Anna Pujadas Botey, PhD, MSc, BSc

Area of Study / Keywords

cancer care clinical pathways social perceptions social supports stakeholder engagement implementation science community and family resilience decision-making

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About

My muti-faced program of research focuses on examining how people affected by cancer in Alberta access and experience health care, to ultimately contribute to improved cancer care delivery, with better patient outcomes and health system improvements. Particular areas of interest include stakeholder engagement, implementation science, community and family resilience, and decision-making.

My methodological strengths are in qualitative and mixed-methods research. My research is done using an applied approach and has an important stakeholder engagement component.

The projects I work on span across a number of academic disciplines and research methodologies, and are designed and conducted in collaboration with colleagues from different academic disciplines and with the active involvement of relevant stakeholders such as patients, their families, clinicians, health-care providers, program administrators, knowledge users and policy-makers.

Degrees

PhD, University of Alberta, 2010

Ended: 2020-09-24

Qualitative study to understand the perspectives of a group of cancer patients and family members on factors associated with timelines to diagnosis and their overall experience with the diagnostic period. We heard from patients and family members that they are struggling emotionally in the diagnostic period, and that it is very important that they are actively involved in their care process. Psychosocial supports available to potential cancer patients and their families are minimal, and may be important for improved experiences before diagnosis.

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2022-09-01 to 2024-05-31

Colorectal cancer is among the four cancers most prevalent in Alberta, and over a third of patients diagnosed with colorectal cancer are diagnosed in the hospital. These patients are often diagnosed with later stage cancer, and associated with lower quality of life after treatment and reduced survival relative to patients diagnosed at earlier stages. There is much we do not know about factors that explain why so many patients are diagnosed in hospital, rather than in the community, with family physicians. The Cancer SCN, in partnership with Unit 83 at the Rockyview General Hospital (Calgary), has a new study to explore that. They are interviewing patients diagnosed with colorectal cancer in hospital and individuals in close relationship with them (like family relatives or close friends) to understand how we could better support diagnosis in the community. Findings of the study will inform the development of a pathway to streamline the diagnosis of colorectal cancer in Alberta, and inform a provincial strategy that supports facilitated cancer diagnosis. Results will also provide insights into approaches to increase awareness about colorectal cancer among Albertans, and enhance nursing professional practice related to diagnosis and care of patients diagnosed with this type of cancer.

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2022-08-01 to 2023-03-30

Project to explore why so many patients in Alberta are diagnosed with colorectal cancer in hospital, rather than in the community. We are interviewing patients diagnosed with colorectal cancer in hospital and individuals in close relationship with them (like family relatives or close friends) to understand how we could better support diagnosis in the community. Findings of the study will inform the development of a pathway to streamline the diagnosis of colorectal cancer in Alberta, and inform a provincial strategy that supports facilitated cancer diagnosis. Results will also provide insights into approaches to increase awareness about colorectal cancer among Albertans, and enhance nursing professional practice related to diagnosis and care of patients diagnosed with this type of cancer.

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Initiative to find ways to streamline the process from first symptom or suspicion of cancer to definitive cancer diagnosis (a process often characterized by delays, and confusion and anxiety in patients), and develop clinical pathways and support tools for physicians and potential cancer patients and their families during this period.

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Ended: 2019-03-30

A survey was conducted on 559 patients diagnosed with cancer who accessed care in three sites (Edmonton, Red Deer, Calgary) in province of Alberta to gain insight on their experience from the time they noticed a symptom to the time they received a cancer diagnosis. They reported long wait times between symptoms to see a family doctor, and reported reported satisfaction with their wait times to see a specialist and to get their diagnostic tests completed, as long as their waits were no greater than 3 weeks. Participants indicated they would like to see changes in the health care received regarding concern/communication by a family doctor, and would have shortened the time they waited to see a family doctor. The majority of participants were satisfied with the way they were told they had cancer. Among most of those that were not satisfied, the most common reasons were not enough information or lack of accurate information, and the context of how they were informed (empathy/compassion of the person giving the news, level of negativity, told over the phone versus in person).

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Ended: 2022-09-23

Evidence review to explore whether here are differences between care outcomes of survivorship care provided in the primary care setting and care outcomes of survivorship care provided in the secondary care setting. Findings showed that survivorship care provided in primary care was associated with similar clinical and patient-reported outcomes, and higher patient satisfaction, when provided in secondary care, and is related to lower costs. Ongoing studies will help provide further insights.

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2022-10-01 to 2024-03-29

Project created to understand and document community strengths and assets that affect access of rural/remote and newcomer-dense communities to Alberta cancer diagnosis resources, and cancer diagnosis outcomes (e.g., diagnostic delays, relative later stage of cancer at diagnosis). With this project we will also co-develop, test and evaluate education materials and clinical decision support tools with primary care practitioners in these rural/remote and newcomer-dense communities that will help primary care providers in these communities to better detect and appropriately support cancer patients during the diagnostic period.

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Started: 2020-09-09

FoCI is a report created in collaboration with an expert group of key stakeholders from across Alberta that included Albertans who have experienced cancer first-hand, experts in various cancer-related domains across the continuum, and other key strategic partners. The FOCI in Alberta report is a comprehensive exploration of cancer in Alberta, and includes current and projected data, as well as clinical and technical interpretations and recommendations. It identifies gaps and opportunities for knowledge generation and implementation that may inform future priorities for cancer research and cancer care. Report findings will be used to guide conversations and prioritization of actions that span the health system and beyond.

https://www.albertahealthservices.ca/assets/about/scn/ahs-scn-cancer-future-of-cancer-impact-summary.pdf

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Started: 2022-11-01

Relevant priority projects to be tackled in the near future are: 1) study Albertans’ knowledge, attitudes and beliefs to better understand how to enhance cancer prevention and screening in the province; 2) identify cost-effective strategies on how to best manage increased cancer survivorship to maximize outcomes and system efficiency; 3) better understand the financial impacts to patients and families managing cancer, with emphasis on those experiencing the greatest impacts on their financial well-being; and, 4) develop approaches for ethical collection, analysis and interpretation of data to understand the unique needs of Indigenous peoples, newcomers, older and younger adults, people living in rural and remote communities, people with disabilities, people identifying as LGBTQ2S+ and other groups who may face inequities in cancer care.

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Ended: 2020-09-23

Project to define a set of quality indicators that will be used to measure progress and success in advancing the work of the Cancer Strategic Clinical Network in advancing the three strategic directions defined in its Transformational Roadmap 2020-2024. To inform the definition of these indicators, we have conducted extensive literature reviews, consulted with academics and experts in the area, facilitated discussions with relevant stakeholders, and administered an indicator prioritization survey.

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Ended: 2021-06-15

In partnership with Screening Programs, we developed a position paper on cancer overdiagnosis. Key messages included: 1) population-based cancer screening programs contribute to improved survival, but are associated with a small risk of overdiagnosis; 2) incidental findings can lead to overdiagnosis of some cancers; 3) benefits of early diagnosis and treatment for most cancers at the population level outweigh the risks of overdiagnosis at the individual level; and, 4) proposed strategies to mitigate risks of overdiagnosis and overtreatment for some cancers must avoid increasing overall cancer mortality rates.

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2023-06-01 to 2024-08-31

This initiative aims to investigate the role of emergency department (ED) healthcare providers in diagnosing cancer in Alberta. By collaborating with the nursing team at the South Health Campus Emergency Department in Calgary, the Cancer and Emergency Strategic Clinical Networks (SCNs) will gather perspectives and experiences from healthcare providers working in EDs in Edmonton and Calgary. Through semi-structured interviews, data will be collected, analyzed, and used to inform the Alberta Cancer Diagnosis Initiative, potentially leading to earlier cancer diagnoses, improved outcomes, and enhanced patient/family experiences. Additionally, the project aims to build nursing research capacity and address challenges faced by nurses in the research realm. Ultimately, the results may contribute to improving recruitment and retention of ED clinical staff and enhancing professional practice related to cancer diagnosis in EDs and hospitals.

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Ended: 2020-08-15

Health campaign to encourage the public to seek advice from healthcare providers when they have unexplained, new, worsening or persistent health changes (Listen to Your Body). It was created and launch in the middle of the COVID-19 pandemic to fight the decline Alberta was experiencing in overall number of cancers being diagnosed. 

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Ended: 2020-09-24

Qualitative study to understand perspectives of primary care physicians and specialists on potentially avoidable delays in diagnosing cancer and approaches to expedite cancer diagnosis in Alberta. Healthcare providers indicated the need for enhanced support for family physicians, and better integration of primary and specialty care before cancer diagnosis. Streamlining cancer diagnosis, with the goals of enhancing patient outcomes, reducing physician frustration, and optimizing efficiency is required.

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Started: 2022-10-01

Project to understand the healthcare consumers of the future, and how healthcare systems in Canada and abroad are getting prepared to respond to their care needs and preferences.

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Ended: 2020-07-07

Framework developed for contingency planning to prioritize cancer treatment (systemic therapy, radiation therapy and supportive care services) in Cancer Care Alberta in the event of staff shortages during a pandemic. It was developed in collaboration with provincial tumor teams and supportive care leads, and included input from patient and family advisors, relevant departments, cancer centre operations, Cancer Care Alberta executive, clinical ethics, and legal services. 

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Started: 2021-01-15

Project done in collaboration with Dr. Lee Green's team at the University of Alberta to understand family physicians’ mental models of using clinical pathways for cancer diagnosis. The study documented how family physicians use pathways to gather information, confirm what they already know, support what they are already doing, and as a quick guide for what steps to take when unsure. Successful implementation of pathways in primary care should ensure pathways are easy to find, easy to use, and easy to be incorporated into family physicians’ workflows. Two reports of this study can be accessed here: Summary Report and Full Report. A second study is underway to further understand how family physicians and other health care professionals approach cancer diagnosis. Dr. Green and his team are conducting a cognitive task analysis project to uncover best practices and areas where knowledge, attitudes, and approaches diverge and converge in health care teams. This work is part of the Cancer SCN’s Alberta Cancer Diagnosis (ACD) program, and will help identify key issues needing to be addressed when considering the design of the program, as well as eventually actuating uptake and implementation.

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2020-07-04 to 2021-02-18

Rapid review on recommendations for deciding suitability of patients with cancer who are infected with COVID-19 for initiating (ore resuming) cancer treatment. The initial review was conducted in April 2020, and has been updated in two occasions (June 2020, February 2021) based on emerging evidence. In the first iteration of the document it was recommended that for cancer patients with COVID-19, cancer treatment is deferred until symptoms of COVID-19 have resolved and the virus is no longer detectable by RT-PCR, unless the cancer is rapidly progressing and the risk-benefit assessment favours proceeding with cancer treatment. In the second and third iterations, revised recommendations reflected the adoption of a symptom-based strategy.

Pujadas Botey A, Barber T, Robson PJ, O’Neill BM, Green LA.

CMAJ Open . 2023 March; 11 (3):E486-E493 10.9778/cmajo.20220084

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Brenner DR, Carbonell C, O’Sullivan DE, Ruan Y, Basmadjian RB, Bu V, Farah E, Loewen SK, Bond TR, Estey A, Pujadas Botey A, Robson PJ.

Current Oncology. 2023 March; 30 (11):9981-9995

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Pujadas Botey A, GermAnn K, Robson P, O’Neill B, Stewart D

CMAJ Open. 2021 November; 9 (4):E1120-E1127 10.9778/cmajo.20210013

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Pujadas Botey A, Robson PJ, Hardwicke-Brown AM, Rodehutskors DM, O’Neill BM, Stewart DA

PloS One. 2020 September; 15 (9):e0239374

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Pujadas Botey A

2020 June;

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Choudhury R, Pujadas Botey A, Wheeler L, Marlett N, Estey A

Health Education Journal. 2020 January; 79 (6):712-723

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Research Facilitation & Analytics, DIMR, Pujadas Botey A

2019 January;

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Judith K, Pujadas Botey A.

Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards. 2016 March; 82 10.1007/s11069-016-2277-1

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Pujadas Botey A, Judith K

Journal of Child & Family Studies. 2013 July; 23 (8):1471-1483 10.1007/s10826-013-9802-6