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

{"title":"Safeguarding against the degradation of Housing First.","authors":"Nick Kerman","doi":"10.17269/s41997-024-00984-5","DOIUrl":"https://doi.org/10.17269/s41997-024-00984-5","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808127","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":"Safer Opioid Supply programs: Hydromorphone prescribing in Ontario as a harm reduction intervention to combat the drug poisoning crisis.","authors":"Rose A Schmidt, Adrian Guta, Nanky Rai, Andrea Sereda, Emmet O'Reilly, Jessica Hales, Gillian Kolla, Carol Strike","doi":"10.17269/s41997-024-00979-2","DOIUrl":"https://doi.org/10.17269/s41997-024-00979-2","url":null,"abstract":"<p><strong>Setting: </strong>The crisis of unregulated fentanyl-related overdose deaths presents a significant public health challenge. This article describes the implementation and evaluation of four Safer Opioid Supply programs (SSPs) in Ontario, one in London and three in Toronto.</p><p><strong>Intervention and implementation: </strong>SSPs aim to curtail overdose fatalities while connecting individuals using drugs to healthcare services. The programs involve a daily dispensed prescription of immediate-release hydromorphone tablets for take-home dosing alongside an observed dose of long-acting opioids like slow-release oral morphine. Implemented within a multidisciplinary primary care framework, these programs emphasize patient-centred approaches and comprehensive health and social support.</p><p><strong>Outcomes: </strong>In our study conducted in 2020/2021, clients and service providers reported that receiving pharmaceutical opioids through these programs improved the clients' health and well-being. The regulated supply was reported to lead to decreases in overdose incidents, use of unregulated substances, and criminalized activities. Increased engagement with healthcare and harm reduction services and improvements in social determinants of health, such as food security, were also reported. Despite these positive outcomes, some implementation challenges, including capacity issues and provider burnout, were described by service providers.</p><p><strong>Implications: </strong>Our findings suggest that the combination of safer supply, wrap-around support, and harm reduction within primary care settings can lead to increased healthcare engagement, HIV/HCV prevention, testing, and treatment uptake, reducing the burden of infectious diseases and overdose risk. SSPs have the potential to meaningfully reduce overdose rates, address the ongoing overdose crisis, and if scaled up, influence population-level outcomes.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808323","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":"Quantitative microbial risk assessment of acute gastrointestinal illness attributable to freshwater recreation in Ontario.","authors":"Henry Ngo, E Jane Parmley, Nicole Ricker, Charlotte Winder, Heather M Murphy","doi":"10.17269/s41997-024-00969-4","DOIUrl":"https://doi.org/10.17269/s41997-024-00969-4","url":null,"abstract":"<p><strong>Objectives: </strong>The burden of disease associated with acute gastrointestinal illness (AGI) in Canada is estimated to be ~ 20 million cases/year. One known risk factor for developing AGI is recreation in freshwater bodies such as lakes. The proportion of cases attributable to freshwater recreation in Canada, however, is currently unknown. The study objective was to estimate the risk of developing AGI from exposure to Giardia, Cryptosporidium, Campylobacter, Escherichia coli O157:H7, norovirus, and Salmonella during freshwater recreation in Ontario, Canada.</p><p><strong>Methods: </strong>A quantitative microbial risk assessment (QMRA) was conducted to estimate the number of AGI cases per 1000 recreational events associated with freshwater recreation. QMRA utilizes four steps: hazard identification, exposure assessment, dose-response modelling, and risk characterization. A probabilistic model was developed using the following inputs accounting for uncertainty and variability: published data on pathogen prevalence and concentration in freshwaters in Ontario (hazard identification), recreator water ingestion volumes (exposure), pathogen-specific dose-response models, and ratios between numbers of infections and symptomatic disease cases to estimate illness risks (risk characterization).</p><p><strong>Results: </strong>The mean estimated AGI risk associated with recreation ranged from 0.8 to 36.7 cases per 1000 swimmers (5th-95th probability interval: 0-226.3 cases/1000) which is in line with previous studies conducted in Lake Ontario, as well as prior QMRAs of freshwater recreation. Upper range predicted values exceeded the Health Canada guideline of less than 20 cases per 1000 recreators.</p><p><strong>Conclusion: </strong>This study shows that QMRA can be used to estimate disease risk in the absence of large-scale epidemiological studies. The results demonstrate a range of risk that is in line with exposure to pristine (low risk estimates) and more contaminated waters (high risk estimates) and capture the potential risk to vulnerable populations.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808126","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":"Building a community of practice to address alcohol harms in Canada: Experience from the Canadian Alcohol Policy Evaluation project.","authors":"Tina R Price, Bryany Denning, Victoria Burns, Amy Hlaing, Jacqueline Deroo, Laura Lee Noonan, Kim Brière-Charest, Angela Haché, Kate Dunn, Marion Waysome McIntyre, Ciana Van Dusen, Patrick Brazeau, Jenna Hopson, Julie McEachern, Kate Johnston","doi":"10.17269/s41997-024-00970-x","DOIUrl":"https://doi.org/10.17269/s41997-024-00970-x","url":null,"abstract":"<p><strong>Setting: </strong>Alcohol is a major cause of health and social costs and harms in Canada. While research and awareness of harms caused by alcohol are on the rise, few transdisciplinary platforms exist that are committed to facilitating bold alcohol policy change to reduce health inequities and improve lives.</p><p><strong>Intervention: </strong>In response to feedback heard during engagement for the Canadian Alcohol Policy Evaluation project, an alcohol policy-focused community of practice (CoP) was launched in January 2022. Webinars, roundtable discussions, working group meetings, networking events, and a digital platform allow practitioners from various sectors (e.g. public health, alcohol regulation and distribution, public safety, justice, non-governmental organizations), researchers, and people with lived/living experience (PWLLE) to connect, share experiences and resources, and build capacity.</p><p><strong>Outcomes: </strong>More than 500 members have joined the CoP from all Canadian provinces and territories, and international jurisdictions. CoP members engage in learning opportunities, contribute to letter-writing campaigns in support of alcohol policy initiatives, and lead a working group focused on alcohol warning labels. Through the CoP, members report gaining and applying new knowledge in their work, while also establishing valuable connections and collaborations that have supported positive change.</p><p><strong>Implications: </strong>This cross-jurisdictional, intersectoral alcohol policy CoP facilitates knowledge sharing, networking, and collaboration among practitioners, policymakers, advocates, and PWLLE, while contributing to public health efforts to prevent alcohol harms. Furthermore, as transdisciplinary approaches continue to be prioritized in research and practice, this CoP offers an example that could be applied to other public health initiatives.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792835","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":"Innovation through collaboration: Identifying opportunities to improve congenital anomalies surveillance in Canada.","authors":"Yonabeth Nava de Escalante, Tanya Bedard, Cora Cole, Kitty Dang, Maya Jeyaraman, Kathryn Johnston, Qun Miao, Lauren Rickert","doi":"10.17269/s41997-024-00949-8","DOIUrl":"https://doi.org/10.17269/s41997-024-00949-8","url":null,"abstract":"<p><strong>Setting: </strong>The burden of congenital anomalies is a significant public health concern. In response to the World Health Organization's recommendations, Canada developed and strengthened congenital anomalies surveillance to build capacity for prevention and optimal health outcomes. Historically, the Public Health Agency of Canada (PHAC) exclusively used hospital discharge data for the Canadian Congenital Anomalies Surveillance System (CCASS). A primary objective of the CCASS is to report prevalence, trends, and factors associated with congenital anomalies in Canada. However, the purpose of hospital discharge data is not for congenital anomalies surveillance; therefore, enhanced local data, which have more complete case ascertainment and additional data quality measures, are necessary.</p><p><strong>Intervention: </strong>Recognizing these significant limitations, PHAC, the provincial and territorial governments, physicians, public health practitioners, and academics collaborated on a project to enhance the CCASS with regional data and expertise. Subsequently, the Government of Canada InfoBase platform will use this enhanced dataset for national reporting.</p><p><strong>Outcomes: </strong>We developed standardized case definitions, a data submission form, and data quality tools, and surveyed programs to describe local congenital anomalies surveillance practice, and to identify barriers and facilitators that impact congenital anomalies surveillance efforts.</p><p><strong>Implications: </strong>This synergistic collaboration across jurisdictions, disciplines, and health care sectors is essential to support Canada's enhanced congenital anomalies surveillance. We identified common themes on funding, operational requirements, data standardization, and legal and privacy considerations from the survey. These themes can be used to inform policy and decision-makers for sustainable congenital anomalies surveillance and to amplify the current momentum.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792836","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 association between medical fitness facility attendance and incident mental disorders.","authors":"Jonathan Tebbi, Ranveer Brar, Alan Katz, Michelle Di Nella, Clara Bohm, Claudio Rigatto, Navdeep Tangri, Sue Boreskie, Carrie Solmundson, Leanne Kosowan, Darlene Lamont, Paul V J Komenda, David Collister, James M Bolton","doi":"10.17269/s41997-024-00971-w","DOIUrl":"https://doi.org/10.17269/s41997-024-00971-w","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the effects of medical fitness facility (MFF) attendance, a proxy for exercise, on the incidence of mental disorders.</p><p><strong>Methods: </strong>This retrospective cohort study linked members at two MFFs in Winnipeg, Canada, to health administrative databases held at the Manitoba Centre for Health Policy population research data repository. Adults aged ≥ 18 years were assigned an index date at MFF membership enrollment between January 1, 2005, and December 31, 2015, and matched to controls based on propensity score weighting. Cox proportional hazards models generated hazard ratios (HR) comparing the MFF group to controls on incident mental disorders (mood and anxiety disorders, substance use disorders, dementia, personality disorders, schizophrenia, and psychotic disorders).</p><p><strong>Results: </strong>There were 15,407 MFF members and 507,400 controls. Attendance at a MFF was associated with a reduced hazards risk of incident substance use disorders (HR = 0.67, 95% confidence interval (CI) 0.62-0.67), psychotic disorders (HR = 0.69, 95% CI 0.60-0.79), personality disorders (HR = 0.63, 95% CI 0.50-0.78), schizophrenia (HR = 0.69, 95% CI 0.52-0.93), and dementia (HR = 0.69, 95% CI 0.64-0.75).</p><p><strong>Conclusion: </strong>Attending a medical fitness facility was associated with a reduced risk of incident mental disorders. Further research in MFFs as preventive initiatives for mental illness is warranted.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787709","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":"Decolonizing urban Indigenous healthcare: The potential of urban reserves.","authors":"Erin Burnley, Patricia Farrugia","doi":"10.17269/s41997-024-00980-9","DOIUrl":"https://doi.org/10.17269/s41997-024-00980-9","url":null,"abstract":"<p><p>The urbanization of Indigenous peoples in Canada has increased substantially during recent decades, with over 44% of Indigenous peoples now residing in urban centres. Despite the urban concentration of healthcare services, Indigenous health outcomes remain significantly worse than non-Indigenous health outcomes for people living in urban centres. The historical and subsisting impacts of colonialism have had a profound negative influence on social determinants of health for Indigenous peoples, resulting in higher rates of chronic disease and mortality. Mistrust of the healthcare system, racial discrimination, and medical paternalism remain barriers to accessing care and diminish the quality of care received. This commentary explores how Indigenous-led health services can improve Indigenous health outcomes and how urban reserves could be used to improve the health of urban Indigenous residents.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774660","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":"Factorial invariance of the Everyday Discrimination Scale among African, Caribbean, Black, and other racialized women living with and without HIV in British Columbia, Canada.","authors":"Charity V Mudhikwa, João L Bastos, Notisha Massaquoi, Allison Carter, Patience Magagula, Elizabeth M King, Hélène C F Côté, Melanie C M Murray, Angela Kaida","doi":"10.17269/s41997-024-00966-7","DOIUrl":"https://doi.org/10.17269/s41997-024-00966-7","url":null,"abstract":"<p><strong>Objectives: </strong>The Everyday Discrimination Scale (EDS) assesses the mistreatment racialized people experience daily. It is widely used in Canadian HIV research to measure racial discrimination among African, Caribbean, and/or Black (ACB), and other racialized women. However, no studies have examined whether the EDS provides valid estimates of racial discrimination that are objectively comparable across racial/ethnic groups or by HIV status in Canada. We aimed to address this gap.</p><p><strong>Methods: </strong>We analyzed EDS data from the British Columbia CARMA-CHIWOS Collaboration study of self-identifying women ≥ 16 years of age living with and without HIV. We conducted confirmatory factor analysis (CFA) by race/ethnicity (ACB; Indigenous; other racialized; white) and also by HIV status to assess validity and reliability of the EDS within these groups. Next, we ran multigroup-CFA (mCFA) to determine whether the EDS measures the same construct to the same extent across race/ethnicity- and HIV status-based groups.</p><p><strong>Results: </strong>Of 504 participants (202 with HIV), 62 were ACB, 152 Indigenous, 90 other racialized, and 200 white. CFA revealed adequate fit within race/ethnicity- and HIV status-based groups-all Cronbach's alpha > 0.9, factor loadings > 0.6, and acceptable fit indices, except for root mean square error of approximation. Residual correlations > 0.4 suggested redundancy between some item pairs. In the mCFA, the EDS was invariant across groups.</p><p><strong>Conclusion: </strong>The EDS provides racial discrimination estimates that are meaningfully comparable across race/ethnicity- and HIV status-based groups. Despite potential redundancy between item pairs that may warrant refinement, the EDS can be included in survey instruments that aim to examine and compare the prevalence and health impacts of racial discrimination among ACB and other racialized women in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774661","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":"Incorporating equity, diversity, and inclusion into the epidemiology and biostatistics curriculum: A workshop report and implementation strategies recommendations.","authors":"Daniel Fuller, Sanja Stanojevic, Gaynor Watson-Creed, Laura Anderson, Natalya Mason, Jennifer Walker","doi":"10.17269/s41997-024-00876-8","DOIUrl":"10.17269/s41997-024-00876-8","url":null,"abstract":"<p><p>There is an obligation among those teaching epidemiology to incorporate principles of equity, diversity, and inclusion (EDI) into the curriculum. While there is a well-established literature related to teaching epidemiology, this literature rarely addresses critical aspects of EDI. To our knowledge, there is no working group or central point of discussion and learning for incorporating EDI into epidemiology teaching in Canada. To address this gap, we convened a workshop entitled \"Incorporating EDI into the epidemiology and biostatistics curriculum and classroom.\" The workshop discussed nine strategies to incorporate EDI in the epidemiology curriculum: positionality (or reflexivity) statements; opportunities for feedback; land acknowledgements; clarifying the purpose of collecting data on race and ethnicity, sex and gender, Indigeneity; acknowledging that race/ethnicity is a social construct, not a biological variable; describing incidence and prevalence of disease; demonstrating explicit bias using directed acyclic graphs (DAGs); critical appraisal of study population diversity; and admission criteria and considerations. Key take-aways from the workshop were the need to be more intentional when determining the validity of evidence, particularly with respect to historical context and the need to recognize that there is no single solution that will address EDI.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"844-850"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864182","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":"Prevalence and regional distribution of obstructive sleep apnea in Canada: Analysis from the Canadian Longitudinal Study on Aging.","authors":"Dorrie Rizzo, Marc Baltzan, Sanjeev Sirpal, James Dosman, Marta Kaminska, Frances Chung","doi":"10.17269/s41997-024-00911-8","DOIUrl":"10.17269/s41997-024-00911-8","url":null,"abstract":"<p><strong>Objectives: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The great majority (92.9%) of the participants at high risk of OSA were unrecognized and had no clinical diagnosis of OSA.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"970-979"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11644135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735623","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}