Skip to main content
Download PDF

BETTER LIFE- guidelines for chronic disease preventive care for people aged 18–39 years: a literature review

BMC Primary Care volume 25, Article number: 224 (2024) Cite this article

Abstract

Background

The original ‘BETTER’ (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) approach consisted of a prevention-focused visit between participants aged 40–65 years and a “Prevention Practitioner” (PP), who empowered the participant to set achievable prevention and screening goals for cancers and chronic diseases. BETTER was successfully adapted for economically deprived communities (BETTER HEALTH) in Canada. Our objective was to conduct a review of guidelines in preparation for adapting the ‘BETTER HEALTH’ approach for younger adults aged 18–39 years living with lower income, a group known to have earlier mortality due to a higher prevalence of preventable chronic diseases than their peers with higher income.

Methods

We searched multiple electronic databases and grey literature for clinical practice guidelines on prevention/screening and included those that met the following criteria: published in English from 2008–2020 in Canada or any of the following countries (Australia, Ireland, New Zealand, Scotland, United States and England); and addressed prevention or screening. We assessed quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and extracted data (publication details, recommendations, and Quality/Level of evidence as reported by authors) from sources with overall scores of 5 or higher. Final recommendations were compiled after harmonization with input from diverse stakeholders (co-investigators, PPs, and the Community Advisory Committee).

Results

We included a total of 85 guidelines, and developed a final list of 42 recommendations for 18–39 year-olds across 21 topics. Specific recommendations fell under the following topics: cancers, cardiovascular disease, diabetes, obesity, lifestyle (alcohol; healthy nutrition/physical activity); healthy relationships and healthy sexuality, immunization, oral health, social determinants of health, and substance use.

Conclusion

We identified evidence-based guidelines on individual-level prevention/screening actions for adults 18–39 years old and relevant for those living with lower income which will directly inform development and implementation of the BETTER LIFE intervention.

Peer Review reports

Introduction

Despite the existence of strong evidence for lifestyle modifications and for screening and preventive actions to improve health outcomes, an implementation gap exists due to limited physician time [1], conflicting/unclear guidelines, and difficulties inherent to sustained behaviour change [2]. The original BETTER (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) intervention was designed to address this gap by providing an integrated approach to increasing uptake of chronic disease prevention and screening (CDPS) actions using a framework of shared decision-making between patient and practitioner. In a pragmatic cluster randomised control trial (RCT), the BETTER approach improved the uptake of CDPS actions against heart disease, diabetes and several cancers (colorectal, breast and cervical cancers) by 32.5% in urban primary care settings in Alberta and Ontario, Canada [2, 3]. The intervention consisted of an individual prevention-focussed visit between participants aged 40–65 years and a “Prevention Practitioner” (PP), who used principles of motivational interviewing to empower the participant to set achievable prevention and screening goals, based on the harmonization of evidence, which were then recorded in a goals sheet and a personalized ‘prevention prescription’.

There have been subsequent modifications of the BETTER approach with similar positive results. ‘BETTER 2’ targeted the same age group as the original BETTER but modified the approach for different populations due to equity concerns, including individuals from rural, lower income, or historically marginalized backgrounds in Newfoundland and Labrador and the Northwest Territories, Canada [4]. Subsequently, BETTER WISE (Building on Existing Tools to Improve Cancer and Chronic Disease Prevention and Screening in Primary Care for Wellness of Cancer Survivors and Patients) tailored the BETTER approach for cancer survivors (breast, colorectal, prostate) aged 40–65 and also included screening for poverty, as well as an updated literature review to recommend specific prevention and screening actions [5]. Another modified version, BETTER HEALTH: Durham used a public health-led model with public health nurses serving as PPs for 40–64 year-olds living with lower income in Durham, Ontario, and found a 53% increase in completed health actions (immediate intervention, n = 60 vs. wait-listed arm, n = 66) [6, 7]. Although there were positive results for this age group, the community advisory group for BETTER HEALTH: Durham suggested that starting the intervention at 40 years of age was too late for people living with low income, where evidence shows an earlier onset of chronic diseases [8]. We aimed to adapt the BETTER HEALTH: Durham intervention to a new population of adults aged 18–39 years living with low income, a group known to have earlier mortality due to, and higher prevalence of, preventable chronic diseases than their peers with higher income.

To support the adaptation, we conducted a review of guidelines to identify and assess prevention and screening actions for health issues and risk factors amenable to individual change for the 18–39 year age group. This paper describes the methods and results of the literature review.

Methods

Overview of search strategy

First, we assessed the data sources (clinical practice guidelines) from the most recent BETTER WISE study [9], which had entailed a rigorous evidence review process to recommend specific prevention and screening actions, for applicability to adults aged 18–39 years.Then, we used a structured grey literature search of specific repositories and websites to find relevant clinical practice guidelines for new topics suggested by the research team. If guidelines were unavailable for these topics, we performed a systematic literature search in the databases Ovid Medline, CINAHL (Cumulated Index to Nursing and Allied Health Literature), and the Cochrane Database of Systematic Reviews to identify systematic reviews/meta-analyses. Thus, our search and eligibility criteria for new sources was restricted to clinical practice guidelines (i.e. excluding systematic reviews, meta-analyses, and review of reviews when guidelines were found) and expanded to allow systematic reviews and meta-analyses when guidelines were not available (See Fig. 1).

Fig. 1
figure 1

Search strategy for guidelines for BETTER LIFE

Full size image

Search strategy for topics of interest

To create the overall search strategy, we consulted an experienced information specialist (CZ). We used different combinations of key words such as ‘guidelines’, ‘chronic disease prevention’, ‘prevention’, ‘clinical practice guidelines’, and ‘screening’ with terms from topics of interest from previous versions of BETTER (cardiovascular disease, diabetes, cancer, obesity, diet and nutrition, physical activity, smoking/tobacco and alcohol use) and new topics suggested by the wider research team (co-investigators, PPs, Community Advisory Committee (CAC)) due to their importance for our target population (See Supp Table 1).

Search sources

We conducted a structured search in repositories of guidelines at the provincial level (Ontario, Alberta, Newfoundland & Labrador): Cancer Care Ontario; Cancer Control Alberta; Eastern Health Cancer Care Program; and national level: Health Canada; Public Health Agency of Canada (PHAC); and the Canadian Task Force on Preventive Health Care (CTFPHC). (Details in Fig. 1).

We did not find guidelines for four topics recommended by our study team for our target population (speeding, texting & driving, seat belts, bullying & cyberbullying). Therefore, we then conducted a systematic search on select databases (Ovid Medline, CINAHL, Cochrane Database of Systematic Reviews) for systematic reviews and meta-analyses published from 2008-August 2020 on these topics.

Inclusion & exclusion criteria

When screening abstracts obtained from our searches, we included articles for full-text review if they met the following criteria: clinical practice guidelines in English only; published from 2008–2020; country of publication was Australia, Canada, England, Ireland, New Zealand, Scotland, or US; included at least one of the identified topics in title or abstract; and addressed prevention or screening.

At full-text screening, we excluded articles if they met any of the following: exclusively focused on management or treatment; exclusively targeted ages not 18–39 years old (i.e., under 18, 40 or older); lacked individual-level recommendations (i.e. contained only macro-level data (e.g. legal, policy)); or lacked evidence of synthesis. With the exception of the four topics covered during the systematic search, we also excluded full-texts if they were systematic reviews, review of reviews, or meta-analyses.

During full-text screening, if multiple eligible sources existed, we used a hierarchical approach to determine inclusion: preference for most recent Canadian guideline/ review and if not available, relevant guidelines from any of 6 aforementioned primarily English-speaking countries of interest. If there were discrepancies or disagreements among guidelines, we searched for and extracted information from primary or common references.

All abstracts and full-texts were uploaded and screened using Covidence [10].

Quality assessment

We chose AGREE-II for quality assessment since it was developed specifically for assessing quality of existing practice guidelines, unlike GRADE (Grading of Recommendations, Assessment, Development, and Evaluations), which is most suited for developing guidelines de novo and for rating primary sources of evidence for specific outcomes, which was outside the scope of our study. We used a two-step process to assess guideline quality. For the first step, two trained reviewers (NM and SC) independently used a shorter 2-item AGREE-II [11] rating system to assess the “Rigour of development” (items 7 and 12—‘Systematic methods were used to search for evidence’ and ‘There is an explicit link between the recommendations and the supporting evidence’, respectively) on all references. If methodological details were missing from guidelines, we emailed authors or guideline developers to request more information. Both reviewers had to assign a score of 4 or higher (out of 7) on both AGREE-II items for the article to move to full quality assessment with the 23-item AGREE-II tool.

Specifically, the reviewers examined the ‘Methods’ section of each guideline to assess the details of systematic methods (Item #7) that were used and consulted any methods papers that governed the overall initiative when available [12,13,14,15,16,17,18,19,20]. If the guideline developer did not report any evidence of an independent synthesis as per the first step in the AGREE–II screening process, the guideline was not assessed further. If no Canadian reference met the criteria for the 2-item AGREE-II screening tool on a given topic, the reviewers then assessed the quality of the non-Canadian documents. Disagreement over scores was discussed and a final decision was determined by consensus.

For step 2, two reviewers independently applied the full AGREE-II instrument on all guidelines that passed the 2-item screening. Overall scores of 5 and above (out of 7) by both reviewers were used to move to full data extraction phase. To ensure consistent interpretation of data quality, we pilot tested the full AGREE-II tool on 5 articles that had previously been included in BETTER WISE and that also met the eligibility criteria for BETTER LIFE.

Data extraction

Two reviewers also pilot tested the data extraction form on 5 articles and resolved differences by consensus. Each reviewer independently extracted data from half the included articles and then checked a subset from the other reviewer for consistency, resolving differences by discussion. Extracted data included publication details (issuing body/author, year and country of publication), participant characteristics (target population, age, ethnicity, socioeconomic metrics, identified risk factors, clinical context) and guideline details (individual-level recommendations, quality of supporting evidence, and whether conflict of interest was declared or not).

Harmonization and synthesis of extracted data

The extracted data were grouped by topics. Each article was assigned to two reviewers who independently either categorized recommendations for inclusion in BETTER LIFE or excluded them if they were duplicative, out of scope, or not actionable (See Fig. 2).

Fig. 2
figure 2

Harmonization process for BETTER LIFE

Full size image

The reviewers met to discuss and assign a final primary categorization to each recommendation with the overall team meeting to resolve differences if there was no agreement between reviewers. The senior co-authors (AL and MAO) reviewed the categorizations, clarified unclear recommendations and identified specific recommendations for further review from content experts/co-investigators in the BETTER team.

Harmonization and synthesis

We followed a similar harmonization process to Campbell-Sherer et al [9] within an overarching ADAPT-ITT framework [21].

All the co-investigators and PPs in the BETTER team were invited to provide input on topics in which they had expertise and asked to rank the newly included recommendations in an online survey (Qualtrics, Provo, UT), with the goal of reaching consensus on the top ranked (most relevant) recommendations. Recommendations ranked with a mean of 90% or above were included, while those that were that consistently ranked low (mean of less than 75%) were removed. For topics with multiple individual recommendations with mean scores of 80–89%, we combined, summarized and simplified the multiple recommendations where it seemed appropriate to do so and included them.

After the harmonization process, we compiled the final list of recommendations and topics into a table and also grouped all related included topics into existing or new ‘domains’ for data visualization.

Results

There were 864 abstracts, of which 762 were unique. Of these, 435 were moved to the full-text phase and assessed for inclusion. One hundred and eighty-five guidelines met the inclusion criteria for quality assessment (Fig. 3a).

Fig. 3
figure 3

a Summary flow from literature search to full-text review for quality assessment. b Quality assessment of guidelines using the AGREE-II instrument to the data extraction stage

Full size image

From the 150 guidelines included in BETTER WISE that were published in 2008 or later, 40 guidelines were applicable to the 18–39 year age group, of which 14 had been updated since inclusion in BETTER WISE. Newer versions were available for the following 8 topics: cancers (breast, cervical, colorectal), CVD, diabetes, obesity, lifestyle (alcohol; healthy nutrition/physical activity).

From the search for topics for which there were no identified guidelines (speeding, texting and driving, seat belts, bullying and cyberbullying), 213 papers were uploaded into Covidence after removing duplicates. However, all the papers on these topics were excluded at various stages.

Quality assessment

One hundred and eighty-five guidelines were eligible for quality screening (Fig. 3b). After exclusion at various stages, 93 guidelines were rated with the 2-item AGREE-II. Of these, 75 were rated with the full AGREE-II tool and 58 papers (77%, 58/75) were scored 5 or higher by both reviewers.

We extracted data from 85 guidelines (58 were new guidelines and 27 were from previous versions of BETTER). Of the 38 new topics (Supp Table 1), 22 were relevant to the 18–39 year age group (Supp Table 2).

Harmonization and synthesis

Of the 19 colleagues invited, 9 responded, reporting expertise on atleast one of the topics on the list (between 1–8 respondents provided ranking on each of the various new recommendations). At the harmonization stage, the team removed the topic ‘falls/injury prevention’ as the recommendation was deemed not in scope for the 18–39 age group.

Due to low ranking scores from Co-investigators, we removed 6 topics from inclusion in the final BETTER LIFE recommendations (intimate partner violence, sexual health, skin cancer, sleep, violence, vitamins). We also excluded hepatitis Cas only one co-investigator provided a ranking for this recommendation, and the recommendation was to not screen for hepatitis C. On the advice of the research team, we also included screening for Adverse Childhood Experiences (ACE) [22, 23].

Based on the results of the data extraction and harmonization, the final list of topics contained 42 recommendations for 18–39 year-olds across 21 total topics (Table 1). We grouped the final list of topics into existing or new domains (See Supp Fig. 1).

Table 1 List of all* topics and recommendations for BETTER LIFE participants aged 18–39 years
Full size table

The CDPS recommendations for heart disease and colorectal and breast cancers were only targeted to those deemed ‘high-risk’ (based on various clinical criteria such as family history) in the 18–39 age group. For most of the new topics, we also identified specific maneuvers or screening questions/tools that could be incorporated into the BETTER visits or into BETTER tools.

Discussion

We used a structured search of published and grey literature, and a systematic search of specific databases to compile recent evidence from clinical practice guidelines on risk factors and individual prevention and screening actions relevant to adults aged 18–39 years, particularly those living with low income, in Canada. We also obtained input from our co-investigators, a team of experts in primary care, public health, the social determinants of health, and the BETTER program. Through this process, we were able to identify 42 recommendations within 21 total topics that will be applied in the BETTER LIFE approach for younger adults living with low income.

Some topics and health recommendations from previous BETTER versions were updated or included, such as those addressing diabetes, cardiovascular disease, cancer, smoking, alcohol, nutrition, and exercise. Risk assessments for diabetes, cardiovascular disease and most cancers were similar for those aged 18–39 years old as with previous versions of BETTER, though routine screening was only recommended for those deemed high risk (with the exception of cervical cancer screening). We found evidence-based guidelines addressing new topics relevant specifically to 18–39 year olds grouped into the following new domains: healthy relationships and healthy sexuality, immunization, oral health, social determinants of health, and substance use. Some recommendations in BETTER LIFE were similar to those published by others [97,98,99], though the recency, diversity, and sources of our search; our harmonization and implementation process, as well as the definition of our target population were different. For example, Persaud et. al. developed 15 preventive care recommendations and 1 policy recommendation that promote health equity in Canada. Although their work and ours both prioritize health equity in primary care, Persaud et al. did not have any age restrictions on their target population nor a primary focus on uptake of individual-level preventive actions. They also utilized systematic reviews, primary research articles and randomized controlled trials to develop recommendations using a GRADE approach. Because we prioritized recommendations that were individually actionable, supported by evidence that met our criteria, and ranked highly by content experts, topics like vitamins and skin cancer prevention were eventually omitted. Although we ultimately excluded skin cancer, this topic is an important one in many countries such as Australia [100].

Taking specific contexts into account is important when determining how best to implement and support uptake of the recommendations. For some new topics, we found stronger evidence for resources and screening tools for PPs than for specific recommendations (e.g. the National Institute on Drug Abuse (NIDA) Quick Screen or the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for substance use). PPs identified local community resources for some new health topics (parenting; substance use; oral health) which could help to support participants achieve recommended actions. They also suggested considering social contexts as opportunities for engagement, e.g. by focusing conversations in BETTER LIFE visits on the concepts of health promotion or meaningful overall health and social well-being rather than explicit chronic disease prevention; by using different media for sharing health information (e.g. mobile apps, social media or online resources); by considering social contexts as barriers or enablers of behaviour change, especially regarding physical activity, alcohol, substance use; or by taking life stage into account (single adult vs. parenting).

Our study had several strengths and limitations. Our strengths include a rigorous critical appraisal of the literature with a two-step quality assessment process and independent review that ensured that only guidelines that met high methodological rigour and transparency were included for data extraction and harmonization; focus on actionable recommendations (e.g. goal-setting, access/referral to community resources); and meaningful collaborations with diverse community, public health, and clinical experts. However, all the guidelines were published prior to the COVID-19 pandemic, so did not take pandemic-related disruptions and health impact into account. COVID-19 has exacerbated health and economic inequities and disproportionately affected racialized and low income groups with a higher risk of exposure due to living and working conditions; higher prevalence of co-morbidities; inequitable access to testing and treatment; and disruption of health services [101, 102]. We also relied on consensus to resolve disagreements during the screening process and to formulate the final recommendations as well as on voluntary responses during harmonization which led to varied numbers of reviewers for each recommendation, and which may be subject to bias. However, we used AGREE-II to ensure transparency and careful documentation, and also consulted a wide and diverse range of experts (in primary care, public health, the social determinants of health, Prevention Practitioners, and the Community Advisory Committee) at many stages of the project. Finally, we may have missed guidelines because we targeted our search to specific criteria, repositories, and databases.

Conclusion

Adults living with low income are at increased risk of chronic disease. Through critical literature review and guideline harmonization, we have curated a list of individual-level actionable recommendations relevant to prevention and screening for people aged 18–39 living with low income in English-speaking countries.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Abbreviations

ACE:

Adverse Childhood Experiences

ADAPT-ITT:

Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, Testing

AGREE-II:

Appraisal of Guidelines for Research & Evaluation II

ASSIST:

Alcohol, Smoking and Substance Involvement Screening Test

AUDIT-C:

Alcohol Use Disorders Identification Test

BETTER:

Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care

BETTER WISE:

Building on Existing Tools to Improve Cancer and Chronic Disease Prevention and Screening in Primary Care for Wellness of Cancer Survivors and Patients

BMI:

Body mass index

BP:

Blood pressure

CAC:

Community Advisory Committee

CDPS:

Chronic disease prevention and screening

CINAHL:

Cumulated Index to Nursing and Allied Health Literature

CTFPHC:

Canadian Task Force on Preventive Health Care

COVID-19:

Coronavirus disease 2019

CVD:

Cardiovascular disease

eGFR:

Estimated glomerular filtration rate

ENDS:

Electronic nicotine delivery systems

GAD-2:

Generalized Anxiety Disorder 2-item

HPV:

Human papillomavirus

MOBP:

Manual office blood pressure device

NIDA:

National Institute on Drug Abuse

PHAC:

Public Health Agency of Canada

PCP:

Primary care provider

PP:

Prevention Practitioner

RCT:

Randomised control trial

STI:

Sexually transmitted infection

US:

United States

References

  1. Yarnall KSH, Pollak KI, Østbye T, Krause KM, Michener JL. Primary Care: Is There Enough Time for Prevention? Am J Public Health. 2003;93(4):635–41. https://doi.org/10.2105/AJPH.93.4.635.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Grunfeld E, Manca D, Moineddin R, et al. Improving chronic disease prevention and screening in primary care: results of the BETTER pragmatic cluster randomized controlled trial. BMC Fam Pract. 2013;14(1):175. https://doi.org/10.1186/1471-2296-14-175.

    Article  PubMed  PubMed Central  Google Scholar 

  3. BETTER. BETTER website. http://better-program.ca/evidence/. Accessed Jan 23, 2022.

  4. Aubrey-Bassler K, Fernandes C, Penney C, et al. The effectiveness of a proven chronic disease prevention and screening intervention in diverse and remote primary care settings: an implementation study on the BETTER 2 Program. BJGP Open. 2019;3(3):bjgpopen19X101656 https://doi.org/10.3399/bjgpopen19X101656 .

    Article  PubMed  PubMed Central  Google Scholar 

  5. Manca DP, Fernandes C, Grunfeld E, et al. The BETTER WISE protocol: building on existing tools to improve cancer and chronic disease prevention and screening in primary care for wellness of cancer survivors and patients – a cluster randomized controlled trial embedded in a mixed methods design. BMC Cancer. 2018;18(1):927. https://doi.org/10.1186/s12885-018-4839-y .

    Article  PubMed  PubMed Central  Google Scholar 

  6. Paszat L, Sutradhar R, O’Brien MA, et al. BETTER HEALTH: Durham – protocol for a cluster randomized trial of BETTER in community and public health settings. BMC Public Health. 2017;17(1):754. https://doi.org/10.1186/s12889-017-4797-3 .

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lofters AK, O’Brien MA, Sutradhar R, et al. Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial. BMC Public Health. 2021;21(1):1496. https://doi.org/10.1186/s12889-021-11452-x .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Roberts KC, Rao DP, Bennett TL, Loukine L, Jayaraman GC. Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada. Health Promot Chronic Dis Prev Can. 2015;35(6):87–94. https://doi.org/10.24095/hpcdp.35.6.01.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Campbell-Scherer D, Rogers J, Manca D, et al. Guideline harmonization and implementation plan for the BETTER trial: Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice. CMAJ Open. 2014;2(1):E1–10. https://doi.org/10.9778/cmajo.20130040.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Covidence systematic review software. https://www.covidence.org. Melbourne, Australia. Computer program

  11. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. Can Med Assoc J. 2010;182(18):E839–42. https://doi.org/10.1503/cmaj.090449.

    Article  Google Scholar 

  12. BC Guidelines. Guidelines and Protocols Advisory Committee Handbook: How our “Made in BC” Clinical Practice Guidelines and Protocols are Developed. Vancouver: British Columbia Ministry of Health;2017. gpachandbook2017.pdf (gov.bc.ca); Accessed Mar 20, 2024.

  13. Alberta Health Services CancerControl Alberta. Guideline Methodology Handbook – Version 5. 2020. GURU Handbook (albertahealthservices.ca) Accessed Mar 20, 2024.

  14. Canadian Task Force on Preventive Health Care (CTFPHC). Canadian Task Force on Preventive Health Care Procedure Manual. Public Health Agency of Canada (PHAC);2014. https://canadiantaskforce.ca/methods/ Accessed Jan 23, 2022.

  15. Davino-Ramaya C, Krause LK, Robbins CW, et al. Transparency Matters: Kaiser Permanente’s National Guideline Program Methodological Processes. Perm J. 2012;16(1):55–62. https://doi.org/10.7812/TPP/11-134.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Michigan Quality Improvement Consortium (MQIC). MQIC Guideline Development Criteria. 2013. Clinical Care Guidelines | University of Michigan Health (uofmhealth.org) Accessed Jan 23, 2022.

  17. National Institute for Health and Care Excellence (NICE). Developing NICE guidelines: the manual. Manchester: National Institute for Health and Care Excellence; 2014.

  18. Toward Optimized Practice (TOP). Toward Optimized Practice Clinical Practice Guideline Development Methodology. 2016. https://actt.albertadoctors.org/cpgs Accessed May 25, 2020.

  19. University of Michigan. Michigan Medicine Quality Department Clinical Care Guidelines: Purpose and Methods. 2019. https://www.uofmhealth.org/provider/clinical-care-guidelines. Accessed May 25 2020. Accessed Mar 20, 2024. 

  20. World Health Organization (WHO). WHO handbook for guideline development, 2nd Edition. Geneva: World Health Organization, WHO Library Cataloguing-in-Publication Data; 2014.

  21. Wingood GM, DiClemente RJ. The ADAPT-ITT Model. JAIDS J Acqu Immune Deficiency Syndromes. 2008;47(Supplement 1):S40–6. https://doi.org/10.1097/QAI.0b013e3181605df1.

    Article  PubMed  Google Scholar 

  22. Watson P. How to screen for ACEs in an efficient, sensitive, and effective manner. Paediatr Child Health. 2019;24(1):37–8. https://doi.org/10.1093/pch/pxy146.

    Article  PubMed  Google Scholar 

  23. California Surgeon General’s Clinical Advisory Committee. Adverse Childhood Experience Questionnaire for Adults. California: Office of the Surgeon General/California Department of Health Care Services; 2020.

  24. BC Guidelines. Problem Drinking. 2013. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/problem-drinking. Accessed May 29, 2020.

  25. Curry SJ, Krist AH, Owens DK, et al. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults. JAMA. 2018;320(18):1899. https://doi.org/10.1001/jama.2018.16789.

    Article  PubMed  Google Scholar 

  26. National Institute for Health and Care Excellence (NICE). [CG115] Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence 2011. Overview | Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence | Guidance | NICE, Accessed Mar 20, 2024.

  27. Canadian Centre on Substance Abuse and Addiction (CCSA). Guidelines for Healthcare Providers to Promote Low-Risk Drinking Among Patients. 2013. www.ccsa.ca/Resource Library/2012-Canada-Low-Risk-AlcoholDrinking-Guidelines-Poster-en.pdf . Accessed May 25, 2020.

  28. UK Chief Medical Officers (CMO). UK Chief Medical Officers’ Low Risk Drinking Guidelines 2016. https://www.gov.uk/government/consultations/health-risks-from-alcohol-new-guidelines. Accessed May 28, 2020

  29. Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14(Suppl 1):S1. https://doi.org/10.1186/1471-244X-14-S1-S1.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gregory KD, Chelmow D, Nelson HD, et al. Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women’s Preventive Services Initiative. Ann Intern Med. 2020;173(1):48–56. https://doi.org/10.7326/M20-0580.

    Article  PubMed  Google Scholar 

  31. Cancer Care Ontario. Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancer. 2018. https://www.cancercareontario.ca/en/guidelines-advice/cancer-continuum/screening/breast-cancer-high-risk-women/faqs-for-healthcare-providers. 2018. Accessed May 25, 2020.

  32. Towards Optimized Practice. Breast Cancer Screening Clinical Practice Guideline. 2013. https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/Breast-Cancer-Screening-CPG.pdf. Accesses May 29, 2020

  33. Eastern Health. Breast Magnetic Resonance Imaging (MRI) and High Risk Hereditary Breast Cancer. 2017 https://www.easternhealth.ca/wp-content/uploads/sites/2/2018/06/Breast-Magnetic-Resonance-MRI-and-High-Risk-Guideline_2017.pdf Accessed May 25, 2020.

  34. Eastern Health. Indications for Use of Breast Magnetic Resonance Imaging (MRI). 2018. https://www.easternhealth.ca/wp-content/uploads/sites/2/2018/06/Indications_for_Use_of_Breast_Magnetic_Imaging_MRI_Jan_2018.pdf Accessed May 25, 2020.

  35. Fischer B, Russell C, Sabioni P, et al. Lower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and Recommendations. Am J Public Health. 2017;107(8):e1–12. https://doi.org/10.2105/AJPH.2017.303818.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Toward Optimized P. Cervical Cancer Screening Clinical Practice Guideline. 2016. cervical-cancer-screening-cpg.pdf (albertadoctors.org) Accessed May 25, 2020.

  37. Dickinson J, Tsakonas E, Conner Gorber S, et al. Recommendations on screening for cervical cancer. CMAJ. 2013;185(1):35–45. https://doi.org/10.1503/cmaj.121505.

    Article  PubMed  Google Scholar 

  38. Cancer Care Ontario. Ontario Cervical Screening Guidelines Summary. Toronto: Cancer Care Ontario; 2016.

  39. Toward Optimized Practice (TOP) Working Group for Colorectal Cancer Screening. Colorectal Cancer Screening Clinical Practice Practice Guideline. Edmonton: Accelerating Change Transformation Team (ACCT) Alberta Medical Association; 2013.

  40. Provenzale D, Ness RM, Llor X, et al. NCCN Guidelines Insights: Colorectal Cancer Screening, Version 2.2020. J Nat Comprehen Cancer Net. 2020;18(10):1312–1320. https://doi.org/10.6004/jnccn.2020.0048.

  41. Scottish Intercollegiate Guidelines Network (SIGN). SIGN 126 Diagnosis and management of colorectal cancer. 2016. https://www.sign.ac.uk/media/1064/sign126.pdf Accessed Mar 20, 2024.

  42. Leddin D, Lieberman DA, Tse F, et al. Clinical Practice Guideline on Screening for Colorectal Cancer in Individuals With a Family History of Nonhereditary Colorectal Cancer or Adenoma: The Canadian Association of Gastroenterology Banff Consensus. Gastroenterology. 2018;155(5):1325-1347.e3. https://doi.org/10.1053/j.gastro.2018.08.017.

    Article  PubMed  Google Scholar 

  43. Canadian Task Force on Preventive Health Care. Recommendations on screening for colorectal cancer in primary care. CMAJ. 2016;188(5):340–8. https://doi.org/10.1503/cmaj.151125.

    Article  PubMed Central  Google Scholar 

  44. Cancer Care Ontario. Colorectal Cancer. 2019 https://www.cancercareontario.ca/en/guidelines-advice/cancer-continuum/screening/resources-healthcare-providers Accessed Mar 20, 2024

  45. U. S. Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA : the journal of the American Medical Association. 2016;315(23):2564–2575. Recommendation: Colorectal Cancer: Screening | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org). Accessed 20 Mar 2024.

  46. Black A, Guilbert E, Costescu D, et al. Canadian Contraception Consensus. J Obstet Gynaecol Can. 2015;37(11):1033–5. https://doi.org/10.1016/s1701-2163(16)30054-8.

    Article  PubMed  Google Scholar 

  47. BC Guidelines. Hypertension – Diagnosis and Management. 2020. https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/hypertension. Accessed Mar 20, 2024.

  48. Lindsay P, Connor Gorber S, Joffres M, et al. Recommendations on screening for high blood pressure in Canadian adults. Can Fam Physician. 2013;59(9):927–933, e393–400.

  49. Siu AL, U.S. Preventive Services Task Force. Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778–86 https://doi.org/10.7326/M15-2223 .

    Article  PubMed  Google Scholar 

  50. Rabi DM, McBrien KA, Sapir-Pichhadze R, et al. Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children. Can J Cardiol. 2020;36(5):596–624. https://doi.org/10.1016/j.cjca.2020.02.086.

    Article  PubMed  Google Scholar 

  51. National Institute for Health and Care Excellence (NICE). Depression in adults: recognition and management : guidance (CG90). National Institute for Health and Care Excellence - NICE; 2009/10/28 2009. https://www.nice.org.uk/guidance/ng222. Accessed May 25, 2020.

  52. Siu AL, Bibbins-Domingo K, Grossman DC, et al. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(4):380–7. https://doi.org/10.1001/jama.2015.18392.

    Article  CAS  PubMed  Google Scholar 

  53. Joffres M, Jaramillo A, Dickinson J et al. Canadian Task Force for Preventive Health Care (CTFPHC). Recommendations on screeming for depression in adults. CMAJ 2013; 185(9):775–782. https://doi.oorg/https://doi.org/10.1503/cmaj. 130403

  54. Institute for Clinical Systems Improvement (ICSI). Adult Depression in Primary Care. 2016. https://www.icsi.org/wp-content/uploads/2021/11/Depr.pdf Accessed Mar 20, 2024.

  55. Diabetes Canada Clinical Prractice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Prractice Guidelines for the Prevention and Management of Diabates in Canada. Can J Diabetes. 2018;42(Suppl1):S1–325.

    Google Scholar 

  56. Pottie K, Jaramillo A, Lewin G, et al. Recommendations on screening for type 2 diabetes in adults. CMAJ. 2012;184(15):1687–96. https://doi.org/10.1503/cmaj.120732.

    Article  PubMed  Google Scholar 

  57. Siu AL, U S Preventive Services Task Force. Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163(11):861–8 https://doi.org/10.7326/M15-2345 .

    Article  PubMed  Google Scholar 

  58. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):e49–64. https://doi.org/10.1097/AOG.0000000000002501.

    Article  Google Scholar 

  59. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S14–31 https://doi.org/10.2337/dc20-S002 .

    Article  Google Scholar 

  60. Wilson RD, Genetics Committee, Wilson RD, et al. Pre-conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies. J Obstet Gynaecol Can. 2015;37(6):534–52 https://doi.org/10.1016/s1701-2163(15)30230-9 .

    Article  PubMed  Google Scholar 

  61. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement. JAMA. 2017;317(2):183–9 https://doi.org/10.1001/jama.2016.19438 .

    Article  Google Scholar 

  62. Health Canada. Canada’s Dietary Guidelines. 2018. CDG-EN-2018.pdf (canada.ca) Accessed Mar 20, 2024.

  63. Nutrition Working Group, O’Connor DL, Blake J, et al. Canadian Consensus on Female Nutrition: Adolescence, Reproduction, Menopause, and Beyond. J Obstet Gynaecol Can. 2016;38(6):508-554.e18 https://doi.org/10.1016/j.jogc.2016.01.001 .

    Article  Google Scholar 

  64. Anderson TJ, Grégoire J, Pearson GJ, et al. 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult. Can J Cardiol. 2016;32(11):1263–82. https://doi.org/10.1016/j.cjca.2016.07.510.

    Article  PubMed  Google Scholar 

  65. Toward Optimized Practice. Prevention and Risk Management of Cardiovascular Disease Risk in Primary Care Clinical Practice Guideline. 2015. https://actt.albertadoctors.org/media/b21chzfk/cvd-risk-cpg.pdf. Accessed Man 20, 2024.

  66. U.S. Preventive Services Task Force (USPSTF). Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement. JAMA :J Am Med Assoc. 2017;318(2):167–74 https://doi.org/10.1001/jama.2017.7171 .

    Article  Google Scholar 

  67. Ross R, Chaput JP, Giangregorio LM, et al. Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S57-S102. https://doi.org/10.1139/apnm-2020-0467

  68. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315–81. https://doi.org/10.1093/eurheartj/ehw106.

    Article  PubMed  PubMed Central  Google Scholar 

  69. National Institute for Health and Care Excellence (NICE). Cardiovascular disease: risk assessment and reduction, including lipid modification – NICE guideline. Royal College of Physicians of London - RCP; 2014/07/01 2016. https://www.nice.org.uk/guidance/ng238. Accessed May 25, 2020.

  70. Allan GM, Lindblad AJ, Comeau A, et al. Simplified lipid guidelines: Prevention and management of cardiovascular disease in primary care. Can Fam Phys. 2015;61(10):857–67 e439–50.

    Google Scholar 

  71. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Breast Cancer Risk Reduction version 1.2020. https://www.nccn.org/guidelines/category 1. Accessed May 25, 2020.

  72. Public Health Agency of Canada. Rubella vaccine: Canadian Immunization Guide. 2016; https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-20-rubella-vaccine.html. Accessed June 4, 2020.

  73. Public Health Agency of Canada. Amendment to the 2015 “Update on the recommended Human Papillomavirus (HPV) vaccine immunization schedule.” Ottawa, Ontario: Public Health Agency of Canada; 2015.

    Google Scholar 

  74. Public Health Agency of Canada. Canadian immunization guide. Part 3. Vaccination of specific populations. 2016. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations.html. Accessed 4 June 2020.

  75. Wharton S, Lau DCW, Vallis M, et al. Obesity in adults: a clinical practice guideline. Can Med Assoc J. 2020;192(31):E875–91. https://doi.org/10.1503/cmaj.191707.

    Article  Google Scholar 

  76. Brauer P, Gorber SC, Shaw E, et al. Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. CMAJ. 2015;187(3):184–95. https://doi.org/10.1503/cmaj.140887.

    Article  PubMed  PubMed Central  Google Scholar 

  77. US Preventive Services Task Force, Curry SJ, Krist AH, et al. Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(11):1163–71 https://doi.org/10.1001/jama.2018.13022 .

    Article  Google Scholar 

  78. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102–38. https://doi.org/10.1161/01.cir.0000437739.71477.ee.

    Article  PubMed  Google Scholar 

  79. Fitch A, Everling L, Fox C, et al. Institute for Clinical Systems Improvement. Prevention and Management of Obesity for Adults. . Updated May 2013. https://1library.net/document/y69pmp7y-prevention-and-management-of-obesity-for-adults.html. Accessed 20 Mar 2024.

  80. LeFevre ML. U.S. Preventive Services Task Force. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2014;161(8):587–93 https://doi.org/10.7326/M14-1796 .

    Article  PubMed  Google Scholar 

  81. Public Health England (PHE). Delivering better oral health: an evidence-based toolkit for prevention. 2017. Delivering better oral health: an evidence-based toolkit for prevention - GOV.UK (www.gov.uk ) Accessed Mar 20, 2024.

  82. Kavan MG, Saxena SK, Rafiq N. General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues. Am Fam Physician. 2018;97(10):642–8.

    PubMed  Google Scholar 

  83. Alberta Health Services. Nutrition Guideline Household Food Insecurity. 2013. https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-household-food-insecurity.pdf Accessed Mar 20, 2024.

  84. Pottie K, Kendall CE, Aubry T, et al. Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience. CMAJ. 2020;192(10):E240–54. https://doi.org/10.1503/cmaj.190777.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Moser A, Stuck AE, Silliman RA, Ganz PA, Clough-Gorr KM. The eight-item modified Medical Outcomes Study Social Support Survey: psychometric evaluation showed excellent performance. J Clin Epidemiol. 2012;65(10):1107–16. https://doi.org/10.1016/j.jclinepi.2012.04.007.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Public Health Agency of Canada (PHAC). Sexually transmitted and blood-borne infections: guides for health professionals. Canadian Guidelines on Sexually Transmitted Infections. Ottawa: Public Health Agency of Canada; 2020.

  87. LeFevre ML, U.S. Preventive Services Task Force. Screening for Chlamydia and gonorrhea: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(12):902–910. https://doi.org/10.7326/M14-1981

  88. Workowski KA, Bolan GA. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015;64(RR-03):1–137.

    PubMed  Google Scholar 

  89. Kaiser P. Sexually Transmitted Infection: Screening, Testing and Treatment Guideline. 2019. https://wa-provider.kaiserpermanente.org/provider-manual/patient-care/clinical-guidelines Accessed May 25, 2020.

  90. Siu AL. U.S. Preventive Services Task Force. Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163(8):622–34 https://doi.org/10.7326/M15-2023 .

    Article  PubMed  Google Scholar 

  91. Thombs BD, Jaramillo Garcia A, Reid D, et al. Recommendations on behavioural interventions for the prevention and treatment of cigarette smoking among school-aged children and youth. CMAJ. 2017;189(8):E310–6. https://doi.org/10.1503/cmaj.161242.

    Article  PubMed  Google Scholar 

  92. CAN-ADAPTT. Canadian Smoking Cessation Clinical Practice Guideline. Toronto, Canada: Canadian Action Network for the Advancement, Dissemination and Adoption of Practice-informed Tabacco Treatment, Centre for Addiction and Mental Health. 2011. The first Canadian Guidelines for Tobacco Control was developed in 2010 (utoronto.ca) Accessed Mar 20, 2024.

  93. Registered Nurses’ Association of Ontario. Engaging Clients Who Use Substances. 2015. https://rnao.ca/sites/rnao-ca/files/Engaging_Clients_Who_Use_Substances_WEB.pdf Accessed Mar 20, 2024.

  94. US Preventive Services Task Force, Krist AH, Davidson KW, et al. Screening for Unhealthy Drug Use: US Preventive Services Task Force Recommendation Statement. JAMA. 2020;323(22):2301–9 https://doi.org/10.1001/jama.2020.8020 .

    Article  Google Scholar 

  95. Ontario Health Cancer Care Ontario. Vaping products including e-cigarettes: Evidence summary. Ontario, Canada: Ontario Health (Cancer Care Ontario); 2020. https://www.cancercareontario.ca/en/content/vaping-products-including-e-cigarettes. Accessed Mar 20, 2024.

  96. Livingston CJ, Freeman RJ, Costales VC, et al. Electronic Nicotine Delivery Systems or E-cigarettes: American College of Preventive Medicine’s Practice Statement. Am J Prev Med. 2019;56(1):167–78. https://doi.org/10.1016/j.amepre.2018.09.010.

    Article  PubMed  Google Scholar 

  97. Shimizu T, Bouchard M, Mavriplis C. Update on age-appropriate preventive measures and screening for Canadian primary care providers. Can Fam Physician. 2016;62(2):131–8.

    PubMed  PubMed Central  Google Scholar 

  98. Ridley J, Ischayek A, Dubey V, Iglar K. Adult health checkup: Update on the Preventive Care Checklist Form©. Can Fam Physician. 2016;62(4):307–13.

    PubMed  PubMed Central  Google Scholar 

  99. Persaud N, Sabir A, Woods H, et al. Preventive care recommendations to promote health equity. Can Med Assoc J. 2023;195(37):E1250–73. https://doi.org/10.1503/cmaj.230237.

    Article  Google Scholar 

  100. Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice (Red Book). Melbourne: Royal Australian College of General Practitioners; 2021. http://Guidelinesfor-preventive-activities-in-general-practice.pdf (http://racgp.org.au). Accessed 20 Mar 2024.

  101. Sundaram ME, Calzavara A, Mishra S, et al. Individual and social determinants of SARS-CoV-2 testing and positivity in Ontario, Canada: a population-wide study. Can Med Assoc J. 2021;193(20):E723–34. https://doi.org/10.1503/cmaj.202608.

    Article  CAS  Google Scholar 

  102. Toronto Public Health. COVID-19 and the Social Determinants of Health: What do we know? 2020. 96e0-SDOHandCOVID19_Summary_2020May14.pdf (toronto.ca). Accessed 20 Mar 2024.

Download references

Acknowledgements

Carolyn Ziegler for the systematic search. Jane Ebreo for all administrative support. Kimberly Devotta for project management support. Tutsirai Makuwaza for feedback on the qualitative work on BETTER LIFE. Mary-Anne Pietrusiak for subject matter expertise. Ranya Mistry for Qualtrics survey development support.

Funding

This study was funded by a Canadian Institutes of Health Research Catalyst Grant: Disease Prevention and Risk Factor Modification – Non-Communicable Diseases (#428589).

Author information

Author notes

  1. Mary Ann O’Brien and Aisha Lofters are co-senior authors.

Authors and Affiliations

  1. Public Health Agency of Canada, Ottawa, ON, Canada

    Nasheed Moqueet

  2. McMaster University, Hamilton, ON, Canada

    Sylvie D. Cornacchi

  3. Women’s College Hospital, 76 Grenville St, Toronto, ON, M5S 1B2, Canada

    Jesmin Antony & Aisha Lofters

  4. Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada

    Ielaf Khalil

  5. Department of Family Medicine, University of Alberta, Edmonton, AB, Canada

    Donna Manca, Carolina Fernandes, Nicolette Sopcak & Jill Konkin

  6. Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Lawrence Paszat

  7. Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John’s, NL, Canada

    Kris Aubrey-Bassler

  8. Ontario Institute for Cancer Research, Toronto, ON, Canada

    Eva Grunfeld

  9. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Andrew Pinto

  10. School of Public Health, University of Alberta, Edmonton, AB, Canada

    Candace Nykiforuk

  11. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Linda Rabeneck

  12. Centre for Addiction and Mental Health, Toronto, ON, Canada

    Peter Selby

  13. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Eva Grunfeld, Peter Selby, Mary Ann O’Brien & Aisha Lofters

  14. Durham Region Health Department, Whitby, ON, Canada

    Becky Wall

Authors
  1. Nasheed Moqueet
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sylvie D. Cornacchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jesmin Antony
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ielaf Khalil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Donna Manca
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carolina Fernandes
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lawrence Paszat
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kris Aubrey-Bassler
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eva Grunfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Nicolette Sopcak
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Andrew Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jill Konkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Candace Nykiforuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Linda Rabeneck
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Peter Selby
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Becky Wall
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Mary Ann O’Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Aisha Lofters
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NM, SDC, JA, IK, MAO, AL provided substantial contributions to the conception and design of the work (review, data synthesis, data extraction, quality assessment, harmonization); NM, SDC, JA, IK, DM, CF, LP, PS, MAO, AL acquired, analyzed, and interpreted data; NM, SDC, IK, MAO, AL wrote the manuscript;NM, SDC, JA, IK, DM,  CF, LP, KAB, EG, NS, AP, JK, CN, LR, PS, BW, MAO, AL (i.e. all authors) reviewed the manuscript critically for important intellectual content; NM, SDC, JA, IK, DM,  CF, LP, KAB, EG, NS, AP, JK, CN, LR, PS, BW, MAO, AL (i.e. all authors) read and approved the final manuscript.

Corresponding author

Correspondence to Aisha Lofters.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moqueet, N., Cornacchi, S.D., Antony, J. et al. BETTER LIFE- guidelines for chronic disease preventive care for people aged 18–39 years: a literature review. BMC Prim. Care 25, 224 (2024). https://doi.org/10.1186/s12875-024-02471-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12875-024-02471-9

Keywords

BMC Primary Care

ISSN: 2731-4553

Contact us