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

{"title":"Experiences with discrimination during pregnancy in Canada and associations with depression and anxiety symptoms.","authors":"Kelsey P Davis, Makayla Freeman, Pariza Fazal, Kristin A Reynolds, Charlie Rioux, Danielle L Beatty Moody, Beatrice Pui-Yee Lai, Gerald F Giesbrecht, Catherine Lebel, Lianne Tomfohr-Madsen","doi":"10.17269/s41997-024-00933-2","DOIUrl":"10.17269/s41997-024-00933-2","url":null,"abstract":"<p><strong>Objectives: </strong>Experiences of discrimination reported during pregnancy are common and are associated with poor mental health and adverse birth outcomes. No Canadian studies have investigated interpersonal discrimination during pregnancy. This study aimed to quantify and identify lived-experiences of discrimination in a Canadian cohort of pregnant individuals, and examine associations with concurrent prenatal anxiety and depression symptoms.</p><p><strong>Methods: </strong>Pregnant individuals from the pan-Canadian Pregnancy During the Pandemic (PdP) study (n = 1943) completed the Everyday Discrimination Scale (EDS), demographic measures and self-report measures of depression and anxiety symptoms. Descriptive statistics and ANCOVA were used to assess prevalence of discrimination and associated mental health outcomes. Open-text responses (n = 189) to a question investigating reasons for discrimination were analyzed using conventional content analysis.</p><p><strong>Results: </strong>Approximately three quarters (72%) of pregnant individuals experienced at least one instance of discrimination during their pregnancy or within the year prior. Pregnant individuals experiencing more frequent and/or more types of discrimination were more likely to identify as non-white, not be partnered, have lower socioeconomic status, and have a pre-pregnancy history of anxiety and depression. The most common attributions for interpersonal discrimination were gender, age, and education/income level. Pregnant individuals who experienced more frequent discrimination and/or more types of discrimination were more likely to report clinically significant symptoms of depression and anxiety (n = 623; 35.2% and 49.1%, respectively) compared to those who reported no discrimination (n = 539; 11.5% and 19.1%, respectively). Conventional content analysis of open-text responses generated the following main themes: (1) personal attributes and sociodemographic characteristics, (2) occupation, (3) the COVID-19 pandemic, (4) pregnancy and parenting, and (5) causes outside the self.</p><p><strong>Conclusion: </strong>Frequent discrimination was associated with more adverse concurrent mental health symptoms. Understanding experiences of discrimination can inform interventions that better address the needs of pregnant individuals and their infants.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"70-85"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512694","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":"Equity-oriented food supports: Learnings from the Nova Scotia COVID-19 pandemic response.","authors":"Valerie Blair, Eleanor Eville, Christine Johnson, Heather Monahan","doi":"10.17269/s41997-024-00929-y","DOIUrl":"10.17269/s41997-024-00929-y","url":null,"abstract":"<p><strong>Setting: </strong>Public health measures enacted during the COVID-19 pandemic significantly impacted Nova Scotians experiencing food insecurity. Public Health (PH), Nova Scotia Health, created a provincial Housing Isolation Program (HIP) which addressed barriers to isolation, including food access, for COVID-19 cases and contacts being followed by PH.</p><p><strong>Intervention: </strong>HIP worked with partners to coordinate and respond to urgent food needs of isolating clients by providing grocery and meal delivery options. HIP also made referrals to government and community partners for income and food supports. This program was intended to minimize the spread of COVID-19 by facilitating isolation while meeting basic needs for people with no other means of support.</p><p><strong>Outcomes: </strong>From December 2020 to March 2022, HIP completed grocery and meal deliveries for 579 clients, 1351 referrals to a provincial Income Support Program, and 231 referrals to external food supports. HIP staff worked with clients to manage potential perceptions of stigma. Challenges reported included the urgency of food needs, lack of social supports, and availability and accessibility constraints in rural communities, as well as difficulty accessing culturally appropriate foods and special diets.</p><p><strong>Implications: </strong>This intervention demonstrates the importance of addressing food insecurity during emergency preparedness, planning, and response. During emergencies, planning and mobilizing food access requires an equity-oriented approach to overcome stigma. Broadly, continued reliance on charitable responses creates significant vulnerability during emergencies and addressing root causes of food insecurity through social policy will provide longer-term protection.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"50-58"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156623","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":"The challenging concept of eradication: A core concept guiding and frustrating public health.","authors":"Arthur Caplan, Nathaniel Mamo","doi":"10.17269/s41997-024-00947-w","DOIUrl":"10.17269/s41997-024-00947-w","url":null,"abstract":"<p><p>The celebrated 1980 announcement that smallpox had been eradicated was made using the following definition of eradication: \"Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts: intervention measures are no longer needed.\" Public health around the world works with this definition of \"eradication,\" setting it as a goal for other infectious disease control programs. The definition is simple. Its application, however, has produced long-running and complex public health campaigns that threaten the commitment of funders, health care providers, and governments. In this paper, the authors demonstrate the disease-specific challenges of eradication through the example of the Global Polio Eradication Initiative (GPEI). While many deem eradication worth its high costs because it is the end of morbidity and mortality from a disease, it does not mean the end of disease control efforts. Public health must be prepared for the possibility of disease reoccurrence in the form of undetected natural reservoirs of disease, lab leaks from stored samples, bioterror attacks using stolen samples, and the synthetic recreation of microbes. This paper clarifies the role of reoccurrence prevention in eradication, calling for its addition in the definition of eradication.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"109-112"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362438","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":"Initiatives to increase breast and cervical cancer-related knowledge, screening, and health behaviours among Black women.","authors":"Camille Williams, Elaine Goulbourne, Elijah Gyansa, Ayan Hashi, Ielaf Khalil, Rumaisa Khan, Patricia Rabel-Jeudy, Ruth Heisey, Aisha Lofters","doi":"10.17269/s41997-024-00953-y","DOIUrl":"10.17269/s41997-024-00953-y","url":null,"abstract":"<p><strong>Setting: </strong>In Canada, racialized and immigrant women are typically under-screened for breast and cervical cancer. Under-screening is linked to numerous barriers to access, including lack of awareness, fear of pain, the stigma of cancer, socio-cultural factors like language, and various socio-economic factors. To address these barriers, our team developed a series of initiatives to promote awareness of breast and cervical health among Black women.</p><p><strong>Intervention: </strong>Building on the development of a breast cancer resource hub for Black women, and in partnership with relevant community organizations, we implemented a series of virtual educational and cancer screening events (two of each thus far). Both event series were targeted towards Black women and tailored to their needs.</p><p><strong>Outcomes: </strong>Each educational event attracted more than 450 attendees and had average attendance times > 1 h. Most (> 87%) survey respondents agreed that an event specifically for Black women helped them feel supported. The 2022 and 2023 screening events provided breast and/or cervical cancer screening for 46 and 48 women, respectively. In both years, most women (> 90% of question respondents) noted that they were (extremely) likely to go for a mammogram or Pap test when next due.</p><p><strong>Implications: </strong>Both event series provided targeted opportunities for Black women to learn about prevention, risk factors, resources, and screening related to women's cancers. It is possible that, over time, such culturally tailored events can reduce or remove the stigmas associated with cancer and decrease differences in cancer-related knowledge and behaviours between racialized and non-racialized groups.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"100-108"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480330","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":"To use or not to use behavioural science evidence in designing health promotion interventions: Identification of targets for capacity building.","authors":"Ariane Bélanger-Gravel, Kim L Lavoie, Sophie Desroches, Tracie A Barnett, Marie-Claude Paquette, Frédéric Therrien, Lise Gauvin","doi":"10.17269/s41997-024-00948-9","DOIUrl":"10.17269/s41997-024-00948-9","url":null,"abstract":"<p><strong>Objectives: </strong>The behavioural sciences provide useful evidence to design effective health promotion interventions, but evidence is infrequently integrated in practice. This study examined associations between theoretical domains framework (TDF) constructs and public health practitioners' use of behavioural science evidence to plan public health actions.</p><p><strong>Methods: </strong>Using a cross-sectional design, a convenience sample of 160 practitioners were recruited from public health agencies across Canada. Respondents completed an online questionnaire assessing TDF constructs and the use of behavioural science theory and approaches (i.e., evidence) in their practice. Logistic regression analyses allowed for identification of factors associated with evidence use and intentions. All analyses were adjusted for sex, years of experience, and type of public health agency.</p><p><strong>Results: </strong>Greater skills (OR_adj = 4.1, 95%CI 1.3, 13.5) and stronger intentions/aligned goals (OR_adj = 9.2, 95%CI 2.3, 36.1) were associated with greater use of behavioural science evidence to plan public health actions. Greater perceived capacity to overcome widespread absence of use of behavioural science evidence in their organization (OR_adj = 7.2, 95%CI 1.7, 30.3) was also associated with greater use. More knowledge (OR_adj = 8.6, 95%CI 1.9, 39.1) and stronger beliefs about consequences (OR_adj = 4.0, 95%CI 1.1, 14.7) were significantly associated with stronger intentions/aligned goals.</p><p><strong>Conclusion: </strong>Findings show that more knowledge, positive attitudes, and stronger perceived competence are associated with greater likelihood of using behavioural science evidence to plan interventions. The use of behavioural science evidence will also require strengthening the norm pertaining to this professional practice in public health organizations.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"146-155"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512696","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":"A prospective study analyzing the use of free public sunscreen dispensers.","authors":"Samuel Farag, Karen Farag, Mélissa Généreux","doi":"10.17269/s41997-024-00946-x","DOIUrl":"10.17269/s41997-024-00946-x","url":null,"abstract":"<p><strong>Setting: </strong>This study evaluates the impact of sunscreen dispensers in increasing sunscreen usage and awareness in Summerside, Prince Edward Island, Canada.</p><p><strong>Intervention: </strong>In June 2022, three touchless sunscreen dispensers offering free Health Canada-approved SPF 30 sunscreen were installed in areas of high pedestrian traffic. A team of four city workers gathered observational data over a 17-day span between July and August 2022.</p><p><strong>Outcomes: </strong>Seven days of monitoring took place at the city ballpark, seven at a children's park, and three at the city beachfront boardwalk. In total, 1202 individuals were observed near the dispensers, of whom 209 utilized the dispensers, yielding a usage rate of 17.4 per 100 persons. The usage rate varied by location, with the children's park recording a higher average (40.0 users per 100 persons), and was also weather-dependent, with increased usage on sunny days (average of 52.2 users per 100 persons). The majority of users were classified with a Fitzpatrick skin type of I or II. The sunscreen bags, designed for 2000 applications, did not require refilling during the observation period. The QR code associated with the dispensers was scanned 14 times.</p><p><strong>Implications: </strong>The findings of this study indicate that installing sunscreen dispensers in public spaces may increase the frequency of sunscreen application. Both the location of the dispensers and the perception of weather conditions seem to impact usage rates.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"140-145"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512692","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":"Acknowledgement of Reviewers of Canadian Journal of Public Health articles, 2024.","authors":"Laura C Rosella","doi":"10.17269/s41997-025-00994-x","DOIUrl":"https://doi.org/10.17269/s41997-025-00994-x","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076546","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":"Implementation and evaluation of a novel community-based urban mobile health clinic in Toronto, Ontario.","authors":"Meghan O'Neill, Robert J Redelmeier, Camilla Michalski, Raymond Macaraeg, Maureen Gans, Alice Schoffel, Lori M Diemert, Luwam Ogbaselassie, Laura C Rosella, Andrew Boozary","doi":"10.17269/s41997-024-00962-x","DOIUrl":"https://doi.org/10.17269/s41997-024-00962-x","url":null,"abstract":"<p><strong>Setting: </strong>Despite Canada's single-payer health system, marginalized populations often experience poor health outcomes and barriers to healthcare access. In response, mobile health clinics (MHCs) have been deployed in several cities across Canada. MHCs are well established in the United States; however, little is known about their role and impact in a country with universal healthcare. We describe the implementation of an urban MHC and early learnings from a mixed methods process and outcome-oriented evaluation.</p><p><strong>Intervention: </strong>In February 2021, Parkdale Queen West Community Health Centre, TELUS Health for Good, and University Health Network's Gattuso Centre for Social Medicine partnered to launch a nurse practitioner‒led, community-based MHC in Toronto, Ontario. The MHC provides low-barrier primary healthcare, harm reduction, and mental health services at five convenient locations.</p><p><strong>Outcomes: </strong>Through an intercept survey (n = 49) and semi-structured interviews (n = 10), we sought to understand the sociodemographic characteristics of clients, their experiences at the MHC, and barriers and facilitators to the MHC in comparison to traditional healthcare settings. Most clients surveyed reported being homeless (61%). Without the MHC, 37% of clients would have accessed care at an emergency department and 18% would not have sought care. Thematic analysis revealed two structural and two relational factors that improved care experiences and care access.</p><p><strong>Implications: </strong>We demonstrate that in a single-payer health system, MHCs alleviate major barriers to care access for marginalized populations. Learnings provide context to the most salient factors influencing clients' decisions to seek care at MHCs and can inform how these outreach models are designed.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980649","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":"Enablers and barriers to public health practice during COVID-19: Perspectives from local public leadership from across Canada.","authors":"Thilina Bandara, Navi Sandhu, Khatira Mehdiyeva, Sarbjeet Singh, Charles Plante, Cory Neudorf","doi":"10.17269/s41997-024-00982-7","DOIUrl":"https://doi.org/10.17269/s41997-024-00982-7","url":null,"abstract":"<p><strong>Objective: </strong>Our study investigates the efforts of local medical health officers during COVID-19 in Canada, with a focus on explicating enabling factors and barriers to effectively respond through local public health efforts.</p><p><strong>Methods: </strong>We conducted 26 semi-structured interviews with local-level public health leadership from across Canada and analyzed the transcripts for salient facilitators and barriers to effective local public health practice using the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>Effective local-level public health practice was facilitated by efforts that potentiated synergistic efforts inside and outside of the public health sector, including trust, buy-in, and ample resources. Barriers to effective practice involved uncertainty associated with governance, human resources, and the complexity of the pandemic itself.</p><p><strong>Conclusion: </strong>Sustained coordinated efforts across organizations together with clear governance mandates are required for robust local emergency management.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958545","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":"Fist fighting and increased mortality post-retirement among National Hockey League players.","authors":"Jordyn Gattie, Mark S Goldberg, Paul J Villeneuve","doi":"10.17269/s41997-024-00972-9","DOIUrl":"https://doi.org/10.17269/s41997-024-00972-9","url":null,"abstract":"<p><strong>Objective: </strong>Fist fighting among hockey players is thought to have long-term impacts on health. Because of methodological concerns of previous studies, we undertook a retrospective cohort study among retired National Hockey League (NHL) players to estimate rates of all-cause mortality according to the cumulative number of fights in their careers.</p><p><strong>Methods: </strong>The cohort comprised male hockey players, excluding goaltenders, who played in the NHL from 1967 to 2022. We compiled their birth and death data, body mass index at entry, and other characteristics of playing. We used the proportional hazards model, with age at retirement as the time axis, to estimate mortality rates through July 31, 2024, in relation to the total number of fights in the NHL. Hazard ratios (HR) were adjusted for body mass index and year starting in the NHL. Mean survival after retirement by fighting status was also computed.</p><p><strong>Results: </strong>Among the 5411 retired players, 407 had died, 2082 (38.5%) never fought, and 759 (14.0%) fought ≥ 30 times. We found a positive linear response between the total number of fights and the risk of mortality: the adjusted HR per 10 fights was 1.04 (95% CI, 1.01, 1.07). Using this estimate, compared to non-fighters, the HR for five fights was 1.02 (95% CI, 1.00, 1.03), and for 50 fights it was 1.20 (95% CI, 1.02, 1.41). The mean loss of survival among those who fought ≥ 10 times compared with ≤ 1 time was 2.5, 2.1, and 1.5 years for those who started playing in 1970, 1980, and 1992, respectively.</p><p><strong>Conclusion: </strong>Our findings suggest that fighting in NHL games increases rates of mortality post-retirement, but that these impacts are substantially less than reported previously. We recommend that the NHL establish standardized methods for collecting fight data to more accurately capture the lifetime fighting history and its associated health impacts for its players.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911064","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}