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

{"title":"A national atlas to improve the study of Canadians living with long COVID (post-COVID-19 condition).","authors":"Aisha Ahmad, Naveed Z Janjua, Lisa M Lix, Nahrain Warda, Daryl L X Fung, Anne Bhéreur, Pavlos Bobos, Sara Carazo, Simon Décary, Suzie Goulding, Lorraine Graves, Gary Groot, Douglas P Gross, Kiran Pohar Manhas, Candace D McNaughton, Elham Rahme, Beate Sander, Hind Sbihi, Amol A Verma, Kieran L Quinn","doi":"10.17269/s41997-025-01083-9","DOIUrl":"10.17269/s41997-025-01083-9","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a national atlas of (1) Canadian cohorts studying or with the potential to study adults living with long COVID (LC) and (2) harmonize provincial and territorial administrative datasets to facilitate the creation of validated case-ascertainment algorithms and foster national collaboration on LC research.</p><p><strong>Methods: </strong>We conducted a multifaceted environmental scan that included a comprehensive literature search and a survey of members of Canada's national LC research network between August 21, 2023, and November 10, 2023. We identified provincial and territorial cohorts, including those that were linkable to administrative data and common data elements among administrative datasets.</p><p><strong>Results: </strong>We included 19 Canadian cohorts from five provinces (Alberta, British Columbia, Manitoba, Ontario, and Québec) containing data on over 580,000 adults. The majority of the cohorts measured sociodemographic data (e.g., age, sex) and measures of healthcare use, whereas equity-related measures such as gender, ethnicity, and race were limited. There was wide variability in the definitions of LC used across all cohorts. Comparable population-level administrative data are currently available in Alberta, British Columbia, Manitoba, Ontario, Québec, New Brunswick, Newfoundland and Labrador, Nova Scotia, and Saskatchewan.</p><p><strong>Conclusion: </strong>Canada has a rich repository of LC datasets that are limited by variable definitions of LC and inadequate equity-related measures such as gender, ethnicity, and race. Standardization and diversification of these measures will facilitate efforts to study healthcare use and develop health policy to improve the care of Canadian adults living with LC at a population level.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"402-417"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978021","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":"Exploring the local impacts of heat on mortality: A small-area spatial analysis of Montreal, Toronto, and Vancouver, Canada.","authors":"Matthew Quick, Monica Duong","doi":"10.17269/s41997-025-01086-6","DOIUrl":"10.17269/s41997-025-01086-6","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this study were to quantify the small-area associations between heat and mortality and to characterize the spatial patterns of mortality risks at hot temperatures.</p><p><strong>Methods: </strong>Daily mortality and temperature data were retrieved for the cities of Montreal, Toronto, and Vancouver during the summer months between 2018 and 2022. Spatial distributed lag non-linear models quantified the associations between temperature and mortality at the small-area scale. Heat-mortality hotspots were identified based on the relative risks of mortality at hot temperatures. The spatial patterns of mortality at hot temperatures were described using small-area sociodemographic and environmental characteristics.</p><p><strong>Results: </strong>Hot temperatures were associated with elevated relative risks of mortality in Montreal and Vancouver compared to median summer temperatures. At 95th percentile temperatures, 38% and 18% of areas in Montreal and Vancouver were classified as heat-mortality hotspots, respectively. In Toronto, 95th and 99th percentile temperatures were not associated with elevated relative risks of mortality and no heat-mortality hotspots were identified. In all cities, the relative risks of mortality at hot temperatures were positively correlated with population density and residential instability. Areas with high levels of greenness had lower relative risks in Montreal and Toronto.</p><p><strong>Conclusion: </strong>Understanding the small-area associations between heat and mortality is important for public health programs that aim to reduce the health impacts of extreme heat. The impacts of heat on mortality exhibited considerable spatial variability, and small-area vulnerability was found to be characterized by high population density and high residential instability.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"307-315"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762265","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":"Associations of Indigenous language knowledge and physical, emotional, mental, and spiritual balance among First Nations living on reserve in British Columbia, Canada.","authors":"Brandi Anne Berry, Nicole S Berry, Marianne Ignace, Jeff Reading, Scott Venners","doi":"10.17269/s41997-025-01077-7","DOIUrl":"10.17269/s41997-025-01077-7","url":null,"abstract":"<p><strong>Objectives: </strong>A First Nations perspective on wellness includes physical, mental, emotional, and spiritual balance. Indigenous languages hold cultural knowledge and values that could promote wellness. Language learning is one way that Indigenous peoples may reclaim their cultural identity. We theorize that Indigenous language knowledge is one of multiple cultural activities causally downstream from Indigenous reclamation of culture among other causal precursors.</p><p><strong>Methods: </strong>Our analysis was informed by the results of qualitative interviews with ten Indigenous language learners. We conducted cross-sectional analysis of the First Nations Regional Health Survey (2015-2017) from adults living on First Nations reserves in British Columbia, Canada. Using logistic regression with adjustment for confounding, we estimated associations of Indigenous language knowledge with self-reported physical, mental, emotional, and spiritual balance.</p><p><strong>Results: </strong>In models adjusted for age and sex and compared to those with little or no fluency, among those with intermediate or fluent Indigenous language ability, the odds ratios (95% CI) of being in balance most or all of the time were 1.06 (0.79, 1.42) for physical balance, 1.23 (0.93, 1.62) for mental balance, 1.19 (0.90, 1.58) for emotional balance, and 1.57 (1.18, 2.10) for spiritual balance. In models adjusted for age, sex, and multiple cultural activities, these were 0.94 (0.69, 1.28); 1.05 (0.79, 1.41); 0.99 (0.73, 1.33); and 1.13 (0.82, 1.55) respectively.</p><p><strong>Conclusion: </strong>In age/sex-adjusted models, Indigenous language knowledge acted as a proxy for multiple cultural activities theoretically downstream from reclamation and promoters of cultural wellness. Our results are consistent with First Nations cultural activities promoting spiritual balance in this population.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"251-260"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546076","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":"Emerging use of oral nicotine pouches among Canadian adolescents: Findings from the COMPASS-Quebec study.","authors":"Katelyn Battista, Mikael Piché-Ayotte, Slim Haddad, Anne-Marie Turcotte-Tremblay, Scott T Leatherdale, Richard E Bélanger","doi":"10.17269/s41997-025-01100-x","DOIUrl":"10.17269/s41997-025-01100-x","url":null,"abstract":"<p><strong>Objectives: </strong>Oral nicotine pouches are gaining global popularity as a novel alternative nicotine product. Our objective was to examine nicotine pouch use among a large sample of Québec adolescents, including sociodemographic and health-related risk factors, co-use with cigarettes and e-cigarettes, and risk perceptions.</p><p><strong>Methods: </strong>We surveyed 13,914 Quebec secondary school students as part of the 2024 COMPASS study. Participants answered questions on past-month use of oral nicotine pouches, e-cigarettes, and cigarettes, as well as perceived addictiveness and health risks. Poisson regression was used to examine relative risks for current nicotine pouch use by sociodemographic and health factors, current smoking and vaping status, and risk perceptions. Risk perceptions were compared across nicotine products.</p><p><strong>Results: </strong>Nicotine pouches were the most used alternative nicotine product following e-cigarettes, with prevalence of current use (2.6%) comparable to cigarette smoking (3.0%). Older adolescents, cisgender boys, gender diverse adolescents, academically at-risk youth, and current cigarette and e-cigarette users had higher relative risks for nicotine pouch use. Nearly one-quarter of adolescents were unsure of the health risks of nicotine pouches and 16% did not know whether they were addictive. Lower risk perceptions were associated with increased likelihood of current use.</p><p><strong>Conclusion: </strong>Nicotine pouches are an emerging nicotine product that appear to be gaining popularity among Canadian youth. Given their design features which allow for use in most situations and environments, nicotine pouches have considerable potential to follow the same popularity trajectory as e-cigarettes if not regulated appropriately.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"391-401"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978035","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":"Two decades of change: The evolution of Canadian public health organizations in chronic disease prevention, 2004-2023.","authors":"Katerina Maximova, Gilles Paradis, Elizabeth Holmes, Michelle Halligan, Greg Penney, David L Mowat, Teodora Riglea, Maryam Marashi, Jennifer L O'Loughlin","doi":"10.17269/s41997-026-01188-9","DOIUrl":"https://doi.org/10.17269/s41997-026-01188-9","url":null,"abstract":"<p><strong>Background: </strong>Over the past two decades, Canada's public health system has undergone transformative structural changes that may impact chronic disease prevention (CDP). PHORCAST is a unique national study of CDP organizations in Canada that documents trends in organizational characteristics, funding, and priorities across the public health system.</p><p><strong>Methods: </strong>PHORCAST conducted national censuses of CDP organizations in 2004, 2010, and 2023, including governmental and non-governmental organizations (NGOs) that develop and deliver CDP activities (classified as \"resource\" and \"user\" organizations, respectively). A standardized questionnaire captured organizational characteristics, populations served, staffing, funding, and activities. Descriptive statistics and stratified analyses were used to describe 20-year trends.</p><p><strong>Results: </strong>Data from 258 organizations in 2004 (92% response), 239 in 2010 (90%), and 267 in 2023 (89%) revealed: (i) a shift toward more centralized delivery of CDP activities, with fewer organizations serving local populations and more serving provincial/territorial or national jurisdictions; (ii) a growing role of NGOs, the presence of which increased from 39 to 62% among resource organizations and from 36 to 51% among user organizations; (iii) declining prioritization of CDP especially among governmental user organizations (from 43% in 2004 to 26% in 2023); (iv) reduced reliance on federal/provincial funding and increased reliance on municipal and private sources; (v) persistent gaps in evaluation with only 19-22% of resource organizations reporting adequate staffing or budget; and (vi) a broadened CDP focus, particularly among NGOs, to include mental health and underserved populations.</p><p><strong>Conclusions: </strong>Canada's CDP landscape has become more centralized, increasingly NGO-driven, and financially unstable, with shrinking government prioritization despite rising chronic disease burdens. Strengthening system-wide capacity, evaluation infrastructure, and stable, equity-oriented funding models will be essential for building a resilient and effective CDP system.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534424","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":"A double disadvantage? Immigrant and disability status as predictors of community belonging in Canada.","authors":"David McConnell, Mashrur Kazi","doi":"10.17269/s41997-026-01184-z","DOIUrl":"https://doi.org/10.17269/s41997-026-01184-z","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between immigrant status, disability status, and sense of community belonging in Canada, and to identify sociodemographic factors associated with weaker community belonging among immigrants with disabilities. Given established links between community belonging and health outcomes, this analysis contributes to understanding social determinants of health equity.</p><p><strong>Methods: </strong>We analyzed data from the 2020 General Social Survey (Cycle 35): Social Identity (n = 30,136), using binary logistic regression to assess the associations between immigrant status, disability status, and sense of community belonging. By including an interaction term in the analysis, we examined whether the effect of one social status (e.g., disability) varied across levels of the other (e.g., immigrant status). Subgroup analysis examined predictors of weak community belonging among immigrants with disabilities.</p><p><strong>Results: </strong>Disability was associated with increased odds of reporting weak community belonging, while immigrant status was associated with decreased odds. A significant interaction indicated that the effect of disability was greater among Canadian-born individuals, and the protective effect of immigrant status was greater among those with disabilities (interaction OR = 0.81, CI [.71-.87] p < .001). Findings suggest that young, male, and single immigrants with disabilities may be particularly vulnerable to experiencing a weak sense of community belonging.</p><p><strong>Conclusions: </strong>Sense of community belonging is a key social determinant of health. These findings highlight the need for public health strategies that address how immigrant and disability status jointly shape social inclusion and health equity in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534434","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":"Temporal trends in emergency department opioid prescribing and related harms in Alberta, Canada: A population-based cohort study.","authors":"Jake Hayward, Henry Li, Jessalyn Holodinsky, Kathryn Dong, Grant Innes","doi":"10.17269/s41997-026-01182-1","DOIUrl":"https://doi.org/10.17269/s41997-026-01182-1","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency department (ED) opioid prescribing has been implicated in the opioid crisis, yet Canadian ED prescribing patterns and related harms remain poorly described. We analyzed trends in ED opioid prescribing and adverse outcomes in Alberta, Canada, from 2010 to -2020.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study using linked administrative health data for all Alberta ED visits, 2010-2020. We included discharged patients ≥ 12 years and excluded those with long-term opioid use (LTU) or possible opioid use disorder (OUD; prior opioid-related ED visit, hospitalization, or opioid agonist therapy). We measured opioid dispensations within three 3 days of discharge and adverse events (LTU and possible OUD) within 12 months. Interrupted time series assessed associations between opioid prescribing guidelines (United States (US): March 2016; Canada: May 2017), prescribing rates, and adverse events.</p><p><strong>Results: </strong>Among 12.1 million ED visits, opioids were prescribed in 7.4% overall, rising from 6.8% (2010) to 8.2% (2016), then declining to 7.1% (2020). Of those prescribed opioids, 3.6% developed LTU and 0.12% possible OUD within one 1 year. LTU incidence decreased over time and appeared uncorrelated with prescribing rates, while possible OUD increased steadily. The US guideline release was associated with reduced prescribing; Canadian guidelines had no impact.</p><p><strong>Conclusion: </strong>ED opioid prescribing in Alberta peaked in 2016 before declining. Prescribing rates did not correlate with adverse outcomes (LTU or possible OUD). This decoupling of exposure from outcomes suggests a limited role for ED prescribing in the opioid crisis.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505585","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":"Reach and effectiveness outcomes of the \"I'm Ready\" HIV self-testing program in Black communities in Canada.","authors":"Wale Ajiboye, Jason Lo Hog Tian, Wangari Tharao, Maureen Owino, Lena Soje, Kristin McBain, Amy Ly, Reena Anthonyraj, David Este, Mary Ndung'u, Roger Antabe, Notisha Massaquoi, Lawrence Mbuagbaw, LaRon Nelson, Sean Rourke","doi":"10.17269/s41997-026-01183-0","DOIUrl":"https://doi.org/10.17269/s41997-026-01183-0","url":null,"abstract":"<p><strong>Objectives: </strong>HIV self-testing is a strategy to scale up HIV testing for communities that face significant barriers to facility-based testing services. The I'm Ready program-an integrated technology solution-is an implementation strategy designed to promote the uptake and use of HIV self-testing kits in Canada. The objective of this study is to examine the reach and effectiveness of the I'm Ready program among Black people in Canada.</p><p><strong>Method: </strong>We performed a secondary analysis of data for Black people who participated in the I'm Ready implementation study from June 2021 to Dec 2023. We defined reach as the number and percentage of persons with indications for HIV testing who accessed the intervention and effectiveness as the number and percentage of those who ordered test kits and reported test results through the app. Participants' characteristics and variables of interest were summarized using descriptive statistics.</p><p><strong>Results: </strong>Overall, 3082 (22%-3082/14,071) Black participants accessed the intervention between June 2021 and December 2023. The intervention reached a majority (86%-1846/2141) of Black people with indications for HIV testing who were either first-time testers (38%-824/2190) or had not tested in the previous 1 year (33%-712/2190). Overall, 29% (894/3082) ordered test kits through the app and 31% (274/894) of those who ordered test kits reported their test results. The majority (72%-240/333) of the test results were negative, 26% (87/333) were invalid, and 2% (6/333) of the results reported were positive.</p><p><strong>Conclusion: </strong>The I'm Ready program reached Black people with indications for HIV testing and facilitated the uptake of HIV self-testing. It could be a potential way to increase HIV testing in Black communities in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505534","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":"Improving hospital substance use care from the ground up and from the outside in.","authors":"Maya Lowe, Landon Morty Morton, Eva Burrill, J Mariah Hughes, Emily MacAdam, William Nevers, Jo Parker, Caitlin Sampson, Thomas D Brothers","doi":"10.17269/s41997-026-01154-5","DOIUrl":"https://doi.org/10.17269/s41997-026-01154-5","url":null,"abstract":"<p><strong>Setting: </strong>The Queen Elizabeth II (QEII) Health Sciences Centre in Halifax, Nova Scotia, is an academic, tertiary care hospital that lacked policies related to unregulated substance use, harm reduction, and addiction care. Substance use care was of poor quality and inconsistent, and the community-based standard-of-care was unavailable to hospitalized patients.</p><p><strong>Intervention: </strong>A group of frontline hospital- and community-based healthcare providers, trainees, harm reduction workers, and people with lived experience organized to navigate this \"policy vacuum\". We invited community-based groups and resources into the hospital, developed informal policies and procedures to standardize care, and trained ourselves and others in substance use care best practices.</p><p><strong>Outcomes: </strong>We introduced several harm reduction initiatives from the community-including take-home naloxone kits, needle and syringe distribution, and oral and injectable opioid agonist treatment-without institutional policy support. We drafted our own informal harm reduction policies for the internal medicine inpatient unit, holding a focus group with people with lived experience for feedback and revision. This work contributed to funding for an addiction medicine consultation service and an institutional commitment to implement harm reduction-oriented substance use policies for healthcare settings across the province.</p><p><strong>Implications: </strong>Despite a lack of institutional policies or buy-in from senior leadership, harm reduction measures can be implemented in hospitals from the bottom-up and the outside-in-by healthcare providers organizing, leveraging existing community resources, and listening to people who use drugs. Clinicians at other hospitals could model our collaborative approach to improve care and push their health systems towards institutional change.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492174","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":"Policy recommendations for overdose response hotlines and applications as a harm reduction tool: A commentary.","authors":"William Rioux, Nathan Rider, Jeremy Weleff, Boogyung Seo, Chelsea Shover, S Monty Ghosh","doi":"10.17269/s41997-026-01180-3","DOIUrl":"https://doi.org/10.17269/s41997-026-01180-3","url":null,"abstract":"<p><strong>Setting: </strong>The ongoing drug poisoning crisis continues to cause significant mortality, with a disproportionate number of overdose deaths occurring when individuals use drugs alone. While supervised consumption sites (SCS) have proven effective in reducing overdose fatalities, their impact is limited by geographic, social, and systemic barriers. In response, overdose response technologies have emerged to expand access to life-saving interventions beyond the reach of traditional harm reduction infrastructure.</p><p><strong>Intervention: </strong>Overdose response technologies (e.g., National Overdose Response Service (NORS)) and applications (e.g., Lifeguard App, UnityPhilly) offer real-time monitoring during solitary substance use. Hotlines provide peer-operated support and activate emergency responses if a caller becomes unresponsive, while apps use timers and geolocation to trigger automatic emergency services dispatch. Despite promising early outcomes, these services operate in a fragmented policy landscape without formalized regulatory guidance or implementation best practices.</p><p><strong>Outcomes: </strong>Preliminary data show that services like NORS have successfully prevented overdose deaths; however, published outcomes for most services remain limited. Key areas of priority for standards include the following: ensuring privacy for service, balancing data usage for quality improvement and research, building capacity to further equity of access to healthcare and harm reduction using the virtual platform, standardizing overdose response, and providing appropriate education around the efficacy of services.</p><p><strong>Implications: </strong>To enhance the effectiveness and sustainability of overdose response technologies, a comprehensive policy or standards framework is needed. This includes guidance on data privacy, service equity, public education, capacity-building, and outcome evaluation, laying the groundwork for safer, scalable, and more accessible overdose prevention interventions.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488423","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}