Concurrent Sessions

B5-A – The BETTER Approach: Implementing an innovative, evidence-based program for cancer and chronic disease prevention and screening in primary care

Theme 5. Why hasn’t this expanded: scalable pilot programs

Presentation Details

  • Date: Wednesday, October 24, 2018
  • Concurrent Session B
  • Time: 3:30-4:15pm
  • Room: Harbour C
  • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
  • Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
  • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives

  1. Learn about BETTER: an innovative approach that integrates preventive care for cancer and chronic diseases in primary care
  2. Hear lessons learned from a Family Health Team that has implemented BETTER
  3. Reflect on how BETTER could be implemented in your Family Health Team


Family physicians often lack time, resources, and tools to address cancer and chronic disease prevention and screening (CCDPS), and to integrate the many guidelines and resources that are focused on one specific disease, organ system, or lifestyle risk. The BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) approach integrates evidence-based preventive care for cancer with other chronic diseases, specifically focusing on lifestyle factors. A health professional in the primary care setting is trained to take on the role of a Prevention Practitioner (PP), who then develops a tailored “Prevention Prescription” with each patient, helping them to set S.M.A.R.T. (specific, measurable, attainable, realistic, time-based) goals for their health.     The St. Joseph’s Health Centre (SJHC) Urban Family Health Team (UFHT) has been implementing the BETTER approach for 2 years.  It has been launched in a stepwise manner to adapt the BETTER tools and BETTER visit to their environment to account for pre-existing patient and provider expectations of what was formerly known as their “Complete General Assessment” (CGA).    Appreciating the collaborative patient centred approach to the BETTER visit, it has expanded from three physicians testing the model to now include the nurse practitioner, one registered nurse and five physicians, with the plan to expand clinic wide. Challenges identified are the paper based survey, cumbersome EMR documentation and managing provider and patient expectations of the appointment. Starting with converting to an electronic survey and with further training, there are plans to address these challenges over the coming year.


  • Linda Weber, MD, CCFP, St Joseph’s Health Centre Family Medicine Centre/Urban FHT
  • Paula Kilkenny, RN,MN, Preventive Care Nurse, St Joseph’s Health Centre Family Medicine Centre/Urban FHT
  • Aisha Lofters, MD , PhD CCFP, University of Toronto

Authors & Contributors

  • Donna Manca, Department of Family Medicine, University of Alberta
  • Carolina Aguilar, Department of Family Medicine, University of Alberta
  • Eva Grunfeld, University of Toronto Department of Family & Community Medicine
  • Alejandra Priego, Patient Care Manager, St Joseph’s Health Centre Family Medicine Centre/Urban Family Health Team