Canadian Cancer Society

Live Well PEI provides individuals and organizations in PEI with information and tools to support healthy behaviours. This paper describes the development of the Live Well PEI community-mobilization intervention, consisting of a website and integrated community granting program for health promotion initiatives. (1) What is an effective design of a web-based community-mobilization intervention for community-led health promotion and (2) what lessons can be learned and shared for community-engaged, evidence-informed public health intervention development? Intervention development followed the Six Steps in Quality Intervention Development (6SQuID) process. Through literature reviews, jurisdictional scans, expert consultations, and community engagement, evidence for conditions that foster community mobilization was gathered and used to inform development of intervention components. The intervention was refined through iterative expert and community consultations. Four conditions that foster community-led health promotion were identified: accessibility of grant funding, availability of community data, resources to enhance capacity, and community collaboration. These conditions informed outputs of a Theory of Change. Intervention design that supports these conditions included website elements such as collections of evidence-informed health promotion interventions, stories of prior community-led projects, and community health status and needs information. The granting program integrates research and community feedback on project eligibility, grant administration and support for awardees. Findings from an evaluability assessment support pilot-testing implementation of the intervention. Development of the community-mobilization intervention provides a prime case example of evidence-informed, community-engaged public health intervention co-design. Learnings are applicable to community-focused health promotion initiatives across Canada.

Introduction Human papillomavirus (HPV) is a well-established cause of cervical cancer and is increasingly recognized as an important risk factor for non-cervical cancers, including oropharyngeal, anal, vulvar, vaginal, and penile cancers. This study assessed temporal trends in the incidence of HPV-related cervical and non-cervical cancers in Canada and the Netherlands by sex assigned at birth and cancer type using population-based registry data. Methods This study is a registry-based observational study, in which we analyzed retrospective data from the Canadian Cancer Registry (1992-2022) and the Netherlands Cancer Registry (2000-2019) for HPV-related cancers. Age-standardized incidence rates, annual percentage changes (APC), and average annual percentage changes (AAPC), with corresponding 95% confidence intervals (95% CI), were estimated using Joinpoint regression. Results In Canada, cervical cancer incidence rate generally declined since 1992 but has increased by 1.1% (0.5, 2.7) annually between 2013 and 2022. In the Netherlands, cervical cancer rates remained stable until 2015, followed by a 5.1% (1.9, 11.5) annual increase between 2015 and 2019. Non-cervical HPV-related cancers generally increased in both countries. In Canada, from 1992 to 2022, incidence rates increased for oropharyngeal (AAPC: 2.0% [1.6, 2.4]), anal (1.7% [1.3, 2.2]), and vulvovaginal (1.9% [1.6, 2.3]) cancers. In the Netherlands, from 2000 to 2019, incidence rates increased for anal (5.3% [4.2, 6.8]), vulvar (3.0% [2.2, 4.0]), penile cancers (2.8% [1.7, 4.0]), and oropharyngeal cancer (0.7% [0.1, 1.2]). Conclusion In general, we observed similar trends in both countries: that the incidence of HPV-related cervical and non-cervical cancers in Canada and the Netherlands is rising. These findings highlight the need to expand HPV vaccination programs, optimize HPV-related cancer screening programs, and enhance public health initiatives for the prevention and early detection of non-cervical HPV-related cancers.

Engaging knowledge users, including patient partners and health-system partners, in embedded health services research is increasingly recognized as essential for strengthening the relevance of research and improving the quality and equity of health services and is foundational to the success of team science. Existing engagement frameworks, however, often capture experiences at single time points and do not fully reflect relational dimensions over time such as trust, reciprocity, shared decision-making, and equity which can impact the outputs and outcomes of partnered research. There remains limited evidence describing how engagement unfolds or what conditions support or hinder meaningful, equitable partnerships in research. This study will address this gap by examining the ripple effects of a long-standing researcher–knowledge user partnership and identifying the relational and structural factors that sustain it. This qualitative, participatory study will be guided by critical patient-oriented research (cPOR), an approach that centres equity, shares power, and structurally situates lived/living experiences throughout the research process. In alignment with cPOR principles, patient partners and health-system partners are co-researchers across all stages of the study from inception through to development of data collection tools and will partner in analysis and interpretation. The study will be conducted within the Lung Health Equity Advisory Committee, a partnership co-established to address inequities in lung health, where patient partners, clinicians, policymakers, program implementers, and researchers have worked together since 2020. Data collection will be informed by patient engagement tools, such as the Engaging with Purpose Patient Engagement Framework, to assess experiences across five pillars: Co-Build, Support, Mutual Respect, Inclusiveness, and Impact, using document analysis and annual surveys. Analysis will be guided by the theoretical concept of ripple effects, to explore how engagement processes, outputs, and outcomes accumulate and influence subsequent phases of work. Data will be analysed using combined deductive–inductive content analysis, with triangulation across all data sources. Preliminary findings will be synthesized with partners through Ripple Effects Mapping (REM), a participatory approach that supports collective interpretation, visualization of impact pathways, and opportunities for continuous improvement. This study offers a novel approach to understanding the experiences and impact of long-standing research-knowledge user partnerships that are not bound by a specific project or timeline. By exploring this relational approach to engagement, we will generate nuanced insights into how knowledge-user engagement is built, experienced, and adapted over time within an equity-oriented partnership. The exploration of ripple effects is expected to strengthen real-time learning and partnership dynamics while offering a transferable model for other research teams seeking to embed iterative, partner-guided improvement into engagement practices that are sustained over time. Working closely with patients, community members, and people who plan and deliver healthcare helps make research more useful and can improve the quality and fairness of care. However, most ways of exploring engagement practices capture people’s experiences as snapshots at different points in time, and do not adequately unpack how aspects such as trust, shared decision-making, and fairness may impact long-standing relationships. This study will help fill this gap by looking at how engagement is experienced over time in a long-standing partnership and by identifying the relationship and system factors that help support meaningful and impactful partnerships. This study will use an approach that focuses on equity, shared decision-making, and lived/living experiences. Patient partners and health-system partners who have been working together since 2020 in the Lung Health Equity Advisory Committee to improve lung health outcomes for all have co-designed this study and research approach. They will help analyse and understand the results. We will collect information from project documents and surveys and work together to create a ripple effects map that visually traces how engagement activities, relationships, and collective decision-making contribute to outcomes and development of novel projects over time. This study will help us better understand how sustained partnerships are built, experienced, and can be improved over time. It will also provide a model that other research teams can use to understand and sustain how they work with partners for greater impact.

Reducing prolonged sedentary behaviour is recommended to improve population health. The development of behaviour change interventions requires understanding context-specific determinants, which may differ across domains of transportation, occupational, and leisure time sedentary behaviour. This study aimed to use the Behaviour Change Wheel to inform the development of domain-specific intervention strategies for reducing prolonged sedentary behaviour among Canadian adults. One-on-one semi-structured interviews were conducted with a diverse sample of adult participants from across Canada. Determinants of reducing prolonged sedentary behaviour were identified through thematic analysis and characterized according to their relevance to domains of transportation, occupational, and leisure time sedentary behaviour. The Behaviour Change Wheel and Behaviour Change Techniques Taxonomy (BCTTv1) were used to identify intervention strategies, components, and modes of delivery specific to and across behavioural domains. Thirty participants were interviewed (63

IntroductionWhile there has been a rapid uptake of virtual care in recent years, understanding of its impact on the quality of cancer care remains fragmented due to the heterogeneity of evaluation measures used to date and the lack of a framework to guide the work. We aimed to develop a comprehensive evaluation framework for virtual care in routine oncology practice.MethodsWe conducted separate nominal consensus groups with key informants (knowledge users, policy makers, clinicians, patients, and caregivers) to generate and prioritize lists of potential virtual cancer care measures. To identify measures from the health equity perspective, we undertook a structured consultation with an established health equity expert patient and caregiver panel. Findings were thematically grouped through a cognitive mapping exercise using a virtual whiteboard. Virtual cancer care-specific initial construct definitions were derived first from a systematic review of the literature, then refined through iterative consensus discussions and voting.ResultsMeasurement priorities varied by key informant group, underscoring the need to consider the impacts of virtual cancer care from multiple key informant perspectives. The final framework included 17 constructs with definitions and operationalization considerations distributed across five domains: implementation, service, and client outcomes, with equity and cost as separate, overarching domains.DiscussionOur findings highlight the need to consider the impacts of virtual care from multiple key informant perspectives. Our final, comprehensive virtual cancer care evaluation framework can help guide and standardize future evaluations to improve comparability, inform policy, and guide practice optimization.