Health Promotion and Chronic Disease Prevention in Canada-Research Policy and Practice最新文献

Introduction: Firearm-related injury and death are leading yet preventable causes of premature death in Canada. Our objective was to identify knowledge gaps and research priorities to inform a national research agenda to prevent firearm-related injury and death.

Methods: In a two-stage process, nominal group technique was used to encourage experts in firearm injury and death (N = 15) to generate ideas relevant to knowledge gaps in three areas: unintentional firearm injury, intimate partner violence (IPV)/femicide and other firearm-related assaults. Relevant parties (N = 43) subsequently voted on the identified gaps to determine top priorities for future research.

Results: In Stage 1, the experts identified 22 knowledge gaps in unintentional firearm injury, 16 in IPV-related firearm injury/femicide and 33 in other assault-related firearm injuries. Based on their importance and feasibility as research projects, they then selected five, three and seven, respectively, of these knowledge gaps. In Stage 2, the top priorities for future research emerged: the economic cost of firearm injuries to victims' families and communities and Canadian society; the impact of social policies and legislation aimed at reducing IPV/femicide-related firearm injuries and deaths; and a description of the available and required Canadian firearm-injury data.

Conclusion: The top priorities highlight the large and diverse gaps in knowledge about firearm injury and death in Canada. This marks the first step toward developing a national research agenda for firearm-related injuries. Next steps include operationalizing these gaps into research questions, identifying data sources and methodological approaches, and choosing knowledge translation strategies.

Introduction: The COVID-19 pandemic and associated public health measures (PHMs) potentially affected alcohol consumption. Our objectives were to evaluate if adherence to PHMs was associated with changes in alcohol consumption and binge drinking during the COVID-19 pandemic.

Methods: A prospective cohort study was conducted with participants (50-96 years) in the Canadian Longitudinal Study on Aging (N = 23 615). Adjusted odds ratios (aORs) were estimated from multinomial logistic regression models for associations between PHM adherence (self-quarantine, attending public gatherings, leaving home, mask wearing and handwashing) and self-reported changes in alcohol consumption during the first year of the pandemic and prospectively measured changes in alcohol consumption frequency and frequency of binge-drinking events from 2015-2018 to 2020.

Results: During the first year of the pandemic, 13% (n = 2733) of participants self-reported increased alcohol consumption, while 13% (n = 2921) self-reported decreased consumption. Prospective measures suggested 19.1% (n = 4421) increased and 34.5% (n = 7971) decreased consumption frequency, while 12.9% (n = 1427) increased and 17.6% (n = 1953) decreased frequency of binge-drinking events. High PHM adherence, compared to low, was associated with higher odds of decreased alcohol consumption frequency (aOR = 1.17; 95% confidence interval [CI]: 1.06-1.30). No associations were observed between PHM adherence and self-reported change in alcohol consumption or frequency of binge-drinking events. Associations were consistent across socioeconomic groups.

Conclusion: PHM adherence was associated with decreased, and not increased, frequency of alcohol consumption by adults aged 50-96 years in the first year of the COVID-19 pandemic.

In this ecological study we examined associations between Google Trends (GT) suicide-related Internet searches and intentional self-harm hospitalizations and suicide mortality in Canada from 31 December 2017 to 31 March 2022. Hospitalizations and mortality data were from the Discharge Abstract Database and Vital Statistics - Death database. Cross-correlations identified lead periods, adjusted for in negative binomial regressions. GT of the search term "how to kill yourself" showed weak positive associations with self-harm hospitalizations. GT of the search terms "commit suicide," "how to commit suicide" and "how to kill yourself" showed weak positive associations with suicide mortality. Additional research is needed to determine the usefulness of GT in monitoring self-harm and suicide.

Ingestion of button batteries poses an acute life-threatening injury risk, particularly for small children. The Canadian Surveillance System for Poison Information reported 1021 single-substance button-battery ingestion cases from 2020 to 2023, and the British Columbia Drug and Poison Information Centre (DPIC) managed 548 unintentional ingestion cases from 2013 to 2023. Nearly all the DPIC cases required hospital admission for X-ray imaging, and seven patients required surgical removal of the battery from the esophagus. Our findings support developing product warning labels and enforcing child-resistant battery packaging and compartments on consumer products.

Although social prescribing is a growing global health and social movement, no Delphi studies have determined which outcomes are critical to assess. Our aim was to identify a core outcome set based on feedback from diverse user groups of people who could be affected by (e.g. adults ≥ 60 years) or who can affect (e.g. providers, researchers) social prescribing.

Methods: Following standard guidelines for Delphi studies, we developed a two-round online survey with a focus on Canadian perspectives. We asked participants to rate 21 outcomes as "critical" (7-9 on a 9-point scale), "important but not critical" (4-6 points) or "not important" (1-3 points). We provide a subgroup description of findings from older adult/family and friend perspectives.

Results: Round 1 was completed by 74 people from 10 user groups and Round 2 by 52 people from eight user groups (70% retention). Ratings between rounds were generally consistent. Seven outcomes met the "critical" threshold. No outcomes were excluded. Critical outcomes focused on mental health, physical and social functioning, and wellbeing. Participants commented on environmental (e.g. resources, care delivery) and equity factors.

Conclusion: This study identified seven critical outcomes to consider in evaluations of social prescribing research and interventions. Future investigations should investigate how contextual and personal factors might influence outcomes and identify specific instruments (e.g. questionnaires, performance-based tests) to assess each outcome. Identification of outcomes is a continuous process, requiring regular updates as results may change due the ongoing evolution of social prescribing and other factors.

Introduction: We sought to map the literature assessing the associations between the social determinants of health (SDoH) and the cognitive health of adults in Canada.

Methods: We searched the Embase, CENTRAL, Global Health and MEDLINE databases through Ovid, from inception to 20 February 2024, for studies examining associations between SDoH and cognitive health among Canadian adults, irrespective of health or cognitive status.

Results: We identified 159 publications covering 93 studies; 27% (n = 25) had nationwide coverage and 48% (n = 45) were from Ontario or Quebec. Of the 410 associations between SDoH and cognition, 20 were from 6 qualitative studies and 390 from 87 quantitative studies. Education was the most frequently evaluated (46%) of the 29 identified SDoH categories, then social support (24%), household/individual income (19%), marital status (17%), occupation (16%), rural or urban area of residence (16%), living arrangement/household composition (12%) and environmental factors (13%). Two-thirds (67%) of the studies examined various cognitive health constructs, while 41% evaluated dementia (all types). Most of the SDoH were from the settings with which individuals directly interact. SDoH related to environmental exposure or pollution, societal norms, beliefs, values and practices were less frequently evaluated.

Conclusion: This scoping review provides a detailed map of the literature on SDoH and cognitive health in Canada. It highlights the importance of considering a comprehensive range of SDoH and of using diverse data sources and data collection approaches. The results also highlight SDoH that remain largely unexamined and should be prioritized in future research.

Introduction: In August 2020, Indigenous Services Canada's Non-Insured Health Benefits (NIHB) program approved reimbursement for silver diamine fluoride (SDF), a dental caries-arresting agent, for NIHB-eligible clients of all ages. We investigated the utilization of SDF for NIHB-eligible children and youth and determined trends and regional differences.

Methods: The NIHB program provided data on SDF claims for children and youth (< 17 years) from 1 August 2020 to 31 July 2022. We derived descriptive statistics and calculated rates of SDF application by dividing the number of children and youth with SDF claims by the number of NIHB-eligible children and youth (n = 215 215). There were 4158 SDF claims for 3465 children and youth (1542 in 2020-2021 and 1923 in 2021-2022, a 24.7% increase). The mean (SD) age was 7.9 (4.0) years, and 52.9% were female. General dentists made the most claims (87.1%). Manitoba had the most initial claims (19.6%), but Alberta had the highest number of follow-up claims. Nunavut (37.0/1000; 95% CI: 33.8-40.4) and Northwest Territories (20.9/1000, 95% CI: 17.2-25.1) had the highest rates of SDF claims. The increase in the number of SDF claims over the 2 years may indicate that more dental care providers have become aware that the NIHB program covers SDF treatment and have incorporating it into their caries treatment approaches. Still, few children and youth received follow-up SDF applications, potentially reducing the effectiveness of caries arrest.

Ongoing, large-scale longitudinal studies and surveillance systems are moving beyond historical single-item sex or gender measures to better capture gender identity. We examined patterns in adolescents' responses over a two-year period (2020-2021 to 2021-2022 school years) after the COMPASS study adopted a two-step measure of gender identity. Descriptive analyses revealed that, over time, 3.5% and 5.5% of high school students (n = 11 618) selected a different response for sex and gender, respectively. Our findings show that by implementing an inclusive measure that recognizes sex and gender as distinct constructs can improve the identification of all gender identities without compromising data quality.

Introduction: Since cannabis legalization in Canada, consumption by older adults has risen more rapidly than in other age groups. There is a need to better understand patterns of consumption, motivations, access, perceptions of risks and benefits, and how legalization has changed older adults' behaviours, especially across gender, and frequency of use.

Methods: We conducted 10 online focus groups with 72 participants aged 60 years and older, segmented by cannabis use frequency. Focus groups were held across five regions in Canada. Data were collected using open-ended questions and analyzed thematically.

Results: Analysis revealed five themes: common practices; general knowledge; perceived harms; perceived benefits; and changes in stigma and social acceptability following legalization. The participants used various consumption methods, primarily oral consumption of edibles (gummies, capsules and baked goods) and inhalation (vaping and smoking). Legalization may have decreased stigma associated with cannabis use. Both frequent and infrequent consumers noted the therapeutic benefits of cannabis, particularly for pain management and mental health, but many expressed concerns about potential physical and cognitive adverse effects, possible interactions with medications and a lack of trustworthy sources of information or guidance from health care providers.

Conclusions: The findings demonstrate the complexities of cannabis consumption among older adults, who have specific challenges and risks, and the need for comprehensive public education and support from health care providers. Targeted research and policy development to address the specific needs of this underrepresented population are urgently needed.