Purpose Cannabis use in pregnancy and lactation is under-researched and politically taboo, resulting in a challenging context for information seeking and health decision-making. This study explored the information needs and information seeking, assessing and triangulation behaviors of individuals considering cannabis use while pregnant or lactating within a challenging legal context. Design/methodology/approach Reflexive thematic analysis (RTA) was used to qualitatively analyze 23 in-depth interview transcripts with individuals in the state of Massachusetts who were considering cannabis use while pregnant or lactating. Themes from the study analysis were used to develop a new model of Everyday Triangulation (ET). Findings Four overarching themes were developed through RTA: (1) information needs are complex and contextual, (2) many information behaviors contribute to ET, (3) ET is complex, relational and intuitive, and (4) Complex information needs lead to complex and dynamic decisions. Themes were used to develop a novel model of ET as applied to this study’s population and context. Research limitations/implications This study presents several implications for information scientists to work collaboratively within public health contexts to better support health information seeking. Areas in need of further research within a public health context are also identified. Originality/value This study explores information needs and seeking behavior in a rarely studied population and unique legal context. A novel information behavior model is presented and applied, contributing robustly to the field of information science.

Introduction. While today’s vaccines have robust scientific evidence supporting broad distribution and use, many individuals experience concerns about vaccination, resulting in vaccine hesitancy. Many factors may contribute to vaccine hesitancy including lack of trust in vaccination recommendations, misinformation about vaccine safety and effectiveness, and social norms. This study explored the information seeking and assessment behaviours of new mothers regarding infant vaccination schedules. Method. Participants were recruited within two communities identified for low vaccine uptake. Semi-structured interviews were conducted with 32 mothers. Interview transcripts and researcher fieldnotes formed the data for analysis. Analysis. Reflexive thematic analysis was used to qualitatively analyse interview transcripts, resulting in four overarching themes addressing the research questions. Results. Vaccine hesitant mothers appear to have different information needs and subsequent information seeking and assessment behaviours compared to vaccine confident mothers in the same communities. Vaccine hesitant mothers reported consistently unmet vaccine-related information needs and described more intensive information seeking and triangulation practices because of these unmet needs. Conclusion. Increased and creative vaccine communication opportunities are necessary to address vaccine hesitancy in target communities. Additionally, the relationship between mistrust and information seeking should be further explored, ideally in collaboration between information scientists and public health.

Recent reports indicate a concerning decline in routine childhood vaccination rates globally. Parental engagement with health information is critical in shaping vaccine acceptance amid rising skepticism and shifting sociopolitical dynamics. In this study, we investigated how Canadian parents engaged with information to decide on COVID-19 vaccination for their children. Using an exploratory qualitative design, we conducted semi-structured interviews with 48 parents between April and August 2022. Data were analyzed thematically and organized around McKenzie’s model of information practices. Our findings revealed that parental engagement is a dynamic process shaped by emotional, social, and informational factors. While parents sought evidence-based information, they also employed sophisticated strategies to navigate uncertainty. Novel insights include the use of source triangulation to build epistemic authority, the strategic use of information avoidance to mitigate social stigma, and a transition toward cognitive closure once decisions were finalized. Notably, most parents reached a “case closed” state before pediatric vaccines were authorized, relying on trusted sources (i.e. schools and pediatricians) as proxies and their experiential lived evidence for decision-making. To improve communication about childhood vaccination, including in future health crises, we recommend a proactive approach that recognizes the finite life cycle of information engagement. Public health strategies can prioritize early messaging before cognitive closure occurs and leverage distributed trust by using health-care providers and schools as primary information proxies. These findings offer a blueprint for navigating the psycho-social complexities of health communication.

OBJECTIVES:Virtual care adoption in pediatric type 1 diabetes (T1D) accelerated during the COVID-19 pandemic, yet little is known about the perspectives of pediatric health care professionals (HCPs). To identify how HCPs navigate and are impacted by pediatric diabetes virtual care, we explored their experiences with virtual care in British Columbia (BC). METHODS:The study team purposively recruited HCPs from across the province. Semistructured interviews were conducted with 32 pediatric HCPs across BC (September 2023 to September 2024). Data were analyzed using inductive thematic analysis informed by the BC Health Quality Matrix. RESULTS:HCPs valued virtual visits for flexibility, safety, accessibility, and efficiency. However, challenges included rapport loss, inability to perform physical assessments, and concerns related to inequities in technology access. Virtual care impacted HCPs' well-being in complex ways, with some reporting benefits but others facing challenges. CONCLUSIONS:Pediatric HCPs view virtual care as both beneficial and challenging, recognizing it as a valuable supplement, not a replacement, for in-person visits. As our understanding of these tensions deepens, addressing care gaps and implementing informed strategies will be essential for sustainable, high-quality virtual diabetes care and broader system integration.

Specialist immunization clinics can support vaccination counseling for individuals experiencing adverse events following immunization (AEFIs) and research into AEFIs. We sought to describe the experiences of participants from the Canadian Special Immunization Clinic Network COVID-19 vaccine safety study. Qualitative interviews were conducted about participants' experiences with COVID-19 vaccination, developing an AEFI, and enrolling in a research study. Interviews were analyzed using interpretive descriptive methods guided by the socio-ecological model. Three women and five men, ages 22-59 y, were interviewed. After experiencing AEFIs, participants largely continued to trust in science and COVID-19 vaccine effectiveness, though some felt they had not been adequately informed about the potential risks of COVID-19 vaccination. They also reported hesitation from healthcare providers to attribute their symptoms to the vaccine and difficulty accessing care for their AEFI. While participants expressed a desire to assist research efforts into AEFIs, challenges included complicated consent procedures and apprehensions regarding privacy. Improving diagnosis and care of individuals with AEFIs and strengthening research efforts will require changes at organizational and policy levels, including enhanced clinician training on AEFIs and simplifying research consent processes, as well as individual and community-level interventions to tailor communication and strengthen interactions between clinicians and vaccine recipients.

Two new RSV immunization products exist for infants: a prenatal vaccine (RSVpreF) and a long-acting monoclonal antibody for infants (nirsevimab). While both showed promise in clinical trials, implementation has varied across jurisdictions. Before rollout in Canada, we conducted an anonymized, online survey with a nationally representative sample of 1,015 expectant and recent birth parents. The primary outcome was product acceptability (disagree, undecided, agree). Odds ratios (ORs) and 95% confidence intervals (CIs) identified factors associated with agreement or indecision versus disagreement. Approximately 49% (n = 499) were expecting; 51% (n = 516) had a baby in the past year. Overall, 72% (n = 727) agreed to receive a product: 61% (n = 624) for RSVpreF and 60% (n = 608) for nirsevimab. RSVpreF agreement was higher among older parents (e.g., OR = 3.64; 95% CI, 1.99-6.67 for age 25-34 versus 18-24 years), those with a university degree (OR = 3.65; 95% CI, 2.01-6.64 versus high school), higher income (OR = 2.31; 95% CI, 1.01-5.28 for ≥$150k versus <$40k), or receipt/intention for Tdap (OR = 3.76; 95% CI, 2.37-5.96 versus no receipt/intention) or influenza (OR = 2.04; 95% CI, 1.29-3.21) vaccines. Agreement was higher among parents of children without a high-risk medical condition compared to those with (OR = 2.32; 95% CI, 1.44-3.72). Similar trends were observed for nirsevimab, with lower agreement also noted among those who self-researched antibodies (OR = 0.51; 95% CI, 0.30-0.88 versus not). As most respondents rated product safety (76%), effectiveness (71%), and disease severity risk (70%) as important in decision-making, providing clear information on these, alongside communications targeted to subgroups with lower agreement, may optimize uptake as programs rollout.

OBJECTIVE:While challenges surrounding vaccine acceptance in pregnancy have long been prevalent in Canada, the COVID-19 pandemic introduced a new context for perinatal vaccine decision-making. Pregnant people had to weigh concerns about SARS-CoV-2 infection during pregnancy and the introduction of the new mRNA pandemic vaccines, with less access to in-person perinatal care and social support than usual. This qualitative analysis sought to understand how trust influenced the decision-making of pregnant people during the early COVID-19 pandemic regarding both routine and SARS-CoV-2 vaccinations. METHODS:This qualitative study, as part of a larger mixed-methods study, analyzed interviews with 73 participants who gave birth in Ontario or British Columbia, Canada from May 1st, 2020, to December 1st, 2021 via reflexive thematic analysis. RESULTS:Three types of trust were influential to pandemic vaccination decisions during pregnancy: 1) trust in prenatal care providers, shaped by goals of alleviating mental load, cultural norms, and perceived transparency, 2) trust in institutions, focused on the government, healthcare system, and pharmaceutical industry, and 3) trust in networks, encompassing (dis)trust in social media, valuation of lived experiences, and views of vaccination as a reciprocal obligation to the broader community. CONCLUSIONS:Several dimensions of trust played vital roles in the experiences of pregnant people navigating vaccine decisions amid high uncertainty. Trust in providers was composed of both honesty and transparency, with the latter enabling a new approach to the patient-provider relationship. Avenues to increase trust include social media moderation and discussion of original research by prenatal care providers.

Background: Digital sexually transmitted and blood-borne infection (STBBIs) testing services are used to improve testing access, but might replicate existing social inequities. Previous research has shown that the digital STBBI testing service GetCheckedOnline has improved access to testing in British Columbia (BC), Canada. As part of the program's continuous evaluation, we examined awareness and use of the service in 5 urban, suburban, and rural communities where the program has expanded. Objective: This study aimed to determine if social location is associated with differences in awareness and use of the service in 5 communities outside Vancouver, BC. Methods: From July to September 2022, we conducted a cross-sectional survey recruiting (in-person and online) sexually active people aged 16 years or older in 5 urban, suburban, and rural communities where GetCheckedOnline had sample collection sites available at the time. We examined differences in awareness and use by age, gender identity, sexual identity, race/ethnicity, education, and income using logistic regression models informed by the Health Equity Measurement Framework. Results: Of the 1658 participants (n=1058, 63.8% in-person and n=600, 36.2% online), 35.3% (586/1658) were aware of GetCheckedOnline and 19.5% (324/1658) had used it. Awareness and use were lower in the first and last age quartiles compared to the second quartile (>38 years: awareness odds ratio [OR] 0.23, 95% CI 0.17-0.32; use OR 0.19, 95% CI 0.12-0.28; <25 years: awareness OR 0.39, 95% CI 0.28-0.53; use OR 0.28, 95% CI 0.18-0.41). Awareness and use were also lower in the lowest income group compared to the highest (awareness OR 0.39, 95% CI 0.24-0.65; use OR 0.36, 95% CI 0.20-0.65). Awareness and use were higher among genderfluid, genderqueer, and nonbinary participants compared to men (awareness OR 2.27, 95% CI 1.63-3.18; use OR 1.97, 95% CI 1.36-2.84), transgender compared to cisgender participants (awareness OR 2.17, 95% CI 1.54-3.06; use OR 2.15, 95% CI 0.46-3.13), and nonheterosexual compared to heterosexual participants (awareness OR 2.37, 95% CI 1.89-2.97; use OR 2.53, 95% CI 1.91-3.38). People of color had higher awareness and use vs White participants (awareness OR 1.74, 95% CI 1.34-2.26; use OR 2.01, 95% CI 1.48-2.72). Indigenous participants had higher awareness than White participants (OR 1.65, 95% CI 1.19-2.20) but no difference in use. Women had similar awareness but lower use compared to men (OR 0.68, 95% CI 0.50-0.92). Conclusions: GetCheckedOnline is an equitable means of access to STBBI testing for some but not all equity-owed groups in BC. Further adaptations should consider factors such as differences in material circumstances to improve its accessibility for all.

Young adults in their 20s have shown slower uptake of COVID-19 vaccines relative to older adults, potentially endangering themselves and their communities. Despite this, little vaccine communication has specifically targeted this age group. This study explored why "20-somethings" in British Columbia (BC), Canada delayed COVID-19 vaccination, and how to better encourage their vaccine uptake. From August 2022 to March 2023, we conducted semi-structured interviews with 25 young adults aged 20-29 years living in southwest BC. Interviews were recorded, transcribed, and analyzed using reflexive thematic analysis. Young adults attributed slower vaccine uptake among their demographic to the perceived lower risks to young and healthy individuals not justifying the effort involved in obtaining vaccination and to lack of trust in the vaccines' safety and effectiveness. To address these factors, participants recommended that vaccine communications attract and maintain young adults' attention, take advantage of the affordances of social media platforms, be clear about both individual advantages and social responsibility to vaccinate, and provide a way to take immediate action. Salient messengers were those deemed credible based on education/credentials or familiarity/similarity to the audience. Marginalized sub-communities may be best reached by health messengers who are already trusted community members. Tailoring vaccine communication to a young adult demographic and using trusted and relatable messengers to deliver vaccine information may facilitate swifter uptake of vaccination in settings with high access but lagging uptake.

Background. Chiropractors and homeopaths are trusted sources of health information for many Canadians, including around vaccination. However, within Ontario, Canada, the College of Chiropractors of Ontario and the College of Homeopaths of Ontario regulations state that vaccines are not within their scope of practice and providers should not express views, treat, or advise patients with respect to vaccination. The aims of the present study were to: (1) describe the attitudes and beliefs regarding vaccination held among participating chiropractors and homeopaths; (2) identify the sources of information about vaccination they trust and use to guide their personal vaccination decisions; and (3) describe how they navigate patient requests for guidance on vaccine decision-making within the current regulatory landscape. Methods. Semi-structured interviews (N = 16) were conducted between February 2020-March 2021 and explored participants’ opinions on vaccination, sources of information they trust and recommend to their patients, and how they navigate vaccine conversations with patients. Results. Providers’ personal beliefs regarding vaccination were described as reinforced by social and professional networks, through their personal experiences, and in consultation with clients. Various strategies were used to support patients while abiding by regulations (e.g. referring patients to providers for whom vaccination is within their scope of practice); however, other strategies described (e.g., stating personal beliefs) could be interpreted as a breach of regulation. Conclusions. This research reinforces existing literature suggesting that patients using chiropractors and homeopaths have questions about vaccination and are looking for trusted information. Public health services should consider engaging with chiropractors and homeopaths to facilitate communication between patients and immunization providers.

This study examined the willingness of Canadians to use patient-centered digital reporting solutions for adverse events following immunization (AEFI) reporting. We identified the preferred medium for reporting, and any privacy and confidentiality concerns among prospective users. A geographically diverse panel of 2,036 Canadian adults 18 y of age and older was surveyed online in September 2024. Descriptive statistics and a multivariable regression model were used to identify factors associated with a willingness to report AEFI. Among respondents 85% (n = 1724) indicated a willingness to report AEFI, and most (n = 1137, 56%) preferred to report AEFI only when they occurred as opposed to answering survey on a regular basis for a short duration after vaccination (n = 458, 22%). The largest proportion of respondents (n = 911, 45%) indicated a preference to use an online fillable form through a secure government website to report AEFI. Living with a disability, age over 24 y and having a great deal of confidence in scientists were all significantly associated with a willingness to report, while having a great deal of trust in pharmaceutical companies was inversely associated. Our results emphasize the importance of considering convenience, privacy and confidentiality, and trust in public institutions when developing patient-centered digital reporting systems for AEFI. Future research should explore income and ethnic disparities in willingness to report AEFI and the effect of tailoring reporting systems to public concerns on willingness to report.

Canadian libraries have traditionally supported and defended intellectual freedom while also being expected to provide communities with trustworthy information in times of personal and collective crisis. Issues of medical misinformation reveal the tension between these two ideals. Library workers face challenges in preparing for and responding to issues with controversial materials, with little guidance on how to navigate this tension and balance the two ideals. In an interview study with 22 Canadian library worker participants, we asked about experiences with navigating these situations. Our preliminary results reveal a range of strategies and considerations at play, ranging from individual incidents to broader policies and power dynamics.

ObjectiveSuccessful clinical conversations about vaccination in pregnancy (pertussis, COVID-19, and influenza) are key to improving low uptake rates of both vaccination in pregnancy and infancy. The purpose of this study was to understand Canadian perinatal care providers’ knowledge, attitudes, and practices around vaccination in pregnancy.MethodsQualitative interviews with 49 perinatal care providers (nurse practitioner, general practitioner, registered nurse, registered midwife, obstetrician-gynecologist, and family physicians) in 6 of 13 provinces and territories were deductively coded using directed content analysis [1] and analyzed according to key themes.ResultsParticipants detailed their professional training and experiences, patient community demographics, knowledge of vaccines, views and beliefs about vaccination in pregnancy, and attitudes about vaccine counselling. Providers generally described having a good range of information sources to keep vaccine knowledge up to date. Some providers lacked the necessary logistical setups to administer vaccines within their practice. Responses suggest diverging approaches to vaccine counselling. With merely hesitant patients, some opted to dig in and have more in-depth discussions, while others felt the likelihood of persuading an outright vaccine-refusing patient to vaccinate was too low to be worthwhile.ConclusionProvider knowledge, attitudes, and practices around vaccination varied by professional background. To support perinatal providers’ knowledge and practices, clinical guidelines should detail the importance of vaccination relative to other care priorities, emphasize the positive impact of engaging hesitant patients in vaccine counselling.

ABSTRACTConsidering the conference theme “Putting People First: Responsibility, Reciprocity, and Care in Information Science Research and Practice,” this panel brings an ethnographic methodological conversation to the 2024 ASIS&T Annual Meeting. Our session emphasizes how participants' stories are one of the most human‐centered tools we have in research, highlighting how storytelling is an integral part of being human. The panelists have conducted ethnographic fieldwork in various contexts and begins with an introduction about ethnography as a form of storytelling, introducing concepts of vulnerability and reciprocity. Panelists will then reflect on ethnographic stories before turning to teaching Information Ethnography. Our session aims to broach the joys and challenges of ethnographic research by bringing a new honesty to the conversation in Information Science. We will engage the audience in open discussion, before breaking out into smaller groups, fostering an intimate, safe space to share stories about past research.

We aimed to determine the incidence of mental health diagnoses and associated health and social risk factors among perinatal people in three different COVID-19 phases. We conducted a population-based, retrospective cohort study using linked administrative datasets. We included persons with live, in-hospital births in Ontario, Canada from January 1 to March 31 in 2019, 2021, or 2022 (three phases relative to COVID-19 with different public health policy measures). We excluded people with prior mental health diagnoses. We used diagnostic codes to identify new onset of depression, anxiety, or adjustment disorder in the antenatal and postpartum period. We developed multivariable, modified Poisson models to examine associations between sociodemographic and clinical factors and new mental health diagnoses in each phase. There were 72,242 people in our cohort. Antenatal mental health diagnoses were significantly higher in 2021 (aRR = 1.32; CI = 1.20–1.46) and 2022 (aRR = 1.22; CI = 1.11–1.35) versus 2019. Postpartum diagnoses were significantly greater in 2021 (aRR = 1.16; CI = 1.08–1.25) versus 2019. Antenatal diagnoses were associated with birth year, previous stillbirth, pre-existing hypertension, multiparity, residential instability, and ethnocultural diversity. Postpartum diagnoses were associated with birth year, maternal age, multiparity, care provider profession, assisted reproductive technology, birthing mode, pre-existing hypertension, intensive care admission, hospital readmission, residential instability, and ethnocultural diversity. Family physicians increasingly made mental health diagnoses in 2021 and 2022. Increased incidence of perinatal mental health diagnoses during COVID-19 suggests complex dynamics involving pandemic and health and social risk factors. This study was registered with Clinicaltrials.gov (NCT05663762) on December 21, 2022.

Objective Gestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and laboratory services, including GDM screening programs. Adapted GDM screening guidelines were introduced in many jurisdictions. This study examined changes in uptake, modality, and experiences of GDM screening in Ontario, Canada during the COVID-19 pandemic. Methods This convergent mixed-method study involved a population-based retrospective cohort analysis of Ontario-based health administrative data to describe and compare gestational diabetes screening rates among 85,228 individuals with live, in-hospital births between January 1-March 31 before (2019) and during the COVID-19 pandemic (2021 and 2022). Descriptive analyses were conducted for GDM screening pathways aligning with usual and pandemic-adapted screening guidance. Qualitative descriptive interviews were conducted about experiences and decision-making of GDM screening with 43 Ontario residents who gave birth between May 2020 and December 2021. Data were integrated during the design and interpretation phases. Results There were small but significant increases in GDM screening during the pandemic; likelihood of screening completion using any modality increased in 2021 and 2022 compared to 2019. Testing modality shifted; the alternate screening strategies introduced during COVID-19 were adopted by clinicians. Interview participants perceived GDM screening to be important and obligatory but accompanied by a degree of stress about potential COVID-19 exposure. Conclusion Despite health system challenges experienced in Ontario during the COVID-19 pandemic, GDM screening rates increased in the study population, demonstrating the success of adapted GDM screening guidelines. Decisions about screening modalities were driven by clinician expertise, and interview participants were satisfied to provide informed consent to these recommendations.

ABSTRACTMedical evidence on the risks and benefits of cannabis is limited; existing research is often inconclusive or conflicting. In the United States, cannabis use during pregnancy is stigmatized and often subject to complex legal constraints; these contextual components may have significant effects on information seeking and informed decision‐making processes. This study applies Reflexive Thematic Analysis to 23 telephone interviews with individuals considering cannabis use in pregnancy or lactation to explore their information needs; how adequately those needs were met; and how information triangulation, and other information seeking behaviours, were used to make decisions given the dearth of scientific evidence. Findings suggest that information needs are complex and contextual, and that participants used forms of triangulation that included relational and intuitive elements as well as cognitive assessment processes. A new model of Everyday Triangulation (ET) is presented to represent these complex assessment practices in a holistic manner.

Failure in research remains a taboo topic for many academics and students. The pressure to be the perfect researcher can make discussing failure with peers and mentors extremely difficult, if not impossible. Academic publishing - not unreasonably - tends to favor the publication of “successful” research. The resulting culture of silence around failure often extends beyond complete failures, leading to the avoidance of discussing what did not go well or what could have gone better in any meaningful way. What opportunities are being missed by not having conversations about failure?