Canadian Armed Forces (CAF) Project – Phase II Development of the “Operational Readiness Evidence-based Care Pathway” for chiropractors managing spinal pain in the Canadian Armed Forces
Objectives
- Develop a PBRN of chiropractors who are consulted by CAF personnel to deliver the care pathway.
- Develop the care pathway in collaboration with the CFHS. The proposed care pathway will include:
- data collection tools
- evidence-based treatments for spinal pain
- CFHS communication tool kit
- Develop an educational module to train PBRN chiropractors on the delivery of the care pathway.
- Implement and assess a model of chiropractic care on a CAF base within the existing team-based, patient-centred CFHS for the management of MSK conditions for the management of MSK conditions among CAF military personnel.
Project Status
- Project is ongoing
- Objectives 1-4 have been completed and introduced to two PBRN sites for the management of LBP in soldiers referred to chiropractors from CFB Trenton and CFB Comox.
- PBRN Trenton: study closed and data has been collected and currently being analyzed. We invited 12 chiropractors to join the PBRN, 4 (33%) agreed to participate and received nine CAF referrals over 4 months. Six chiropractors declined for personal reasons, five because of work demands and one relocated his office.
- PBRN Comox: study closed early due to covid-19 pandemic. We invited 8 chiropractors to join the PBRN, 6 (75%) agreed to participate and received 18 CAF referrals over 3 months. Data collected except for interviews, which are currently underway.
- Based upon feedback from participants, we learned that there some soldiers self-refer for chiropractic care. Therefore, we have added another component to our Phase II study that will seek to better understand the reasons behind such self-referrals. We will recruit active soldiers who self-refer to off-base chiropractors for the treatment of MSK conditions to better understand their motivations and experiences. The start of this project has been delayed due to the covid-19 pandemic. We have submitted change requests to both institutional REBs and received approval to proceed. We are now planning the start of our project.
Publications
- Cancelliere C, Sutton D, Côté P, French SD, Taylor-Vaisey A, Mior SA. Implementation interventions for musculoskeletal programs of care in the active military and barriers, facilitators, and outcomes of implementation: A scoping review. Implement Sci. 2019;14(1):82.
- Mior S, Sutton D, Cancelliere C, French S, Taylor-Vaisey A, Côté P. Chiropractic services in the active duty military setting: A scoping review. Chiropr Man Therap. 2019;27:45.
- Mior SA, Vogel E, Sutton D, French S, Côté P, Nordin M, Loisel P, Laporte A. Exploring chiropractic services in the Canadian Forces Health Services - Perceptions of facilitators and barriers among key informants. Mil Med. 2019;184(5-6):e344-e51.
External Funding
- The Canadian Chiropractic Association and the Ontario Chiropractic Association have committed funding for a project to address the barriers and challenges identified in Phase I to ultimately improve health and work outcomes for CAF personnel, by developing the “CAF Operational Readiness Evidence-based Care Pathway” with the intent of delivering care to CAF personnel with spinal pain by a practice-based research network (PBRN) of chiropractors.
- The Canadian Chiropractic Guideline Initiative has committed funding for a project to develop a practice-based research network (PBRN) of chiropractors who deliver care to Canadian Armed Forces personnel with spinal pain.
Research Team
- Silvano Mior (Project Lead)
- Carol Cancelliere (Co-Principal Investigator)
- Pierre Côté (Co-Principal Investigator)
- Simon French (Co-Principal Investigator)
- Patrick Loisel (Co-Investigator)
- Margareta Nordin (Co-Investigator)
- Audrey Laporte (Co-Investigator)
- Ellen Vogel (Co-Investigator)
- Corey Hofkirchner (Clinical Sciences Resident)
- Deborah Sutton (Project Manager)
- Gaelan Connell (Project Manager)
- Poonam Cardoso (Finance Officer)
