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Chronic Diseases in Canada cover of the  PDF version

Volume 29, No. 1, 2008

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Table of Contents

 

Feature Articles

1. Health Literacy and Numeracy: Key Factors in Cancer Risk Comprehension
View Abstract

L Donelle, JF Arocha, L Hoffman-Goetz

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2. Colorectal Cancer Screening in Canada: Results of a National Survey
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MJ Sewitch, C Fournier, A Ciampi, A Dyachenko

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3. Stroke Surveillance in Manitoba, Canada: Estimates from Administrative Databases.
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DF Moore, LM Lix, MS Yogendran, P Martens, A Tamayo

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4. Population-Based Data Sources for Chronic Disease Surveillance
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LM Lix, MS Yogendran, SY Shaw, C Burchill, C Metge, R Bond

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Workshop Reports

1. The Second National Sun Survey: Workshop Report
B Waller, E Pichora, L Marrett

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Chronic Diseases in Canada (CDIC) is a quarterly scientific journal focussing on current evidence relevant to the control and prevention of chronic (i.e. non-communicable) diseases and injuries in Canada. Since 1980 the journal has published a unique blend of peer-reviewed feature articles by authors from the public and private sectors and which may include research from such fields as epidemiology, public/community health, biostatistics, the behavioural sciences, and health services or economics. Only feature articles are peer reviewed. Authors retain responsibility for the content of their articles; the opinions expressed are not necessarily those of the CDIC editorial committee nor of the Public Health Agency of Canada.

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Abstracts from Feature Articles in Chronic Diseases in Canada Volume 29, No 1, 2008

Article 1: Health literacy and numeracy: Key factors in cancer risk comprehension

Authors: L Donelle, JF Arocha, L Hoffman-Goetz

Abstract: In this age of chronic disease and shared decision making, individuals are encouraged to contribute to decisions about health care. Health literacy, including numeracy, is requisite to meaningful participation and has been accepted as a determinant of health. The purpose of this study was to describe the influence of literacy, consisting of prose and numeracy skill, math anxiety, attained education and context of information on participant ability to comprehend Internet-based colorectal cancer prevention information. Prose, numeracy, and math-anxiety data, as well as demographic details, were collected for 140 Canadian adults, aged 50+ years. Participants had adequate prose literacy (STOFHLA) scores, high STOFHLA numeracy scores, moderate levels of health-context numeracy, poorer generalcontext numeracy and moderate math anxiety. There was better comprehension by participants of common (9.14/11) compared with uncommon (7.64/11) colorectal cancer information (p < 0.01). Prose literacy, numeracy, math anxiety and attained education accounted for 60% of the variation in participant comprehension scores. Numeracy, ranging from basic to advanced proficiency, is required to understand online cancer risk information. Prose literacy enhances numeracy when the subject matter is less familiar. These findings highlight the importance of presenting Web-based information that accommodates diverse health literacy and numeracy levels.

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Article 2: Colorectal cancer screening in Canada: results of a national survey

Authors: MJ Sewitch, C Fournier, A Ciampi, A Dyachenko

Abstract: Canadian guidelines recommend colorectal-cancer (CRC) screening for individuals aged 50 to 74 years. The study objective was to estimate rates of CRC screening according to individual and geographical characteristics, and of adherence to current CRC screening guidelines. Respondents to the 2003 Canadian Community Health Survey Cycle 2.1 (aged ≥ 50 years, without past or present CRC) participated. Fecal occult blood test (FOBT) and endoscopy utilization and screening rates were calculated. The sample included 16 747 residents of Newfoundland, Ontario, Saskatchewan and British Columbia. Overall, the FOBT screening rate was 7.7% in the past year, and the endoscopy screening rate was 8.8% in the past 5 years. FOBT screening rates were higher in older and male respondents; endoscopy screening rates were higher in older respondents. Individuals aged 50 to 59 and over 90 years were least likely to have been screened. Approximately 70% of respondents were non-adherent to current CRC screening guidelines. Non-adherence rates were higher in most health regions of British Columbia. National survey data suggest CRC screening in Canada is low; younger persons and residents of British Columbia were least likely to report CRC screening.

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Article 3: Stroke surveillance in Manitoba, Canada: Estimates from administrative databases

Authors: DE Clarke, PhD; A Colantonio, PhD; AE Rhodes, PhD; M Escobar, PhD

Abstract: This study investigated the use of population-based administrative databases for stroke surveillance. First, a meta-analysis was conducted of four studies, identified via a PubMed search, which estimated the sensitivity and specificity of hospital data for ascertaining cases of stroke when clinical registries or medical charts were the gold standard. Subsequently, case-ascertainment algorithms based on hospital, physician and prescription drug records were developed and applied to Manitoba's administrative data, and prevalence estimates were obtained for fiscal years 1995/96 to 2003/04 by age group, sex, region of residence and income quintile. The meta-analysis results revealed some over-ascertainment of stroke cases from hospital data when the algorithm was based on diagnosis codes for any type of cerebrovascular disease (Mantel-Haenszel Odds-Ratio [OR] – 1.70 [95% confidence interval (CI): 1.53 – 1.88]). Analyses of Manitoba administrative data revealed that while the total number of stroke cases varied substantially across the algorithms, the trend in prevalence was stable regardless of the algorithm adopted.

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Article 4: Population-based data sources for chronic disease surveillance

Authors: LM Lix, MS Yogendran, SY Shaw, C Burchill, C Metge, R Bond

Abstract: This study estimated agreement between population-based administrative and survey data for ascertaining cases of arthritis, asthma, diabetes, heart disease, hypertension and stroke. Chronic disease case definitions that varied by data source, number of years and number of diagnosis or prescription drug codes were constructed from Manitoba's administrative data. These data were linked to the Canadian Community Health Survey. Agreement between the two data sources, estimated by the κ coefficient, was calculated for each case definition, and differences were tested. Socio-demographic and comorbidity variables associated with agreement were tested using weighted logistic regression. Agreement was strongest for diabetes and hypertension and lowest for arthritis. The case definition elements that contributed to the highest agreement between the two population-based data sources varied across the chronic diseases. Low agreement between administrative and survey data is likely to occur for conditions that are difficult to diagnose, but will be mediated by individual socio-demographic and health status characteristics. Construction of a chronic disease case definition from administrative data should be accompanied by a justification for the choice of each of its elements.