatment may contribute to health disparities if barriers to treatment are greater for more disadvantaged groups. We describe and evaluate the public health impact of a novel outreach program to improve access to smoking cessation treatment in Ontario, Canada. Methods We partnered with Publi...

Background: Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of di...

Introduction: Standard knowledge delivery formats for CME may have limited impact on long-term practice change. A community of practice (CoP) is one tool that may enhance competencies and support practice change. This study explores the utility of an interprofessional CoP as an adjunct to a CME program in tobacco addiction treatment (Training Enha...

Objective To develop and encourage the adoption of clinical practice guidelines (CPGs) for smoking cessation in Canada by engaging stakeholders in the adaptation of existing high-quality CPGs using principles of the ADAPTE framework. Methods An independent expert body in guideline review conducted a review and identified six existing CPGs, which m...

Background: Many continuing professional development (CPD) Web-based programs are not explicit about underlying theory and fail to demonstrate impact. Objective: The aim of this study was to develop and apply an aggregate mixed-methods evaluation model to describe the paradigm, theoretical framework, and methodological approaches used to evaluat...

Qualitative evaluations of courses prove difficult due to low response rates. Online courses may permit the analysis of qualitative feedback provided by health care providers (HCPs) during and after the course is completed. This study describes the use of qualitative methods for an online continuing medical education (CME) course through the analys...

This study examined the degree to which the pregnant or postpartum women, in the process of quitting smoking, felt that writing in a blog about their smoking cessation journeys helped them in their efforts to become or remain smoke free. Five women who blogged for Prevention of Gestational and Neonatal Exposure to Tobacco Smoke (a website designed...

Women who are younger in age are more likely to smoke during pregnancy and postpartum and tend to have less success with cessation/reduction. There is an unmet need for interventions targeted to pregnant and postpartum young women that provide them with support to quit/reduce long-term into the postpartum period and beyond. Aims: Our study aimed t...

Background: Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. Objective: The aim...

Motivational interviewing (MI) is a patient-centered counselling approach to guide health behaviour change, including patient health behaviours associated with asthma management, taking medications appropriately, and quitting smoking. The Ontario Lung Association (OLA) and the Centre for Addiction and Mental Health (CAMH)'s Training Enhancement in...

Background There are important inequities in smoker access to clinic-based smoking cessation services. Low barrier high-reach interventions are proposed as solutions to these inequities. Although effective, telephone quitlines, which provide multi-session counselling but no medication, have low utilization with high attrition. The objective of this...

To facilitate interprofessional knowledge transfer to practice by increasing treatment capacity of health care practitioners to deliver evidence-informed smoking cessation counseling. TEACH (Training Enhancement in Applied Cessation Counseling and Health) combines diffusion of innovations with principles of adult learning to address the lack of sys...

With the increasing availability of gambling throughout North America, there is interest in developing more effective treatments. This study compares the effectiveness of two brief outpatient treatments for problem gambling: eight sessions of Cognitive-Behavioral Therapy (n = 65) and eight sessions of a twelve-step treatment-oriented approach based...

Accumulating evidence suggests that treatment-seeking problem gamblers have high rates of substance abuse. However, relatively little is known about the relation between gambling problems and specific psychoactive substances apart from alcohol and methadone-treated opiate addicts. In this study of 169 individuals seeking outpatient treatment for pr...

A sample of 38 regular and heavy gamblers, recruited through advertisements and not seeking treatment, were asked to describe special strategies, techniques or rituals that they used to increase their chances of winning at gambling in an open-ended interview. The mean South Oaks Gambling Screen Score for the sample was 7.7 with 64% of the sample sc...