Project Members: What is CIRCUIT?
The Centre d’Intervention en prévention et en Réadaptation CardiovascUlaIres pour Toute la famille (CIRCUIT) is a multidisciplinary program to promote healthy lifestyle habits, designed at the CHU Sainte-Justine in Montréal, Québec.
The program targets children and adolescents between 5 and 18 years of age, with at least two risk factors of cardiovascular disease such as obesity, type 2 diabetes, dyslipidemia and hypertension.
The team at CIRCUIT is composed of a network of experienced health care professionals including a kinesiologist, nutritionist, psycho-educator, doctors and researchers. CIRCUIT is also working in collaboration with the Centre territorial de coordination en télésanté du CHUM and with CHU Sainte-Justine’s telehealth clinical director to integrate the new telehealth modules.
Why is the CIRCUIT program important?
In Quebec, 25% of youth between 6 and 17 years of age are overweight or obese. This trend is alarming seeing that overweight and obesity can have important health consequences such as type 2 diabetes and cardiovascular disease. However, despite this pressing issue, there is still a lack of resources available to assist and to guide families towards better lifestyle habits.
Development of CIRCUIT
The CIRCUIT program was first created in 2010, in light of the increasing trend in cardiovascular risk factors among the pediatric population. The program is unique and innovative, as it provides a personalized intervention using wearable devices to evaluate and promote healthy lifestyle behaviours. Our specialists can help families learn and discover new skills, hobbies and activities, transforming this journey towards a healthier lifestyle into a FUN project for the whole family!
Over the years, this intervention has shown to be effective to improve multiple health indicators including blood pressure, adiposity and fitness levels. Given these promising findings, the program garnered Québec Ministry of Health funding to pilot the deployment of CIRCUIT to two alternate settings, in order to develop an efficient strategy for a province-wide deployment. To facilitate the deployment of CIRCUIT in our outreach centres and support the successful expansion of the program, CIRCUIT continued to innovate in the care of children at risk of cardiometabolic disease by optimizing the use of health technology within the program. These changes will increase the accessibility of the program, enhance its intensity, and will allow more children and adolescents to benefit from it, by reducing the geographic barriers.
The Current Program
CIRCUIT+ is a one-year program during which participants are followed by a kinesiologist, nutritionist and psycho-educator. Following comprehensive assessments of the children’s lifestyle habits and fitness levels, the clinicians then collaborate with the families in order to recommend a personalized plan to promote healthy lifestyle habits, while leveraging available community resources and the child’s interests. Every month, fun and diverse activities are also planned and are great opportunities for kids to get together and have a good time. In fact, CIRCUIT aims to create memorable experiences, serving as examples that embracing healthier habits can be enjoyable!
Use of Technology
Historically, CIRCUIT used innovative technologies (including accelerometer, GPS and heart rate monitor) to evaluate participants’ lifestyle habits, however these were bulky, had complex data extraction and interpretation, and did not provide real-time feedback to participants. Moreover, as with many lifestyle modification programs, program dropout was a considerable concern to the team. The program was therefore modified to integrate user-friendly technologies (including Fitbits and telehealth) in order to overcome these challenges, enhance accessibility and efficiency of care, as well as patient engagement within the program.
Fitbits
Fitbits are simple and easily wearable devices that have been gaining popularity among the general population. . These watches allow the team at CIRCUIT to gather all necessary information to map the children’s progression and provide real-time feedback to the participants. As an example, one of the indicators measured by the Fitbit is the number of steps accumulated during the day. For some children, this can drive and motivate them to continue staying active in order to reach their personal goals. The professionals at CIRCUIT encourage children by sending messages directly to their Fitbit, making it both a tool to evaluate lifestyle habits but also enhance the intervention.
Telehealth
Telehealth provides a virtual platform where patients can connect with the CIRCUIT team, making it easier to be in contact more often. This can improve commitment to the program, and could lead to better results in improving patient lifestyle behaviours.
Through virtual telehealth sessions, the CIRCUIT program will be able to reach a wider group of patients from more remote areas in Quebec who would find it challenging to travel to in-person sessions at CHU Sainte Justine or the new outreach centres.
Through virtual Telehealth sessions, the CIRCUIT program will be able to reach a wider group of patients from more remote areas in Québec, who would find it challenging to travel to in-person sessions at CHU Sainte Justine.
Goals of the project
The goal of the project is to help engage kids who are in a program that helps to prevent cardiometabolic disease. Using Fitbits and telehealth, the project hopes to expand to reach kids living all across Quebec.
- Add the use of Fitbits and telehealth into the existing CIRCUIT program at CHU Sainte-Justine and the two outreach centres.
- Establish the satisfaction and appreciation of families and staff in CIRCUIT of integrating these technologies into clinical care.
- Determine how using these technologies leads to better outcomes among participants in the program.
“Greater accessibility to local treatment across Quebec allows earlier intervention for children at risk of diabetes and cardiovascular disease. This can lead to improved success, prevention of the onset of complications, and can reduce health care costs.”
Plan
Phase 1
2020-2021
Implement technology in the program at CHU Sainte-Justine to assess effectiveness and feasibility.
Phase 2
2021-2022
Expand the program to 2 centres in the community (Hôpital Pierre-Le Gardeur and Hôpital régional de Rimouski).
Phase 3
2023 –
Continue to expand the program across Quebec.
Current Status
The project is currently in phase 2
- Deployment of CIRCUIT+ at Hôpital Pierre-Le Gardeur and Hôpital régional de Rimouski has begun.
- A network for the teleheatlh modules of the project has been created.
- The Fitbits as well as virtual telehealth follow ups are being used successfully.