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

Setting: A public health society working group wanted to use social marketing approaches to engage with a community and stimulate social support for a health treatment. The group struggled to collect effectiveness (summative) data during the project. To make up for this lack, the group explored ways to measure effectiveness of engagement (the primary outcome) based on written records (meeting minutes) kept during the project.

Intervention: The working group kept minutes of meetings that contained records of the level of participation of members by names. The text of 18 meetings (14,000 words) was edited so that the names of participants were replaced with roles that corresponded to working group members' roles: grassroots health advocates, community health agency representatives, and experts or knowledge leaders. The corpus was imported into a text analysis platform that measured word frequency. Results were tallied for the three categories of group member roles. To validate the method as a meaningful summative evaluation, the text analysis approach was critiqued using a developmental evaluation framework.

Outcomes: The text analysis evaluation indicated that the word frequency of "partner," (community health partner), "community" (grassroots health advocates), and "expert" (or knowledge leaders) tags began to converge as the campaign progressed. Initially, experts and community health partners spoke less in meetings, and community members spoke more. Over time, all members began contributing more equally during the meetings. The checklist evaluation indicated alignment of the technique with established evaluation protocols used in the field of public health.

Implications: The text and checklist analyses support the notion that engagement among working group members may be, and thus may be seen as, a precondition of engagement with the community. When used with evidence from event evaluations, the innovation may be used as an argument for effectiveness as an outcome in community-based public health campaigns that do not use conventional project (summative) evaluations.

Objectives: To generate concrete, youth-derived recommendations to support Canada's post-pandemic recovery from COVID-19 to support youth mental health and substance use (MHSU), economic, and educational recovery.

Methods: Using a virtual, modified Delphi, participants rated recommendation items over three rounds, with the option to create their own recommendation items. A priori consensus was defined as ≥ 70% of the entire group, or subgroups of youth (e.g., age, race/ethnicity, gender and sexual identities), rating items at a 6 or 7 (on a 7-point Likert scale). Items were dropped in subsequent rounds if they did not achieve consensus. Qualitative responses were analyzed using content analysis for Round 1.

Results: A total of 40 youths participated in Round 1, with good retention (97.5%) in subsequent rounds. Youths achieved consensus on eight recommendations to support post-pandemic recovery. Youths endorsed post-pandemic strategies that prioritize the implementation of effective, accessible, and low-cost MHSU services in schools, workplaces, and communities; the integration of MHSU education into school lessons; increased awareness about MHSU services in schools and workplaces; and the prioritization of health and well-being in schools and workplaces.

Conclusion: Findings indicate the need for stronger partnerships between schools, community-based MHSU services, and hospitals, and job opportunities that pay a living wage.

Increasing evidence suggests that public health systems governance should focus on organizational leadership competencies in addition to individual competencies to better enable collaborative, equitable, and effective public health systems. As part of a broader study, we conducted 12 interviews to understand the perspectives of public health leaders in Canada regarding the importance of focusing on organizational leadership competencies. Public health leaders viewed organizational leadership as a collective contribution that requires sustained efforts through organizations' learning environment and culture. According to informants, a focus on the organizational level can enable (1) team building and structural dismantling of inequities, (2) tailoring of leadership responses to different provincial and local contexts, and (3) the building of an ecosystem that promotes nurturing and adaptive spaces to facilitate mindset change and prevent siloing. Interviewees also emphasized the dynamic and changing nature of these competencies, particularly in light of the system-level weaknesses highlighted during the COVID-19 pandemic and the global political climate, which necessitate regular review and careful examination to ensure relevance. We conclude by calling for greater focus on organizational leadership competencies for public health governance.

Setting: Climate change in Canada has expanded suitable habitats for both native and invasive mosquitoes, heightening the need for more robust and adaptable surveillance systems. Traditional surveillance methods face significant logistical and geographical challenges, particularly in remote or underserved areas, emphasizing the importance of innovative strategies that complement existing approaches.

Intervention: We developed a community-based mosquito surveillance toolkit, informed by a systematic review and validated by a multidisciplinary expert group. The toolkit includes a structured guide for developing a community science project, including how to design an effective mosquito surveillance program through data collection, volunteer engagement, and evaluation. It also features a quick reference guide and a 90-s animated video to facilitate understanding and engagement.

Outcome: The toolkit was introduced at a national community meeting, with 69 participants bringing together public health professionals, educators, scientists, and community leaders from across Canada in February 2025. Participants expressed enthusiasm for using the toolkit to enhance local monitoring efforts, and discussions at the meeting helped identify key opportunities and challenges for adoption.

Implications: Organizations and public health authorities now have a clear, evidence-based guide to designing, implementing, and evaluating community-driven initiatives. This toolkit not only helps ensure that volunteer participation is meaningful and effective, but it also enhances the capacity to respond to emerging challenges in vector control, laying the groundwork for sustainable, community-driven surveillance efforts.

Objective: Public health practice necessitates effective health communication. Now, more than ever, public health practitioners must possess the competencies - the skills, knowledge, and attitudes - to communicate effectively. Using a robust, multi-step, multi-method research process, we sought to develop a set of communication competency statements for public health professionals in Canada, in communication-focused roles.

Methods: Following earlier research steps that included scoping reviews, environmental scans, a national survey (n = 378), and key informant interviews (n = 12), which established an initial set of competency statements, a modified Delphi technique was conducted with a panel of public health communication experts which included two online survey rounds (n = 19, n = 18) with one virtual meeting (n = 7) in between to develop consensus on the initial competency statements. An a priori threshold for consensus of 75% agreement was set.

Results: After the second Delphi survey, participants reached consensus on all competency statements with 96% of participants agreeing with each statement on average, an increase from the first Delphi survey. Between the two Delphi surveys, revisions were made to the statements based on quantitative and qualitative participant feedback.

Conclusion: The research has resulted in 18 communication competency statements comprising the Public Health Communication Competency Framework, which are intended to serve as a roadmap for public health professionals whose roles encompass communication, guide curricula development in public health programs, catalyze professional development in communication, and support public health systems to achieve the essential public health functions.

Objective: SARS-CoV-2 serological surveillance used blood donors, research cohorts, and residual patient samples. Differences in socio-demographic characteristics across these sources may bias seroprevalence estimates, necessitating statistical adjustment.

Methods: We re-analyzed data from six serosurveillance sources, comparing the estimated percent of the population positive for SARS-CoV-2 anti-nucleocapsid antibodies for six regions during periods when the sources' sample collection overlapped. We assessed the concordance between sources with and without using multilevel regression and poststratification (MRP) to adjust for differences in representation by age, sex, and race.

Results: Across regions and timepoints, unadjusted seroprevalence differed between sources by up to 20%. MRP did not consistently improve comparability of seroprevalence across sources. In 2022, seroprevalence was consistently highest among blood donors, and MRP increased regional seroprevalence across all sources (except in Manitoba during January-April 2022 in ABC Study). In a secondary regression analysis, immunoassay kit and sample type (dried blood spot or venous blood draw) strongly influenced the odds that a sample was classified as seropositive.

Conclusion: Adjusting for representativeness using common socio-demographic variables did not systematically improve concordance in seropositivity estimates between serosurveillance sources. While discrepancies between sources might be influenced by studies' representativeness of characteristics we did not assess, methods for measuring seropositivity appear to explain much of the differences between sources. Serosurveillance findings are influenced by many aspects of study design beyond representativeness, such as sample type (venous blood draw or dried blood spots), choice of immunoassay, and laboratory procedures such as dilution or immunoassay calibration.

Objectives: This environmental scan has two aims. The first is to identify wholistic, physical activity (PA)-based wellness interventions for Indigenous women in Canada through the completion of a scoping review of published and grey literature and key informant interviews. The second is to identify promising practices and potential barriers to intervention development and delivery.

Methods: Components of the environmental scan included (1) the creation of a logic model in collaboration with a community-based Advisory Group, (2) a scoping review of wholistic PA-based wellness interventions between January 1990 and March 2022, (3) key informant interviews of individuals involved in PA-based wellness programming, and (4) thematic analysis of promising practices, enablers, and barriers found in both the articles and interviews.

Synthesis: The scoping review identified 16 interventions. Through key informant interviews, 6 additional interventions were identified. Programs were largely community-based and culturally appropriate. Financial factors were the most common barrier. Walking as a form of PA was commonly employed and key informant interviews highlighted the importance of exploring on-the-land activities, group activities, and the incorporation of all elements of wholistic health (mental, physical, spiritual, and emotional). Only one study employed Indigenous research methods.

Conclusion: There is limited published literature and a dearth of PA-based, wholistic health programs for Indigenous women in Canada. More programming and research are required to address the unique health needs of Indigenous women and mitigate the legacy impacts of colonization on health.

Objectives: This qualitative study examines how trust has changed during and after the pandemic among our study participants. It reveals how they made meaning of trust in federal and provincial governments, scientific research, and digital platforms, and how this meaning-making process changed and was challenged by a global public health crisis.

Methods: We applied a descriptive phenomenological approach to semi-structured interviews that were conducted between July and November of 2024. In total, 41 interviews were conducted. Interview transcripts were analyzed using the descriptive phenomenological approach to understand participants' lived experiences of the pandemic, followed by how these lived experiences contributed to how they made meaning of public trust, both during and after the height of the pandemic. This analysis resulted in themes by giving attention to expressive language and past experiences, and ultimately revealing the "essence" or distinct nature of these participants' experiences of the pandemic.

Results: Research participants expressed polarized views on government trust, with provincial administrations often perceived as prioritizing economic or political interests over public health, while federal government were associated more with incompetence than with self-serving motives. Our participants experienced relatively stable trust in scientists, though they were concerned about transparency and profit-driven motives - particularly concerning the short time it took for vaccines to be developed. Social media was largely perceived as an unreliable source of information, yet it remained influential in shaping participants' perceptions, especially regarding vaccine hesitancy.

Conclusions: We found that participants' public trust during the pandemic in Canada was highly dynamic and subjective, and was greatly informed by histories, lived experiences, and preconceptions about various institutions, such as the government, public health officials, and scientists. Changes in trust experienced by participants were anchored in experts' ability to communicate reliable information. Participants further emphasized the need for transparent and consistent messaging, particularly from the Government of Canada, to rebuild lost trust and prepare for future public health crises.