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

This commentary explores the position that community-academic partnerships (CAPs) can guide collaborative, equitable, and innovative research activities, enhancing knowledge mobilization and overall research impact. We use an example within behavioural sciences (with the broader goal of improving physical literacy development and physical activity for newcomer children and youth) to apply key practices that build bidirectional and trustworthy relationships between researchers, practitioners, and policy-makers, ultimately leading to equity-centered outputs. We report on our experiences both narratively and in video format by interweaving the perspectives of diverse and multi-sectoral team members and describing efforts to continue to engage and drive the momentum of research network activities.

Objectives: Youth vaping is a concern in Canada. While school-level policies influence student behaviours, few studies have investigated the association between school vaping policies and student vaping. This study reviewed and scored the comprehensiveness of school vaping policies and investigated the association between school vaping policy scores and student vaping.

Methods: Online policy documents from n = 39 schools in Ontario, Alberta, and British Columbia, Canada, participating in the 2021-2022 wave of the COMPASS study were collected, reviewed, and scored for comprehensiveness (/39) using the School Tobacco Policy Index (STPI) rating form. The mean and range of scores for each domain of the STPI were calculated. School policy scores were linked to student vaping data from the COMPASS study. Multilevel logistic regression analyses identified the association between school vaping policy score and student lifetime and current (past 30-day) vaping.

Results: The mean total policy score was 10.2/39 (range 0‒24), and 28% of schools scored 0/39. The majority of school policies did not identify enforcement approaches or available preventive or cessation resources. Increasing STPI score was not associated with the odds of student lifetime or current vaping in multilevel logistic regression analyses.

Conclusion: The STPI quickly identified components of school vaping policies that were missing. The overall score of most school vaping policies in our sample was low and most school vaping policies lacked many important components. Future studies should explore factors associated with adolescent vaping and identify effective prevention measures.

Objectives: In the first year of pandemic measures, opioid-related deaths across Ontario's (ON) 34 public health units (PHUs) increased by 60%. Death rates for all seven Northern ON PHUs were above the provincial average. This study describes and compares factors surrounding opioid-related deaths before and after pandemic measures were introduced, for Northern ON compared to the rest of ON.

Methods: Aggregate data were provided for Northern ON and the rest of the province by the Office of the Chief Coroner/Ontario Forensic Pathology Services. Opioid-related deaths were cohorted by date of death for the year before and after pandemic measures were introduced on March 16, 2020. Chi-square tests were used to compare between cohorts and geographies to determine significant differences for each variable, and for dichotomized levels within variables. P-values < 0.05 were considered statistically significant a priori.

Results: In Northern ON, the number of opioid-related deaths approximately doubled from the pre-pandemic cohort (n = 185) to the early pandemic cohort (n = 365). Compared to the rest of ON, higher proportions of deaths occurred in Northern ON among individuals who lived and died in private residences, among women (although the majority of decedents were male) and among individuals employed in mining, quarrying, and oil and gas industries. Compared to the pre-pandemic year, in Northern ON, higher proportions of opioid-related deaths involved fentanyl and stimulants as direct contributors, and the majority involved evidence of inhaled drugs.

Conclusion: Differences between the circumstances of death in Northern ON and in the rest of ON suggest opportunities to tailor interventions.

Objectives: Conventional serological approaches lack sensitivity for the detection of recent SARS-CoV-2 infections in vaccinated individuals, as these individuals exhibit a blunted anti-nucleocapsid (N) response. This limitation was recently addressed by the development of a "ratio-based approach", which compares longitudinally collected specimens. Here, we used this approach to estimate the incidence of SARS-CoV-2 infection and reinfection in Québec (Canada) during the Omicron wave.

Methods: Consenting plasma donors were included if they donated plasma before December 15, 2021 and during six consecutive periods of ~ 3 months between December 15, 2021 and July 7, 2023 (study period). Anti-N levels were measured with an enzyme-linked immunosorbent assay, and seroconversion was characterized by a ratio of ≥ 1.5 between the optical density of two consecutive samples.

Results: Among the 254 donors, the adjusted proportion of donors (95% confidence interval [CI]) with a new infection ranged between 18.1% (13.2‒23.0) and 24.2% (18.8‒29.7) over Periods 1-5 and fell to 7.9% (4.9‒11.0) during Period 6. During the study period, the proportion of newly infected donors decreased among those aged < 60 (Period 1 = 31.6%, Period 5 = 4.4%), but increased among those aged ≥ 70 (Period 1 = 0.3%, Period 6 = 10.3%). Throughout the study period, 72 (28.3%) reinfections occurred, including two seroconversion events in a single donor. Overall, 87.4% (95% CI = 82.7‒91.2) were infected by SARS-CoV-2 at least once during the study period.

Conclusion: The vast majority of the Québec population may have been infected during the Omicron wave. This longitudinal survey demonstrates the usefulness of the "ratio-based approach" for identifying both new infections and reinfections in a vaccinated population.

Objectives: This research examines the temporal rates and spatial patterns of police-involved Mental Health Act (MHA) apprehensions in Toronto, Canada, from 2014 to 2022. Building from the work of Toronto Police Services (TPS), the goal of this research is to deepen our understanding of MHA apprehensions and provide insights which may be used to guide local mental health reform efforts.

Methods: Using data collected by TPS, an exploratory, descriptive analysis of spatial patterns of MHA apprehension events between 2014 and 2022 at the neighbourhood level was conducted. To identify high-rate clusters, we used a discrete Poisson model in SaTScan, with a circular moving window. Primary and secondary clusters with a relative risk of 1.5 or greater are reported.

Results: From 2014 to 2022, 93,932 MHA apprehensions occurred in Toronto. Apprehension rates were found to vary substantially between neighbourhoods, with approximately 91% of Toronto's 140 neighbourhoods experiencing a net positive increase in rates during the study period after adjusting for population growth. Repeated spatial cluster analysis for each year revealed a range of 4 to 7 clusters annually, with the downtown core consistently emerging as an area of elevated risk (RR range 1.58-1.99).

Conclusion: Rising MHA apprehensions within Toronto highlight the pressing need to confront the city's intensifying mental health needs. These findings offer valuable insights into the patterns and nature of police-involved MHA apprehensions, outline reproducible analysis methods that can be used by others, and support targeted evaluation, expansion, and implementation of downstream initiatives to improve mental health responses.

Setting: Regional Public Health Unit (Office of the Chief MHO, Vancouver Coastal Health Authority, BC, Canada).

Intervention: Recognizing the need to invest resources that strategically move public health work "upstream" where policies and investments can shape the determinants of health, the Office of the Chief MHO for Vancouver Coastal Health embarked on a process in 2019 to develop a population health team designed to engage in Healthy Public Policy (HPP) and Health in All Policies (HiAP) approaches to health promotion. The mission and design of this unit was informed by internal and external research and engagement which continued even through the COVID-19 pandemic.

Outcomes: In the fall of 2022, this new unit, the first of its kind in British Columbia, was launched. In 2023, it embarked on strategic planning, engaged in key public policy processes, and implemented priority areas of work to help advance healthy public policy in the region, including the development of processes, tools, and practices to support a more systematic and rigorous approach to this emerging area of public health practice.

Implications: The creation of this new Healthy Public Policy Unit invites discussion within Canada's public health community on the issue of resource allocation to support upstream interventions seeking to build the capacity and effectiveness of HPP and HiAP approaches.

Objectives: We investigated the prevalence and population attributable fraction (PAF) of 12 potentially modifiable risk factors for dementia in middle-aged and older Canadians.

Methods: We conducted a cross-sectional study of 30,097 adults aged 45 to 85 with baseline data from the Canadian Longitudinal Study on Aging (2011‒2015). Risk factors and associated relative risks were taken from a highly cited systematic review. We calculated the prevalence of each risk factor using sampling weights. Individual PAFs were calculated both crudely and weighted for communality, and combined PAFs were calculated using both multiplicative and additive assumptions. Analyses were stratified by household income and repeated at CLSA's first follow-up (2015‒2018).

Results: The most prevalent risk factors were physical inactivity (63.8%; 95% CI, 62.8-64.9), hypertension (32.8%; 31.7-33.8), and obesity (30.8%; 29.7-31.8). The highest crude PAFs were physical inactivity (19.9%), traumatic brain injury (16.7%), and hypertension (16.6%). The highest weighted PAFs were physical inactivity (11.6%), depression (7.7%), and hypertension (6.0%). We estimated that the 12 risk factors combined accounted for 43.4% (37.3‒49.0) of dementia cases assuming weighted multiplicative interactions and 60.9% (55.7‒65.5) assuming additive interactions. There was a clear gradient of increasing prevalence and PAF with decreasing income for 9 of the 12 risk factors.

Conclusion: The findings of this study can inform individual- and population-level dementia prevention strategies in Canada. Differences in the impact of individual risk factors between this study and other international and regional studies highlight the importance of tailoring national dementia strategies to the local distribution of risk factors.

Objectives: Gestational age at birth (GA) shows an inverse gradient of risk with social-emotional and behavioural outcomes among children born late preterm (≥ 34 and < 37 weeks) and early term (≥ 37 and < 39 weeks). Childcare has the potential to influence this association. This study aimed to estimate the association between GA and social-emotional/behavioural problems among children born between ≥ 34 and < 41 weeks gestation, determine whether this association was modified by childcare use, and describe the relationship between childcare and behavioural and social-emotional functioning at age 5.

Methods: Using data from the All Our Families cohort (n = 1324), logistic regression models were used to model the association between GA and social-emotional/behavioural problems (BASC-2 composite scales at age 5). Models were fit with interaction terms between GA and childcare variables (amount, multiplicity, and type of childcare at age 3) to assess effect modification.

Results: GA showed no significant associations with social-emotional/behavioural problems at age 5, though the type of childcare significantly modified the association between GA and externalizing and internalizing problems. Neither the number of hours spent in childcare (amount) nor the number of childcare arrangements used (multiplicity) modified the association between GA and social-emotional/behavioural problems. However, multiplicity was associated with externalizing behavioural problems (aOR = 2.09, 95% CI 1.14‒3.83).

Conclusion: This study found no significant association between GA and social-emotional/behavioural problems at age 5, though childcare type modified this association. Factors such as using multiple childcare arrangements to meet families' childcare needs have the potential to influence a child's social-emotional and behavioural functioning at age 5.

Objectives: Obstructive sleep apnea (OSA) is a common chronic condition that is often undiagnosed or diagnosed after many years of symptoms and has an impact on quality of life and several health factors. We estimated the Canadian national prevalence of OSA using a validated questionnaire and physical measurements in participants in the Canadian Longitudinal Study on Aging (CLSA).

Methods: The method used individual risk estimation based upon the validated STOP-BANG scale developed for OSA. This stratified population sample spans Canada to provide regional estimates.

Results: In this sample of adults aged 45 to 85 years old, the overall prevalence in 2015 of combined moderate and severe OSA in the 51,337 participants was 28.1% (95% confidence intervals, 27.8‒28.4). The regional prevalence varied statistically between Atlantic Canada and Western Canada (p < 0.001), although clinically the variations were limited. The provincial prevalence for moderate and severe OSA ranged from 27.5% (New Brunswick and British Columbia) to 29.1% (Manitoba). Body mass index (BMI) was the dominant determinant of the variance between provinces (β = 0.33, p < 0.001). Only 1.2% of participants had a clinical diagnosis of OSA.

Conclusion: The great majority (92.9%) of the participants at high risk of OSA were unrecognized and had no clinical diagnosis of OSA.

Objective: To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents.

Methods: We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES).

Results: Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/"prefer not to say" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES.

Conclusion: Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities.