A Special Edition of Tomorrow’s News >>

[Pages:20]A Special Edition of Tomorrow's News >>

hope for tomorrow

Sandy Ferns

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WHAT'S INSIDE

Get an inside look at the Tomorrow Project with the founder of the study

4 Dr. Heather Bryant on PAGE

There's never a dull moment in Cheryl Yaremchuk's household. See how this Tomorrow Project participant and working mother of two helps keep her family at the top of their game.

8 PAGE

Faces of Tomorrow by the Numbers

Check out how Tomorrow Project participants' modifiable risk factors stack up against international standards from a major Cancer Prevention report on

10 PAGE

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Sandy Ferns believes in going the distance for cancer prevention. He joined the Tomorrow Project after his wife was diagnosed with cancer. Read Sandy's story on

14 PAGE

As a flight attendant Robyn Paul has travelled to places that many of us dream of. Read about her zest for life and her connection to the Tomorrow Project on

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What does the Commonwealth Stadium in Edmonton have to do with the Tomorrow Project? Flip to page 16 to find out.

Yesterday, Today & Tomorrow The Tomorrow Project has come a long way since it began in 2001. Check out the progress report on page 16.

What is a Cohort Study and why is it important? Find out more on page 17.

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AN INSIDE LOOK AT THE TOMORROW PROJECT

Dr. Heather Bryant working out at the ALIVE personal training facility in Calgary.

Dr. Heather Bryant

We can't go through life just thinking about one disease we're trying to prevent. We're trying to develop a

lifestyle that will put us at lower risk for many diseases.

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Dr. Heather Bryant is the founder of

the Tomorrow Project and a former Vice

President of the Alberta Cancer Board.

Dr. Bryant sits down with us to talk about

the journey of bringing the cohort study to

life and shares her Hopes for Tomorrow.

Q Why did you think it would be a good idea to start a cohort study in Alberta?

A We had a unique opportunity when the Alberta Cancer Board received some one-time funding to encourage research in five areas. One of these areas was Population Health and so we decided to develop a population feasibility study about cohorts. Not only would this study be helpful to be able to measure the health of Albertans over various points of time, but it would be a great tool to facilitate future researchers. We thought this would be a chance to really create a legacy. We wanted the Tomorrow Project to be a living, breathing thermometer of what's actually going on with health behaviours in Alberta.

Q What challenges did you face at the start convincing people that an Alberta cohort study would be a good idea?

A Everybody thought cohorts were a good idea but there was a concept that it would be very difficult to do. For example, many researchers believed that we wouldn't be able to get people to participate from all walks of life ? and if we did, they believed people would not be willing to continue on and give detailed personal information. We wanted to demonstrate that they would because we believed that most people really are motivated towards trying to contribute to the understanding of what puts people at risk for poor health and what would sustain good health.

We're very pleased with the uptake of this cohort from the number of people that were originally approached. When we first started we had feasibility funding for 10,000 people and we actually got 12,000 people involved with that funding, so we were pleasantly surprised. Of those, over 90 per cent continue to be involved six to eight years later.

Q What were your hopes for the cohort when you started it?

A First of all and most importantly we hoped that it would be our opportunity to look at the causes of cancer and other chronic diseases in a new way. There are cohorts around from the past but they don't have the same access to markers that we have now (i.e. biological markers), or they are very selective groups of people. We wanted to come up with something that would add to the cohorts that currently exist. It would give us an opportunity to do some unique things like look at much better ways of measuring dietary intake as we go down the road. For our next cycle we're going to be looking more at occupational and environmental exposures than other cohorts have been able to do.

Secondly, we hoped that the study would allow us to see what's going on with the health of Albertans on a regular basis rather than wait for a cohort to mature 20 years later. So we have come up with some unique opportunities out of it already. For example, we've been able to look at prostate screening behaviours and look at who is getting prostate screening and who is not. We've been able to look at colorectal cancer screening behaviours in the same way. We have detailed reports on dietary supplement use, which we didn't have a good handle on in Alberta, and now we're looking at predictors of women who changed their use of hormone replacement therapy after the release of results of the Women's Health Initiative study. So it's really been very helpful for us to get a picture of what's going on in Alberta and as a result it's going to help us and help the Health Regions with programming.

Q What hopes do you have for the cohort now?

A We now have 30,000 people in the cohort. We hope to build it to 50,000 within Alberta and potentially to 250 ? 300,000 in the country which would give us great opportunities to really come up with some answers about cancer in Canada. In Alberta, a cohort of 50,000 would provide some great opportunities to deal with chronic disease and cancer in the province.

So that it becomes a richer database, we hope that people continue to be engaged in the study. The feedback that we get is always very positive as participants get information back that's helpful for them. As well, we're able to engage the research community by using information from the study to answer cancer questions in addition to other health related questions.

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Q What health choices and changes in modifiable risk factors have you made in your lifestyle?

A I, like a lot of women, was busy with a career and busy with a family and really didn't have a lot of time to also jam physical activity into that life. I paid the price with increase in weight and not feeling as fit. So about 10 years ago when our kids were in their early teens we all joined the YMCA. I was going out of commitment, but the kids and my husband all took to it like ducks to water. Eventually, I came to actually enjoy it as well! The kids have all grown up now but all four of us have kept it up because we found the positive benefits from exercise. And so we're there at the gym at 5:30 a.m. on weekdays and 7 a.m. on weekends.

Q What was your motivation for making these changes?

A I felt I was becoming unfit and overweight and I didn't want to go through the rest of my life that way.

I've been fortunate not to have a family history with a lot of cancer in it. But I do have a family history of cardiovascular disease and as we all know for prevention, we can't be going through life just thinking about one disease we're trying to prevent. We're trying to develop a lifestyle that will put us at lower risk for many diseases.

Q What challenges have you faced for maintaining the lifestyle changes that you have made?

A In my work, probably the biggest issue I've had to deal with is travel and the disruption to my schedule that comes with that. So I have gone through various phases of trying to figure out how to fit exercise in. When I travel for more than a few days I'll use an exercise bike at the hotel gym. If I'm gone only a day I'll take a break as everyone needs to rest a day or two a week. I also find the meals that I get when I travel very difficult to control.

Q People who volunteer to participate in the Tomorrow Project receive no compensation for the time they spend filling in questionnaires or talking to researchers on the phone. What do you think motivates people to take part in a long-term study that may not provide them with any direct personal benefit?

A I think most people want to make a contribution. I think most people who do this, do it with an understanding that it may help provide knowledge that will help their kids or themselves later in life. And I think people who participate in this project are just positive people trying to make a difference.

Q What's your Hope for Tomorrow?

A I'd like to see the Tomorrow Project established as something that truly is seen as a resource in Alberta that we would not want to be without because it gives us so much information that benefits Albertans. I do hope that the Tomorrow Project will allow us to have much more insight into the prevention of cancer, much more insight into how to position things so that people are able to live lives that are healthier and longer.

Final Thoughts:

I think it's important for people in the Tomorrow Project to know what a major contribution they are making but also to know how positive the team is about their participation and our hopes that we provide information back to them that they find constructive and helpful. And if they have ideas about that we'd love to hear them.

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THE TOMORROW PROJECT AT A GLANCE

1999

September 2000 October 2000 February 2001

February 2001 February 2001

March 2001

October 2001 November 2001

March 2002 May 2003 April 2004 September 2004 June 2006

October 2006 December 2007 mid 2008

Concept of the Tomorrow Project is developed by population health researchers at the Alberta Cancer Board, under the leadership of Dr. Heather Bryant

Ethical approval for the first phase of the study granted

First phase of random digit dialing started

2,500 study information packages sent to potentially interested people identified by random digit dialing

First issue of Tomorrow's News (biannual newsletter) sent out

First person enrolled in the study by returning completed consent form and Health and Lifestyle Questionnaire

Second wave of random digit dialing started with the goal of finding 5,000 potentially interested people

Third wave of random digit dialing started

Started study to determine feasibility of collecting blood from study participants: 1,140 people invited; 769 provided a sample

Fourth wave of random digit dialing started

Fifth wave of random digit dialing started

First follow-up survey mailed to participants who had joined the study between 2001 and 2003

Sixth wave of random digit dialing started

Seventh wave of random digit dialing started; the largest in the history of the project. The aim of this recruitment drive was to find approximately 23,500 potentially interested people.

Dr. Paula Robson takes over as Principal Investigator of the Tomorrow Project

Approximately 30,000 Albertans enrolled in the Tomorrow Project

Second follow-up survey to be sent to all participants

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WHO'S WHO IN THE TOMORROW PROJECT

There's never a dull moment in the Yaremchuk household. Married for 15 years Cheryl and her husband Ken own and operate a vending machine company in Sherwood Park. Cheryl is also a program co-ordinator for Linking Generations, a non-profit organization that brings together children in the junior high age group and matches them with seniors for biweekly visits during the lunch hour.

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