An Implementation Study of the Canadian Pulmonary Rehabilitation Program
Bibliographic record
Abstract
Aim: The Canadian Pulmonary Rehabilitation (PR) program enables existing Canadian PR programs to increase their quality of service and enables more Canadian institutions or health care professionals (HCP’s) to provide PR to individuals with COPD. The implementation of the Canadian PR program needs to be evaluated, before it can be implemented on a wider scale in Canada.\nMethods: A single-site implementation study with a prospective pre-post design was conducted. Outcome assessment was guided by the RE-AIM framework. Outcomes on the individual (patients with COPD) and organization level (PR program staff) on multiple domains (Reach, Effectiveness, Adoption, Implementation and Maintenance) were identified. In order to assess the Maintenance of the program, data collection was divided into two phases; 1) the initial implementation phase (first three cycles of PR after implementation) and 2) the sustainability phase (two cycles of PR 18 months after implementation). All HCP’s and patients with COPD in the PR program during these periods were invited to participate and included when they provided informed consent and met the inclusion criteria.\nResults: Of the patients referred for PR, 19-37.5% participated in the Canadian PR program. A total of 16 patients were included in the initial implementation phase and 10 patients in the sustainability phase. Outcomes that had the most clinically important improvements (N=7, 64%) in patients were functional exercise capacity and knowledge. Most clinical important improvements at 3-month follow-up were found in knowledge, self-efficacy for exercise and walking and spiritual domain of the functional performance inventory. Adoption of the program was maximal. Fidelity for the group education sessions ranged from 76% to 95% and the HCP’s followed almost all recommendations for exercise.\nConclusion: This study provides a full implementation evaluation of the Canadian PR program on the domains Reach, Effectiveness, Adoption, Implementation and Maintenance from the RE-AIM framework. The program was successfully implemented at a single site and was greatly accepted by patients and HCP’s and outcomes of this study informs future implementation.\nClinical relevance: The Canadian PR program provides HCP’s relevant resources and recommendations to improve quality of PR services and/or to start a new PR program.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".