Canadian Journal of Public Health-Revue Canadienne De Sante Publique最新文献

Setting: Public health measures enacted during the COVID-19 pandemic significantly impacted Nova Scotians experiencing food insecurity. Public Health (PH), Nova Scotia Health, created a provincial Housing Isolation Program (HIP) which addressed barriers to isolation, including food access, for COVID-19 cases and contacts being followed by PH.

Intervention: HIP worked with partners to coordinate and respond to urgent food needs of isolating clients by providing grocery and meal delivery options. HIP also made referrals to government and community partners for income and food supports. This program was intended to minimize the spread of COVID-19 by facilitating isolation while meeting basic needs for people with no other means of support.

Outcomes: From December 2020 to March 2022, HIP completed grocery and meal deliveries for 579 clients, 1351 referrals to a provincial Income Support Program, and 231 referrals to external food supports. HIP staff worked with clients to manage potential perceptions of stigma. Challenges reported included the urgency of food needs, lack of social supports, and availability and accessibility constraints in rural communities, as well as difficulty accessing culturally appropriate foods and special diets.

Implications: This intervention demonstrates the importance of addressing food insecurity during emergency preparedness, planning, and response. During emergencies, planning and mobilizing food access requires an equity-oriented approach to overcome stigma. Broadly, continued reliance on charitable responses creates significant vulnerability during emergencies and addressing root causes of food insecurity through social policy will provide longer-term protection.

Objective: Characterizing the seroprevalence of SARS-CoV-2 antibodies in children is needed to optimize the COVID-19 public health response. We quantified the seroprevalence of SARS-CoV-2 infection-acquired antibodies and vaccine-acquired antibodies among children receiving primary care in Toronto, Canada.

Methods: We conducted a longitudinal cohort study between January 2021 and November 2022 in healthy children aged 0-16 years receiving primary care in Toronto. The primary and secondary outcomes were seroprevalence of SARS-COV-2 infection-acquired antibodies and vaccine-acquired antibodies ascertained from finger-prick dried blood spots. Samples were tested using an enzyme-linked immunosorbent assay for antibodies to full-length spike trimer and nucleocapsid. We explored sociodemographic differences with Firth's penalized generalized estimating equations.

Results: Of the 475 participants, 50.1% were girls and mean age was 6.4 years (SD = 3.2). We identified 103 children seropositive for infection-acquired antibodies, with a crude seroprevalence that rose from 2.6% (95%CI 1.39-4.92) from January to July 2021 to 50.7% (95%CI 39.5-61.8) by July to November 2022. Seroprevalence of vaccine-acquired antibodies was 45.2% by July to November 2022 (95%CI 34.3-56.58). No differences in sociodemographic factors (age, sex, income, or ethnicity) were identified for infection-acquired antibodies; however, children with vaccine-acquired antibodies were more likely to be older, have mothers with university education, and have mothers who had also been vaccinated.

Conclusion: Our results provide a benchmark for seroprevalence of SARS-CoV-2 antibodies in children in Toronto. Ongoing monitoring of the serological status of children is important, particularly with the emergence of new variants of concern, low vaccine coverage, and discontinuation of PCR testing.

Objective: The Cannabis Policy Study in the Territories (CPST) is an annual repeat cross-sectional study aiming to evaluate the impacts of cannabis legalization in the Canadian territories (Yukon, Northwest Territories, and Nunavut), where there is a paucity of data on cannabis use. This current study's objective was to describe the 2022 CPST, including methods, population prevalence estimates of cannabis use, and legal cannabis sources and perceptions in the territories.

Methods: The 2022 CPST includes 2462 respondents (aged 16 +) residing in the territories who either use or do not use cannabis. Respondents were recruited through mail-push-to-web invitations sent via licensed mailing lists, sampling from a near census of households in the territories. Population-weighted indicators of cannabis use are described.

Results: Past 12-month cannabis use was self-reported by 46.1%, and 21.8% self-reported daily/almost daily use. The most commonly used product types among past 12-month consumers were dried flower (73.4%), edibles (59.0%), and vape oils (35.7%). On average, 74.8% of cannabis products used in the past 12 months were from legal sources, though legal sourcing varied by product type (54.4‒92.2%). Cannabis consumers reported favourable perceptions of legal compared to illegal cannabis products regarding quality, convenience, and safety, but a lesser extent for price.

Conclusion: Cannabis use is highly prevalent in the territories, particularly daily/almost daily use, and legal market penetration is high despite region remoteness. Following cannabis legalization, monitoring cannabis use prevalence and patterns in remote regions is important for informing the development of harm reduction and prevention initiatives that consider the unique needs of these regions.

Objective: There is a lack of published evidence on factors associated with adherence (maintenance of cumulative vaccination) to seasonal influenza vaccination (SIV) in Manitoba, Canada. We sought to assess the associations.

Methods: A cohort study utilizing Manitoba administrative health databases. Participants received SIV in 2010/11 influenza season, remained registered Manitoba residents and received at least one SIV during the 2011/12‒2019/20 seasons. We dichotomized adherence into "more adherent" (6‒9 SIVs) and "less adherent" (1‒5 SIVs) and used multivariable adjusted generalized estimating equation logistic regression models to assess association between adherence and socioeconomic, health-related, and primary care physician (PCP) characteristics, stratified by age group (< 5, 5‒17, 18‒44, 45‒64, ≥ 65) and sex. Results are adjusted odds ratios with 95% confidence intervals.

Results: There were 152,493 participants. Males had lower odds of being more adherent except among ≥ 65-year-olds (1.03, 95% CI 1.01‒1.05). Compared with the lowest income quintile, those in higher income quintiles had higher odds of being more adherent. The odds mostly increased with increase in income quintile. Those with more contact with their PCP/hospitalization one year prior had higher odds of being more adherent. The odds increased with increased contact among those 18‒44, 45‒64 and ≥ 65 years old. Those who had PCP with more years of practice had higher odds of being more adherent. The odds increased as years of practice increased. These observations were mostly consistent irrespective of sex.

Conclusion: Female gender, having higher income, having more contact with the health system, and having an experienced PCP may determine increased adherence to SIV in Manitoba. These findings require attention.

Recent events, such as the COVID-19 pandemic, have drawn nationwide attention to systemic racism as a serious threat to public health in Canada. One promising approach to address such racism is through developing and implementing standardized procedures for collecting and using disaggregated, race-based data. In this commentary, we summarize why this approach is necessary to address systemic racism in Canada, and highlight municipal actions being taken in Edmonton, Alberta, to move this approach forward. In 2021, a Race-based Data Table, comprising 24 institutions and organizations affiliated with health, education, and policing systems, was formed in Edmonton. It aimed to engage practitioners, systems representatives, academics, and community members in collective advocacy around accessing race-based data to better understand and address disparate health outcomes associated with COVID-19 for racialized communities. Further, the Table intends to co-create a charter and toolkit outlining best practices for ethical, race-based data collection and use with local stakeholders and knowledge users. In documenting the beginning stages of the Table, and in evaluating its ongoing progress, we contribute to national conversations regarding the need for government institutions and other organizations to consistently collect and use race-based data as a means of increasing transparency and accountability in their actions.

Objective: Built environment interventions provide structural solutions to complex urban challenges. Though community voices are part of municipal decision-making, planners and public health professionals need tools to better integrate their perspectives for desired changes (what) when implementing built environment interventions (how). We present two simultaneous concept mapping exercises conducted in Montréal, Canada, to facilitate the consideration of these dimensions.

Methods: Community members were prompted about neighbourhood changes that could improve their quality of life; stakeholders were prompted about factors that contribute to successful implementation of interventions. Through each exercise, items were generated, grouped, and rated on importance and feasibility. Concept maps were produced using multidimensional scaling and hierarchical cluster analysis. The clusters identified by community members and stakeholders were combined into a Community × Stakeholder Matrix, which supported discussions on interventions with the research's Advisory Committee.

Results: Thirty-two community members generated 41 responses, which resulted in 6 clusters: (1) strengthen public transportation, (2) reduce space dedicated to cars, (3) foster local social connections, (4) develop quality cycling infrastructure, (5) improve pedestrian accessibility, and (6) green the city. Thirty-seven stakeholders generated 40 items, which resulted in 5 clusters: (1) collaboration with stakeholders and citizens, (2) planning and evaluation, (3) common vision for the future, (4) regulatory framework and funding, and (5) context-informed approach.

Conclusion: Capturing the collective vision of our urban environments and the processes underlying change through concept mapping can lead to more successful changes. We propose combining understandings of the what and how into a matrix to support evaluation and strategic planning of interventions and better integrate community voices into operational planning.

Objectives: Alcohol availability is associated with alcohol consumption and related harms, but there is less evidence on associations with heavy episodic drinking (HED), a drinking pattern prevalent among young adults. This study aimed to assess the associations between alcohol availability and HED among young Canadians.

Methods: We used a population-based sample of Canadian urban-dwelling young adult drinkers (18‒29 years) from the cross-sectional Canadian Community Health Survey (CCHS; cycles 2015‒2019). We linked data from CCHS respondents in British Columbia and Quebec with two measures of alcohol availability for both offsite and onsite outlets: density (AOD) and accessibility (SAI) within dissemination areas (N = 1,067,747). We used logistic regression to estimate the associations between alcohol availability and monthly HED, adjusting for covariates.

Results: The associations between availability and HED differed by province, and availability measure. In British Columbia, offsite and onsite accessibility using SAI was inversely associated with HED. For example, living in neighbourhoods with medium alcohol accessibility (as compared to low) was significantly associated with reduced odds of HED (offsite OR = 0.33, 95% CI 0.17‒0.64; onsite OR = 0.49, 95% CI 0.27‒0.89). In Quebec, offsite availability was positively associated with HED using SAI (although not statistically significant) while no clear trend was seen for onsite availability.

Conclusion: Results were consistent with previous evidence. Restricting spatial availability of alcohol remains an important public health strategy for decreasing the ease/convenience of access. Understanding why patterns of availability and drinking differ across regions could inform regionally tailored policies.

Objectives: Since the publication of the Core Competencies for Public Health in Canada in 2008, the public health and communication landscape has changed dramatically. Digital media and infodemics have shifted how practitioners must communicate and respond to health information. The age of the current competency framework, which is relied on for workforce development, alongside emerging public health challenges, have prompted calls for modernized competency statements. This study aims to (i) measure self-reported communication competence in the public health workforce, (ii) measure agreement with new communication competency statements, (iii) identify variation in agreement between sub-groups of professionals, and (iv) explore current and needed communication training.

Methods: Using a mixed-methods online survey, a sample of 378 participants in various Canadian public health roles and regions were asked to rate their current communication competence and agreement with a modernized, evidence-based draft communication competency framework. The survey was distributed in both official languages through partner organizations and social media. Descriptive statistics were performed to assess agreement and variation was analyzed in relation to public health roles and experience.

Results: While most participants self-reported communication competence, specific areas were rated lower. All 21 proposed competency statements received high agreement with some variation observed between expertise and experience levels. Demand for communication training is high.

Conclusion: Strong agreement with statements indicates support for a modernized communication competency framework among sampled professionals. Research to gather more evidence surrounding the communication demands of the public health workforce and observed variation in strong agreement for the proposed statements is underway.