As Full Professor in the School of Kinesiology and Health Science and Department of Psychology at York University, I aim to increase healthy changes of behavior through population-based, epidemiological studies of attitudes towards vaccine development, vaccine uptake and cancer screening, qualitative studies related to cancer screening policy and promotion strategies, intervention-based, randomized controlled trials (RCTs) for cancer care and prevention, and electronic health-based programs for Type-II diabetes and cardiovascular disease that feature cognitive- behavioural management guided by smartphone-based interventions.
Cancer Screening Policy and Screening Promotion Policy: Changes in policy and uptake promotion have been informed by several qualitative research projects (Tinmouth, Ritvo, McGregor et al. 2011) (McGregor, Ritvo, Tinmouth et a., 2011) (Tinmouth, Ritvo, McGregor et al., in press) (Tinmouth, Ritvo, McGregor et al., in press).
Vaccine Development and Uptake: Vaccines in the Public Eye, a Nature Medicine commentary, traced the history of vaccine development, public acceptance-rejection, and applicable bioethical principles governing uptake, distribution and development (Ritvo et al. 2005). Other interests concern vaccine attitudes in the general population (Ritvo et al., 2003) and naturopathic students (Wilson et al, 2004), vaccine cost-effectiveness (Krahn et al., 2005), Canadian vaccine policy (Wilson et al., 2006), vaccine trial preparedness in Africa (Ritvo, et al., 2006), parental views on vaccination (Wilson et al., 2008) and a Canadian survey on pandemic flu preparations (Ritvo, et al. 2010; Ritvo et al. 2012, submitted).
Cancer Control and Prevention: Ontario responded to evidence of reductions in mortality-morbidity with colorectal cancer screening by initiating a new colorectal cancer screening program for individuals over 50 years. Several publications focus on data from the Provincial Screening Pilot w (Ritvo, et al., 2008, Ritvo et al., 2009) which, in turn, supported a CIHR team grant supporting a recently completed randomized controlled trial (RCT) assessing an innovative ‘navigator’ intervention involving care-givers (nurses) managing discussions with patients prior to decisions about colonoscopy screening.
Cancer Screening and Treatment: Interests in genetic screening in ovarian cancer (Ritvo et al., 1999; Ritvo et al., 2000; Ritvo et al., 2002), and breast cancer mammographic/genetic screening (Edwards et al., 2009, Zhang et al., 2011, Edwards et al., 2011, Campitelli et al. 2011, Zhang et al. 2012, Glendon et al., 2009, Ritvo et al. 2012) have combined with interests in treatment and the quality of life assessment of patients undergoing treatment (Ritvo et al.,1996; Bampoe, Ritvo, Bernstein, 1998; Krahn, Ritvo, et al. 2000; Krahn, Ritvo et al. 2003; Brundage et al. 2003; Brundage et al. 2005; Ritvo et al., 2005; Cohen et al., 2006; Krahn et al. 2007; Matthew et al., 2007; Power et al., 2008) and psychosocial support interventions, spearheaded by graduate students (Santa Mina et al. 2012a, Santa Mina et al. 2012b, Santa Mina et al. 2012c, Moonsammy et al, submitted). We are viewing the patient as whole person who can increase survivability and quality of life through active engagement in exercise programs, dietary modification and neurophysiological health practices (meditation, tai chi).
Electronic Health Promotion: Interests in large-scale behaviour change led to implementing electronic health communications to promote health, improve medication adherence and motivate individuals to maintain exercise regimens. A cell-phone text-messaging intervention for HIV+ Kenyans initiating anti-retroviral medications yielded reduced viral loads in a groundbreaking RCT (Lester, Ritvo, Mills et al., 2010) and the success of this simple procedure motivated a search for an effective eHealth research strategy in Canada. Our first Canadian project tested a health promotion software program, HealthCoach, developed with colleagues in partnership with programmers at Nex J Systems, Inc. Funded by the Ontario Ministry of Research and Innovation, we tested and refined the smartphone-based program to help people manage Type 2 diabetes. The project was conducted at the Black Creek Community Health Centre in the Jane-Finch community of Toronto. This project led to associations with Research in Motion and a collaboration on a National Science and Engineering Research Council (NSERC) Strategic Program grant where our team (two engineers, a psychologist, a neuropsychiatrist) developed an ambulatory wireless encephalography (EEG) device that beams high quality data to Blackberry Smartphones via Bluetooth technology. The results of this project indicate high quality signals are achievable with a wireless device that could eventually be used at home and interwoven in a cloth cap (Radhu et al. 2012). This latter work is associated with other collaborations with neuropsychiatrist Jeff Daskalakis of the Centre for Addiction and Mental Health) on projects using EEG technology and Transcranial Magnetic Stimulation to monitor neurophysiological changes in response to CBT interventions and mindfulness meditation (Radhu et al, 2012a; Radhu et al, 2012b; Guglietti et al., in press).
eHealth-based Cogntive-Behavioural Therapy: Fortunate recipients of funding from the Public Health Agency of Canada, Ontario Centres of Excellence, Mitacs, Merck Investments and the Federal Development Grant, we can now undertake Phase III clinical trials of eHealth-based CBT interventions developed for university students with perfectionist tendencies, and individuals with Type II diabetes, uncontrolled hypertension and acquired brain injury. The common thread in these projects is cognitive-behavioural interventions guided by smartphone-based software.
Mentorship of Graduate Students and other Trainees: a new type of clinician is emerging for whom exercise promotion skills are central and whose focus is health behaviour change, especially in patients with chronic disease. This follows refinements in exercise promotion that emphasize the right fit of exercise modality and training intensity with the unique needs of patients. Twenty-three past and present students have created new clinical roles by training to become certified exercise physiologists and physical trainers, in combination with training in cognitive behaviour therapy and mindfulness meditation, while initiating innovative programs in cancer treatment (e.g. Princess Margaret Hospital), diabetes management (Black Creek Community Health Centre) and stress management in undergraduate students (York University Psychology Clinic). Currently, three post-doctoral fellows, three PhD students, three Master’s students and six undergraduate students under my supervision receive stipends from the Federal Development Program funding and other programs.
Our lab is a productive setting, as we develop a health coaching specialty at York University, infusing smartphone technology into health promotion.
