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

{"title":"Decriminalization undone: Assessing the amendment to British Columbia's decriminalization of personal drug possession framework.","authors":"Kelsey A Speed, Kat Gallant, Mathew Fleury, Erica McAdam, Tyson Singh Kelsall","doi":"10.17269/s41997-025-01012-w","DOIUrl":"10.17269/s41997-025-01012-w","url":null,"abstract":"<p><p>The Province of British Columbia (BC) is in the midst of an ongoing public health emergency, declared in 2016 in response to significant levels of drug poisonings/overdoses stemming from the unregulated drug supply. In response, BC implemented decriminalization in 2023, removing criminal sanctions for adults possessing up to 2.5 cumulative grams of opioids, cocaine, methamphetamine, and MDMA. Approximately 15 months later, BC amended their decriminalization framework, effectively re-criminalizing public drug consumption and possession in public spaces across BC to prioritize safety to an undefined \"public\" over the health and safety of people who are structurally marginalized by dominant, intersecting systems of power. This commentary assesses BC's amended decriminalization framework through a public health lens, to examine how this unbalanced prioritization of \"public safety\" (as defined by law enforcement bodies) contributes to health and social inequities. By focusing on the (1) discursive exclusion of members of the public who already endure structural marginalization in the weaponization of \"public safety,\" (2) escalation of efforts to displace these groups from public spaces, and (3) opportunity costs of law enforcement prioritization, we argue that BC's most recent drug policy shift is incompatible with its stated goal of balancing public safety and public health.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive substance use services within primary care settings: The Safer Opioid Supply program at London InterCommunity Health Centre.","authors":"Kaitlin Fajber, Andrea Sereda, Sean Warren, Cassidy Morris, Greg Nash, Bernie Pauly, Karen Urbanoski, Gillian Kolla","doi":"10.17269/s41997-025-01006-8","DOIUrl":"10.17269/s41997-025-01006-8","url":null,"abstract":"<p><strong>Setting: </strong>This paper describes the Safer Opioid Supply (SOS) program, a public health intervention in London, Ontario, in response to the toxic unregulated drug supply which is driving the overdose crisis in Canada.</p><p><strong>Intervention: </strong>The London InterCommunity Health Centre (LIHC) SOS program provides comprehensive harm reduction and primary health care services to individuals at risk of overdose from the toxic drug supply. Clients are prescribed high-dose pharmaceutical opioids as replacement for unregulated toxic substances within a low-barrier primary care clinic, with wraparound interdisciplinary social services, embedded in the Ontario Community Health Centre model of care. The program serves people dependent on street-acquired fentanyl who are experiencing medical issues due to their substance use, and who are experiencing challenges accessing other forms of healthcare.</p><p><strong>Outcomes: </strong>A qualitative analysis of interviews and focus groups conducted in 2022-2023 with staff (n=5) and clients (n=20) was used to explore impacts of the SOS program. Four outcomes are discussed: safer supply as crucial to engage clients in primary care; safer supply as one component of comprehensive care; the use of a harm reduction approach; and challenges with limited medication options and program capacity.</p><p><strong>Implications: </strong>Positive health and social outcomes demonstrate the utility of embedding comprehensive substance use services within a primary health care model to address health and social complexity among people who use drugs amid the continuing toxic drug crisis. Responding to an increasingly volatile unregulated supply of drugs, having limited medication options, and providing comprehensive care without long-term funding remain ongoing challenges.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sur la route des surdoses: un portrait canadien.","authors":"André-Anne Parent, Antoine Bertrand-Deschênes","doi":"10.17269/s41997-025-01001-z","DOIUrl":"10.17269/s41997-025-01001-z","url":null,"abstract":"<p><strong>Objectives: </strong>The overdose crisis continues to grow in Canada, and those involved in intervention must innovate to propose solutions. This exploratory research aims to paint a portrait of the situation, understand prevention efforts, and hear the experiences of people who have lived an overdose and those who intervene in this context.</p><p><strong>Methods: </strong>A qualitative, descriptive-interpretive approach was adopted. Data collection took place in 2021 and 2022 in four Canadian provinces and 11 cities. A variety of data collection methods were used, including a logbook, periods of participant observation, and semi-structured interviews with 39 caregivers, 10 peer caregivers, and 11 service users. A thematic analysis of the material was carried out.</p><p><strong>Results: </strong>Mobilizing Nancy Fraser's critical theory, our results present an inequitable distribution of resources, the exclusion of representation mechanisms, and institutionalized denials of recognition. Several interventions implemented in response to overdoses or transformed to better address the crisis are identified. We situate them according to the recognition and redistribution of solutions, whether more corrective or more radical.</p><p><strong>Conclusion: </strong>Structural reforms aimed at improving the recognition and redistribution of resources are essential if interventions are to retain their innovative potential in the context of the overdose crisis, while being part of a longer-term aim of social transformation.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual identity, child maltreatment, mental health, and substance use among emerging adults aged 18 to 23 years.","authors":"Tracie O Afifi, Ana Osorio, Janique Fortier, Ashley Stewart-Tufescu, Tamara L Taillieu, Julie-Anne McCarthy","doi":"10.17269/s41997-024-00992-5","DOIUrl":"https://doi.org/10.17269/s41997-024-00992-5","url":null,"abstract":"<p><strong>Objectives: </strong>Although past studies have identified sex differences in child maltreatment experiences and poor mental and physical health‒related outcomes, more research is needed to understand child maltreatment among sexual minorities (i.e., those who identify as other than heterosexual) and how child maltreatment and sexual identity are related to depression, anxiety, and at-risk alcohol and cannabis use among emerging adults.</p><p><strong>Methods: </strong>Data were drawn from the longitudinal Well-Being and Experiences (WE) Study collected from 2017 (14 to 17 years) to 2022 (18 to 23 years) from Manitoba, Canada (n = 584). Descriptive statistics and logistic regression models were computed.</p><p><strong>Results: </strong>Compared to heterosexual or straight sexual identity: homosexual, gay or lesbian; bisexual; and different or other identity were associated with an increased likelihood of experiencing child maltreatment, with the most robust relationships for bisexual identity and all child maltreatment outcomes. Indicating \"I don't know\" for sexual identity compared to heterosexual identity was associated with 7.45 increased odds of exposure to intimate partner violence in adjusted models. Bisexual identity compared to heterosexual identity had the most robust association, with increased odds of depression, anxiety, at-risk alcohol use, and at-risk cannabis use. Findings provide some evidence to suggest that trends may be worse for some mental health and substance use outcomes among sexual minorities who also experience child maltreatment.</p><p><strong>Conclusion: </strong>Preventing child maltreatment among all children, including youth identifying as other than heterosexual, is a public health priority. Such efforts will work towards optimizing mental health and reducing substance use in early adulthood.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal mental illness in Ontario (2007-2021): A population-based repeated cross-sectional surveillance study.","authors":"Simone N Vigod, Amreen Babujee, Anjie Huang, Kinwah Fung, Kelsey Vercammen, Jennifer Lye, Susie Dzakpasu, Wei Luo","doi":"10.17269/s41997-024-00987-2","DOIUrl":"10.17269/s41997-024-00987-2","url":null,"abstract":"<p><strong>Objective: </strong>Perinatal mental illness can negatively impact pregnant and postpartum women and gender-diverse birthing persons, their children, and families. This study aimed to describe population-level trends in perinatal mental health service use, including outpatient and acute care contacts, to guide decisions about investments in evidence-based treatment.</p><p><strong>Methods: </strong>In this repeated cross-sectional population-based surveillance study in Ontario, Canada, we measured monthly rates of mental health service use for perinatal people (conception to 1 year postpartum) from January 2007 to December 2021. Event rates were calculated by dividing the number of contacts in a given month by the total eligible perinatal time for that month expressed in per 1000 person-months. Rates by service type (outpatient, acute care), diagnosis, and sociodemographic characteristics, and by history of pre-existing mental illness were also calculated.</p><p><strong>Results: </strong>In total, 22-28% of perinatal people had perinatal mental health service use annually (10-15% in pregnancy, 17-21% in postpartum). Perinatal mental health outpatient care rates decreased initially (2007-2012), stabilized, and then increased after March 2020. Acute care rates were stable from 2007 to 2015, then increased (especially for anxiety and substance/alcohol use disorders). Across all contact types, the highest rates were in postpartum vs. pregnancy, those aged < 25 and > 40 years, non-immigrants, urban-dwellers, and those with pre-existing mental illness.</p><p><strong>Conclusion: </strong>Ensuring rapid access to evidence-based supports and services for perinatal mental illness is essential. Groups with increased need based on sociodemographic and clinical characteristics may benefit from targeted supports and services to ensure optimal treatment and prevent adverse outcomes.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food insecurity and youth suicidal behaviours: Evidence from the Canadian Health Survey of Children and Youth.","authors":"Lilia Lounis, Lovena Jacqdom, Frank J Elgar","doi":"10.17269/s41997-025-00998-7","DOIUrl":"https://doi.org/10.17269/s41997-025-00998-7","url":null,"abstract":"<p><strong>Objective: </strong>Youth suicide, a major cause of death, is linked to poverty and other adverse experiences. Evidence of its association with food insecurity is unclear due to inadequate controls for household income in previous research. This cross-sectional study used independent reports of household income, food insecurity, and suicidal behaviours to examine these associations in a population-based sample.</p><p><strong>Methods: </strong>The 2019 Canadian Health Survey on Children and Youth surveyed 6735 youth (15-17 years), gathering data on sadness/hopelessness, suicidal ideation, and suicide attempts. Adults provided information on household food insecurity using a multi-item scale and about diagnosed mood disorders in youth. Household income data were provided by government tax records. We used Poisson regressions to estimate the relative risk (RR) of each suicidal behaviour attributed to household food insecurity, adjusting for household income and other covariates.</p><p><strong>Results: </strong>Approximately one in five (19.8%) youth experienced marginal (5.2%), moderate (7.9%), or severe (3.3%) food insecurity. Moderate or severe food insecurity was associated with increased risks of sadness/hopelessness, mood disorder, suicide ideation, and suicide attempts (RRs 1.30-2.17) after controlling for household income differences and other covariates. Generally, more severe food insecurity was positively associated with suicide behaviours.</p><p><strong>Conclusion: </strong>Household food insecurity is associated with youth suicidal behaviours, independently of household income. Its underlying pathway to youth mental health includes social and psychological factors that require targeted policy intervention.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel adulterants in unregulated opioids and their associations with adverse events.","authors":"Samuel Tobias, Jennifer Angelucci, Evan Wood, Jane A Buxton, Lianping Ti","doi":"10.17269/s41997-024-00990-7","DOIUrl":"10.17269/s41997-024-00990-7","url":null,"abstract":"<p><strong>Objective: </strong>In recent years, Canada's unregulated drug supply has become permeated by novel adulterants (e.g., fentanyl analogues, benzodiazepines, xylazine). While fentanyl has been shown to be associated with overdose mortality and other non-fatal health outcomes, adverse events (AE) associated with these adulterants remain poorly described. This study seeks to identify whether common adulterants identified through drug checking services are associated with increased prevalence of specific adverse events reportedly experienced by people who use drugs.</p><p><strong>Methods: </strong>Drug checking samples were analyzed using Fourier-transform infrared spectroscopy and immunoassay strips at harm reduction sites in British Columbia. Self-reported AE (e.g., non-fatal overdose, prolonged sedation, seizures) were recorded from individuals who checked opioids post-consumption. Adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI) of AE among common adulterants were calculated using generalized linear models with a Poisson distribution, controlled for presence of other adulterants, expected drug, geographic location, and month.</p><p><strong>Results: </strong>Between February 2022 and May 2024, 80,415 samples were analyzed at community sites. Among eligible samples, 36.1% were expected opioids, 42.2% of which were checked post-consumption. AE were noted among 10.7% of post-consumption opioid drug checks. After adjustment, the presence of benzodiazepines in opioid samples was associated with increased prevalence of any AE (aPR 1.97; 95% CI 1.70-2.27), as was the presence of xylazine (aPR 1.50; 95% CI 1.09-2.07). Considering specific AE, benzodiazepines were associated with increased prevalence of overdose (aPR 2.05; 95% CI 1.68-2.51) and prolonged sedation (aPR 3.35; 95% CI 2.54-4.43).</p><p><strong>Conclusion: </strong>Non-fatal AE associated with unregulated opioids have been largely undescribed. Our findings report specific AE associated with different adulterants in the unregulated opioid supply. With this information, tailored public health interventions and services focused on these adulterants can be developed.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of overdose response hotline use for mental health and fatal overdose prevention.","authors":"Will Rioux, Dylan Viste, Taylor Orr, Nathan Rider, S Monty Ghosh","doi":"10.17269/s41997-024-00981-8","DOIUrl":"10.17269/s41997-024-00981-8","url":null,"abstract":"<p><strong>Objectives: </strong>The overdose crisis remains one of the largest public health issues facing North America to date. Formalized virtual spotting services have gained popularity as a harm reduction intervention, proving early effectiveness in reducing overdose mortality. This study determined the characteristics of individuals who recurrently use one such service, Canada's National Overdose Response Service (NORS).</p><p><strong>Methods: </strong>In this retrospective study, call logs from NORS were analyzed from service inception. Demographics including age, gender, province, community size, substance used, routes of administration, and adverse events were all collected and imputed into a marginal means and rates model to determine the predictors of recurrent service use.</p><p><strong>Results: </strong>A total of 7340 unique calls were included within our analysis. Of those, 1167 (15.8%) reported their gender as male, 3744 (51.0%) as female, and 1329 (18.1%) as gender diverse, and 1100 (14.9%) did not report their gender. In terms of age, 46 (0.6%) were individuals under the age of 18 years, 3561 (48.5%) were between 18 and 30, 557 (7.6%) were between 31 and 40, 2505 (34.1%) were between 41 and 50, 525 (7.1%) were age 51 or over, and 146 (2.0%) did not report their age. Men's rate ratios for recurrent calls were significantly lower than women's (RR = 0.08, 95% CI = 0.07‒0.09), as were those for respondents aged 31‒40 years as compared with those aged 18‒30 (RR = 0.26, 95% CI = 0.15‒0.45). Between regions, rate ratios for callers from British Columbia (RR = 0.28, 95% CI = 0.17‒2.24) and Atlantic provinces (RR = 0.09; 95% CI = 0.07‒0.12) were significantly lower than those for callers from the province of Ontario. Similarly, rural callers demonstrated lower recurrent service use (RR = 0.08; 95% CI = 0.07‒0.11) than their urban counterparts.</p><p><strong>Conclusion: </strong>NORS demonstrates higher usage patterns within certain demographic groups, in particular, urban women. The results can therefore be used to target public health messaging toward those who derive the most benefit from the service and to tailor programming to those who are at highest risk to use alone.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promises and perils of a free rural inter-city transportation scheme: A mixed-methods study from Northern Saskatchewan.","authors":"Jacob Albin Korem Alhassan, Daniel Fuller, Ron Woytowich","doi":"10.17269/s41997-024-00986-3","DOIUrl":"https://doi.org/10.17269/s41997-024-00986-3","url":null,"abstract":"<p><strong>Objective: </strong>Transportation is a critical health determinant, yet the last decade has witnessed rapid disinvestment across Canada (particularly in rural contexts) with negative health consequences. We sought to explore and describe the benefits and challenges faced in operating the first community-driven free-transportation scheme in Saskatchewan that emerged in response to widespread unavailability of public transportation due to budget cuts (austerity).</p><p><strong>Methods: </strong>We conducted a mixed-methods community-based participatory research study involving 22 interviews with bus riders and service administrators. We also performed descriptive statistics and chi-squared analyses on bus rider data (data on 1185 trips routinely collected between July 2023 and December 2023) to explore sociodemographic characteristics and trip purposes of bus riders.</p><p><strong>Results: </strong>All trips were completed by 616 community members using the free bus service between July 2023 and December 2023. Community members took an average of 5 trips (median = 2.0) with a maximum of 22 trips being taken by one community member (1.9% of all trips). Most trips were by women (53%), and older adults mostly used the free bus for medical purposes (22% of riders were older adults and 34% of these used the bus for medical reasons). Qualitatively, the bus service has increased access to care and promotes social participation and autonomy, especially for older adults. The service however faces some challenges, including funding disruptions and difficulty recruiting and retaining drivers.</p><p><strong>Conclusion: </strong>Free inter-community transportation (i.e. transportation across cities and municipalities) promotes health equity and access. In contexts without access to public transportation, governments could support community-driven initiatives through increased funding.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation to stabilization: A Housing First approach to address homelessness in Kingston, Ontario.","authors":"Yvonne Tan, Zack Revell, Victoria Wilson, T Hugh Guan, Julie Lambert, Sahar Saeed","doi":"10.17269/s41997-024-00936-z","DOIUrl":"10.17269/s41997-024-00936-z","url":null,"abstract":"<p><strong>Setting: </strong>Homelessness is a significant and growing public health concern across Canada. In Kingston, Ontario, the number of people experiencing chronic homelessness has more than doubled from 136 people in 2020 to 296 in 2023.</p><p><strong>Intervention: </strong>An emergency shelter-in-place hotel program was established in April 2020 to provide non-congregate shelter to people experiencing homelessness and vulnerable to SARS-CoV-2 infections. Beyond preventing COVID transmission, the unintentional consequence was that a population that experienced chronic homelessness reduced drug consumption and became stable. In 2022, with increased funding from the Ministry of Health and the City of Kingston, a new Housing First program was implemented to transition individuals from homelessness to long-term stable housing.</p><p><strong>Outcomes: </strong>Between November 2022 and June 2023, a total of 34 clients initiated the program. Of these clients, 10 completed the program and were successfully housed, 10 remained active participants, and 14 were discharged before completion. Strengths and challenges were identified. Diverse services provided to meet the population's needs and strong collaborations with various community partners were facilitating factors. Inadequate external resources, a lack of evening and prosocial activities, and outside peers (not part of the program) who influenced recovery plans were identified as challenges.</p><p><strong>Implications: </strong>This program illustrates that simultaneously integrating housing, community building, mental health, and addiction services is possible and provides an innovative way to stabilize this vulnerable population of people experiencing homelessness. Results from this program and the knowledge generated through implementation are being used to further scale up the program.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"39-46"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}