Clinical trials

Extreme heat events pose a significant health threat in Canada, as demonstrated by the 2021 heat wave that claimed over 600 lives in Western Canada. Most heat-related deaths occur indoors and are preventable. Primary care providers (PCPs), who serve 88% of Canadians, are uniquely positioned to identify and support at-risk individuals. Heat Smart, in alignment with Heat Alert and Response Systems (HARS), aims to bridge the gap between primary care and public health to enhance community resilience and reduce health inequities related to extreme heat events. This randomized control trial in Eastern Ontario will examine whether patients receiving tailored digital health messages from their family physician or nurse practitioner change their behaviour to protect themselves from extreme heat-related illness. The Heat Smart study will: * Assess risk: Analyze electronic medical records and patient surveys to identify vulnerable individuals. * Deliver tailored messages: Send personalized digital guidance via e-mail or text, offering heat safety advice and local resource information in English and French. * Issue early warning alerts: Notify at-risk patients of upcoming heat events, prompting action. * Evaluate impact: Use surveys and health data to measure effectiveness in reducing heat-related health impacts. Short-term outcomes include increased awareness and preparedness among patients about heat-related health risks. Long-term goals involve scaling the intervention across Canada to reduce heat-related illnesses, enhance social connectedness, and decrease healthcare utilization.

Steatosis is the building of fat in the liver. Steatotic liver disease (SLD) regroups MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic dysfunction-associated steatohepatitis) i.e. MASLD with inflammation. An estimated 30% of the population worldwide has MASLD and 5% of Canadians have MASH. MASH is a leading cause of liver transplantation in Canada. There is no cure for SLD, and the treatment relies on diet, weight loss, and physical activity (PA). Is a counselling intervention to help patients progressively engage in more PA a feasible and acceptable approach? Objectives. This proposal has three primary objectives: 1) To assess the feasibility of our PA counselling intervention (to be delivered online) with SLD patients; 2) To evaluate the acceptability of our intervention; 3) To evaluate the feasibility of the study methods/procedures. Methodology. This study is an open-label, mono-centred, single-case experimental design with multiple base levels. The study will comprise 3 phases, alternating periods of observation (A) and 1 period of counselling (B) with an A1-B-A2 design. PA will be assessed continuously using an accelerometer for 7 to 14 days per (A) phase. During phase (B), participants will receive the intervention, i.e. 6 x 45-minute, real-time, face-to-face, virtual sessions with a PA counsellor. Based on past studies, our sample size will be 12 participants. They will be recruited through the hepatology clinic at Hôpital Montfort. The primary outcomes of the project are to evaluate the feasibility and acceptability of the trial and intervention. The secondary outcomes are Daily PA time and biological/imaging data evolution