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

News media are an underused source of localized information on complex and structural public health issues that are neglected in policy and unaccounted for in mainstream data collection. We applied systematic review search methods to online news media and developed a dataset highlighting municipal reactions and initiatives in response to public washroom pressures during the first year of the COVID-19 pandemic. Reliance on consumer-based models of washroom access "became news" amid the closures and lockdowns. Our results showed that many municipalities were grappling with the issue, but overwhelmingly responding with temporary and pandemic-specific measures that did not address the needs of marginalized groups.

Introduction: Anti-Black racism is a social determinant of health that has significantly impacted Black children and families. Limited research has examined anti-Black racism during the early years-a critical period of development. In this study, we sought to understand the manifestations of anti-Black racism in early childhood and explore its impact on Black children and families.

Methods: This qualitative research project was informed by critical race theory, Black Critical Theory and interpretive description. Early childhood educators (ECEs) and parents with Black children between the ages of 18 months and 5 years (n = 15) participated in virtual, semistructured interviews.

Results: Awareness of and protection against anti-Black racism was a constant in Black families' lives. Parents felt as though they had to remain hypervigilant and overprotective of their Black children, knowing they were liable to encounter racial violence. The early learning environment was a source of heightened stress for families, given the significant amount of time young children spend in child care. Black children were often "othered" in predominately White spaces and had been objectified by White ECE staff and children. Parents worked to instill a strong sense of self-confidence in their children to counteract the negative impacts of racial discrimination.

Conclusion: Results from this study suggest that children as young as 18 months are experiencing racial violence and adverse childhood experiences. Findings may contribute to antiracist policy development and a focus on more inclusive early childhood education for Black children and families.

Introduction: In Canada, people experiencing socioeconomic inequities have higher rates of late diagnosis and lower survival rates than the general population. Palliative care services focussed on this population are scarce. We developed a community-based nursing intervention to improve access to palliative care for people experiencing socioeconomic inequities and living with life-limiting illnesses in an urban Canadian setting.

Methods: This community-based, qualitative research study combined critical and participatory research methodologies. The study was conducted in partnership with the Palliative Care Outreach Advocacy Team (PCOAT) based in Edmonton, Alberta, a team dedicated to serving populations experiencing socioeconomic inequities who require palliative care. Following an exploratory phase that served to delineate the intervention, we undertook a one-year pilot implementation during which a part-time registered nurse (RN) joined PCOAT. The RN engaged in trust building, resolution of health and practical needs and complex care coordination. Twenty-five patients participated in the intervention. Participants were interviewed at least once to explore their experiences with the intervention. Data were analyzed through thematic analysis.

Results: Most participants were men, were Indigenous and had advanced cancer. Participants had significant financial concerns, lived or had lived in precarious housing situations and had previously faced serious challenges accessing health care. Participants reported social and health needs including housing, finances, transportation, symptom control, harm reduction and end-of-life care. Participants reported improved access to health and social services and expressed satisfaction with the study intervention.

Conclusion: Study findings suggest the study intervention may have contributed to improved access to palliative care, improved experiences for participants and increased equity in the delivery of care.

Introduction: The broaden and build theory of positive emotions maintains that positive emotions serve to broaden individuals' thoughts and behaviours, resulting in the accrual of resources (e.g. resilience) that catalyze upward spirals of well-being. However, there is a relative dearth of research examining the upward spiral hypothesis in the context of adolescence.

Methods: Adolescents (n = 4064) in participating Canadian high schools were surveyed annually for three years as part of the COMPASS study. Reciprocal associations between positive emotions and resilience were examined as predictors of flourishing.

Results: Adolescents who experienced positive emotions more frequently than usual reported higher levels of resilience one year later. Similarly, adolescents who had higher levels of resilience than usual reported more positive emotions the following year. Higher than usual levels of resilience and positive emotions positively predicted flourishing.

Conclusion: Positive emotions result in a cascade of beneficial outcomes including increased resilience and enhanced well-being, catalyzing an upward spiral towards flourishing. Opportunities to enhance positive emotions early on in adolescence may help build resources that can set students on the path towards increased well-being.

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.