Canadian Journal of Public Health最新文献

{"title":"Responding to Pandemic Influenza","authors":"Laurie A. Doxtator, Charles Gardner, J. Medves","doi":"10.1007/BF03403630","DOIUrl":"https://doi.org/10.1007/BF03403630","url":null,"abstract":"","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"29 1","pages":"27 - 31"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72800760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS: Lessons Learned from a Provincial Perspective","authors":"C. D'cunha","doi":"10.17269/CJPH.95.467","DOIUrl":"https://doi.org/10.17269/CJPH.95.467","url":null,"abstract":"To say that SARS was a unique threat, and one that challenged public health and the entire health system in Ontario could be viewed as somewhat of an understatement. Never had the modern public health or the health care system been put to such a test or been put under such pressure to respond as during the two phases of SARS outbreaks earlier this year. The very uniqueness and stress that the SARS outbreaks placed on our system inevitably revealed the weaknesses and the areas where change or fortification in our public health defenses was needed in order for us to meet successfully future challenges. In Ontario, public health services are delivered locally by 37 public health units. Funding for public health services in Ontario is based on a mixed model with municipal and provincial partners contributing to the funding. While funding is referred to as “50/50”, in actual fact, the Province matches the municipal contribution, and goes further. An additional 10-15% of funding is made available through the Community Reinvestment Fund to offset the increase in municipal costs over the base year. The total funding for the public health sector has gone up by 55% over 5 years. SARS provides an opportunity for a re-examination of the funding arrangement as some local health units have had difficulty in obtaining funding at the municipal level. The absence of surge capacity, locally, provincially and nationally, in public health infrastructure came to the forefront during the outbreak. While many individuals volunteered for the response, other public health functions that they were engaged in had to be put on the back burner. The area of public health human resources has been the subject of many studies since 2001. Creating extra capacity takes time as public health professionals take a few years to train. For instance, a fully qualified public health nurse takes 4 years to train, a public health inspector 4 years, a public health physician 5 years post graduation. Therefore aggressive investment and strategic planning is needed to meet public health human resource needs. A cadre of trained communicable disease investigators has to be nurtured and made available for deployment on an ongoing basis. Other public health professionals should be cross-trained in communicable disease management to create additional surge capacity. Epidemiological training is offered nationally through Health Canada. 1 During the outbreak, the immigrant health resources pool was used successfully. The vast majority of the two provincial rapid response teams assembled were international medical graduates at differing stages on the pathway to qualifying as physicians in Ontario/Canada. Some of these individuals are now considering public health as a career. In Ontario, the information technology system in place since the late 1980s was the Reportable Disease Information System (RDIS). 2 Nothing came of the efforts of a steering committee who undertook to modernize this system in th","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"103 1","pages":"25 - 26"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76126447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in the Influence of Economic, Lifestyle, and Psychosocial Factors on Later-life Health","authors":"Steven G. Prus, E. Gee","doi":"10.17269/CJPH.94.349","DOIUrl":"https://doi.org/10.17269/CJPH.94.349","url":null,"abstract":"BackgroundGender differences in exposure to social resources play a significant role in influencing gender inequalities in health. A related question — and our focus — asks whether these inequalities are also influenced by gendered vulnerabilities to social forces. Specifically, this paper examines the differential impact of social forces on the health of elderly (65+) men and women.MethodsMultiple linear regression analysis is used to estimate gender differences in the influence of socioeconomic, lifestyle, and psychosocial factors on both self-rated health and overall functional health using data from the 1994–1995 National Population Health Survey.ResultsKey findings include: 1) the relationship between income and health is significant for older women only, whereas the converse holds for education; 2) having an acceptable body weight is positively associated with health for elderly women only; and 3) stress-related factors are stronger determinants of health for older women.InterpretationOur findings shed light on the processes of healthy aging for men and women, and suggest that interventions to improve the health of elderly Canadians need to be gender-specific.RésuméContexteLes différences dans l’exposition des hommes et des femmes aux ressources sociales influencent beaucoup les inégalités entre les sexes en matière de santé. Une question liée — celle qui nous intéresse — est de savoir si ces inégalités sont aussi influencées par la vulnérabilité différente des hommes et des femmes aux forces sociales. Plus précisément, nous analysons ici les répercussions différentes des forces sociales sur la santé des hommes et des femmes âgés (65 ans et plus).MéthodePar analyse de régression linéaire multiple et à l’aide des données de l’Enquête nationale sur la santé de la population (1994–1995), nous avons estimé les différences entre les sexes dans l’influence des facteurs socio-économiques, psychosociaux et du mode de vie sur l’état de santé auto-évalué et sur la santé fonctionnelle globale.RésultatsNos principales constatations sont les suivantes: 1) la relation revenu-santé n’est significative que pour les femmes âgées, mais c’est l’inverse pour la relation instruction-santé; 2) un poids acceptable est positivement associé à la santé, mais chez les femmes âgées seulement; et 3) les facteurs liés au stress sont des déterminants de la santé qui jouent davantage chez les femmes âgées.InterprétationCes constatations éclairent en partie les processus de vieillissement en santé chez les hommes et les femmes et portent à croire que les mesures d’amélioration de la santé des personnes âgées au Canada doivent tenir compte du sexe.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"16 1","pages":"306-309"},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86872930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Varicella Vaccine","authors":"F. P. de Courval, G. De Serres, B. Duval","doi":"10.17269/CJPH.94.348","DOIUrl":"https://doi.org/10.17269/CJPH.94.348","url":null,"abstract":"BackgroundIn Canada, varicella vaccine is recommended but its uptake has been low. In contrast to most other recommended paediatric vaccines, this one is not currently provided free of charge in all provinces and territories in Canada.ObjectiveTo evaluate the rate of health care provider offer of varicella vaccine to parents and the most important determinants of parental decision to accept the offer.MethodsA structured questionnaire was administered by phone interview to parents of children aged 14 to 17 months in the Quebec City area where the vaccine is not publicly funded.ResultsAmong the 477 participants, 37% had been offered the vaccine by their health care provider: 45% when the provider was a paediatrician and 29% for general practitioners or public health clinics. Only 13% of offers included information on the risk of varicella complications, the cost, efficacy and safety of the vaccine. By decreasing order of importance, the factors that positively increased parental decision to use varicella vaccine included: information on vaccine safety, a positive recommendation and a higher family income.ConclusionDespite a recommendation for universal vaccination, varicella vaccine is not broadly offered and few offers contain all the information both needed to elicit proper consent and correlated with a positive uptake.RésuméIntroductionAu Canada, le vaccin contre la varicelle est recommandé, mais la couverture vaccinale est faible. À la différence de la plupart des autres vaccins pédiatriques recommandés, ce vaccin n’est pas actuellement offert gratuitement dans toutes les provinces et territoires du Canada.ObjectifL’objectif de cette étude était d’évaluer la proportion de parents s’étant fait offrir ce vaccin par leur vaccinateur et de déterminer les facteurs les plus importants dans la décision parentale d’accepter une telle offre.MéthodeLors d’entrevues téléphoniques, un questionnaire standardisé a été administré aux parents d’enfants âgés de 14 à 17 mois de la région de Québec, où le vaccin n’est pas payé par un programme public.RésultatsParmi les 477 participants, 37 % s’étaient fait offrir le vaccin par leur vaccinateur: 45 % lorsqu’il s’agissait d’un pédiatre et 29 % pour les omnipraticiens ou dans les cliniques publiques. Seulement 13 % des offres présentaient des informations sur les risques de complications de la varicelle, le coût, l’efficacité et l’innocuité du vaccin. En ordre décroissant d’importance, les facteurs qui favorisaient la décision des parents de faire vacciner leur enfant contre la varicelle étaient: l’information sur l’innocuité du vaccin, une forte recommandation du vaccinateur et un revenu familial relativement élevé.ConclusionMalgré une recommandation de vaccination universelle, le vaccin contre la varicelle n’est pas largement offert, et peu d’offres présentent toutes les informations nécessaires pour obtenir un consentement éclairé et qui sont associées à un meilleur taux de vaccination.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"40 1","pages":"268-271"},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80506899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Health: Five Reasons Why Canadians Should Get Involved","authors":"M. Rekart, J. Rekart, D. Patrick, R. Brunham","doi":"10.1007/BF03403546","DOIUrl":"https://doi.org/10.1007/BF03403546","url":null,"abstract":"","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"1 1","pages":"258-259"},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83420049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal Behaviours Among Adolescents in Northern Nova Scotia","authors":"JianLi Wang, J. Hughes, G. Murphy, J. Rigby, D. Langille","doi":"10.17269/CJPH.94.435","DOIUrl":"https://doi.org/10.17269/CJPH.94.435","url":null,"abstract":"Objectives: To estimate the 12-month prevalence of suicidal behaviours by gender and to investigate the gender-specific factors associated with suicidal behaviours and to describe health service utilization by suicidal adolescents.Methods: This was a cross-sectional study. The baseline data of the Adolescent Health Study conducted in northern Nova Scotia were used.Results: Female students were more likely to report suicidal behaviours than male students (p<0.005). There was no gender difference in injurious suicide attempts. Depression was the strongest risk factor for suicidal behaviours in the two genders (p<0.005). Female students who reported drug use and living in a non-intact family were at higher risk of suicide attempts. Low self-esteem was positively associated with suicidal ideation and suicide planning among male students. Suicidal girls were more likely to seek professional help for emotional disturbance than boys. Family doctors were the most frequently contacted professional by suicidal adolescents.Conclusions: Some factors associated with suicidal behaviours among adolescents may be gender specific. Suicidal behaviours have been considered a depressive symptom. Most suicidal students, however, had not contacted a health professional for an emotional problem in this population. This presents challenges for prevention of suicidal behaviours among adolescents.RésuméObjectifs: Estimer la prévalence sur 12 mois des comportements suicidaires selon le sexe, étudier les facteurs propres à chaque sexe associés à ces comportements et décrire l’utilisation des services de santé par les adolescents suicidaires.Méthode: Étude transversale fondée sur les données de référence d’une étude sur la santé des adolescents menée dans le nord de la Nouvelle-Écosse.Résultats: Les élèves de sexe féminin étaient plus susceptibles que les élèves de sexe masculin de mentionner des comportements suicidaires (p<0,005). Il n’y avait aucune différence entre les sexes dans le nombre de tentatives de suicide avec blessures. La dépression était le principal facteur de risque de comportement suicidaire chez les deux sexes (p<0,005). Les filles qui disaient consommer des drogues et vivre dans une famille dissociée couraient un risque plus élevé de commettre des tentatives de suicide. La faible estime de soi était positivement associée aux idées suicidaires et aux projets de suicide chez les garçons. Les filles suicidaires étaient plus susceptibles que les garçons de chercher de l’aide professionnelle pour leurs troubles affectifs. Les médecins de famille étaient les professionnels les plus souvent contactés par les adolescents suicidaires.Conclusions: Certains facteurs associés aux comportements suicidaires chez les adolescents peuvent être propres à l’un ou l’autre sexe. On considère les comportements suicidaires comme un symptôme de dépression. Dans la population à l’étude, cependant, la plupart des élèves suicidaires n’avaient pas contacté un professionnel de la sa","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"65 1","pages":"207-211"},"PeriodicalIF":0.0,"publicationDate":"2003-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85147096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and Barriers to Cervical Cancer Screening Among Chinese Canadian Women","authors":"T. Hislop, Michele Deschamps, C. Teh, Carey J. Jackson, Carey J. Jackson, S. Tu, S. Tu, Yutaka Yasui, Stephen M. Schwartz, Stephen M. Schwartz, A. Kuniyuki, Vicky M Taylor, Vicky M Taylor","doi":"10.17269/CJPH.94.365","DOIUrl":"https://doi.org/10.17269/CJPH.94.365","url":null,"abstract":"Background: Chinese Canadian women have higher cervical cancer incidence, and lower Pap testing, rates than the general Canadian population. Predisposing, enabling and reinforcing factors associated with ever having a Pap test, and having a recent Pap test within the last 2 years, were assessed in Chinese women in British Columbia using the PRECEDE-PROCEED model.Method: Chinese women (n=512) between the ages of 20 and 79 years and residing in Greater Vancouver were interviewed about Pap testing, health care, traditional health beliefs, acculturation and sociodemographic characteristics. Two analyses were done, comparing women who had ever and never had a Pap test, and comparing women who had and had not received a recent Pap test. Focus groups and qualitative interviews ensured cultural sensitivity in the survey questionnaire.Results: Seventy-six percent reported ever having a Pap test and 57% reported having a Pap test within the last 2 years. Traditional health beliefs were not associated with ever or recent Pap testing. However, belief that Pap testing prevented cancer and general knowledge about the Pap test were associated with screening. Concern about pain/discomfort with the test, availability of time, culturally sensitive health care services and recommendation for Pap testing by a physician were also associated with screening. Factors differed for ever, and recently, having a Pap test.Interpretation: Pap testing is less common among Chinese Canadian women. Continuing education about Pap testing is recommended for physicians serving underscreened Chinese women. Culturally and linguistically appropriate educational materials are needed for the Chinese community.RésuméContexte: La proportion des Canadiennes d’origine chinoise qui se soumettent au test de Papanicolaou est plus faible, et les taux d’incidence du cancer du col de l’utérus sont plus élevés que dans la population canadienne en général. Nous avons utilisé le modèle PRECEDE/PROCEED pour évaluer la relation entre les facteurs de prédisposition, d’incitation et de renforcement et le fait d’avoir ou de ne pas avoir subi un test de Papanicolaou au cours des deux dernières années, chez les Canadiennes d’origine chinoise de la Colombie-Britannique.Méthode: Nous avons mené des entrevues auprès de femmes d’origine chinoise (n=512) âgées de 20 à 79 ans qui habitent la région métropolitaine de Vancouver. Les questions ont porté sur le test de Papanicolaou, les soins de santé, les croyances traditionnelles en matière de santé, l’acculturation et les caractéristiques socio-démographiques. Nous avons ensuite établi une première comparaison entre les femmes qui ont déjà subi un test de Papanicolaou et celles qui ne l’ont jamais subi, et une deuxième entre celles qui ont ou qui n’ont pas subi le test récemment. Des groupes échantillons et des entretiens en profondeur ont permis de s’assurer que le questionnaire d’enquête prenait en compte les réalités culturelles.Résultats: Parmi les femmes inte","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"101 1","pages":"68-73"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85459669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate Partner Violence and Health","authors":"Jocalyn P Clark, Janice Mont","doi":"10.17269/CJPH.94.362","DOIUrl":"https://doi.org/10.17269/CJPH.94.362","url":null,"abstract":"Objective: The Canadian Public Health Association, along with other professional organizations, has identified intimate partner violence (IPV) as a priority health issue to which the health professions must respond. This study synthesizes Canadian studies on the prevalence of IPV against women, focusing in particular on the stated implications for women’s health and health care.Methods: Medical and social science databases were searched for all articles pertaining to IPV in Canada for 1974 through September 2000. Reference lists of these and other related publications were consulted to supplement the literature review. Data on study characteristics, methods, and results were extracted by two independent reviewers. Discrepancies were resolved by consensus.Results: Sixteen studies were identified in this review, 11 population-based and 5 conducted in clinical settings. Age, ethnicity, and socioeconomic status were not consistently documented, making comparisons and evaluations of generalizability difficult. Annual prevalence of IPV in Canada was found to range from 0.4% to 23%, with severe violence occurring from 2% to 10% annually. Less than two fifths (37.5%) of the studies incorporated a health-related measure.Interpretation: This review reveals a paucity of Canadian prevalence data on IPV, marked by design and methodological issues. Poor quality data may pose a challenge to articulating and establishing a coordinated health care response to eliminating IPV in Canada.RésuméObjectif: L’Association canadienne de santé publique, comme d’autres organisations professionnelles, considère la violence entre partenaires intimes (VPI) comme une question prioritaire pour les professionnels de la santé. On fait ici une synthèse des études canadiennes sur la prévalence de la VPI à l’endroit des femmes, surtout dans l’optique de ses conséquences énoncées sur la santé des femmes et sur les soins de santé qu’elles reçoivent.Méthode: On a répertorié dans les bases de données médicales et de sciences sociales canadiennes tous les articles sur la VPI au Canada de 1974 à septembre 2000. Pour compléter l’enquête bibliographique, on a consulté les listes de référence de ces articles et de publications connexes. Deux examinateurs indépendants ont extrait des données sur les caractéristiques, les méthodes et les résultats des études et se sont concertés là où leurs constatations différaient.Résultats: L’examen a permis de trouver 16 études, dont 11 études représentatives et cinq réalisées dans des conditions cliniques. L’âge, l’appartenance ethnique et le statut socio-économique n’y étaient pas documentés systématiquement, ce qui a compliqué le travail de comparaison et d’évaluation de la généralisabilité. Selon les constatations, la prévalence annuelle de la VPI au Canada varie entre 0,4 % et 23 %, et celle de la violence grave, entre 2 % et 10 %. Moins des deux cinquièmes des études (37,5 %) intégraient une mesure de la santé.Interprétation: Cet examen témoigne de la","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"4 1","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74656055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saskatchewan Public Health Nursing Survey","authors":"Bonnie M. Schoenfeld, M. Macdonald","doi":"10.17269/CJPH.93.391","DOIUrl":"https://doi.org/10.17269/CJPH.93.391","url":null,"abstract":"Objective: To explore perceived roles and activities of Saskatchewan public health nurses (PHNs).Methods: This replication study surveyed Saskatchewan PHNs using the instrument developed by the Hamilton-Wentworth Social and Public Health Services Division in a 1992 survey of Ontario PHNs. This instrument is based on the roles and activities for community/public health nurses described by the Canadian Public Health Association (1990). Descriptive statistics were used to analyze the 124 responses received.Results: Most of the nurses perceived that they were at least somewhat prepared for all of the roles. The activities of: caring for individuals and families; immunizing; educating individuals, families, and groups; acting as a resource person for clients and lay helpers; linking those needing services to appropriate community resources; and using marketing strategies were carried out most often by PHNs. Activities within the roles of community developer, policy formulator, researcher and evaluator, and resource manager/planner/coordinator were carried out to a much lesser degree. The roles and activities being done less often were also the ones PHNs felt less prepared to do.Interpretation: It is important, as health authorities begin to support a more preventive approach to health care, that PHNs are competent in the roles outlined by the Canadian Public Health Association. As well as preparing new graduates for these roles, it is essential to provide continuing education for practicing PHNs. Public health administrators must also support public health nurses in carrying out these roles.RésuméObjectif: Analyser les rôles et les activités perçus des infirmières et des infirmiers de la santé publique de la Saskatchewan.Méthodes: Nous avons mené un sondage auprès des infirmières et des infirmiers de la santé publique de la Saskatchewan en reprenant un instrument élaboré par la Direction des services sociaux et de la santé publique de Hamilton Wentworth en 1992 pour un sondage auprès des infirmières et des infirmiers de la santé publique de l’Ontario. Cet instrument s’inspirait des rôles et des activités des infirmières et des infirmiers communautaires et de la santé publique décrits par l’Association canadienne de santé publique (1990). Nous avons utilisé des données descriptives pour analyser les 124 réponses reçues.Résultats: La plupart des infirmières et des infirmiers percevaient qu’ils étaient au moins quelque peu préparés pour tous les rôles. Les activités le plus souvent exercées par les infirmières et les infirmiers de la santé publique étaient les soins aux personnes et à leurs familles, l’immunisation, la sensibilisation de particuliers, de familles et de groupes, le rôle de personne-ressource auprès des clients et des assistants non qualifiés professionnellement, l’aiguillage de la clientèle vers les ressources communautaires appropriées et l’utilisation de stratégies de marketing. Les activités de développement communautaire, de formulati","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"14 1","pages":"452-456"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88442547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle Exchange Programs","authors":"C. Strike, Laurel Challacombe, T. Myers, M. Millson","doi":"10.17269/CJPH.93.337","DOIUrl":"https://doi.org/10.17269/CJPH.93.337","url":null,"abstract":"Objective: Examine the challenges of four service delivery models (i.e., fixed, mobile, satellite and home visits) and how service delivery may impact on NEP HIV prevention efforts.Methods: Using a modified ethnographic approach, semi-structured interviews concerning policies and procedures were conducted with staff (n=59) of NEPs (n=15) in Ontario. An iterative, inductive analytic process was used.Results: According to workers and managers, effectiveness of NEP prevention efforts depend on client development and retention and service design. Fixed and satellite sites, home visits and mobile services provide varied levels of temporal and spatial accessibility. Combining modes of delivery can offset the disadvantages of individual modes.Discussion: NEP evaluations that do not consider service and resource factors run the risk of concluding that NEPs are ineffective when it may be that the program works for a small proportion of IDUs whom the NEP has the resources to serve.RésuméObjectif: Nous avons examiné les défis de quatre modes de prestation de services (service fixe, mobile et par satellite et visites à domicile) et leurs incidences possibles sur les efforts de prévention du VIH des programmes d’échange de seringues (PES).Méthode: Selon une démarche ethnographique modifiée, nous avons mené des entretiens semidirectifs avec 59 employés de 15 PES ontariens à propos des politiques et méthodes de ces PES, puis effectué une analyse itérative et inductive.Résultats: Aux dires du personnel et des cadres, l’efficacité des efforts de prévention des PES dépend de l’élargissement et du maintien de leur clientèle et du mode de prestation choisi. L’accessibilité aux services, dans l’espace et dans le temps, varie selon qu’ils sont offerts au moyen d’installations fixes, mobiles ou par satellite ou lors de visites à domicile. En combinant plusieurs modes de prestation, on peut compenser leurs inconvénients respectifs.Discussion: Les évaluations des PES qui font abstraction des différences dans les services et les ressources risquent de conclure à l’inefficacité de certains programmes, alors qu’ils peuvent donner des résultats pour la faible proportion d’utilisateurs de drogues injectables que le PES a les moyens de desservir.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"1 1","pages":"339-343"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81399918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}