In This Issue

  • Report from the Chair
  • Project Update
  • ACHORD Seen & Heard
  • Recent Literature
  • Meet the Staff
  • ACHORD Accolades
  • Events

Previous Issues

ACHORD Seen & Heard

Recent Publications

Al Sayah F, Mladenovic A, Gaebel K, Xie F, Johnson JA. How dead is dead? Qualitative findings from participants of combined traditional and lead-time trade-off valuations. Qual Life Res 2016;25(1):35-43. PMID: 26216584.

Al Sayah F, Johnson ST, Vallance J. Health Literacy, Pedometer, and Self-Reported Walking Among Older Adults. Am J Public Health. 2016;102(2):327-33. PMID: 26691129.

Alsabbagh MW, Lix LM, Eurich D, Wilson TW, Blackburn DF. Multiple-domain Versus Single-Domain Measurements of Socioeconomic Status (SES) for Predicting Nonadherence to Statin Medications: An Observational Population-based Cohort Study. Med Care 2016;54(2):195-204. PMID: 26683784.

Chan AW, Mercier P, Schiller D, Bailey R, Robbins S, Eurich DT, Sawyer MB, Broadhurst D. (1)H-NMR urinary metabolomics profiling for diagnosis of gastric cancer. Br J Cancer 2016;114(1):59-62. PMID: 26645240.

Donovan LE, Savu A, Edwards AL, Johnson JA, Kaul P. Prevalence and Timing of Screening and Diagnostic Testing for Gestational Diabetes: A Population Based Study in Alberta, Canada. Diabetes Care 2016;39(1):55-60. PMID: 26486187.

Fabreau GE, Leung AA, Southern DA, James MT, Knudtson ML, Ghali WA, Ayanian JZ. Area Median Income and Metropolitan Versus Nonmetropolitan Location of Care for Acute Coronary Syndromes: A Complex Interaction of Social Determinants. J Am Heart Assoc 2016;5(2). PMID: 26908400.

Johnson ST, Lier DA, Soprovich A, Mundt C, Johnson JA. How much will we pay to increase steps per day? Examining the cost-effectiveness of a pedometer-based lifestyle program in primary care. Prev Med Rep 2015;2:645-650. PMID: 26844131.

Johnson ST, Lynch B, Vallance J, Davenport MH, Gardiner PA, Butalia S. Sedentary behavior, gestational diabetes mellitus, and type 2 diabetes risk: where do we stand? Endocrine 2016;52(1):5-10. PMID: 26823010.

Johnson ST, Mundt C, Qui W, Soprovich A, Wozniak L, Plotnikoff R, Johnson JA. Increase in daily steps after an exercise specialist led lifestyle intervention for adults with type 2 diabetes in primary care: a controlled implementation trial. J Physical Activity Health 2016;12(11)1492-9. PMID: 25634940.

Lai FY, Johnson JA, Dover D, Kaul P. Outcomes of singleton and multiple pregnancies complicated by pre-existing diabetes and gestational diabetes: a population-based study in Alberta, Canada, 2005-2011. J Diabetes 2016;8(1):45-55. PMID: 25496644.

Padwal R, Lin M, Eurich DT. The Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Patients with Diabetes. J Clin Hupertens (Greenwich). 2016;18(3):200-6. PMID: 26289255.

Pederson JL, Majumdar SR, Forhan M, Johnson JA, McAlister FA. Current depressive symptoms, but not history of depression, predict hospital readmission or death after discharge from medical wards: a multi-site prospective cohort study. Gen Hosp Psychiatry 2016;39:80-85. PMID: 26804774.

Raymond J, Johnson ST, Diehl-Jones W, Vallance JK. Walking, Sedentary Time and Health-Related Quality Life Among Kidney Transplant Recipients: An Exploratory Study. Transplant Proc 2016;48(1):59-64. PMID: 26915844.

Tang KL, Rashid R, Godley J, Ghali WA. Association between subjective social status and cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis. BMJ Open 2016;6(3):e010137. PMID: 26993622.

Weir DL, McAlister FA, Majumdar SR, Eurich DT. The Interplay Between Continuity of Care, Multimorbidity, and Adverse Events in Patients with Diabetes. Med Care 2016;54(4):386-93. PMID: 26807539.

Xie F, Pullenayegum E, Gaebel K, Bansback N, Bryan S, Ohinmaa A, Poissant L, Johnson JA, on behalf of the Canadian EQ-5D-5L Valuation Study Group. A time trade-off-derived value set of the EQ-5D-5L for Canada. Med Care 2016;54:98-105. PMID: 26492214.

Recent Presentations

Johnson JA. Cost-effectiveness of Nurse-led Collaborative Care For Patients With Diabetes Who Screen Positive For Depression in Primary Care. Baker IDI Heart and Diabetes Institute, December 14, 2015, Melbourne, Australia.

Johnson JA. Pharmacoepidemiology: applying epidemiologic methods to observational studies of drug therapy. Baker IDI Heart and Diabetes Institute, December 16, 2015, Melbourne, Australia.

Eurich DT. Patient Centered Outcomes in Head and Neck Oncology Patients. Medical Grand Rounds, University of Alberta, Edmonton, Alberta, Canada, December 18, 2015.

Rewa O, Villeneuve P, Lachance, P, Eurich DT, Stelfox T, Gibney N, Hartling L, Featherstone R, Bagshaw SM. Key Quality Indicators in Continuous Renal Replacement Therapy (CRRT) Care in Critically Ill Patients. Alberta Society of Intensive Care Physicians Annual Meeting 2016 – Lake Louise, AB, January 23 2016. Canadian Critical Care Trials Group Winter Meeting 2016 – Lake Louise AB, January 26 2016. AKI & CRRT 2016 – San Diego, CA, February 17, 2016. AKI & CRRT 2016, San Diego, CA, February 2016.

Johnson JA. Patient-Reported Outcomes in Assessing Oncology Drugs. Pan-Canadian Oncolody Drug Review (pCODR) Expert Review Committee, Toronto, ON, February 18, 2016.

Johnson JA. Alberta PROMs and EQ-5D Research and Support Unit (APERSU). 2016 Winter Forum PCN Physician Leads. DoubleTree Hilton, Edmonton, AB, January 30, 2016, School of Public Health, University of Alberta, February 10, 2016, Department of Community Health Sciences/O’Brien Institute for Public Health Seminar Series, University of Calgary, April 1, 2016.

Eurich DT.  Future Trends and Management of Type 2 Diabetes.  Alberta Health, Edmonton, Alberta, Canada, March 8, 2016


14th Annual ACHORD Retreat

March 9-10, 2017
The Banff Centre
Banff, Alberta, Canada

2nd Annual APERSU End User Meeting

November 9-10, 2016
Matrix Hotel
Edmonton, Alberta, Canada



13th Annual ACHORD Retreat

The 13th Annual ACHORD Retreat was held on March 10-11, 2016 at the Banff Centre. As in past years, this informal meeting provides an opportunity for ACHORD investigators, collaborators and trainees to share research activities, and plan for continued growth of the ACHORD group.Thank you to all who presented at the Retreat:
Steve Johnson and Nonsi Mathe on HEALD-GDM and ABCD Cohort Substudy
Fatima Al Sayah provided an update on the ABCD Cohort
– Trainee presentations from Hayford Avedzi, Ming Ye, Travis Featherstone, Ana Mladenovic, Danielle Thiel and Chris Chen
Dean Eurich and Lisa Wozniak presented on the RADAR Project with Dean also presenting accolades celebrating ACHORD successes for both students and faculty in the past year
– Sonia Butalia on Transition Coordinator for Youth with Diabetes Mellitus project
Jeff Johnson on ongoing work with the Alberta Retired Teachers Association project and the newly established APERSU
– Fred Horne, Alun Edwards and Dev Menon led discussion on Incorporating Evidence into Policy

We would like to extend a special thank you to Fred Horne and Dev Menon who came to Banff to interact with our ACHORD group this year. We appreciated both of these individuals taking the time to come to our meeting and for presenting, along with Alun Edwards, a regular attendee, and Senior Medical Director with the Diabetes, Obesity and Nutrition Strategic Clinical Network (DON SCN). This session was very well received, and especially of value to our ACHORD trainees. We were also very fortunate to have Fred stay on for an additional question and answer session, which was originally for students, but everyone stayed to engage in the hour-long session.

As we typically do, we held an organized physical activity this year, a guided yoga class. We had a better turn out this year for yoga than last year.  It was enjoyed by all of us who attended!

Thank you to everyone who attended the 13th Annual Retreat. As is the case every year, this event is a success because of those of you that attend. Special thanks to Sherry Lydynuik who helped Jeff Johnson in planning this year’s ACHORD retreat.

Report from the Chair

Hello everyone! Hope you have had a great year so far, nice to see the snow is gone and beautiful spring weather is upon us! I have been busy since returning from my sabbatical leave in January, as has everyone else in ACHORD! Here is a quick update on what we have been doing since our last newsletter.

As you can see from the first article in this newsletter, we held another successful ACHORD Retreat in Banff on March 10 & 11. This retreat was well attended, and we were very pleased to have Fred Horne, a former Minister of Health in Alberta, Alun Edwards, Senior Medical Director with the DON SCN, and Dev Menon, from the School of Public Health, share with us their wisdom on incorporating evidence into policy. The discussions were very insightful, and enjoyed by all. More information on the retreat will be available on our ACHORD website.

The newly established Alberta’s PROMs and EQ-5D Research and Support Unit (APERSU) continues to pick up steam as more groups are registering to use the EQ-5D. We held a Board of Directors teleconference in January and a Scientific Advisory Committee teleconference in early March. We updated members on our activities so far and gained excellent feedback from the members of both committees. We have subsequent teleconferences planned for the Scientific Advisory Committee in April and the Board of Directors in June. We have started to plan the second End User Meeting in November, 2016, in Edmonton. The EuroQol Foundation held a mid-year meeting in Amsterdam in which Fatima Al Sayah, Arto Ohinmaa and I attended on behalf of APERSU. We have done several presentations to various audiences around the province, to both academic and non-academic stakeholders. Our next presentation on campus will be on Monday, April 18 at the WCHRI Lunch & Learn, 12:00 pm in 4-036 ECHA. Our APERSU website is up and running, so please visit and follow us on Twitter @apersu1.

I will be participating in two workshops on EQ-5D this spring, the first at the CADTH Symposium in Ottawa in April, then at the Health Technology Association International (HTAi) annual meeting in Tokyo in May. Both workshops will include presentations by my EuroQol colleagues Feng Xie and Simon Pickard.

Our epidemiologic research on the relationship between diabetes and cancer continues, as you will see in our project update elsewhere in the newsletter. Chris Chen (MSc student), Samantha Bowker and I will be attending the annual Diabetes and Cancer Research Consortium (DCRC) workshop in Reykjavik, Iceland in April, where Chris will be presenting his thesis project results.

I hope the information in our newsletter is informative, and if you have any questions about our activities, please do not hesitate to contact us. I look forward to updating you in late summer/early fall with more on ACHORD’s activities.

Project Update

Metformin, Ethnicity and Risk of Prostate Cancer

By: CB Chen, SR Majumdar, DT Eurich, and JA Johnson

There is a growing body of evidence suggesting individuals with diabetes are at an increased risk of cancer, triggering further studies investigating the ability of hypoglycemic agents to mitigate the risk. Our project aims to assess the impact of metformin exposure on prostate cancer risk and whether there are disparate effects between ethnic groups. We conducted a systematic review that did not find an association between metformin exposure and prostate cancer in Western- or Asian-based populations. However the pooled studies were highly heterogeneous hence we are conducting our own cohort study using an administrative database from British Columbia. Preliminary results do not suggest a relationship between metformin use and prostate cancer risk in Asian, Indian or other populations. A separate study using the same database also indicates that, as previously published, individuals with diabetes are at a lower risk of prostate cancer relative to those without. Although in both studies, there are indications of detection bias thus we will be investigating methods to mitigate this bias including adjusting for the number of physician visits and prostate specific antigen tests.

Recent Literature from the ACHORD Journal Club

(Paper discussed Tuesday, March 1, 2016; Commentary by Ben Dubois)

Long JAD, Stevens KR. Using Technology to Promote Self-Efficacy for Healthy Eating in Adolescents. Journal of Nursing Scholarship. 2004;36(2):134-39. PMID: 15227760


Obesity and overweight have reached epidemic proportions and they are risk factors for the development of chronic disease. Fifty-nine million American adults are obese and 9 million young people are overweight, more than doubling in the last 20 years. Healthy dietary practices are important in preventing overweight and obesity, but although many Americans are adopting healthier diets, a gap remains between dietary recommendations and what is actually consumed. The need to promote healthy eating among young people is a public health priority.

Self-efficacy is important in health behaviors. Self-efficacy, the belief in ones’ ability to accomplish a task in varying circumstances, has been described as a generative capability in relationship to one’s social, environmental, cognitive, and personal circumstances (Bandura, 1997).

This month, we discussed this paper’s methods and conclusions on the use of internet based tools to promote self-efficacy and healthy eating in adolescent populations.

Study methods and summary

The study was conducted with a quasi-experimental pretest-posttest design in a random sample of students in two junior high schools, grades seven to nine. Schools were randomly assigned to an intervention consisting of a combination of 5 hours of Web-based instruction and 10 hours of classroom curriculum. The intervention group was compared to students who were randomly assigned to receive nutrition education embedded in the standard school curriculum during a 1-month period. Participants completed six questionnaires. Data were analyzed using descriptive statistics, t tests, and Pearson’s r correlation coefficient.

The study concluded that the intervention group had significantly higher scores for self-efficacy for fruits and vegetables and lower fat, usual food choices, and dietary knowledge of fat compared to the control group. No difference was found between groups in food consumption. Self-efficacy was significantly associated with dietary knowledge of lower fat, and usual food choices. The intervention was tailored to the social and developmental preferences of adolescents and effectively increased self-efficacy for healthy eating. The mediating role of self-efficacy in the hypothesized model of adolescent eating behavior warrants further investigation.


The results of this study did not indicate a significant change in eating behavior in the intervention school, and several explanations are possible. The measurement of food consumption may not have been sufficiently sensitive to detect a significant change in eating behavior. The study’s resources were limited as well, which is why only a pretest-posttest design was used with questionnaires. The study was also limited to one month, and a comment was made in the discussion that the majority of diet interventions occur for three months or more, suggesting one month is not near long enough to produce any real results.One major issue highlighted in our discussion is that the majority of reported conclusions are made based on the comparison between exposed and unexposed groups’ reported results at the end of the study. The issue with this kind of comparison is that the change in behaviour between the beginning of the study and the end in both groups is not taken into account in the calculation. This study shows the intervention group performed better than the control group, but only after the intervention, it is possible that the students assigned to the intervention may have had better habits before the study, and it is also possible that the students in the control group may have had worse habits before the study. Further to this issue, the researchers did not take the health or demographics of the children into account in the study, which may have had important influences on the students. It was also noted that this was an older study, and the conclusions may not have generalizability today, as both technology and testing methods have improved over time.

Meet the Staff

Michelle Lindberg, M.Ed.

Michelle is the Project Support Officer for the Career Development in Methods and Health Services Research Platform of the Alberta “Strategies for Patient Oriented Research” (SPOR) SUPPORT unit at the University of Alberta. Michelle completed her Physical Education, Education and Masters of Educational Leadership Degree at the University of Alberta. Her Masters was focused on essential components of the training process of health promotion leaders. She spent a few years as a teacher before she returned to the University of Alberta, joining the School of Public Health. Michelle worked with two initiatives focused on comprehensive school health and was honoured to learn about health promotion in various diverse Alberta communities. Michelle is passionate about life-long learning and creating positive environments for professional development to be successful.

Recent Presentations (cont)

Majumdar SR, Josse RG, Lin M, Eurich DT. Does sitagliptin affect the rate of osteoporotic fractures in type-2 diabetes? Population-based cohort study. Endocrine Rev. 2016; (suppl 1). ENDO 2016 Annual Meeting, Boston, MA, USA, April 1-4, 2016.

ACHORD Accolades

Congratulations to:

Jessica Beatty on successfully completing her Master of Science Oral Exam

Steve Johnson on being awarded two MarCom Awards

Maxim Eskin on being awarded a DSECT scholarship

Other ACHORD News

Congratulations to Nonsikelelo Mathe on her marriage to Mac-Jordan Degadjor

Congratulations to Samantha Bowker on her marriage to Tim Stanistreet

Farewell to Haley Breedlove

ACHORD Contact Information

Phone Numbers: General Inquiries: 780-248-1010 | Fax : 780-492-7455
University of Alberta | 2-040 Li Ka Shing Centre for Health Research Innovation | Edmonton, AB, T6G 2E1