While human papillomavirus (HPV) infections and associated cancers are preventable through immunization, vaccine coverage for school-aged boys and girls remains suboptimal in Alberta and across Canada. To reconcile this coverage gap and inform Alberta’s school-based HPV immunization program, this study looks to understand barriers and enablers of immunization, how they vary across health zones and population groups, and summarize recommendations to overcome these barriers. Virtual interviews were conducted with members of the Healthier Together Panel of Albertans who were parents/guardians of school-aged children (11–17 years old). Program stakeholders (e.g., leaders, front-line workers) were separately invited to participate in virtual focus groups. Development of study materials and data analysis were guided by the Conceptual Framework of Access to Health Care. Template thematic analysis was used to analyze the interview and focus group data. Enablers of HPV immunization included convenience of the school-based program, normalization of the vaccine alongside other routine vaccines, relationship building with schools, parents/guardians, and communities, messaging that included personal stories, and youth engagement. Barriers included gaps in HPV knowledge, perceived lack of trust and transparency, links to sexual activity, consent processes, language barriers, and immunization anxiety. Key recommendations included addressing gaps in HPV messaging, changing the method of program material distribution, employing strategies to reduce immunization anxiety, and continuing to build relationships with parents/guardians, schools, and communities. A need to improve HPV messaging to address knowledge gaps and misconceptions was identified. Future work could consider perspectives from other providers, including family physicians and pharmacists.
Canada’s agri-food system relies on temporary migrant workers (TMW), yet many experience precarious conditions and barriers to accessing adequate, nutritious food during their stay. Despite advocacy for improved conditions, empirical data on TMWs’ food insecurity, and on several social determinants of health (SDoH), remain limited in Canada. We address this gap by comparing SDoH, including TMW living and working conditions, food insecurity, and health in Québec’s agriculture and food manufacturing sectors. A cross-sectional survey was embedded within a multiple case study, with agriculture and food manufacturing selected as sectoral cases characterised by similar and different structural SDoH. A total of 283 TMW (152 agriculture, 131 food manufacturing) completed interviewer-administered questionnaires covering the Household Food Security Survey Module, SDoH, and health. Agricultural TMW were more often housed by employers (98.7
Public health surveillance (PHS) supports the detection of health threats, monitoring of population health, and coordinated public health action. While its core functions remain unchanged, Canada’s last national vision for PHS was articulated in 2016, and the public health landscape has since evolved considerably. These changes have been shaped by lessons from the COVID-19 pandemic, advances in data systems and technologies, evolving data governance expectations, and increasing demand for timely, integrated public health information. We therefore sought to develop a renewed vision for PHS in Canada through broad engagement, qualitative synthesis, and expert consensus. This work used a two-phase, multi-method approach. First, national engagement with public health interest holders was conducted between September 2023 and March 2024 through regional consultations, an expert meeting, and an online survey. Qualitative data were analyzed using reflexive thematic analysis to generate draft vision components and statements. Second, a three-round modified Delphi process with Canadian PHS experts was used to iteratively review, refine, and assess agreement on the draft statements. Engagement activities captured input from 1740 participants across Canada, generating 38 draft statements organized within a conceptual framework. Through the Delphi process, experts refined statements based on quantitative agreement measures and qualitative feedback, achieving consensus on a final set of 30 statements. The resulting vision provides a shared reference point for public health professionals and partners to align efforts to strengthen and modernize PHS systems in Canada.
We aimed to examine the dynamic changes in positive mental health (PMH) over a period of 12 years between 2012 and 2024, and explore their relationships with sociodemographic characteristics, with additional exploratory analyses of COVID-19-related stressors with PMH in 2024. A total of 894 participants from an established longitudinal cohort with complete PMH before and after the outbreak of the pandemic were analyzed. Generalized linear mixed models and multivariate logistic regression were used to investigate the associations of changes in PMH with sociodemographic characteristics and COVID-19-related stressors. Flourishing PMH decreased from 57.9–62.8
People experiencing substance use problems frequently use emergency departments (EDs). Some ED visits may be safely divertible to non-medical settings. This study evaluated the service use and program-level impacts of the Stabilization and Connection Centre (SCC), an ED diversion program for people experiencing alcohol and/or opioid intoxication in Toronto. This retrospective cross-sectional study used administrative data from 1/1/2023 to 12/31/2024 to describe SCC visitor volumes and characteristics. Poisson and linear regression models were fitted to examine the temporal and environmental correlates of SCC visit counts, and differences in lengths of stay and paramedic transition times at the SCC compared to patients presenting to two nearby EDs for substance intoxication. There were 4574 SCC visits during its first two operational years, with most visitors being male, 24–54 years of age, and homeless. Lengths of stay at the SCC (M = 10.11 h, SD = 8.38) were significantly longer than in the comparison group visiting the ED (M = 4.61 h, SD = 4.22). Paramedic transfer of care times were also significantly shorter at the SCC (M = 7.20 min, SD = 3.62) than the ED (M = 34.10 min, SD = 45.22). SCC visits were significantly lower during the winter and weekdays, but higher on days when nearby EDs were busier and during the week when monthly income support payments are issued. The SCC was associated with some intended program-level outcomes in the forms of safe ED diversions of patients experiencing intoxication and reduced paramedic transfer of care times.
