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

Introduction: Although body weight has been positioned as a strong predictor of physical and mental health, positive and negative body-related psychosocial factors may also be important. Further, both theoretical tenets and empirical evidence suggest that these associations may differ by gender. Our objectives were to examine the associations between body-related self-conscious emotions (body shame, body authentic pride) and physical and mental health in young adults, and to identify potential differences in these associations by gender.

Methods: Data for this cross-sectional study were drawn from the Nicotine Dependence in Teens (NDIT) study for 799 young adults (M [SD] age = 33.6 y [0.5]; 43.9% male). We estimated the associations between each of body shame and body authentic pride (i.e. the exposures) and both self-rated physical and self-rated mental health (i.e. the outcomes) in linear regression models that controlled for age, education and body mass index, and we examined potential gender differences in these associations by conducting gender-stratified analyses.

Results: In females, self-rated health and mental health decreased by 0.37 and 0.38, respectively, with each unit increase in body shame. Self-rated health and mental health increased by 0.25 and 0.23, respectively, for each unit increase in body authentic pride. In males, self-rated health and mental health decreased by 0.35 and 0.45, respectively, with each unit increase in body shame, and increased by 0.32 and 0.21, respectively, with each unit increase in body authentic pride.

Conclusion: Interventions that focus on body weight to the exclusion of body-related self-conscious emotions may side-step a key contributor to self-rated health.

Introduction: People who use substances may access hospital services for treatment of infections and injuries, substance use disorder, mental health issues and other reasons. Our aim was to identify the experiences, issues and recommendations of people who use methamphetamine and have accessed hospital services.

Methods: Of the 114 people with lived and living experience of methamphetamine use recruited for a mixed-methods study conducted in southwestern Ontario, Canada, 104 completed the qualitative component. Interviews were conducted from October 2020 to April 2021. Participants were asked open-ended questions and the responses were analyzed using an ethnographic thematic approach.

Results: Negative patient-staff interactions included stigma and a lack of understanding of addiction and methamphetamine use, leading to distrust, avoidance of hospital care and reduced help-seeking and health care engagement. The consequences can be infections, unsafe needle use, discharge against medical advice and withdrawal. Almost all participants were in favour of in-hospital harm reduction strategies including safe consumption services, provision of sterile equipment and sharps containers, and withdrawal support. Clinical implications include education to reduce knowledge gaps about methamphetamine use and addiction and address stigma, which could facilitate the introduction of harm reduction strategies.

Conclusion: Although the strategies identified by participants could promote a safer care environment, improving therapeutic relationships through education of health care providers and hospital staff is an essential first step. The addition of in-hospital harm reduction strategies requires attention as the approach remains uncommon in hospitals in Canada.

Introduction: Cycling increased in popularity during the COVID-19 pandemic, but the impact on cycling injuries is not known. We examined the effect of lockdowns on cycling injury hospitalizations.

Methods: We identified hospitalizations for cycling injuries in Quebec, Canada, between April 2006 and March 2021. We used rate ratios (RR) and 95% confidence intervals (CI) to compare hospitalization rates by type of cycling injury and anatomical site during two waves of the pandemic. We performed interrupted time series regression to assess the effect of lockdowns on monthly cycling injury hospitalization rates, according to age, sex and other characteristics.

Results: There were 2020 hospitalizations for cycling injuries between March 2020 and March 2021, including 617 during the first lockdown and 67 during the second lockdown. Compared with the period before the pandemic, risk of cycling-related injuries during the first lockdown increased the most for fractures (RR = 1.44; 95% CI: 1.26- 1.64) and head and neck injuries (RR = 1.59; 95% CI: 1.19-2.12). Cycling injury hospitalization rates increased significantly among adults, adolescents and individuals from socioeconomically advantaged neighbourhoods or those with low concentrations of racialized people every month of the first lockdown. The second lockdown was not associated with cycling injuries.

Conclusion: The first lockdown triggered a sharp increase in cycling injury hospitalizations, especially among adults, adolescents and individuals from socioeconomically advantaged and less racialized neighbourhoods.

Introduction: Social determinants of health (SDH) may influence children's weight status. Our objective was to examine relationships between SDH and preschoolers' weight status.

Methods: This retrospective cohort study included 169 465 children (aged 4-6 years) with anthropometric measurements taken at immunization visits from 2009 to 2017 in Edmonton and Calgary, Canada. Children were categorized by weight status based on WHO criteria. Maternal data were linked to child data. The Pampalon Material and Social Deprivation Indexes were used to assess deprivation. We used multinomial logistic regression to generate relative risk ratios (RRRs) to examine associations between ethnicity, maternal immigrant status, neighbourhood-level household income, urban/ rural residence and material and social deprivation with child weight status.

Results: Children of Chinese ethnicity were less likely than those in the General Population to have overweight (RRR = 0.64, 95% CI: 0.61-0.69) and obesity (RRR = 0.51, 0.42-0.62). Children of South Asian ethnicity were more likely than those in the General Population to have underweight (RRR = 4.14, 3.54-4.84) and more likely to have obesity (RRR = 1.39, 1.22-1.60). Children with maternal immigrant status were less likely than those without maternal immigrant status to have underweight (RRR = 0.72, 0.63-0.82) and obesity (RRR = 0.71, 0.66-0.77). Children were less likely to have overweight (RRR = 0.95, 0.94-0.95) and obesity (RRR = 0.88, 0.86-0.90) for every CAD 10 000 increase in income. Relative to the least deprived quintile, children in the most materially deprived quintile were more likely to have underweight (RRR = 1.36, 1.13-1.62), overweight (RRR = 1.52, 1.46-1.58) and obesity (RRR = 2.83, 2.54-3.15). Relative to the least deprived quintile, children in the most socially deprived quintile were more likely to have overweight (RRR = 1.21, 1.17-1.26) and obesity (RRR = 1.40, 1.26-1.56). All results are significant to p < 0.001.

Conclusion: Our findings suggest the need for interventions and policies to address SDH in preschoolers to optimize their weight and health.

This qualitative study highlights parents' perspectives on pandemic-related changes to health promotion programming. We conducted 60-minute, semi-structured telephone interviews with 15 parents (all mothers) of children in Grades 4 to 6 between December 2020 and February 2021 in two western Canadian provinces. Transcripts were analyzed through thematic analysis. While some parents found the health promotion materials helpful, most were overwhelmed and did not access the materials, finding them intrusive, being preoccupied with other things and facing their own personal stressors. This study highlights key factors to be addressed and further investigated to ensure the successful delivery of health promotion programming during future crises.

As Canada begins to recover and learn from the COVID-19 pandemic, health equity and public health policies must be a central tenet of reform. Recent work has begun to provide guidance on an equitable pandemic recovery in Canada, which highlights many important groups that require specific consideration in recovery policies.1 There is a key omission in many of these guidelines and, in fact, most health equity efforts-people with disabilities.

Introduction: School-based health-promoting interventions (HPIs) foster adolescent health and well-being. Access to HPIs may differ by the socioeconomic advantage of students at each school (school deprivation). We assessed the importance of health issues and availability of HPIs and extracurricular activities by school deprivation in high schools in Quebec, Canada.

Methods: In 2016/17, 2017/18 and 2018/19, we interviewed school principals or a designee in 48 public high schools classified as disadvantaged (33%) or advantaged (67%). Schools rated whether 13 common health-related issues were important (i.e. warranted intervention) in their student population and reported whether HPIs to address these or other health issues and/or sports or special interest extracurricular activities had been available in the past year.

Results: 84% of disadvantaged schools offered one or more HPIs in the past year compared to 73% of advantaged schools. Higher proportions of disadvantaged schools perceived most of 13 health-related issues as important. HPIs for bullying/exclusion, sex education and physical activity (issues subject to government mandates) were available in most schools. Higher proportions of disadvantaged schools offered non-mandated HPIs (i.e. for healthy eating, mental health/well-being and substance use). Higher proportions of advantaged schools offered extracurricular activities in all areas other than non-competitive sports, which was offered by equal proportions of advantaged and disadvantaged schools.

Conclusion: Government mandates appear to facilitate universal availability of HPIs in schools, possibly boosting equity in school-based health promotion. Further investigation of possible differences in the content, implementation and/or effects of HPIs based on school deprivation is warranted.

Gender identity and sexual attraction are important determinants of health. This study reports distributions of gender identity and sexual attraction among Canadian youth using data from the 2019 Canadian Health Survey on Children and Youth. Among youth aged 12 to 17, 0.2% are nonbinary and 0.2% are transgender. Among youth aged 15 to 17, 21.0%, comprising more females than males, report attraction not exclusive to the opposite gender. Given known associations between health and gender and sexual attraction, oversampling of sexual minority groups is recommended in future studies to obtain reliable estimates for identifying inequities and informing policy.