The need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change

In Northern Canada, climate change has led to many acute and interrelated health and environmental impacts experienced among Inuit populations. Community-based monitoring, in which community members participate in monitoring initiatives using various forms of technology, is a key strategy increasingly used to detect, monitor and respond to climate change impacts. To better understand the landscape of existing environmental and health monitoring programmes mobilising different technologies and operating in the North we conducted a review that used environmental scan methodologies to explore and contextualise these programmes. We consulted with academic researchers with experience in community-led monitoring, conducted systematic searches of grey and peer-reviewed literature, and conducted a secondary search for environment-health mobile-phone applications. Following specific criteria, we identified 18 monitoring programmes using information and communication technologies in the North, and three global monitoring mobile-phone applications, which cumulatively monitored 74 environment and health indicators. Several themes emerged, including the need for: (1) community leadership, (2) indicators of environment and/or human health and (3) innovative technology. This synthesis supports the development of community-led, environment-health monitoring programmes that use innovative technology to monitor and share information related to the health implications of climate change in and around Indigenous communities throughout the Circumpolar North

How does the media portray drinking water security in Indigenous communities in Canada? An analysis of Canadian newspaper coverage from 2000-2015

Background Drinking water insecurity and related health outcomes often disproportionately impact Indigenous communities internationally. Understanding media coverage of these water-related issues can provide insight into the ways in which public perceptions are shaped, with potential implications for decision-making and action. This study aimed to examine the extent, range, and nature of newspaper coverage of drinking water security in Canadian Indigenous communities. Methods Using ProQuest database, we systematically searched for and screened newspaper articles published from 2000 to 2015 from Canadian newspapers: Windspeaker, Toronto Star, The Globe and Mail, and National Post. We conducted descriptive quantitative analysis and thematic qualitative analysis on relevant articles to characterize framing and trends in coverage. Results A total of 1382 articles were returned in the search, of which 256 articles were identified as relevant. There was limited coverage of water challenges for Canadian Indigenous communities, especially for Métis (5%) and Inuit (3%) communities. Most stories focused on government responses to water-related issues, and less often covered preventative measures such as source water protection. Overall, Indigenous peoples were quoted the most often. Double-standards of water quality between Indigenous and non-Indigenous communities, along with conflict and cooperation efforts between stakeholders were emphasized in many articles. Conclusion Limited media coverage could undermine public and stakeholder interest in addressing water-related issues faced by many Canadian Indigenous communities

Responding to Climate and Environmental Change Impacts on Human Health via Integrated Surveillance in the Circumpolar North: A Systematic Realist Review

Environments are shifting rapidly in the Circumpolar Arctic and Subarctic regions as a result of climate change and other external stressors, and this has a substantial impact on the health of northern populations. Thus, there is a need for integrated surveillance systems designed to monitor the impacts of climate change on human health outcomes as part of broader adaptation strategies in these regions. This review aimed to identify, describe, and synthesize literature on integrated surveillance systems in Circumpolar Arctic and Subarctic regions, that are used for research or practice. Following a systematic realist review approach, relevant articles were identified using search strings developed for MEDLINE® and Web of Science™ databases, and screened by two independent reviewers. Articles that met the inclusion criteria were retained for descriptive quantitative analysis, as well as thematic qualitative analysis, using a realist lens. Of the 3431 articles retrieved in the database searches, 85 met the inclusion criteria and were analyzed. Thematic analysis identified components of integrated surveillance systems that were categorized into three main groups: structural, processual, and relational components. These components were linked to surveillance attributes and activities that supported the operations and management of integrated surveillance. This review advances understandings of the distinct contributions of integrated surveillance systems and data to discerning the nature of changes in climate and environmental conditions that affect population health outcomes and determinants in the Circumpolar North. Findings from this review can be used to inform the planning, design, and evaluation of integrated surveillance systems that support evidence-based public health research and practice in the context of increasing climate change and the need for adaptation

Differential Item Functioning in the SF-36 Physical Functioning and Mental Health Sub-Scales: A Population-Based Investigation in the Canadian Multicentre Osteoporosis Study.

BackgroundSelf-reported health status measures, like the Short Form 36-item Health Survey (SF-36), can provide rich information about the overall health of a population and its components, such as physical, mental, and social health. However, differential item functioning (DIF), which arises when population sub-groups with the same underlying (i.e., latent) level of health have different measured item response probabilities, may compromise the comparability of these measures. The purpose of this study was to test for DIF on the SF-36 physical functioning (PF) and mental health (MH) sub-scale items in a Canadian population-based sample.MethodsStudy data were from the prospective Canadian Multicentre Osteoporosis Study (CaMos), which collected baseline data in 1996-1997. DIF was tested using a multiple indicators multiple causes (MIMIC) method. Confirmatory factor analysis defined the latent variable measurement model for the item responses and latent variable regression with demographic and health status covariates (i.e., sex, age group, body weight, self-perceived general health) produced estimates of the magnitude of DIF effects.ResultsThe CaMos cohort consisted of 9423 respondents; 69.4% were female and 51.7% were less than 65 years. Eight of 10 items on the PF sub-scale and four of five items on the MH sub-scale exhibited DIF. Large DIF effects were observed on PF sub-scale items about vigorous and moderate activities, lifting and carrying groceries, walking one block, and bathing or dressing. On the MH sub-scale items, all DIF effects were small or moderate in size.ConclusionsSF-36 PF and MH sub-scale scores were not comparable across population sub-groups defined by demographic and health status variables due to the effects of DIF, although the magnitude of this bias was not large for most items. We recommend testing and adjusting for DIF to ensure comparability of the SF-36 in population-based investigations

Percentage distribution of item responses on the SF-36 physical functioning and mental health sub-scale items in the Canadian Multicentre Osteoporosis Study.

<p>Percentage distribution of item responses on the SF-36 physical functioning and mental health sub-scale items in the Canadian Multicentre Osteoporosis Study.</p

Regression coefficient estimates for the effects of demographic and health status variables on physical functioning and mental health latent variables in models without differential item functioning (no-DIF) and with differential item functioning (DIF) in the Canadian Multicentre Osteoporosis Study.

<p>Regression coefficient estimates for the effects of demographic and health status variables on physical functioning and mental health latent variables in models without differential item functioning (no-DIF) and with differential item functioning (DIF) in the Canadian Multicentre Osteoporosis Study.</p

Tests for differential item functioning on the SF-36 physical functioning and mental health sub-scale items in the Canadian Multicentre Osteoporosis Study.

<p>Tests for differential item functioning on the SF-36 physical functioning and mental health sub-scale items in the Canadian Multicentre Osteoporosis Study.</p

Illustration of the multiple indicators multiple causes model to test for differential item functioning on SF-36 sub-scale items.

<p>In this model, <i>y</i>_<i>i</i> is the <i>i</i>th sub-scale item (<i>i</i> = 1, …, <i>I</i>); the dashed arrow from each covariate to the item represents the DIF (i.e., direct) effect; <i>β</i>_<i>1Sex</i> is the regression coefficient for the difference in thresholds on item <i>i</i> for males and females; similar regression coefficients are defined for other model covariates; <i>α</i>_<i>i</i> is the regression coefficient for the latent variable and the <i>i</i>th item; <i>γ</i>_<i>k</i> is the regression coefficient for the latent variable and the <i>k</i>th covariate (<i>k</i> = 1, …, <i>K</i>); <i>τ</i>_<i>ij</i> is the threshold for the (<i>j</i>– 1) th response category <i>(j</i> = 1, <i>…</i>,<i>J</i>) for item <i>i</i>; <i>ε</i>_<i>i</i> is the error term for the <i>i</i>th item; <i>ζ</i> is the residual error for the latent variable.</p