Welcome to our 2014 Webinar Series
Living Successfully with Bipolar Disorder:
Tips from the Experts
The broadcast will beg...
2014 Webinar Series
Instructions for
Audio & Chat
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Speakers
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Microphone
Chat Box!
Living Successfully with
Bipolar Disorder:
Tips from the Experts
Erin Michalak
Associate Professor,
Department of Psychiat...
Objectives:
 Introduction to CREST.BD
 Self-management in BD
 Discussion of how CREST.BD has applied Delphi
methods in ...
Objectives:
 Introduction to CREST.BD
 Self-management in BD
 Discussion of how CREST.BD has applied Delphi
methods in ...
Strategic Vision for
Research and Knowledge Exchange
Effective psychosocial research and knowledge
exchange in BD is criti...
CREST.BD
Methods
•Membership: academic researchers, people with
BD, family members, healthcare providers
•Multidisciplinary: psycho...
Organizational
Structure
Partner
Organizations
(Canada)
Objectives:
 Introduction to CREST.BD
 Self-management in BD
 Discussion of how CREST.BD has applied Delphi
methods in ...
Previous research
• First study of wellness strategies used
by people with BD
• Strategies to stay well:
- acceptance of d...
Wellness in BD study
Study Aim –
To identify self-management strategies
used by people living well with BD
Methods -
Purpo...
Sleep, rest, diet and exercise
Regular monitoring and adjustment
Reflective, meditative, spiritual
practices
Understanding...
Sleep, rest, diet and exercise
Regular monitoring and adjustment
Reflective, meditative, spiritual
practices
Understanding...
Gaps and limitations
• Methodological limitations
• Where are we getting our
evidence?
• Little known about
strategies for...
Objectives:
 Introduction to CREST.BD
 Self-management in BD
 Discussion of how CREST.BD has applied Delphi
methods in ...
Study objective:
To generate knowledge on what self-
management strategies work best for:
- Keeping balance in mood
- Stop...
CREST.BD definition of ‘self-management’
• Plans and/or routines that a person with BD uses to
promote health and QoL
• He...
Peer-reviewed
literature
Re-analysis
of Wellness
Study
Phase 1
Phase 1
Grey
Literature
Search
Materials NOT published in
academic journals
Videos
Conference Proceedings
Blogs
Websites
G...
Phase 1
Grey
Literature
Search
Materials NOT published in
academic journals
Phase 1
Grey
Literature
Search
Materials NOT published in
academic journals
Videos
Conference Proceedings
Blogs
Websites
G...
Organisation
Phase 2
Panel
Recruitment
Phase 3
Survey
Phase 3a Consent Form
Sample Question
Survey
Phase 3a
Demographics Form
Recruitment
Techniques
Recruitment
Techniques
Objectives:
 Introduction to CREST.BD
 Self-management in BD
 Discussion of how CREST.BD has applied Delphi
methods in ...
Round 1 Results
Gender & Age
Female
70%
Male
30%
Female
78%
Male
22%
Healthcare Providers: Community Members:
• 79 female
...
Round 1 Results
Community members, diagnosis
• Type I: 49 respondents
• Type II: 48 respondents
• Other: 9 respondents
“Ot...
Round 1 Results
Healthcare providers, discipline
22%
2%
26%
0%
50%
Psychiatrist (11)
Nurse Practitioner (1)
Psychologist (...
Respondents by geography
“Other” included: Australia, France, Hong Kong, Italy, New
Zealand, Spain, Sweden, Turkey, United...
Looking at “Other” Geographies
• 3% of CMs (n=6) from other geographies
• These were Australia, France, Italy & UK
Healthc...
Round 1 Results
SMS ratings
There was a very high
level of consensus
between both panels
on the ratings
Strategies about e...
Round 1 Results
And while there was consensus…
…there were also interesting, though
slight, differences between the opinio...
Round 1 Results
What about low-rated strategies?
The lowest-rated
strategy for both panels
was “Take St. John’s
Wort”
Stra...
Choosing which SMSs to include in Round 2
• Strategies for Maintaining Balance received
higher ratings than those for Stop...
Top Strategies
• We chose the strategies in the top quartile
(highest 25%) for both Maintaining Balance
and Stopping Progr...
Choosing which SMSs to include in Round 2
• Round 1: 436 strategies
• Round 2: 154 strategies
• 70 strategies for both Mai...
Delphi Survey Round 2:
Live Today!
Sharing
Research
Findings
Phase 4
Delphi research
blogs
Phase 4
Sharing
Research
Findings
With thanks to…
Our 152 Delphi participants –
you rock!
Objectives:
 Introduction to CREST.BD
 Self-management in BD
 Discussion of how CREST.BD has applied Delphi
methods in ...
Twitter.com/CREST_BD
Facebook.com/CRESTBDBipolarResearch
Youtube.com/CRESTBD
Flickr.com/photos/CRESTBD
Slideshare.net/CRES...
Next up in our 2014 Webinar Series
That’s Just Crazy Talk: Using theatre to address bipolar stigma
April 30th 2014
Registr...
2014 Webinar Series
Instructions for
Audio & Chat
Enable
Speakers
Enable
Microphone
Chat Box!
Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak
Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak
Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak
Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak
Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak
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Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak

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On March 31st 2014 - following the inaugural World Bipolar Day - Dr. Erin Michalak, Associate Professor of Psychiatry, hosted a live webinar to explore findings from CREST.BD's current Delphi Self-Management study. During the webinar Dr. Michalak discussed the study's participatory methods, shared some of the demographic data and research findings from Phase 1 of the study, as well as discussed the team's experiences with using Delphi Consensus methods. We've recently launched Round 2 of our Delphi study to our 150 survey panel members. In this 30 minute webinar you'll learn more about the findings of this unique international study, how the findings will be used to improve wellness in bipolar disorder, and how to get involved in CREST.BD's community-engaged research.

Don't forget to check out the Storify from our World Bipolar Day #bipolarchat on March 30th 2014! http://sfy.co/tSZU

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Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak

  1. 1. Welcome to our 2014 Webinar Series Living Successfully with Bipolar Disorder: Tips from the Experts The broadcast will begin at 11am PDT March 31st 2014. Thank you for your patience Featuring Sara Lapsley and Dr. Erin Michalak In Collaboration with
  2. 2. 2014 Webinar Series Instructions for Audio & Chat Enable Speakers Enable Microphone Chat Box!
  3. 3. Living Successfully with Bipolar Disorder: Tips from the Experts Erin Michalak Associate Professor, Department of Psychiatry, UBC Leader, CREST.BD Sara Lapsley Counsellor and Group Clinician, Forensic Psychiatric Hospital Peer Researcher, CREST.BD
  4. 4. Objectives:  Introduction to CREST.BD  Self-management in BD  Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach  What we’ve learned so far  Q&A
  5. 5. Objectives:  Introduction to CREST.BD  Self-management in BD  Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach  What we’ve learned so far  Q&A
  6. 6. Strategic Vision for Research and Knowledge Exchange Effective psychosocial research and knowledge exchange in BD is critical. CREST.BD advances BD psychosocial research and application of research in Canada and internationally. In doing so, we optimise health and QoL and diminish stigma for people with BD across the lifespan.
  7. 7. CREST.BD
  8. 8. Methods •Membership: academic researchers, people with BD, family members, healthcare providers •Multidisciplinary: psychology, psychiatry, criminology, nursing, gerontology, genetic counselling, social work, OT •Expertise: wide range of BD specialisation •Focus: integrated knowledge exchange •Emphasis: community-based participatory research framework
  9. 9. Organizational Structure
  10. 10. Partner Organizations (Canada)
  11. 11. Objectives:  Introduction to CREST.BD  Self-management in BD  Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach  What we’ve learned so far  Q&A
  12. 12. Previous research • First study of wellness strategies used by people with BD • Strategies to stay well: - acceptance of diagnosis - mindfulness education - identifying triggers/warning signs - sleep/stress management - lifestyle changes - treatment access - stay well plans Russell and Browne (2005) Staying well with bipolar disorder. Aust N Z J Psychiatry; 39(3):187-93. Russell and Browne (2005) Staying well with BD. Aust N Z J Psychiatry; 39(3):187-93.
  13. 13. Wellness in BD study Study Aim – To identify self-management strategies used by people living well with BD Methods - Purposeful sampling used to identify: ~ People with BD Type I/II (N = 32) ~ Median Age: 41 13 yrs ~ 63% female ~ 78% BD I ~ Functioning well Individual interviews or focus groups, thematic analysis. Suto et al. (2010) JAD, 124 (1-2):76-84; Murray et al (2011) Clinical Psychology and Psychotherapy, 18:95-109. Clinical Psychology and Psychotherapy, 18:95-109.
  14. 14. Sleep, rest, diet and exercise Regular monitoring and adjustment Reflective, meditative, spiritual practices Understanding BD, educating others Connecting with others Enacting a plan Results: Categories of self-management
  15. 15. Sleep, rest, diet and exercise Regular monitoring and adjustment Reflective, meditative, spiritual practices Understanding BD, educating others Connecting with others Enacting a plan - acceptance of diagnosis - mindfulness education - identifying triggers/warning signs - sleep/stress management - lifestyle changes - treatment access - stay well plans
  16. 16. Gaps and limitations • Methodological limitations • Where are we getting our evidence? • Little known about strategies for hypo/mania
  17. 17. Objectives:  Introduction to CREST.BD  Self-management in BD  Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach  What we’ve learned so far  Q&A
  18. 18. Study objective: To generate knowledge on what self- management strategies work best for: - Keeping balance in mood - Stopping progression in hypomania and mania
  19. 19. CREST.BD definition of ‘self-management’ • Plans and/or routines that a person with BD uses to promote health and QoL • Healthcare providers can provide information about self-management strategies • Friends, family or caregivers can be involved in developing strategies and supporting their use • Outside of hospital settings, it is typically the person with BD who chooses, enacts their approach to self-management and tailors their self- management strategies • Encompass a wide range of plans, activities or routines, e.g., optimising sleep or eating habits, pursuing leisure activities, engaging in relaxation practices
  20. 20. Peer-reviewed literature Re-analysis of Wellness Study Phase 1
  21. 21. Phase 1 Grey Literature Search Materials NOT published in academic journals Videos Conference Proceedings Blogs Websites Government Documents Books
  22. 22. Phase 1 Grey Literature Search Materials NOT published in academic journals
  23. 23. Phase 1 Grey Literature Search Materials NOT published in academic journals Videos Conference Proceedings Blogs Websites Government Documents Books
  24. 24. Organisation Phase 2
  25. 25. Panel Recruitment Phase 3
  26. 26. Survey Phase 3a Consent Form Sample Question
  27. 27. Survey Phase 3a Demographics Form
  28. 28. Recruitment Techniques
  29. 29. Recruitment Techniques
  30. 30. Objectives:  Introduction to CREST.BD  Self-management in BD  Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach  What we’ve learned so far  Q&A
  31. 31. Round 1 Results Gender & Age Female 70% Male 30% Female 78% Male 22% Healthcare Providers: Community Members: • 79 female • 22 male, mean age 43 (range 19-68) • 101 total • 35 female • 15 male, mean age 47 (range 24-81) • 51 total
  32. 32. Round 1 Results Community members, diagnosis • Type I: 49 respondents • Type II: 48 respondents • Other: 9 respondents “Other” included: Unknown (2), NOS (5), Forgot (2) Type I 46% Type II 45% Other 9% 0%
  33. 33. Round 1 Results Healthcare providers, discipline 22% 2% 26% 0% 50% Psychiatrist (11) Nurse Practitioner (1) Psychologist (13) Family physician (0) Other (25) “Other” included: Occupational Therapist (5), Social Worker (4), Psychotherapist (2), Mental Health Worker (2), Did not specify (2), Researcher (2), Peer Support Worker, Nurse, Genetic Counsellor, Nurse Educator, Family Counsellor, CBT & EMDR Therapist.
  34. 34. Respondents by geography “Other” included: Australia, France, Hong Kong, Italy, New Zealand, Spain, Sweden, Turkey, United Kingdom, Yemen. 0 10 20 30 40 50 60 70 80 90 Canada United States Other* Number of respondents
  35. 35. Looking at “Other” Geographies • 3% of CMs (n=6) from other geographies • These were Australia, France, Italy & UK Healthcare provider respondents were more diverse than community member respondents • 20% of healthcare providers (n=10) from geographies other than US/Canada • These were Australia, HK, NZ, Spain, Swed en, Turkey, UK & Yemen
  36. 36. Round 1 Results SMS ratings There was a very high level of consensus between both panels on the ratings Strategies about early warning signs were prominent for Stopping Progression Strategies about relationships and emotions were prominent for Maintaining Balance Strategies for Maintaining Balance were rated higher than those for Stopping Progression
  37. 37. Round 1 Results And while there was consensus… …there were also interesting, though slight, differences between the opinions of the panels. HCPs had more strategies for Stopping Progression in their top quartile than CMs did CMs rated strategies about social supports lower than HCPs for both MB and SP
  38. 38. Round 1 Results What about low-rated strategies? The lowest-rated strategy for both panels was “Take St. John’s Wort” Strategies that referenced spirituality received low ratings from panels Strategies about regulating diet generally did not rate highly in either panel No strategies on parenting and only one on sex in the highest quartile for either panel
  39. 39. Choosing which SMSs to include in Round 2 • Strategies for Maintaining Balance received higher ratings than those for Stopping Progression • We decided to choose an equal number of both types of strategy
  40. 40. Top Strategies • We chose the strategies in the top quartile (highest 25%) for both Maintaining Balance and Stopping Progression • This gave us an equal number of both types of strategy
  41. 41. Choosing which SMSs to include in Round 2 • Round 1: 436 strategies • Round 2: 154 strategies • 70 strategies for both Maintaining Balance and Stopping Progression • 42 each for only MB or SP • Approximately 15 to 20 minutes to complete
  42. 42. Delphi Survey Round 2: Live Today!
  43. 43. Sharing Research Findings Phase 4
  44. 44. Delphi research blogs
  45. 45. Phase 4 Sharing Research Findings
  46. 46. With thanks to… Our 152 Delphi participants – you rock!
  47. 47. Objectives:  Introduction to CREST.BD  Self-management in BD  Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach  What we’ve learned so far  Q&A
  48. 48. Twitter.com/CREST_BD Facebook.com/CRESTBDBipolarResearch Youtube.com/CRESTBD Flickr.com/photos/CRESTBD Slideshare.net/CRESTBD www.crestbd.ca/get-involved
  49. 49. Next up in our 2014 Webinar Series That’s Just Crazy Talk: Using theatre to address bipolar stigma April 30th 2014 Registration will open soon! Featuring Victoria Maxwell and Dr. Erin Michalak
  50. 50. 2014 Webinar Series Instructions for Audio & Chat Enable Speakers Enable Microphone Chat Box!

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