Axes and activities

Axe 1

Behavioural science theory, frameworks, and core methods

Co-leads: Claudia T-Fitzgerald (Psychology, Université du Québec à Trois-Rivières) and Tracie Barnett (Family Medicine, McGill University)

Healthy behaviours, such as physical activity, healthy eating, and refraining from smoking, are paramount to the prevention and management of major chronic diseases (Liu Y, Croft JB, Wheaton A, al. et al. Clustering of Five Health-Related Behaviors for Chronic Disease Prevention Among Adults, United States, 2013. Prev Chronic Dis. 2016;13:160054). While some efficacious behaviour change interventions exist, little to no progress has been observed in the uptake of healthy behaviours, especially in at-risk populations. This may be explained, in part, by insufficient consideration of the upstream causes of these behaviours, notably, social determinants of health. To address this, the precision health framework combines insights from the social, behavioural, and biological sciences. The mission of Axe 1 is to provide evidence-based, theory-driven research tools and training designed to integrate key individual (psychological and motivational factors) and social (social capital, stigma, food insecurity) determinants of health across subgroups (age, sex, socioeconomic status, etc.).

Axe 1 will provide the Quebec scientific community with skills, knowledge, and resources essential to integrate behavioural science theory, frameworks, methods, and measures into their research by:

  • Supporting all Quebec health researchers to integrate key measures of individual and social determinants of health in their research through hands-on in-person and virtual seminars on theory-informed research, measurement and design and evidence synthesis (e.g., meta-analyses)

  • Bringing together a range of expertise to innovate and solve socially rooted health problems through low-cost and time-efficient mechanisms that engage all relevant partner networks

  • Building capacity in training the next generation of behavioural scientists through annual student internships supporting interdisciplinary projects targeting psychological and social determinants of behaviour in at-risk populations

  • Leveraging open access dataset infrastructures already available to the network

  • Improving the accessibility of validated measures and tools used across studies in the field by creating a publicly accessible online resource bank of validated behavioural measures in both English and French

  • Expanding our knowledge and providing guidance and resources on theory, frameworks, and methods that explicitly measure and interpret upstream psychological and social determinants of health

Axe 2

Behavioural intervention development and testing

Co-leads: Sylvie Lambert (Nursing, McGill University) and Serge Sultan (Psychology, Université de Montréal)

Behavioural interventions targeting health behaviours have been shown to be effective for individuals, families, groups, communities, and populations, yet there remains a proliferation of poorly conceived/implemented behavioural interventions that are not only ineffective, but counterproductive. Major innovations in behavioural science have come from international efforts to increase the uptake and effectiveness of behavioural interventions through the use of intervention development frameworks (including the Behaviour Change Wheel - Michie S, van Stralen M, West R. The Behavior Change Wheel: a new method for characterizing and designing behavior change interventions. Implementation Science. 2011;6:42), behaviour change theories and models, innovative trial designs, implementation frameworks, and transparent reporting of research. However, many behavioural researchers still lack awareness of and training in these methods.

To address this, Axe 2 will expand the use of state-of-the-art frameworks and methods for the development, testing and implementation of behavioural interventions, with a focus on priority areas identified by the MSSS policies and action plans for sustainable health by:

  • Strengthening and building capacity for the development and delivery of high quality behavioural interventions

  • Fostering the development of high quality interdisciplinary, intersectoral, and innovative projects

  • Bringing together all Quebec behavioural interventionists under a unified virtual community of practice to share ideas and innovate on how to contribute to sustainable health with other Quebec networks and strategic partners

  • Developing a core curriculum in behavioural interventions applied to health that can be delivered across multiple fields (medicine, nursing, nutrition, kinesiology, etc.)

  • Funding an internship program with our partners to expose trainees to short-term, project-driven, translational research training in behavioural interventions, to offer them inter-disciplinary mentorship and to leverage networking events with multiple sectors (researchers, clinicians, industry, health administrators/ systems) to facilitate job opportunities for mentees

Axe 3

Digital Behaviour

Co-leads: Nicole Alberts (Concordia University) and Mylène Aubertin (Université du Québec à Montréal)

Effective chronic disease prevention and management largely relies on modifying health behaviours (e.g., diet, physical activity, medication adherence). However, behaviour change interventions face implementation challenges related to engagement and accessibility, resulting in suboptimal outcomes. Moreover, traditional behaviour change interventions are resource-intensive and may not be easily scalable, limiting their reach and impact. Artificial intelligence (AI)-driven digital health interventions (DHIs) offer a transformative opportunity via personalisation to create better patient-centered care, offer improved outcomes, and reduce healthcare costs. 

Axe 3 aims to improve engagement with and access to sustainable and evidence-based behavioural DHIs targeting a variety of health behaviours to improve a range of physical and mental health outcomes by:

Cartographier et relier tous les chercheurs, chercheuses et partenaires clés du Québec travaillant sur les INS comportementales avec des utilisatrices et utilisateurs finaux des INS afin de faciliter l'intégration des INS comportementales dans les écosystèmes du Québec en vue de la poursuite d'une santé durable

  • Mapping and connecting all the key researchers and partners in Quebec working on behavioural DHIs with a broad range of DHI end-users to facilitate the integration of behavioural DHI solutions into multiple levels of the Quebec ecosystems in pursuit of sustainable health

  • Connecting the community in collaboration with our partners through an environmental scan of DHI studies completed in Quebec to create an open access resource bank to support interdisciplinary and intersectoral collaborations

  • Leveraging the community by developing evidence-based standardised guidance on the development and use of behavioural DHIs, with an emphasis on the integration of AI functionality

  • Identifying the most effective DHIs or DHI components that hold the greatest potential to be deployed to increase accessibility and reach with a focus on the key priorities of the MSSS through co-funded brainstorming and seed funding competitions

  • Increasing access to effective behavioural DHIs, particularly in underserved populations or those in underserved areas, thus minimising travel and its related climate impacts

  • Deepening our understanding of ‘digital behaviour’ and engagement to optimise the impact of DHIs and platforms more generally

Axe 4

Implementation science and behavioural public health

Co-leads: Ariane Bélanger-Gravel (Université Laval) and Geneviève Rouleau (Université du Québec en Outaouais)

Implementation failures are common when attempting to translate efficacious health interventions into practice, suggesting that best evidence is not being optimally translated into patient care and population health. The fact that less than 50% of healthcare professionals adhere to treatment guidelines across chronic diseases is evidence of the scope of these implementation failures. This supports the need for research to identify effective and optimal strategies to bridge the gap between research (evidence) and practice.

 Axe 4 will catalyse highly interdisciplinary and intersectoral expertise in supporting the development of scientific knowledge resulting in an optimal, high quality, inclusive and sustainable healthcare system; ultimately, resulting in improved population health for Quebecers by:

Renforcer les capacités en matière de santé publique comportementale et de science de la mise en œuvre en développant et en dispensant des formations dans ce domaine par l'intermédiaire des infrastructures de formation existantes qui ciblent divers aspects de la science de la mise en œuvre et du comportement, y compris la participation de diverses parties intéressées

  • Fostering the development of high quality interdisciplinary, intersectoral, and innovative research projects by building capacity in behavioural public health and implementation science through the development and delivery of training through existing training infrastructures that target various aspects of implementation and behavioural science, including engagement with various interested parties

  • Developing high quality interdisciplinary, intersectoral, and innovative projects through yearly one-hour online “speed dating” activities on various publish health topics with researchers, networks, students, and knowledge users, healthcare and public health professionals, ASPQ, and policy makers)

  • Stirring innovation and solution generation in implementation science and public health through sandbox approaches

  • Holding funding competitions focused on team building to create and strengthen engagement and partnerships around research projects involving the implementation of behavioural interventions critical for optimising patient care and public health

  • Stimulating new collaborations between researchers and interested parties through open funding for multi-network proof-of-concept or pilot projects

  • Creating an internship/mentorship program which pairs a mentor and a mentee to offer personalised training

  • Creating a Wiki-type repository to disseminate a range of training opportunities

  • Offering travel awards for ECRs, postdoctoral fellows and graduate students to support the dissemination and mobilisation of research findings in the field of implementation science and behavioural public health at conferences and government policy meetings

  • Funding implementation and public health researchers to deliver training activities at an annual network conference

Activities

  • Excellent method for generating innovative early phase projects that can start the process of forming interdisciplinary and intersectoral teams to answer specific questions. Once a question is defined, any interested and affected party can apply to be part of the sandbox. An evaluation committee is charged with forming the research team who will receive network funding to address the question.

  • Creation of knowledge translation products and activities addressing partner needs and priorities. This dissemination strategy will also be used to help us develop future collaborations.

  • Co-create training activities about the nature of behavioural science and frame these activities in specific contexts. Examples include summer schools, training camps, workshops, online courses, etc.

  • Offer training led by content experts from behavioural science and fields specific to the topic.

  • Create opportunities where highly qualified mentees can bring behavioural science to our partners while also offering mentees a chance to acquire experience and explore non-academic networks.