Sexe, genre et contexte : Une compréhension en matière de promotion de la santé sexuelle et prévention du VIH/ITS auprès des jeunes autochtones au Nouveau-Brunswick

Au Canada, les jeunes autochtones sont confrontés de plus en plus aux taux importants d’infections transmissibles sexuellement (ITS) et à une épidémie du virus de l’immunodéficience humaine (VIH). Des expériences historiques et les conditions sociales actuelles interagissent pour avoir une incidence sur la vulnérabilité de la population autochtone. Le but de cette étude ethnographique était d’améliorer la compréhension de la santé publique des jeunes autochtones et leurs expériences en matière de promotion de la santé sexuelle et de prévention de VIH/ITS. Un devis qualitatif axé sur l’approche communautaire et culturelle a servi à comprendre l’expérience des jeunes pour accéder à des services de dépistage. Vingt jeunes ont participé à l’étude. L’analyse thématique a permis d’identifier quatre thèmes : financement et législation; intergénération et santé sexuelle; contexte de santé sexuelle et éducation; perceptions des services de santé sexuelle et dépistage du VIH/ITS. Il est essentiel que les prestataires de santé et les décideurs adoptent une approche culturellement adéquate et respectueuse des genres en matière de promotion et de prévention.In Canada, young Aboriginal men and women are faced with growing sexually transmitted infection (STI) rates and a human immunodeficiency virus (HIV) epidemic. Historical and present day social conditions interact and impact on the vulnerability of the Aboriginal population. The purpose of this ethnographic study was to enhance the public health understanding of Aboriginal youths’ experiences with sexual health services. A culture and community-based qualitative process sought to understand youths’ lived experiences of accessing sexual health services and HIV/STI testing. A purposeful sample of twenty Aboriginal youths was used for this study. Thematic analysis was informed by all data sources was carried out to interpret the data for themes. Four themes were identified in regard to access: funding and legislative bodies, intergenerational shaping of sexual health, sexual health places and education, and perceptions of sexual health services and HIV/STI testing. It is vital that health care providers and policy makers work with a culturally competent and gender-based approach that is sensitive to the many processes that interact to influence health promotion and disease prevention

Observation and Institutional Ethnography: Helping Us to See Better

Observation is a staple data collection method, which is used in many qualitative approaches, including both traditional and institutional ethnographies. While observation is one of the most used data collection methods in traditional ethnography, less is written about its use by institutional ethnographers. Institutional ethnography is an approach to social research where the aim is to explicate how peoples’ every activities are coordinated or ruled by different institutions. In this article we explore uses of observation as a data collection method, focusing on its use in institutional ethnography. We use examples from the health care literature to show how observation can be beneficial and help institutional ethnographers see better. </jats:p

Factors Related to the Intention to Get Vaccinated Against COVID-19 in the Province of New Brunswick, Canada

Vaccine refusal by even a small subset of the population can undermine the success of the vaccination campaigns which are currently underway worldwide. The goal of this study was to identify determinants of intention to receive COVID-19 vaccine. More precisely, it aimed at examining whether socioeconomic factors, levels of mistrust toward authorities, perceived scientific consensus, and perceived severity of COVID-19 can predict vaccination intentions against COVID-19. Vaccination intentions included being ready to get vaccinated, contemplating vaccination, and not considering vaccination. A sample of 399 individuals from New Brunswick, Canada, completed an online survey in March and April 2021. Results revealed that participants who declared they would probably get vaccinated were more likely to report lower levels of mistrust toward authorities, as well as higher perceived scientific consensus and perceived severity of COVID-19, compared to those who did not intend to get vaccinated or remained unsure. Strategies to guide healthcare professionals in assisting their patients in making the best healthcare decision for their family and themselves are discussed.udemauteur: Mylène Lachance-Grzela; Andréanne Charbonneau; Jalila Jbilou; Anik Dubé; Josée Richar

What features of drug treatment programs help, or not, with access? a qualitative study of the perspectives of family members and community-based organization staff in Atlantic Canada

Abstract Background Withdrawal management and opioid agonist treatment (OAT) programs help to reduce some of the harms experienced by people who use substances (PWUS). There is literature on how features of drug treatment programs (e.g., policies and practices) are helpful, or not helpful, to PWUS when seeking access to, or in, treatment. There is, however, relatively little literature based on the perspectives of family members/family of choice of PWUS and community-based organization staff within the context of Atlantic Canada. This paper explored the perspectives of these two groups on what was helpful, or not, about drug treatment programs in Atlantic Canada in terms of supporting access to, and retention in, treatment. Methods One-on-one qualitative telephone interviews were conducted in 2020 with the two groups. Interviews focused on government-funded withdrawal management and OAT programs. Data were coded using a qualitative data management program (ATLAS.ti) and analyzed inductively for key themes/subthemes using grounded theory techniques. Results Fifteen family members/family of choice and 16 community-based organization staff members participated ( n  = 31). Participants spoke about features of drug treatment programs in various places, and noted features that were perceived as helpful (e.g., quick access), as well as not helpful (e.g., wait times, programs located far from where PWUS live). Some participants provided their perceptions of how PWUS felt when seeking or accessing treatment. A number of participants reported taking various actions to help support access to treatment, including providing transportation to programs. A few participants also provided suggestions for change to help support access and retention such as better alignment of mental health and addiction systems. Conclusions Participants highlighted several helpful and not helpful features of drug treatment programs in terms of supporting treatment access and retention. Previous studies with PWUS and in other places have reported similar features, some of which (e.g., wait times) have been reported for many years. Changes are needed to reduce barriers to access and retention including the changes recommended by study participants. It is critical that the voices of key groups, (including PWUS) are heard to ensure treatment programs in all places support access and retention

Addressing the Shortage of Health Professionals in Official Language Minority Communities to Strengthen Retention Strategies for the Benefit of New Brunswick Francophone and Acadian Communities: Protocol for a Mixed Methods Design

Background: COVID-19 has highlighted already existing human resource gaps in health care systems. New Brunswick health care services are significantly weakened by a shortage of nurses and physicians, affecting regions where Official Language Minority Communities (OLMCs) reside. Since 2008, Vitalité Health Network (the “Network”), whose work language is French (with services delivered in both official languages, English and French), has provided health care to OLMCs in New Brunswick. The Network currently needs to fill hundreds of vacant physician and nurse positions. It is imperative to strengthen the network’s retention strategies to ensure its viability and maintain adequate health care services for OLMCs. The study is a collaborative effort between the Network (our partner) and the research team to identify and implement organizational and structural strategies to upscale retention. Objective: The aim of this study is to support one of New Brunswick health networks in identifying and implementing strategies to promote physician and registered nurse retention. More precisely, it wishes to make 4 important contributions to identify (and enhance our understanding of) the factors related to the retention of physicians and nurses within the Network; determine, based on the “Magnet Hospital” model and the “Making it Work” framework, on which aspects of the Network’s environment (internal or external) it should focus for its retention strategy; define clear and actionable practices to help the Network replenish its strength and vitality; and improve the quality of health care services to OLMCs. Methods: The sequential methodology combines quantitative and qualitative approaches based on a mixed methods design. For the quantitative part, data collected through the years by the Network will be used to take stock of vacant positions and examine turnover rates. These data will also help determine which areas have the most critical challenges and which ones have more successful approaches regarding retention. Recruitment will be made in those areas for the qualitative part of the study to conduct interviews and focus groups with different respondents, either currently employed or who have left it in the last 5 years. Results: This study was funded in February 2022. Active enrollment and data collection started in the spring of 2022. A total of 56 semistructured interviews were conducted with physicians and nurses. As of manuscript submission, qualitative data analysis is in progress and quantitative data collection is intended to end by February 2023. Summer and fall 2023 is the anticipated period to disseminate the results. Conclusions: Applying the “Magnet Hospital” model and the “Making it Work” framework outside urban settings will offer a novel outlook to the knowledge of professional resource shortages within OLMCs. Furthermore, this study will generate recommendations that could contribute to a more robust retention plan for physicians and registered nurses.udemauteur: Stéphanie Collin; Claire Johnson; Anik Dubé; Marie-Eve Laforest; Manon Cormie

Troubling the boundaries: Overcoming methodological challenges in a multi-sectoral and multi-jurisdictional HIV/HCV policy scoping review

Policy scoping reviews are an effective method for generating evidence-informed policies. However, when applying guiding methodological frameworks to complex policy evidence, numerous, unexpected challenges can emerge. This paper details five challenges experienced and addressed by a policy trainee-led, multi-disciplinary research team, while conducting a scoping review of youth Human Immunodeficiency Virus and Hepatitis C primary and secondary prevention policies, which occurred across and within sectors and jurisdictions in Atlantic Canada. How these challenges were addressed is described, as are suggestions for how the lessons learned may provide guidance to other policy scoping reviews. Implications for future directions are also discussed.</jats:p

Promoting Identification and Use of Aid Resources by Caregivers of Seniors: Co-Design of an Electronic Health Tool

Background The importance of supporting caregivers is recognized in home care for older persons, and facilitating their help-seeking process is a way to meet that need. The use of electronic health (eHealth) is a potentially promising solution to facilitate caregivers’ help-seeking process. Objective The aim of this research was to develop, in partnership with community organizations, health and social service professionals and caregivers, an eHealth tool promoting the earlier identification of needs of older persons and an optimal use of available resources. Methods To design the tool, 8 co-design sessions (CoDs) were conducted and 3 advisory committees were created (in 11 regions) in Quebec between May 2017 and May 2018. A variety of methods were used, including the sorting method, the use of personas, eHealth tool analysis, brainstorming, sketching, prototyping, and pretesting. Results A total of 74 co-designers (women n=64 and men n=10) were recruited to participate in the CoDs or the advisory committees. This number allowed for the identification of needs to which the tool must respond and for the identification of its requirements (functionalities and content), as well as for the development of the information architecture. Throughout the study, adjustments were made to the planning of CoD, notably because certain steps required more sessions than expected. Among others, this was true for the identification of functionalities. Conclusions This study led to the development of an eHealth tool for caregivers of functionally dependent older persons to help them identify their needs and the resources available to meet them. International Registered Report Identifier (IRRID) RR2-10.2196/11634 </jats:sec