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

Introduction: As a foundation for prevention, evidence is required to establish the contemporary distribution of hunger in Canadian adolescents. We present findings from a nationally representative survey of young Canadians on how perceived hunger is distributed demographically, socially and contextually.

Methods: A probability-based sample of 15 656 young Canadians aged 11 to 15 years who completed the 2017/18 cycle of the Health Behaviour in School-aged Children study was used. Descriptive statistics and multivariable regression analyses were used to profile the study population and the distribution of hunger attributed to "not having enough food at home."

Results: Overall, one in six (16.6%) survey participants reported experiencing hunger. There was a strong and significant correlation between low socioeconomic status and hunger (p $lt; 0.001 for the low and middle socioeconomic groups, compared to the high socioeconomic status group). Notably, 12.5% of participants with high levels of affluence also reported such experiences of hunger; however, this was not a statistically significant finding. Hunger was less frequently reported in older participants and in higher grade levels, with some level of significance. Regression analyses indicated that, within the sample, some demographic characteristics correlated with experiences of hunger: lower levels of affluence, identifying as male or nonbinary gender, long-term immigrant status, and identifying as Black, Latin American or mixed ethnicity.

Conclusion: Clear disparities exist in the self-reported experience of hunger among young people in Canada.

Introduction: The overdose epidemic continues to be one of the largest public health crises in Canada. Various harm reduction supports have been implemented to curb this epidemic; however, they remain concentrated within urban settings. To address this limitation, overdose response hotlines and applications (ORHA) are novel, technologybased harm reduction services that may reduce drug-related mortality for people who use substances (PWUS) living in rural communities through virtual supervised consumption. These services enable more timely and remote activation of emergency responses, should an individual become unresponsive. We aimed to explore the experiences, perceptions and attitudes surrounding ORHA of individuals living in rural areas.

Methods: We conducted semistructured interviews with 15 PWUS (7 [46.7%] male, 9 [60%] Indigenous) who lived in rural, remote or Indigenous communities. Interviews were conducted until data saturation was reached. Data were analyzed using thematic analysis.

Results: Six key themes emerged: (1) participants viewed ORHA as a pragmatic intervention for rural areas but noted potential limitations to its uptake and effectiveness; (2) rural geography may hinder EMS response times, reducing the efficacy of ORHA; (3) ORHA uptake may be limited due to significant stigma faced by PWUS in these communities; (4) lack of access to technology remains a barrier to ORHA access; (5) harm reduction awareness is often limited in rural communities; and (6) there are unique social implications around substance use and harm reduction for rural Indigenous PWUS.

Conclusion: While participants believed that ORHA may be a feasible harm reduction strategy for rural PWUS, limitations, including response times, technological access and substance use stigma, remain.

Introduction: This study evaluated the effect of the COVID-19 pandemic on temporal trends in mental health and addiction-related inpatient hospitalization rates among youth (aged 10-17 years) in Canadian provinces and territories (excluding Quebec) from 1 April 2018 to 5 March 2022.

Methods: We conducted an interrupted time series analysis across three periods: T0 (pre-pandemic: 1 April 2018 to 15 March 2020); T1 (early pandemic: 15 March 2020 to 5 July 2020); and T2 (later pandemic: 6 July 2020 to 5 March 2022).

Results: Pre-pandemic mental health and addiction-related hospitalization rates had significant regional variability, with weekly rates from 6.27 to 85.59 events per 100 000 persons in Manitoba and the territories combined, respectively. During T1, the national (excluding Quebec) weekly hospitalization rate decreased from a pre-pandemic level of 12.82 (95% CI: 12.14 to 13.50) to 5.11 (95% CI: 3.80 to 6.41) events per 100 000 persons. There was no statistically significant change in the mental health and addiction- related hospitalization rate across provinces and territories in T2 compared to T0. However, there was a significant increase in the rate of self-harm-related hospitalizations among females Canada-wide and in most provinces during this period.

Conclusion: Although several Canadian studies have reported increases in mental health and addiction-related outpatient and emergency department visits among youth during the COVID-19 pandemic, this did not correspond to an increase in the inpatient hospital burden, with the notable exception of self-harm among young females.

Introduction: Psychological well-being (PWB) is an important component of positive mental health (PMH) and an asset for population health. This study examined correlates of PWB among community-dwelling adults (18+ years) in the 10 Canadian provinces.

Methods: Using data from the 2019 Canadian Community Health Survey Rapid Response on PMH, we conducted linear regression analyses with sociodemographic, mental health, physical health and substance use variables as predictors of PWB. PWB was measured using six questions from the Mental Health Continuum-Short Form, which asked about feelings of self-acceptance, personal growth, environmental mastery, autonomy, positive relations and purpose in life during the past month.

Results: In unadjusted and adjusted analyses, older age, being married or in a commonlaw relationship and having a BMI in the overweight category (25.00-29.99) were associated with higher PWB, while reporting a mood disorder, anxiety disorder, high perceived life stress, engaging in heavy episodic drinking and frequent cannabis use were associated with lower PWB. Sex, having children living at home, immigrant status, racialized group membership, educational attainment, household income tertile, having a BMI in the obese category (≥30.00), major chronic disease and smoking status were not significantly associated with PWB.

Conclusion: This research identifies sociodemographic, mental health, physical health and substance use factors associated with PWB among adults in Canada. These findings highlight groups and characteristics that could be the focus of future research to promote PMH.

Introduction: Cardiovascular disease (CVD) surveillance in Quebec and the rest of Canada is carried out using health administrative databases, which in Quebec includes the physician claims database. The presence of billing claims without diagnoses can lead to the number of CVD cases being underestimated. The purpose of this study is to estimate the proportion of CVD diagnoses and CVD cases that may be missing from these databases.

Methods: The study was conducted using a prospective cohort of 8781 participants living in the Québec City area. Access to health administrative databases was granted for the entire 28-year follow-up period. First, we performed frequency analyses to estimate the proportion of missing CVD diagnoses. Then we used validated algorithms to identify CVD cases and estimate the proportion of CVD cases that were potentially not captured over the 28-year period.

Results: About one-fifth (22.1%) of the diagnoses in the physician claims database were missing. The proportion of missing CVD cases was estimated at 12.7% for 1991-2018, although this varied with the period covered (1991-1996: 15.5%; 1997-2013: 10.7%; and 2014-2018: 16.3%).

Conclusion: Approximatively 1 in 10 CVD cases are not identified due to a missing diagnosis. This underestimation of CVD cases is a potential limitation that should be considered when using Quebec health administrative databases to identify CVD cases for surveillance work and epidemiological studies.

Introduction: Many of the social and economic factors that shape conditions for population health and health equity (e.g. income, education and employment) lie outside of the health sector. Intersectoral action (ISA) is pivotal to building diverse partnerships that address these social determinants of health. Despite the significant role of ISA, there are few comprehensive reports from the health sector on how such partnerships are evaluated. The purpose of this scoping review is to provide an overview of examples of ISA partnership evaluations, including the identification of evaluation methods, tools and indicators.

Methods: A literature search of two academic databases, Embase and MEDLINE, identified seven relevant studies published between 2012 and 2022.

Results: Common evaluation approaches were network analysis, community- or system- level analysis, partnership evaluation and longitudinal process evaluation. Five of the studies assessed the strength and functionality of partnerships, with reach (e.g. distance between partners) used most frequently as an indicator.

Conclusion: Despite the complexity of evaluating ISA partnerships, such evaluations are crucial for assessing impacts on health outcomes and social determinants of health, goal achievement, accountability and sustainability. Different evaluation models are available to program planners and evaluators involved in ISA initiatives.

Social prescribing offers a practical mechanism by which public health and health care systems can work together toward a future in which well-being is prioritized, health equity is addressed and people and communities thrive. The articles in this second part of the Health Promotion and Chronic Disease Prevention in Canada special issue on social prescribing explore how social prescribing in Canada supports action on two frameworks important to public health and health care communities: the Ottawa Charter for Health Promotion, which emphasizes building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services, and the Quintuple Aim for health care improvement, which focusses on improved population health, health equity, patient experience, care team well-being and reduced costs.

This corrigendum is being published to acknowledge the contribution of Dr. Deborah Norris, which was omitted from the original version of the article: Heber A, Testa V, Groll D, Ritchie K, Tam-Seto L, Mulligan A, Sullo E, Schick A, Bose E, Jabbari Y, Lopes J, Carleton RN. Glossary of terms: A shared understanding of the common terms used to describe psychological trauma, version 3.0. Health Promot Chronic Dis Prev Can. 2023;43(10/11). https://doi.org/10.24095/hpcdp.43.10/11.09.

Introduction: Social prescribing (SP) is a rapidly growing health and social model of care. The concept of social prescribing is based on well-known clinical practices such as community referrals, integrated health and social care, and navigator models. Although SP began in the United Kingdom's mental health and social care field, there are many examples of different models of SP foci and pathways. Here in Canada, SP is emerging at several provincial locations, with differences in its delivery reflecting the local context of people and places.

Executive summary: The age of Canada's population is increasing, necessitating innovative methods and tools for assessing the needs of older adults and identifying effective health and social prescriptions. In Alberta, a community-based, senior-serving organization undertook the development and piloting of the Healthy Aging Asset Index, an assessment tool and social prescribing guide for use by a variety of professionals within the community. Tool development was rooted in medical complexity assessment and social work practice, and adhered to the determinants of healthy aging established by Alberta's Healthy Aging Framework, which is based on the determinants of healthy aging published by the World Health Organization. Results from the pilot showed improvement in the functionality of older adults within the determinants over time, as they were supported in addressing areas of personal vulnerability. Adopting tools such as the Healthy Aging Asset Index can bring cohesiveness to the support that older adults receive across the care continuum and has the potential to shift the balance of care away from the health system and towards the community, thus improving the capacity of health systems and government to meet the needs of Canada's older adults.