Sonya Allin - Academia.edu (original) (raw)

Papers by Sonya Allin

BACKGROUND Globally, 1 in 3 adults live with multiple chronic conditions. Thus, effective interve... more BACKGROUND Globally, 1 in 3 adults live with multiple chronic conditions. Thus, effective interventions are needed to prevent and manage these chronic conditions and to reduce the associated health care costs. Teaching effective self-management practices to people with chronic diseases is one strategy to address the burden of chronic conditions. With the increasing availability of and access to the internet, the implementation of web-based peer support programs has become increasingly common. OBJECTIVE The purpose of this scoping review is to synthesize existing literature and key characteristics of web-based peer support programs for persons with chronic conditions. METHODS This scoping review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching MEDLINE, CINAHL, Embase, PsycINFO, and the Physiotherapy Evidence Database. Chronic diseases identified by the Public Health A...

— The ability to rise from a chair is a prerequisite for upright mobility and independent living.... more — The ability to rise from a chair is a prerequisite for upright mobility and independent living. We are developing an inexpensive stereo based system capable of cheaply and automatically assessing the quality of “sit-tostand” movements in environments outside of clinics. Automated assessments have been designed to translate perceived kinematics onto assessment scores that are consistent with expert opinion on the Berg Balance Scale (BBS). In addition, automated assessments reveal movement strategies associated with age and disability, like the use of the arms while rising or excess extension at the knees. In this paper, we present preliminary work to translate perceived movement kinematics from community dwelling balance impaired elders onto expert assessments of sit-to-stand health. Our ultimate goal is to create automated tools to identify falls risk, quantify real-world movement changes that result from therapeutic interventions, and perform ergonomic analyses of elders ’ seatin...

We present a system to automatically assess the functional performance of stroke survivors along ... more We present a system to automatically assess the functional performance of stroke survivors along axes defined by the Arm Motor Ability Test (AMAT). The upper body motion of seven stroke survivors was measured in a laboratory environment using a commercial motion capture device and a novel kinematic tracker of our design. Statistics generated by each individual were related to expert-determined assessments of functional health. Results indicate several kinematic targets that correlate with and predict opinions of health. These include recorded motion of the torso during the performance of tasks and flexion about the elbow on the hemiparetic (impaired) side. We show that both kinematic statistics can be cheaply and robustly measured with video cameras while still preserving their diagnostic value. Such cheap and robust measurements will ultimately facilitate assessment outside of clinics and in places where functioning is valuable to individuals, such as homes and workplaces. 1

AMIA ... Annual Symposium proceedings. AMIA Symposium, 2014

In a large database of EMR records, we explore: 1) completeness in capture of bone mineral densit... more In a large database of EMR records, we explore: 1) completeness in capture of bone mineral density (BMD) T-scores required for diagnosis of osteoporosis; 2) concordance of BMD exam information with other osteoporosis information; and 3) evidence of osteoporosis screening among fracture patients. To explore completeness of exam capture, BMD exams in the EMR were related to a provincial billing database. To explore concordance of information and screening rates, 7500 EMR records were reviewed for osteoporosis and fracture details. Results show that 98% of exams billed to the province for EMR patients were found in the EMR. However, documented osteoporosis was substantiated with BMD results only 55.8% of the time. Of 151 charts for fragility fracture patients, 1 in 4 contained no evidence of osteoporosis investigation. In summary, while EMR information about osteoporosis is of variable quality, EMR records shed light on osteoporosis management indicators and completely capture BMD resu...

The ability to rise from a chair is a prerequisite for independent ambulation. Difficulty rising ... more The ability to rise from a chair is a prerequisite for independent ambulation. Difficulty rising from a chair, moreover, is an indicator of balance deficits likely to result in a fall. In this paper we present preliminary work to affordably detect sit to stand strategies associated with balance impairment using web cameras. The long term goal is to create systems that can monitor functional movements that are common at home in a way that reflects changes in stability and impairment.

In this thesis, we propose a novel measurement methodology for long term monitoring and assessmen... more In this thesis, we propose a novel measurement methodology for long term monitoring and assessment of stroke survivors’ functional motion. Our long-term goal is to measure and provide feedback about changes in functional movements that happen in everyday environments across days, months or years. The research contained in the thesis consists of three parts. First, therapists were interviewed to determine common observations they make about stroke survivors functional activity for the purpose of assessment. Protocol analysis was used to gain insight onto parts of the body as well as motor symptoms that were particular points of focus. Next, a prototype system was built to measure functional movement and its ability to capture statistics that discriminate between levels of functional impairment was tested. The technologies explored were primarily chosen because they are inexpensive and robust. They include simple computer vision and force sensing devices. Several different score predi...

This paper details an effort to determine heuristics used in practice by expert therapists to fun... more This paper details an effort to determine heuristics used in practice by expert therapists to functionally assess the upper extremity of stroke survivors. The goal is to be able to compare these heuristics to heuristics used by a computer system that performs similar assessments, automatically. Three expert therapists were asked to verbalize their decision-making process as they made assessments of eight stroke survivors’ upper extremity function using the Arm Motor Ability Test (AMAT). Transcripts were coded to determine which specific parts of the upper extremity and/or trunk were focused on in order to arrive at assessment scores. Results indicate that therapists were consistent in their heuristics, and prioritized distal features (like motion of the fingers) when making assessment decisions over proximal ones. The automated system, by contrast, prioritized proximal movement features (like motion of the torso) over distal ones to make the same assessments.

JMIR Rehabilitation and Assistive Technologies, 2020

Background Individuals with spinal cord injury (SCI) are at high risk of experiencing secondary c... more Background Individuals with spinal cord injury (SCI) are at high risk of experiencing secondary conditions like pressure injuries. Self-management programs may reduce the risk of complications, but traditional programs have proven to be insufficiently tailored to the needs of people with SCI. To overcome barriers to self-management support, a web-based, self-management program was developed for Canadians with SCI called SCI & U. Objective This study aims to evaluate the feasibility and potential impact of the SCI & U program in the context of a mixed methods pilot study. Methods The study followed an explanatory, sequential mixed methods design. Participants (N=11) were Canadians with SCI who had been living in the community for more than 1 year. Each took part in a self-paced, six-session self-management program guided by a trained peer health coach. During sessions, participants could discuss a health topic with their coach from a predefined list (eg, skin or bowel management). Qu...

Proceedings 10th Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems. HAPTICS 2002

This paper describes preliminary work in the use of a virtual environment to derive just noticeab... more This paper describes preliminary work in the use of a virtual environment to derive just noticeable differences (JNDs) for force. Specifically, we look for thresholds of force sensitivity so that we may ultimately construct therapeutic force feedback distortions that stay below these thresholds. Initially, we have concentrated on JNDs as they are applied to the index finger; preliminary data in healthy individuals shows an average JND of approximately 10%. More significantly, the data indicate that visual feedback distortions in a virtual environment can be created to encourage increased force productions by up to 10%, and that this can be done without a patient's awareness.

BACKGROUND Rehospitalization rates resulting from secondary conditions in persons with spinal cor... more BACKGROUND Rehospitalization rates resulting from secondary conditions in persons with spinal cord injuries (SCI) are high. Self-management programs for many chronic conditions have been associated with decreases in hospital readmissions. However, in the SCI community, evidence suggests that satisfaction with traditional self-management programs is low. Users with SCI have indicated preference for programs that are online (rather than in-person), that target SCI-specific concerns, and are led by peers with SCI. There is currently no program with all of these features, which addresses self-management of secondary conditions after SCI. OBJECTIVE The aim of this study was to provide details of a participatory design (PD) process for an internet-mediated self-management program for users with SCI (called SCI & U) and illustrate how it has been used to define design constraints and solutions. METHODS Users were involved in development as codesigners, codevelopers, and key informants. Cod...

BACKGROUND Individuals with spinal cord injury (SCI) have a high risk of experiencing a condition... more BACKGROUND Individuals with spinal cord injury (SCI) have a high risk of experiencing a condition secondary to injury like a pressure sore. Self-management programs may reduce the risk of such complications, but traditional programs have proven to be insufficiently tailored to the needs of people with SCI. To overcome barriers to self-management support, an online self-management program was developed for Canadians with SCI called “SCI&U”. OBJECTIVE To evaluate the feasibility and potential impact of the “SCI&U” program in the context of a mixed-methods pilot study. METHODS The study followed an explanatory sequential mixed-methods design. Participants (N=11) were Canadians with SCI who had been living in the community for more than 1 year. Each took part in a self-paced, 6-session self-management program guided by a trained peer health coach. During most sessions participants could elect to discuss a health topic with their coach from a pre-defined list (e.g. Skin or Bowel Manageme...

JMIR rehabilitation and assistive technologies, Jan 21, 2018

Rehospitalization rates resulting from secondary conditions in persons with spinal cord injuries ... more Rehospitalization rates resulting from secondary conditions in persons with spinal cord injuries (SCI) are high. Self-management programs for many chronic conditions have been associated with decreases in hospital readmissions. However, in the SCI community, evidence suggests that satisfaction with traditional self-management programs is low. Users with SCI have indicated preference for programs that are online (rather than in-person), that target SCI-specific concerns, and are led by peers with SCI. There is currently no program with all of these features, which addresses self-management of secondary conditions after SCI. The aim of this study was to provide details of a participatory design (PD) process for an internet-mediated self-management program for users with SCI (called SCI & U) and illustrate how it has been used to define design constraints and solutions. Users were involved in development as codesigners, codevelopers, and key informants. Codesigners and codevelopers wer...

The Journal of Spinal Cord Medicine

To determine the implementation considerations for a targeted self-management program for individ... more To determine the implementation considerations for a targeted self-management program for individuals with spinal cord injury (SCI) from the perspective of a national stakeholder advisory group using the Theoretical Domains Framework (TDF) as a guide. Qualitative descriptive approach. Two focus groups held at the 6th National Spinal Cord Injury Conference (October 2-4th, 2014) in Toronto, Ontario, Canada. A total of 25 stakeholders from across Canada participated in focus groups or &amp;amp;amp;quot;brainstorming sessions&amp;amp;amp;quot;. The stakeholders included 5 clinicians, 14 researchers, 3 policy makers, and 3 individuals with SCI. Not applicable. Not applicable. All 14 theoretical domains were identified in the brainstorming sessions. No new themes or domains were identified. The need to consider the theoretical domains of Knowledge, Skills, Reinforcement, Intentions, Goals (e.g. the readiness of the individual with SCI), Environmental Context and Resources (e.g. considerations for governance and ownership of the program and a business model for sustainability), as well as Social Influences (e.g. issues of privacy and security in the context of on-line delivery) was identified. The current study provides complementary results to our previous series of studies on the implementation considerations for the development of a targeted self-management program for individuals with SCI by emphasizing the health care professional/health policy perspective. It is anticipated that such a program could not only reduce secondary complications and subsequent inappropriate health care use but it may also improve the quality of life for individuals with SCI and their caregivers.

BMJ Open

IntroductionPeer support is receiving increasing attention as both an effective and cost-effectiv... more IntroductionPeer support is receiving increasing attention as both an effective and cost-effective intervention method to support the self-management of chronic health conditions. Given that an increasing proportion of Canadians have internet access and the increasing implementation of web-based interventions, online peer support interventions are a promising option to address the burden of chronic diseases. Thus, the specific research question of this scoping review is the following:What is known from the existing literature about the key characteristics of online peer support interventions for adults with chronic conditions?Methods and analysisWe will use the methodological frameworks used by Arksey and O’Malley as well as Levac and colleagues for the current scoping review. To be eligible for inclusion, studies must report on adults (≥18 years of age) with one of the Public Health Agency of Canada chronic conditions or HIV/AIDS. We will limit our review to peer support interventi...

Journal of osteoporosis, 2016

Introduction. The purpose of this study is to understand the experience of primary care providers... more Introduction. The purpose of this study is to understand the experience of primary care providers (PCPs) using an evidence-based requisition for bone mineral density (BMD) testing. Methods. A qualitative descriptive approach was adopted. Participants were given 3 BMD Recommended Use Requisitions (RUR) to use over a 2-month period. Twenty-six PCPs were interviewed before using the RUR. Those who had received at least one BMD report resulting from RUR use were then interviewed again. An inductive thematic analysis was performed. Results. We identified four themes in interview data: (1) positive and negative characteristics of the RUR, (2) facilitators and barriers for implementation, (3) impact of the RUR, and (4) requisition preference. Positive characteristics of the RUR related to both its content and format. Negative characteristics related to the increased amount of time needed to complete the form. Facilitators to implementation included electronic availability and organizationa...

Mva, 2007

Journal of Clinical Densitometry, 2016

Fracture risk assessments are not always clearly communicated on bone mineral density (BMD) repor... more Fracture risk assessments are not always clearly communicated on bone mineral density (BMD) reports; evidence suggests that structured reporting (SR) tools may improve report clarity. The aim of this study is to compare fracture risk assessments automatically assigned by SR software in accordance with Canadian Association of Radiologists and Osteoporosis Canada (CAROC) recommendations to assessments from experts on narrative BMD reports. Charts for 500 adult patients who recently received a BMD exam were sampled from across University of Toronto&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Joint Department of Medical Imaging. BMD measures and clinical details were manually abstracted from charts and were used to create structured reports with assessments generated by a software implementation of CAROC recommendations. CAROC calculations were statistically compared to experts&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; original assessments using percentage agreement (PA) and Krippendorff&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha. Canadian FRAX calculations were also compared to experts&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, where possible. A total of 25 (5.0%) reported assessments did not conform to categorizations recommended by Canadian guidelines. Across the remainder, the Krippendorff&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha relating software assigned assessments to physicians was high at 0.918; PA was 94.3%. Lower agreement was associated with reports for patients with documented modifying factors (alpha = 0.860, PA = 90.2%). Similar patterns of agreement related expert assessments to FRAX calculations, although statistics of agreement were lower. Categories of disagreement were defined by (1) gray areas in current guidelines, (2) margins of assessment categorizations, (3) dictation/transcription errors, (4) patients on low doses of steroids, and (5) ambiguous documentation of modifying factors. Results suggest that SR software can produce fracture risk assessments that agree with experts on most routine, adult BMD exams. Results also highlight situations where experts tend to diverge from guidelines and illustrate the potential for SR software to (1) reduce variability in, (2) ameliorate errors in, and (3) improve clarity of routine adult BMD exam reports.

Journal of Osteoporosis, 2016

Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in... more Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario’s family physicians (FPs).Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing.Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described.Conclusions. These findings lend support to what has been documented a...