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

{"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":"https://doi.org/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}

{"title":"Embracing Housing First as a continuum: A response to \"Safeguarding against the degradation of Housing First\".","authors":"Sahar Saeed, Yvonne Tan, Zack Revell, Victoria Wilson, T Hugh Guan, Julie Lambert","doi":"10.17269/s41997-024-00988-1","DOIUrl":"10.17269/s41997-024-00988-1","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"49"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910756","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}

{"title":"Rising out-of-hospital mortality in Canada during 2020‒2022: A striking impact observed among young adults.","authors":"Mukesh Kumar, Jessalyn K Holodinsky, Amy Y X Yu, Candace D McNaughton, Peter C Austin, Anna Chu, Michael D Hill, Colleen Norris, Douglas S Lee, Moira K Kapral, Nadia Khan, Noreen Kamal","doi":"10.17269/s41997-024-00934-1","DOIUrl":"10.17269/s41997-024-00934-1","url":null,"abstract":"<p><strong>Objective: </strong>Out-of-hospital mortality rates surged during the early COVID-19 pandemic. While expecting a return to pre-pandemic levels, the evolving patterns of out-of-hospital mortality in Canada remain uncertain. We investigated whether these rates returned to pre-pandemic levels.</p><p><strong>Methods: </strong>This retrospective study, employing linked administrative data, analyzed out-of-hospital mortality trends among adult residents in Ontario, Alberta, and Nova Scotia. Interrupted time series analysis assessed trends in age- and sex-standardized rates/100,000/quarter during pre-pandemic (April 2014-March 2020) and pandemic periods (April 2020-March 2022), while considering April to June 2020 as the pandemic onset period. Crude mortality rates were also examined, stratified by sex and age groups.</p><p><strong>Results: </strong>Pre-pandemic, Ontario's standardized out-of-hospital mortality rates were rising, while Alberta's and Nova Scotia's remained stable. At the pandemic onset, all provinces experienced significant increases in standardized out-of-hospital mortality rates/100,000 (Ontario: β 14.6, 95% CI [3.97, 25.22]; Alberta: 21.3, 95% CI [9.26, 33.34]; Nova Scotia: 10.5, 95% CI [1.06, 19.88]). During the pandemic, standardized out-of-hospital mortality rates/100,000/quarter remained above pre-pandemic levels, with no significant departure from the increased pandemic onset levels (Ontario: - 1.6, 95% CI [- 3.63, 0.52]; Alberta: 0.45, 95% CI [- 1.47, 2.36]; Nova Scotia: - 0.06, 95% CI [- 2.18, 2.06]). Crude out-of-hospital mortality rates increased most prominently among individuals aged 18 to 45 in Alberta and Ontario, and among males across all provinces.</p><p><strong>Conclusion: </strong>The sustained increase in out-of-hospital mortality, observed from the pandemic's onset, spanning more than 2 years, potentially suggests its persistent direct and indirect effects on population health in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"26-38"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332142","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}

{"title":"Sexual and gender minority youth in Canada: An investigation of disparities in positive mental health.","authors":"Sonia Hajo, Colin A Capaldi, Li Liu","doi":"10.17269/s41997-024-00931-4","DOIUrl":"10.17269/s41997-024-00931-4","url":null,"abstract":"<p><strong>Objectives: </strong>While studies indicate that 2SLGBTQ + youth are more likely to experience negative psychological outcomes compared to their heterosexual and cisgender peers, less is known about the positive mental health (PMH) of 2SLGBTQ + youth in Canada. To fill this gap, we investigated disparities in PMH by self-reported sexual attraction among 15‒17-year-olds and gender modality among 12‒17-year-olds.</p><p><strong>Methods: </strong>We analyzed data from youth respondents in the 2019 Canadian Health Survey on Children and Youth. We obtained estimates of average life satisfaction and high self-rated mental health, happiness, autonomy, competence, and relatedness for youth with an exclusively heterosexual attraction and youth with a minority sexual attraction (those exclusively attracted to the same gender, and those attracted to both females and males), and for cisgender and gender minority youth. Regression analyses were conducted to test for disparities on each PMH outcome.</p><p><strong>Results: </strong>Compared with exclusively heterosexual youth, sexual minority youth reported lower life satisfaction and were less likely to report high self-rated mental health, happiness, autonomy, competence, and relatedness. Significant disparities were more consistently found for youth attracted to both females and males than youth exclusively attracted to the same gender. Gender minority (versus cisgender) youth also reported lower average life satisfaction and were less likely to report high self-rated mental health, happiness, autonomy, competence, and relatedness.</p><p><strong>Conclusion: </strong>Although this study provides evidence for the presence of disparities in PMH, its strength-based focus on PMH also documents the presence of well-being among many sexual and gender minority youth in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"86-96"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332144","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}

{"title":"Association between food security status and dietary patterns in a cohort of first-time food-aid users.","authors":"Emma Teasdale, Geneviève Mercille, Federico Roncarolo, Mylène Riva, Marie-Pierre Sylvestre, Rosanne Blanchet, Louise Potvin","doi":"10.17269/s41997-024-00932-3","DOIUrl":"10.17269/s41997-024-00932-3","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations between food security status and dietary patterns among first-time food-aid users.</p><p><strong>Methods: </strong>From September 2018 to January 2020, a sample of 1001 newly registered food-aid users from 106 community-based food donation organizations were recruited across urban, rural, and peri-urban areas in four administrative regions of the province of Quebec, Canada. The Household Food Security Survey Module (HFSSM) and the Short Diet Questionnaire (SDQ) were used to assess food security status and food intake, respectively. A posteriori dietary patterns were identified through principal component analysis. Regression analyses were performed on 987 participants with complete data to quantify the association between food security status and dietary patterns.</p><p><strong>Results: </strong>Three main dietary patterns were identified: prudent (intake of fruits and fruit juice, plant-based beverages and legumes, green salad, carrots, other vegetables, whole grains, and fish), western (intake of poultry, red meat, potatoes and fried potatoes, rice, and pasta and refined grains), and snack foods (intake of salty snacks, cheese, butter and margarine, sweets, condiments, sweet beverages, and processed meat). Food insecurity was negatively associated with the prudent dietary pattern and positively associated with the snack food dietary pattern.</p><p><strong>Conclusion: </strong>This study highlights the complexity of dietary patterns in a vulnerable population of first-time food-aid users, especially among those who are severely food insecure.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"59-69"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480316","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}

{"title":"Stillbirth rates following the change in definition of fetal mortality in Quebec.","authors":"Golden Welsh, Aimina Ayoub, Marianne Bilodeau-Bertrand, Antoine Lewin, Nathalie Auger","doi":"10.17269/s41997-024-00930-5","DOIUrl":"10.17269/s41997-024-00930-5","url":null,"abstract":"<p><strong>Objectives: </strong>In 2019, Quebec changed its stillbirth definition to include fetal deaths at 20 weeks gestation or more. Previously, the criterion was a minimum birth weight of 500 g. We assessed the impact of the new definition on stillbirth rates.</p><p><strong>Methods: </strong>We conducted a retrospective study of stillbirth rates between 2010 and 2021 in Quebec. The exposure consisted of the period during the new definition versus the preceding period. We assessed how the new definition affected stillbirth rates using interrupted time series regression, and compared the period during the new definition with the preceding period using prevalence differences and prevalence ratios with 95% confidence intervals (CI). We determined the extent to which fetuses at the limit of viability (under 500 g or 20‒23 weeks) accounted for any increase in rates.</p><p><strong>Results: </strong>Stillbirth rates went from 4.11 before the new definition to 6.76 per 1000 total births immediately after. Overall, the change in definition led to an absolute increase of 2.58 stillbirths per 1000 total births, for a prevalence ratio of 1.76 (95% CI 1.61‒1.92) compared with the preceding period. Fetal deaths due to congenital anomalies increased by 6.82 per 10,000 (95% CI 4.85‒8.78), while deaths due to pregnancy termination increased by 10.47 per 10,000 (95% CI 8.04‒12.89). Once the definition changed, 37% of stillbirths were under 500 g and 42% were between 20 and 23 weeks, with around half of these caused by congenital anomalies and terminations.</p><p><strong>Conclusion: </strong>Stillbirth rates increased after the definition changed in Quebec, mainly due to congenital anomalies and pregnancy terminations.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"113-123"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300493","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}

{"title":"Examining the role of industry lobbying on Canadian front-of-pack labelling regulations.","authors":"Jennifer J Lee, Emily R Ziraldo, Hayun Jeong, Mary R L'Abbé","doi":"10.17269/s41997-024-00950-1","DOIUrl":"10.17269/s41997-024-00950-1","url":null,"abstract":"<p><p>Health Canada recently issued a Marketing Authorization to expand the eligibility of the dairy-related exemption for Canadian front-of-pack labelling (FOPL) regulations. The 2024 Marketing Authorization exempts dairy-related products that are a 'source of calcium,' rather than only 'high in' calcium as previously regulated, from displaying a 'High in' front-of-pack nutrition symbol, regardless of their saturated fat and sodium levels. The Marketing Authorization, heavily influenced by the food industry, lacks strong scientific evidence to support its adoption. Although there is a high prevalence of inadequate calcium intakes among Canadians, the Marketing Authorization will exempt more dairy-related products that are significant contributors of saturated fat and sodium for Canadians. While providing very little calcium, many dairy-related products, particularly cheese products, are 'high in' saturated fat and/or sodium. Expanding the exemption criteria will allow dairy-related products with little health benefits to be reflected as 'healthy' (i.e., not display a 'High in' nutrition symbol), blunting the potential impact that FOPL regulations could have on improving the diets of Canadians. We strongly urge Health Canada to reconsider the expansion of the exemption and encourage others to conduct policy-relevant research and participate in the policy decision-making process to promote evidence-informed public health policies for the health of Canadians.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"156-162"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407135","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}

{"title":"Validation of algorithms to identify human immunodeficiency virus cases using administrative data in Manitoba.","authors":"Alexandrea J Anderson, Lisa Lix, Carla Loeppky, Paul Van Caeseele, John A Queenan, Alyson L Mahar","doi":"10.17269/s41997-024-00951-0","DOIUrl":"10.17269/s41997-024-00951-0","url":null,"abstract":"<p><strong>Objective: </strong>Population-based administrative data are valuable for describing human immunodeficiency virus (HIV) cases, and their health status and outcomes. Our objective was to validate algorithms consisting of physician visits, hospitalizations, and antiretroviral prescriptions against positive confirmatory HIV laboratory tests to identify individuals living with HIV.</p><p><strong>Methods: </strong>The primary validation cohort consisted of adult Manitoban residents with at least 3 years of health coverage between 2007 and 2018. Positive confirmatory HIV tests from the provincial laboratory were the reference standard. We evaluated 15 algorithms requiring 2 or 3 years of administrative data (hospital, physician, and prescription records) to ascertain cases. Seven measures of accuracy were estimated: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden's J, kappa, and area under the receiver operating characteristic curve (AUC) and their 95% confidence intervals. Validity was estimated for pregnant females.</p><p><strong>Results: </strong>The primary validation cohort included 966,507 individuals, of whom 1452 (0.2%) were HIV cases. Algorithm sensitivity ranged from 82.8% to 97.5%. PPV ranged from 51.8% to 97.8%. Youden's J ranged from 0.83 to 0.97. Kappa ranged from 0.68 to 0.93. AUC ranged from 0.91 to 0.99.</p><p><strong>Conclusion: </strong>Researchers have a range of algorithms to ascertain HIV cases in administrative data; selection of an appropriate algorithm depends on the user goal. To maximize performance to distinguish HIV cases and non-cases while minimizing data requirements, an algorithm based on three or more physician visits in 2 years is recommended. Further validation in other provinces and territories will assess the generalizability of these findings.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"124-135"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632379","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}