Billy Vinette

Background: Cannabis use (CU) among young adults continues to be an important public health issue. Interventions to support lower-risk CU during young adulthood can improve health outcomes. Mobile applications constitute a promising mode of service delivery. However, there is a lack of evidence-based apps specifically developed for young adult cannabis users. Objective: This study aimed to evaluate the acceptability of a novel mobile app intervention (Joint Effort) and to assess the feasibility and outcome responsiveness of the study procedures used. Methods: A pilot study with a parallel-group randomized trial design was conducted with Canadian-based university students aged 18‐30 years reporting using cannabis ≥1 day in the past month. Participants were randomly assigned on a 1:1 ratio to either an experimental group (EG) involving the use of the Joint Effort mobile app or to a control group (CG) involving a web-based brief normative feedback message. The Joint Effort mobile app was designed to support CU self-management. This theory-informed behavior change intervention aims to reinforce the use of protective behavioral strategies by targeting intention, attitude, social norms, and self-efficacy. The app’s acceptability was assessed via uptake, engagement, and appreciation. The feasibility of study procedures was assessed via recruitment time, recruitment rate, and attrition rate. Outcome responsiveness was informed by participant-reported outcomes: CU frequency, intention to take action on CU, protective behavioral strategies use, severity of dependence, and psychological distress. All data were collected using a web-based survey at baseline, one-month (T1), and 2-month (T2) postbaseline. Descriptive analyses were carried out on all outcomes. Results: The recruitment period lasted 124 days, and the recruitment rate was 56% (99/178). The final dataset analyzed included 80 participants (39 in EG and 41 in CG). Mean age was 23.4 (SD 2.6) years, and 66% (53/80) self-identified as women. Study attrition was 18% (14/80). User uptake of the Joint Effort app (ie, proportion of participants in the EG who downloaded the app) was estimated at 59% (23/39), and the average time spent on it per participant was 8.2 minutes (SD 7.3; median 7.5, IQR 5.7). The app obtained a mean total score on the User Engagement Scale-Short Form of 3.8/5 (SD 0.5) and a mean app quality total score of 4.2/5 (SD 0.5) on the end user version of the Mobile App Rating Scale. The proportion of participants who reported daily CU in the past month decreased from 13% (5/39) at baseline to 4% (1/24) at T2 in the EG and from 7% (3/41) to 6% (2/36) in the CG. Conclusions: Joint Effort appears to be a promising, acceptable, and scalable mobile app to help young adult cannabis users who wish to better manage their CU. Findings should inform future randomized controlled trials to assess the efficacy of this mobile-based intervention for cannabis users.

Introduction: Oncology nurses are pivotal to delivering high-quality cancer care; yet, the uptake of evidence-based practices (EBPs) remains inconsistent. Though continuing professional education is widely used to support EBP uptake, persistent gaps remain, likely driven by the intricate and interrelated mechanisms that unfold differently across individual, organisational and system contexts. Objective: To understand how, why, for whom and under what conditions continuing professional education interventions enhance (or fail to enhance) the uptake of EBPs among oncology nurses. Methods and analysis: This realist review will adhere to the Realist and Meta-narrative Evidence Syntheses: Evolving Standards methodological standards. The Theoretical Domains Framework will guide the exploration of potential mechanisms. 33 initial programme theories, developed from the Theoretical Domains Framework, prior reviews, expert input and consultations with interested parties working in oncology (eg, oncology nurses, managers), will be refined through systematic searches (CINAHL, MEDLINE, EMBASE, PsycINFO and Google Scholar). These initial programme theories represent hypothesised Context-Mechanism-Outcomes Configurations that may influence the uptake of EBPs among oncology nurses. Eligible peer-reviewed and grey literature from high-income countries in English or French will be screened in duplicate. Data will be coded deductively and inductively in MaxQDA and synthesised into Context-Mechanism-Outcome Configurations. These configurations will be reviewed in collaboration with interested parties. Ethics and dissemination: Findings will be disseminated through open-access, peer-reviewed publications and presentations at national and international conferences. Key stakeholders, including various professional associations (eg, the Canadian Association of Nurses in Oncology and the International Society of Nurses in Cancer Care), will be actively engaged to ensure the clinical relevance of the findings and to maximise their translation into nursing practice. PROSPERO registration number: CRD420251133710.

Introduction: Young adults (aged 18–39) diagnosed with cancer often turn to cannabis to manage symptoms such as pain, anxiety, or cachexia. However, few educational interventions exist to train oncology nurses in supporting the safe use of cannabis in this population. Methods: We conducted a two-arm pilot randomized controlled trial (1:1) to evaluate the feasibility and preliminary effects of a digital educational intervention grounded in the Theory of Planned Behavior. Nurses were randomized to either the intervention group ( n = 35) or an active control group ( n = 35). Feasibility outcomes included recruitment and retention rates, intervention uptake, module completion, participant engagement (eg, log-ins, time spent), and questionnaire completion. Nurses' knowledge, attitudes, self-efficacy, and intention to support safe cannabis use were measured at baseline and 1 month after randomization. Descriptive statistics summarized feasibility outcomes and sociodemographics; outcome changes were assessed using linear mixed effects models. Results: Participants were mostly over 40 years old (60%) and 74% held a bachelor's degree. Of 70 participants enrolled, 57 completed the 1-month follow-up. In the intervention group, 89% (31/35) completed the full intervention. The intention to support safe cannabis use significantly increased in the intervention group compared to controls ( P = .016). Discussion: This digital educational intervention demonstrated strong feasibility and preliminary effectiveness in enhancing nurses' intention to support safe cannabis use. Findings support the value of tailored, theory-informed educational strategies in oncology nursing and suggest the potential for scaling up in a larger trial.

Background: Canada’s legalization of recreational cannabis use (CU) has further highlighted the need for innovative interventions that promote lower-risk CU. Young adults aged 18-25 years represent the age group with the highest prevalence of CU. Protective behavioral strategies (PBSs) have been shown to help manage CU and reduce its negative consequences. To date, only a few interventions have focused on PBSs. To address this gap, a mobile app prototype using PBSs to influence CU was developed with and for young adults. Objective: This study aims to describe the development process and usability testing of Joint Effort, a CU self-management mobile app prototype centered on promoting the use of PBSs among young adults with any past 30-day CU. Methods: Intervention mapping (IM) and a co-design approach were used. Six steps were followed: (1) focus groups were conducted to identify needs and preferences regarding CU interventions; (2) a matrix of change objectives was used to select target behaviors and determinants; (3) theory-based intervention methods and practical applications were selected; (4) focus groups were held to validate the intervention structure and examples of tailored messages; (5) preliminary intervention content was created; and (6) the intervention content was transposed into a mobile app prototype. Usability was assessed through qualitative semistructured interviews and the User Version of the Mobile Application Rating Scale (uMARS), completed by a sample of 20 university students with a mean age of 21.8 (median 22) years, 14 (70%) of whom were women and 15 (75%) were undergraduates. Qualitative data were analyzed using thematic analysis. Results: Four themes were identified from the interviews: Joint Effort was visually pleasing and easy to use; the content was well-adapted to the target audience and nonjudgmental; customization functions were appreciated; and the app was perceived as helpful and relevant for initiating behavior change. The prototype received a mean quality score of 4.43/5.0 (SD 0.53) per item on the uMARS. The mean scores on the 5 subscales were as follows: engagement (4.14, SD 0.53), functionality (4.60, SD 0.47), aesthetics (4.53, SD 0.52), information quality (4.44, SD 0.61), and subjective quality (3.36, SD 0.53). Conclusions: Our findings highlight the added value of IM and a co-design approach, underscoring the importance of incorporating user feedback in the development of mobile apps. Building on the strong usability results, the Joint Effort prototype has since been developed into an iOS mobile app, and larger-scale evaluations are currently underway to assess its acceptability, feasibility, and efficacy.

The global incidence of cancer in young adults aged 18 to 39 has risen significantly, presenting unique challenges that permeate many aspects of their lives, from education to careers and finances. Despite expressing a desire for psychological support, many young adults are reluctant to share their concerns with nurses. As a result, these young adults may feel that their unique experience is not properly acknowledged and that their complex needs are not satisfied. This project aims to share the experience of developing an e-learning training for continuous nursing education, focusing on enhancing nurses’ awareness, knowledge, and support for young adults with hematological cancer through a collaborative approach. Utilizing verbatim data from co-design workshops, literature reviews, and The Leukemia & Lymphoma Society of Canada (LLSC) podcasts and resources, a multidisciplinary team developed three modules on understanding young adults, exploring psychosocial challenges, and providing effective support. Pedagogical approaches, inspired by Adult Learning Theory, were combined for a comprehensive and engaging learning experience. The collaborative e-learning initiative provides a tailored educational experience for nurses that addresses young adults’ unique needs and challenges. The program’s innovation consists of collaboration with patient-partners and community organizations to design, develop and evaluate its content and its structure. The preliminary evaluation highlights the program’s strong potential to enhance nurses’ awareness in addressing the unique psychosocial needs of young adults.

BACKGROUND Cannabis use (CU) among young adults continues to be an important public health issue. Interventions to support lower-risk CU during young adulthood can improve health outcomes. Mobile applications constitute a promising mode of service delivery. However, there is a lack of evidence-based apps specifically developed for young adult cannabis users. OBJECTIVE The current study aimed to evaluate the acceptability of a novel mobile app intervention (Joint Effort) and to assess the feasibility and outcome responsiveness of the study procedures used. METHODS A pilot study with a parallel-group randomized trial design was conducted with Canadian-based university students aged 18¬–30 reporting using cannabis ≥1 day in the past month. Participants were randomly assigned on a 1:1 ratio to either an experimental group (EG) involving the use of the Joint Effort mobile app or to a control group (CG) involving a web-based brief normative feedback message. The Joint Effort mobile app was designed to support CU self-management. This theory-informed behavior change intervention aims to reinforce the use of protective behavioral strategies (PBS) by targeting intention, attitude, social-norms and self-efficacy. The app’s acceptability was assessed via uptake, engagement, and appreciation. The feasibility of study procedures was assessed via online recruitment time, recruitment rate, and attrition rate. Outcome responsiveness was informed by participant-reported outcomes: CU frequency, intention to take action on CU, PBS use, severity of dependence, and psychological distress. All data were collected using a web-based survey at baseline, one-month (T1) and two-month (T2) post-baseline. Descriptive analyses were carried out on all outcomes. RESULTS The recruitment period lasted 124 days, and the recruitment rate was 55.6%. The final dataset analyzed included 80 participants (39 in EG and in 41 CG). Mean age was 23.4 years (standard deviation (SD) = 2.57) and 66% self-identified as women. Study attrition was 17.5% (14/80). User uptake of the Joint Effort app (i.e. proportion of participants in the EG who downloaded the app) was estimated at 59% (23/39) and the average time spent on it per participant was 8.2 minutes (SD = 7.3; median = 7.5, interquartile range = 5.7). The app obtained a mean total score on the User Engagement Scale - Short Form (UES-SF) of 3.81/5 (SD = 0.46) and a mean app quality total score of 4.20/5 on the end-user version of the Mobile App Rating Scale (uMARS). The proportion of participants who reported daily CU in the past month decreased from 12.8% at baseline to 4.2% at T2 in the EG and from 7.3% to 5.6% in the CG. CONCLUSIONS Joint Effort appears to be a promising, acceptable, and scalable mobile app to help young adult cannabis users who wish to better manage their CU. Findings should inform future randomized controlled trials to assess the efficacy of this mobile-based intervention for cannabis users. CLINICALTRIAL ClinicalTrials.gov NCT05099016

BACKGROUND Canada’s legalization of recreational cannabis use (CU) has further highlighted the need for innovative interventions that promote lower-risk CU. Young adults aged 18-25 years represent the age group with the highest prevalence of CU. Protective behavioral strategies (PBSs) have been shown to help manage CU and reduce its negative consequences. To date, only a few interventions have focused on PBSs. To address this gap, a mobile app prototype using PBSs to influence CU was developed with and for young adults. OBJECTIVE This study aims to describe the development process and usability testing of Joint Effort, a CU self-management mobile app prototype centered on promoting the use of PBSs among young adults with any past 30-day CU. METHODS Intervention mapping (IM) and a co-design approach were used. Six steps were followed: (1) focus groups were conducted to identify needs and preferences regarding CU interventions; (2) a matrix of change objectives was used to select target behaviors and determinants; (3) theory-based intervention methods and practical applications were selected; (4) focus groups were held to validate the intervention structure and examples of tailored messages; (5) preliminary intervention content was created; and (6) the intervention content was transposed into a mobile app prototype. Usability was assessed through qualitative semistructured interviews and the User Version of the Mobile Application Rating Scale (uMARS), completed by a sample of 20 university students with a mean age of 21.8 (median 22) years, 14 (70%) of whom were women and 15 (75%) were undergraduates. Qualitative data were analyzed using thematic analysis. RESULTS Four themes were identified from the interviews: Joint Effort was visually pleasing and easy to use; the content was well-adapted to the target audience and nonjudgmental; customization functions were appreciated; and the app was perceived as helpful and relevant for initiating behavior change. The prototype received a mean quality score of 4.43/5.0 (SD 0.53) per item on the uMARS. The mean scores on the 5 subscales were as follows: engagement (4.14, SD 0.53), functionality (4.60, SD 0.47), aesthetics (4.53, SD 0.52), information quality (4.44, SD 0.61), and subjective quality (3.36, SD 0.53). CONCLUSIONS Our findings highlight the added value of IM and a co-design approach, underscoring the importance of incorporating user feedback in the development of mobile apps. Building on the strong usability results, the Joint Effort prototype has since been developed into an iOS mobile app, and larger-scale evaluations are currently underway to assess its acceptability, feasibility, and efficacy.

Purpose Hematopoietic cell transplantation (HCT) is a common treatment for people diagnosed with hematological cancers. However, it can cause side effects that may affect work participation. This scoping review aims to provide an overview of the factors that influence the work participation of hematological cancer survivors who have undergone HCT. Methods We conducted a scoping review following the Joanna Briggs Institute guidelines and developed our search strategy in collaboration with a scientific librarian and searched nine databases (CINAHL, MEDLINE, EMBASE, Cochrane, PubMed, PsycINFO, Web of Science, Scopus, ProQuest Dissertations, & Theses Global) for primary studies in French or English until February 2024. Two reviewers extracted the data and analyzed it thematically. We synthesized and presented the findings using a narrative description approach. Results We identified 940 publications, of which 36 met the eligibility criteria. Our findings underscore the significance of considering individuals over 50, those undergoing allogeneic HCT, women, and those with lower incomes. We noted disparities in evaluating or describing work participation. Conclusion It is crucial for researchers and healthcare professionals in hematological care to be aware of the intersecting factors that influence work participation. There are still significant gaps in how workplace dynamics, legislation, and healthcare systems affect the return to work process.

Background: The high prevalence of cannabis use among young adults poses substantial global health concerns due to the associated acute and long-term health and psychosocial risks. Digital modalities, including websites, digital platforms, and mobile apps, have emerged as promising tools to enhance the accessibility and availability of evidence-based interventions for young adults for cannabis use. However, existing reviews do not consider young adults specifically, combine cannabis-related outcomes with those of many other substances in their meta-analytical results, and do not solely target interventions for cannabis use. Objective: We aimed to evaluate the effectiveness and active ingredients of digital interventions designed specifically for cannabis use among young adults living in the community. Methods: We conducted a systematic search of 7 databases for empirical studies published between database inception and February 13, 2023, assessing the following outcomes: cannabis use (frequency, quantity, or both) and cannabis-related negative consequences. The reference lists of included studies were consulted, and forward citation searching was also conducted. We included randomized studies assessing web- or mobile-based interventions that included a comparator or control group. Studies were excluded if they targeted other substance use (eg, alcohol), did not report cannabis use separately as an outcome, did not include young adults (aged 16-35 y), had unpublished data, were delivered via teleconference through mobile phones and computers or in a hospital-based setting, or involved people with mental health disorders or substance use disorders or dependence. Data were independently extracted by 2 reviewers using a pilot-tested extraction form. Authors were contacted to clarify study details and obtain additional data. The characteristics of the included studies, study participants, digital interventions, and their comparators were summarized. Meta-analysis results were combined using a random-effects model and pooled as standardized mean differences. Results: Of 6606 unique records, 19 (0.29%) were included (n=6710 participants). Half (9/19, 47%) of these articles reported an intervention effect on cannabis use frequency. The digital interventions included in the review were mostly web-based. A total of 184 behavior change techniques were identified across the interventions (range 5-19), and feedback on behavior was the most frequently used (17/19, 89%). Digital interventions for young adults reduced cannabis use frequency at the 3-month follow-up compared to control conditions (including passive and active controls) by −6.79 days of use in the previous month (95% CI −9.59 to −4.00; P<.001). Conclusions: Our results indicate the potential of digital interventions to reduce cannabis use in young adults but raise important questions about what optimal exposure dose could be more effective, both in terms of intervention duration and frequency. Further high-quality research is still needed to investigate the effects of digital interventions on cannabis use among young adults. Trial Registration: PROSPERO CRD42020196959; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=196959