Interprofessional collaboration and collaborative patient and family-centered practice is increasingly advocated as a means of improving patient outcomes and the cost effectiveness of health care. The Canadian Interprofessional Health Collaborative and Registered Nurses Association of Ontario identified best practices and competencies required for interprofessional collaboration and collaborative practice. Despite the widespread dissemination of these competencies and best practice guidelines to health professional schools, there remains a gap in nursing practice regarding nursing knowledge about the core competencies required for interprofessional collaboration. The purpose of this project was the planning of an education program for nurses on interprofessional collaboration and collaborative care. At the project facility, the interprofessional practice team planned an education program for nursing staff to promote interprofessional collaborative practices and thereby improve patient and population health outcomes. The education project was guided by a model of instructional design used previously by the interprofessional practice department. The education program included a handout and a PowerPoint presentation describing the contents of the handout and clinical application of the competencies in nursing practice. The PowerPoint will be retained by the organization to present to nursing staff employed at the organization. Process evaluation included a team member questionnaire assessing leadership, participant involvement and meeting facilitation. Members of the interprofessional practice team agreed on the success of the process and involvement in the overall project. Increasing nursing knowledge about interprofessional collaboration and collaborative practices would represent positive social change to improve nursing practices and as a result, health outcomes for patients and their families.

Yes / (1) Present deprescribing experiences of patients living with frailty, their informal carers and healthcare professionals; (2) interpret whether their experiences are reflective of person-centred/collaborative care; (3) complement our findings with existing evidence to present a model for person-centred deprescribing for patients living with frailty, based on a previous collaborative care model. Qualitative design in English primary care (general practice). Semi-structured interviews were undertaken immediately post-deprescribing and 5/6 weeks later with nine patients aged 65+ living with frailty and three informal carers of patients living with frailty. Fourteen primary care professionals with experience in deprescribing were also interviewed. In total, 38 interviews were conducted. A two-staged approach to data analysis was undertaken. Three themes were developed: attitudes, beliefs and understanding of medicines management and responsibility; attributes of a collaborative, person-centred deprescribing consultation; organisational factors to support person-centred deprescribing. Based on these findings and complementary to existing evidence, we offer a model for person-centred deprescribing for patients living with frailty. Previous models of deprescribing for patients living with frailty while, of value, do not consider the contextual factors that govern the implementation and success of models in practice. In this paper, we propose a novel person-centred model for deprescribing for people living with frailty, based on our own empirical findings, and the wider evidence base. / This research was funded by the National Institute for Health and Care Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC).

Class of 2005 Abstract / Objective: To determine the effect that a pharmacist run diabetes mellitus (DM) care clinic has on glycemic control, as measured by glycosylated hemoglobin (HbA1c) levels. The baseline comparison group is the current standard of care consisting of physician only treated DM patients. Methods: This project is a retrospective cohort analysis of clinical data obtained from patient charts, patients were matched on age. The pharmacist treated group, from a community health center clinic with a collaborative care agreement for the treatment of DM (Group 1), provided comprehensive DM treatment based upon a prearranged treatment protocol with clinic physicians. The physician treated group, is from an outpatient clinic situated at a community hospital (Group 2). The primary outcome was change in HbA1c over at least a 6 month period of time. Patients from both groups were diagnosed with type 2 diabetes mellitus, >18 years of age, and enrolled in an Arizona Health Care Cost Containment System (AHCCCS) Medicaid insurance program. Patients could be treated with oral antidiabetic medication, an insulin product, or a combination of both. Results: A total of 321 patients were included in the study, Group 1 n=161, Group 2 n=160. Ages were similar, mean age=57.7 (SD=12.2) for Group1 and mean age=57.4 (SD=12.3) for Group 2. Gender (male=33.5% and 37.5% respectively) and ethnicity were also similar (p>0.45). The average HbA1c levels at baseline and at the end of treatment were as follows; Group 1 (9.8 and 7.8), and Group 2 (8.8 and 8.9) p<0.001 for post treatment comparison. Implications: This study indicates that physician pharmacist collaborative care improves glycemic control, as shown by significantly lower HbA1c levels than the physician treated group.

Entrepreneurs in integrated care face some of the same challenges in empirically demonstrating impact, regardless of the model of care they espouse. In this editorial, 2 leading model developers reflect on the state of the science in primary care integration, including research gaps and promising research underway. We asked these leaders to discuss conceptual areas of shared concern, and we present those with reference to the metaphor of the translational research bridge. Their insights resonate with one another and suggest a role for collaboration to advance empirical support for the implementation of integrated care.

No description available.

O uso de medicamentos representa um dos recursos terapêuticos mais utilizados na resolução de grande parte dos problemas e situações em saúde. Nesse contexto, o interesse na forma como os pacientes gerem suas doenças e tratamentos farmacológicos tem crescido em importância. Esta tese objetivou compreender as dimensões da autogestão do uso de medicamentos e variáveis associadas na população brasileira. Para isso, foram analisados três comportamentos relacionados ao uso de medicamentos: a automedicação, a não-adesão intencional e as alterações das doses prescritas. Os dados analisados são provenientes da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM), estudo transversal realizado entre os meses de setembro de 2013 e janeiro de 2014 em 245 municípios brasileiros distribuídos nas cinco regiões geográficas do país. A população do estudo foram os indivíduos residentes em domicílios permanentes na zona urbana do território brasileiro. Nesta tese, foram analisados os dados de 31.573 indivíduos com idade igual ou superior a 20 anos. Modelos de Regressão de Poisson com ajuste robusto da variância foram utilizados a fim de estimar o efeito independente de cada variável nos três comportamentos estudados. Entre os entrevistados, 73,6% declararam utilizar algum medicamento sem indicação médica quando já fizeram uso do mesmo produto anteriormente, 73,8% declararam utilizar medicamentos sem prescrição médica quando já tem o medicamento em casa e 35,5% declararam utilizar algum medicamento sem prescrição quando conhecem alguém que já tomou o mesmo medicamento. As variáveis que se mostraram associadas à maior probabilidade de uso de medicamentos por automedicação foram: região geográfica do Brasil, sexo, faixa etária, renda per capita, auto avaliação da saúde, declaração de que usa medicamento sem prescrição médica quando já usou o mesmo medicamento anteriormente e declaração de que usa medicamento sem prescrição médica quando já tem o medicamento em casa. Mais da metade dos entrevistados relataram alguma situação de automedicação, enquanto que 38% relataram deixar intencionalmente de tomar medicamentos prescritos em alguma situação. Com relação às alterações nas prescrições, 8,8% dos entrevistados relataram amentar a dose dos medicamentos em alguma situação e mais de 21% relataram diminuir a dose. Nos modelos de regressão ajustados, as variáveis sexo, idade e autoavaliação de saúde mostraram-se associadas à não-adesão intencional. As alterações de dose aparecem associadas à idade, renda e autoavaliação de saúde. Os resultados indicam, portanto, que um percentual significativo da população brasileira utiliza medicamentos não exclusivamente da forma como são prescritos pelo médico. Buscando contemplar esses diferentes comportamentos cotidianos dos indivíduos em relação aos medicamentos, a presente tese propôs o conceito de “autogestão do uso de medicamentos”. Esse conceito visa ampliar a compreensão do uso de medicamentos para além da adesão às prescrições médicas como já indicado no conceito de medication self-management e de compliance. A partir dessa perspectiva, destaca-se a necessidade de adoção de outros paradigmas nos cuidados em saúde, como o dos cuidados colaborativos e da corporalidade (lived body), onde o próprio indivíduo, com a colaboração dos profissionais da saúde, tome as decisões sobre as estratégias mais adequadas de tratamento e promoção da saúde. / The use of medications represents one of the most utilized therapeutic resources to the resolution of most health problems and situations. In this context, the interest in how patients manage their diseases and pharmacological treatment has increased. This thesis had as main objective to comprehend the self-management of medications use and related variables on the Brazilian population. Three behaviors related to the use of medications were analyzed: self-medication, intentional non-adherence and prescribed doses changes. Analyzed data are part of the “Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM)”, a cross-sectional study performed between September 2013 and January 2014 in 245 Brazilian cities in the five geographic regions. Study population were individuals living permanently in the urban area of Brazil. In this thesis, data from 31.573 individuals aged 20 years or above were analyzed. Poisson Regression Models with robust variance adjustment were used to estimate independent effect of each variable on the three studied behaviors. Among the interviewed, 73.6% have declared the use of any medication without medical prescription when they have used the same product previously, 73.8% have declared the use of not prescribed drugs when the medication is available at home and, 35.5% have declared to use any drug without medical prescription when someone they know have used the same medication. Variables related to higher probability of drug use by self-medication were: geographic region, gender, age, per capita income, health self-evaluation, the use without medical prescription of the same drug used before and the use without medical prescription when the drug is available at home declarations. More than half of the interviewed reported any situation of self-medication while 38% reported to, intentionally, stop taking prescribed medications in any situation. Regarding prescription alterations, 8.8% of the interviewed reported to increase the medication dose in any situation and more than 21% reported to decrease medication dose. On the adjusted regression models variables as gender, age and health self-evaluation showed to be related to intentional nonadherence. Dose changes are related to age, income and health self-evaluation. Therefore, results show that a significant percentage of the Brazilian population uses medications not exclusively as they are prescribed by the physician. Seeking to address these different daily behaviors of individuals regarding medications, this thesis has proposed the concept of “self-management of medications use”. This concept aims to amplify the comprehension of medications use beyond medical prescriptions adherence as already indicated in the concept of medication self-management and compliance. From this perspective stands out the need of other paradigms introduction on health care, such as collaborative care and lived body, in which the individual himself, with health professionals’ collaboration, take the decisions about the most adequate treatment strategies and health promotion.

Canadian doctors have historically been an extremely powerful interest group. While there are many variables that account for their political influence, it is widely accepted that much of their power is due to their control over specialized knowledge. To determine whether or not physicians’ control over knowledge is changing, I examine doctors’ position relative to the state, the public and other health professionals. This research finds that, in all three relationships, physicians’ control over knowledge is weakening. Moreover, organized medicine’s response to these developments has largely been a strategy of co-optation, demonstrating that doctors are aware that these changes often cannot be openly fought. This strategy signals that the medical profession recognizes that some changes in its control over knowledge are bound to occur. This study concludes that these changes could contribute to a ‘critical juncture’ signalling the potential for significant change in the physician-state relationship.

O uso de medicamentos representa um dos recursos terapêuticos mais utilizados na resolução de grande parte dos problemas e situações em saúde. Nesse contexto, o interesse na forma como os pacientes gerem suas doenças e tratamentos farmacológicos tem crescido em importância. Esta tese objetivou compreender as dimensões da autogestão do uso de medicamentos e variáveis associadas na população brasileira. Para isso, foram analisados três comportamentos relacionados ao uso de medicamentos: a automedicação, a não-adesão intencional e as alterações das doses prescritas. Os dados analisados são provenientes da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM), estudo transversal realizado entre os meses de setembro de 2013 e janeiro de 2014 em 245 municípios brasileiros distribuídos nas cinco regiões geográficas do país. A população do estudo foram os indivíduos residentes em domicílios permanentes na zona urbana do território brasileiro. Nesta tese, foram analisados os dados de 31.573 indivíduos com idade igual ou superior a 20 anos. Modelos de Regressão de Poisson com ajuste robusto da variância foram utilizados a fim de estimar o efeito independente de cada variável nos três comportamentos estudados. Entre os entrevistados, 73,6% declararam utilizar algum medicamento sem indicação médica quando já fizeram uso do mesmo produto anteriormente, 73,8% declararam utilizar medicamentos sem prescrição médica quando já tem o medicamento em casa e 35,5% declararam utilizar algum medicamento sem prescrição quando conhecem alguém que já tomou o mesmo medicamento. As variáveis que se mostraram associadas à maior probabilidade de uso de medicamentos por automedicação foram: região geográfica do Brasil, sexo, faixa etária, renda per capita, auto avaliação da saúde, declaração de que usa medicamento sem prescrição médica quando já usou o mesmo medicamento anteriormente e declaração de que usa medicamento sem prescrição médica quando já tem o medicamento em casa. Mais da metade dos entrevistados relataram alguma situação de automedicação, enquanto que 38% relataram deixar intencionalmente de tomar medicamentos prescritos em alguma situação. Com relação às alterações nas prescrições, 8,8% dos entrevistados relataram amentar a dose dos medicamentos em alguma situação e mais de 21% relataram diminuir a dose. Nos modelos de regressão ajustados, as variáveis sexo, idade e autoavaliação de saúde mostraram-se associadas à não-adesão intencional. As alterações de dose aparecem associadas à idade, renda e autoavaliação de saúde. Os resultados indicam, portanto, que um percentual significativo da população brasileira utiliza medicamentos não exclusivamente da forma como são prescritos pelo médico. Buscando contemplar esses diferentes comportamentos cotidianos dos indivíduos em relação aos medicamentos, a presente tese propôs o conceito de “autogestão do uso de medicamentos”. Esse conceito visa ampliar a compreensão do uso de medicamentos para além da adesão às prescrições médicas como já indicado no conceito de medication self-management e de compliance. A partir dessa perspectiva, destaca-se a necessidade de adoção de outros paradigmas nos cuidados em saúde, como o dos cuidados colaborativos e da corporalidade (lived body), onde o próprio indivíduo, com a colaboração dos profissionais da saúde, tome as decisões sobre as estratégias mais adequadas de tratamento e promoção da saúde. / The use of medications represents one of the most utilized therapeutic resources to the resolution of most health problems and situations. In this context, the interest in how patients manage their diseases and pharmacological treatment has increased. This thesis had as main objective to comprehend the self-management of medications use and related variables on the Brazilian population. Three behaviors related to the use of medications were analyzed: self-medication, intentional non-adherence and prescribed doses changes. Analyzed data are part of the “Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM)”, a cross-sectional study performed between September 2013 and January 2014 in 245 Brazilian cities in the five geographic regions. Study population were individuals living permanently in the urban area of Brazil. In this thesis, data from 31.573 individuals aged 20 years or above were analyzed. Poisson Regression Models with robust variance adjustment were used to estimate independent effect of each variable on the three studied behaviors. Among the interviewed, 73.6% have declared the use of any medication without medical prescription when they have used the same product previously, 73.8% have declared the use of not prescribed drugs when the medication is available at home and, 35.5% have declared to use any drug without medical prescription when someone they know have used the same medication. Variables related to higher probability of drug use by self-medication were: geographic region, gender, age, per capita income, health self-evaluation, the use without medical prescription of the same drug used before and the use without medical prescription when the drug is available at home declarations. More than half of the interviewed reported any situation of self-medication while 38% reported to, intentionally, stop taking prescribed medications in any situation. Regarding prescription alterations, 8.8% of the interviewed reported to increase the medication dose in any situation and more than 21% reported to decrease medication dose. On the adjusted regression models variables as gender, age and health self-evaluation showed to be related to intentional nonadherence. Dose changes are related to age, income and health self-evaluation. Therefore, results show that a significant percentage of the Brazilian population uses medications not exclusively as they are prescribed by the physician. Seeking to address these different daily behaviors of individuals regarding medications, this thesis has proposed the concept of “self-management of medications use”. This concept aims to amplify the comprehension of medications use beyond medical prescriptions adherence as already indicated in the concept of medication self-management and compliance. From this perspective stands out the need of other paradigms introduction on health care, such as collaborative care and lived body, in which the individual himself, with health professionals’ collaboration, take the decisions about the most adequate treatment strategies and health promotion.

O uso de medicamentos representa um dos recursos terapêuticos mais utilizados na resolução de grande parte dos problemas e situações em saúde. Nesse contexto, o interesse na forma como os pacientes gerem suas doenças e tratamentos farmacológicos tem crescido em importância. Esta tese objetivou compreender as dimensões da autogestão do uso de medicamentos e variáveis associadas na população brasileira. Para isso, foram analisados três comportamentos relacionados ao uso de medicamentos: a automedicação, a não-adesão intencional e as alterações das doses prescritas. Os dados analisados são provenientes da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM), estudo transversal realizado entre os meses de setembro de 2013 e janeiro de 2014 em 245 municípios brasileiros distribuídos nas cinco regiões geográficas do país. A população do estudo foram os indivíduos residentes em domicílios permanentes na zona urbana do território brasileiro. Nesta tese, foram analisados os dados de 31.573 indivíduos com idade igual ou superior a 20 anos. Modelos de Regressão de Poisson com ajuste robusto da variância foram utilizados a fim de estimar o efeito independente de cada variável nos três comportamentos estudados. Entre os entrevistados, 73,6% declararam utilizar algum medicamento sem indicação médica quando já fizeram uso do mesmo produto anteriormente, 73,8% declararam utilizar medicamentos sem prescrição médica quando já tem o medicamento em casa e 35,5% declararam utilizar algum medicamento sem prescrição quando conhecem alguém que já tomou o mesmo medicamento. As variáveis que se mostraram associadas à maior probabilidade de uso de medicamentos por automedicação foram: região geográfica do Brasil, sexo, faixa etária, renda per capita, auto avaliação da saúde, declaração de que usa medicamento sem prescrição médica quando já usou o mesmo medicamento anteriormente e declaração de que usa medicamento sem prescrição médica quando já tem o medicamento em casa. Mais da metade dos entrevistados relataram alguma situação de automedicação, enquanto que 38% relataram deixar intencionalmente de tomar medicamentos prescritos em alguma situação. Com relação às alterações nas prescrições, 8,8% dos entrevistados relataram amentar a dose dos medicamentos em alguma situação e mais de 21% relataram diminuir a dose. Nos modelos de regressão ajustados, as variáveis sexo, idade e autoavaliação de saúde mostraram-se associadas à não-adesão intencional. As alterações de dose aparecem associadas à idade, renda e autoavaliação de saúde. Os resultados indicam, portanto, que um percentual significativo da população brasileira utiliza medicamentos não exclusivamente da forma como são prescritos pelo médico. Buscando contemplar esses diferentes comportamentos cotidianos dos indivíduos em relação aos medicamentos, a presente tese propôs o conceito de “autogestão do uso de medicamentos”. Esse conceito visa ampliar a compreensão do uso de medicamentos para além da adesão às prescrições médicas como já indicado no conceito de medication self-management e de compliance. A partir dessa perspectiva, destaca-se a necessidade de adoção de outros paradigmas nos cuidados em saúde, como o dos cuidados colaborativos e da corporalidade (lived body), onde o próprio indivíduo, com a colaboração dos profissionais da saúde, tome as decisões sobre as estratégias mais adequadas de tratamento e promoção da saúde. / The use of medications represents one of the most utilized therapeutic resources to the resolution of most health problems and situations. In this context, the interest in how patients manage their diseases and pharmacological treatment has increased. This thesis had as main objective to comprehend the self-management of medications use and related variables on the Brazilian population. Three behaviors related to the use of medications were analyzed: self-medication, intentional non-adherence and prescribed doses changes. Analyzed data are part of the “Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM)”, a cross-sectional study performed between September 2013 and January 2014 in 245 Brazilian cities in the five geographic regions. Study population were individuals living permanently in the urban area of Brazil. In this thesis, data from 31.573 individuals aged 20 years or above were analyzed. Poisson Regression Models with robust variance adjustment were used to estimate independent effect of each variable on the three studied behaviors. Among the interviewed, 73.6% have declared the use of any medication without medical prescription when they have used the same product previously, 73.8% have declared the use of not prescribed drugs when the medication is available at home and, 35.5% have declared to use any drug without medical prescription when someone they know have used the same medication. Variables related to higher probability of drug use by self-medication were: geographic region, gender, age, per capita income, health self-evaluation, the use without medical prescription of the same drug used before and the use without medical prescription when the drug is available at home declarations. More than half of the interviewed reported any situation of self-medication while 38% reported to, intentionally, stop taking prescribed medications in any situation. Regarding prescription alterations, 8.8% of the interviewed reported to increase the medication dose in any situation and more than 21% reported to decrease medication dose. On the adjusted regression models variables as gender, age and health self-evaluation showed to be related to intentional nonadherence. Dose changes are related to age, income and health self-evaluation. Therefore, results show that a significant percentage of the Brazilian population uses medications not exclusively as they are prescribed by the physician. Seeking to address these different daily behaviors of individuals regarding medications, this thesis has proposed the concept of “self-management of medications use”. This concept aims to amplify the comprehension of medications use beyond medical prescriptions adherence as already indicated in the concept of medication self-management and compliance. From this perspective stands out the need of other paradigms introduction on health care, such as collaborative care and lived body, in which the individual himself, with health professionals’ collaboration, take the decisions about the most adequate treatment strategies and health promotion.

The overall aim of this Participatory Action Research (PAR; Chevalier & Buckles, 2013; Lewin, 1946) project was to design, implement, and evaluate a specialized sport-focused mental health service delivery model for competitive and high-performance athletes, integrated within a broader Canadian Centre for Mental Health and Sport (CCMHS). A transformative mixed methods research design (Cresswell, 2014) guided by the PAR approach was employed across three phases during which (a) a sport-specific mental health service delivery model for competitive and high-performance athletes was collaboratively designed by stakeholders (Design Phase [Study 1]), (b) the model was pilot-tested within the CCMHS (Implementation Phase [Study 2]), and (c) the model was evaluated to understand whether practitioners and service-users perceived the care delivered / received within the model to be acceptable and appropriate (Evaluation Phase [Study 3]). Design Phase (Study 1). The purpose of study 1 was to (a) perform an environmental scan of the Canadian mental health care and sport contexts, and (b) design a sport-focused mental health service delivery model for competitive and high-performance athletes within a broader CCMHS. To meet these objectives, 20 stakeholders from the sport and mental health sectors explored (a) the availability and effectiveness of mental health care for competitive and high-performance Canadian athletes, and (b) the strengths, weaknesses, opportunities and threats associated with creating a CCMHS, via two iterations of stakeholder-led focus groups (Rio-Roberts, 2011). The resulting data informed a subsequent Group Concept Mapping (GCM; Burke et al., 2005; Kane & Trochim, 2007; Rosas & Kane, 2012) activity undertaken by stakeholders, which produced an actionable framework (i.e., concept map) organized into six clusters that visually represented the elements (e.g., services, personnel, organizational structures) that stakeholders deemed important to include in the sport-focused mental health care model (e.g., bilingual services, a triage system, sport-specialized practitioners). In addition, the results revealed that misconceptions about the competitive and high-performance population’s mental health and experience of mental illness were widespread and required clarification before significant advances could be made. This led the group to develop six principles designed to establish a common language and understanding upon which to build effective models of mental health care, improved programming, and strategic education for Canada’s competitive and high-performance athletes, coaches, and organizations (Article 1). The framework that emerged from the GCM activity served to guide the remainder of the project, and supported actions (e.g., develop eligibility criteria to access services, hire a team of mental health practitioners with sport competencies [i.e., CCMHS Care Team]) to build the CCMHS and test the model during the Implementation Phase (Article 2). Implementation Phase (Study 2). The purpose of study 2 was to pilot test the mental health service delivery model designed during the first phase of the research project. To do so, an illustrative case study (Keegan et al., 2017; Stake, 1995, 2005) was carried out to demonstrate how (i.e., intake, referral, and service delivery processes) the CCMHS Care Team provided mental health care to a high-performance athlete, and what outcomes resulted from this process. Data to inform the case study was gathered through a review of the service-user’s clinical documents (e.g., intake summary, session notes), and qualitative interviews (n = 2) with the athlete’s Collaborative Care Team lead and the CCMHS Care Coordinator. Document analysis (Bowen, 2009) was used to organize the details of the case found within clinical documents under the categories of the case study framework (i.e., intake and referral process, service-user description, integrated care plan, and outcomes), while a conventional descriptive content analysis (Hsieh & Shannon, 2005) served to extract salient data from the interviews to further build out the case study. Results revealed that sport significantly influenced the onset and experience of mental illness for the athlete service-user. The lead practitioner’s sport-specific knowledge played a significant role in the diagnosis, treatment and recovery of this athlete given the nature of the athlete’s concerns and high athletic identity. Findings support the notion that specialized mental health care models and teams are necessary to address sport-related factors that can pose unique threats to the diagnosis and treatment of mental illness in athletes (Article 3). Implementation Phase (Study 3). The purpose of study 3 was to evaluate the acceptability and appropriateness of the mental health service delivery model designed during Phase 1 and implemented during Phase 2. Qualitative data from three sources (CCMHS practitioners, CCMHS service-users, and CCMHS stakeholders) were collected and analyzed using a multi-step, multi-method process, including16 one-on-one semi-structured interviews with CCMHS practitioners (n = 10) and service-users (n = 6), and a meeting with CCMHS stakeholders (captured via meeting minutes). In addition, 47 documents (e.g., clinical, procedural) created during the implementation phase of the project by CCMHS team members (i.e., practitioners, stakeholders, members of the board of directors) were used to triangulate the other data (Carter, Bryant-Lukosius, DiCenso, Blythe, and Neville, 2014). The Framework Method (Gale et al., 2013; Ritchie and Spencer, 1994) was used to analyze, synthesize, integrate, and interpret the dataset. The deductive data analysis approach taken was guided by the seven components of acceptability developed by Sekhon and colleagues (2017), and the Canadian Medical Association’s definition of appropriate care. Findings showed that the care provided and received within the CCMHS service delivery model was perceived to be acceptable and appropriate, and each component of the model uniquely contributed to practitioner and service-user experiences. For example, the collaborative interdisciplinary approach contributed to the ethicality of the model, promoted the professional development of team members, and enabled Pan-Canadian service provision. The sport-centered nature of care was perceived to enhance the ethicality of services delivered, effectiveness of care, and affective experience of service-users. Implications for further research and practice were discussed in light of areas of the model that emerged as needing improvement (e.g., prohibitive cost of care, practitioner burden from collaborative processes and procedures). Overall, the findings of the research project demonstrate that collaborative approaches to inquiry and practice can be successfully applied in sport to guide stakeholders in developing and testing novel models to improve the health outcomes of sport participants. The research also shows that an interdisciplinary team of practitioners can successfully deliver sport-focused mental health care that is acceptable and appropriate to service-users. Lastly, the project provides data on the first known empirical project to design, implement and evaluate a specialized mental health service delivery model applied nationwide in person and virtually with competitive and high-performance athletes experiencing mental health challenges and symptoms of mental illness.