Equity Aspects of Canadian Immunization Programs: Differences within and between countries

There is a global recognition that immunization is one of the most cost-effective public health interventions which should be available to everyone.  The equity approach to immunization provides a holistic and integrated framework for addressing inequalities and disproportions in the realization of human rights. The aim of this study is to review the performance of the immunization programs in Canada through an equity lens using two analytical frameworks for immunization programs. It focuses on four elements of the programs: a) the burden of disease; b) immunization strategy; c) ability to evaluate; and d) research questions.  To achieve universal access to vaccination, Canada should have a strong connection with human rights, where realities and outreach need to be prioritized. Preventable diseases such as influenza, H1N1, and varicella have been reported specifically in Aboriginal Canadians, immigrants and refugees. Our study seeks to demonstrate that access to vaccines should be considered one of the most vital human rights and as a matter of fundamental intervention to achieve health equity

How do Ontario family medicine residents perform on global health competencies? A multi-institutional survey

Background: There is an increased interest in global health among medical students, family medicine residents, and medical educators. This paper is based on research to assess confidence in knowledge and skills in global health in family medicine residents in five universities across Ontario. Methods: A web based survey was sent to 166 first-year family medicine residents from five universities within Ontario. Descriptive statistics were used to analyze residents’ confidence in their knowledge and skills in global health. The strength of association between each of the self-perceived knowledge and skills variables was assessed by the Spearman correlation coefficient.  Results: The response rate ranged from 29% to 66% across the five universities. Self-perceived knowledge scores revealed that 34.3% of the respondents were very confident, 51.9% were somewhat confident, and 13.8% were not at all confident about their global health knowledge. Participants' confidence scores were lower in relation to knowledge of access to health care for low income nations (44.3%), and were better on their global health skills related to working in a team (70.9%) and listening actively to patients' concerns (64.6%). Conclusions: The global health competency scale has identified key areas of strengths and weaknesses of family medicine programs in global health education. This can be used to evaluate and analyze progress over time

A province-wide survey on self-reported language proficiency and its influence in global health education

Objective Literature has reported that language is the most common barrier in a health care setting and a risk factor associated with negative outcomes. The present study reports the differences between nursing students who speak one language and nursing students who speak two or more languages (self-reported language proficiency) and their skills and learning needs in global health.Method An observational cross-sectional study was performed among nursing students from five Ontario universities. A survey was designed to measure knowledge, skills and learning needs in global health.Results Students who speak more than two languages are more likely to have more interest in learning global health issues, such as health risks and their association with travel and migration (p=0.44), and social determinants of health (p=0.042).Conclusion Language training is needed for nursing students to be able to face language barriers in health care settings and improve global health, locally and internationally.Objetivo De acuerdo con la literatura, el idioma es el obstáculo más común en el contexto de la atención médica y un factor de riesgo asociado con resultados negativos. El objetivo de este estudio es presentar las diferencias percibidas entre los estudiantes de enfermería que hablan un idioma y aquellos que hablan dos o más (competencia lingüística reportada por ellos mismos) y sus habilidades y necesidades de aprendizaje en salud global.Método Estudio observacional de corte transversal entre estudiantes de enfermería de cinco universidades de Ontario. Se diseñó una encuesta para medir el conocimiento, las habilidades y las necesidades de aprendizaje en salud global.Resultados Se observó que los estudiantes que hablan más de dos idiomas tienen mayor probabilidad de interesarse más en aprender sobre problemas de salud global, los riesgos para la salud y su asociación con los viajes y la migración (p=0,44), así como sobre los determinantes sociales de la salud (p=0,042).Conclusión Es necesario que se brinde capacitación en aprendizaje de otros idiomas a los estudiantes de enfermería para que puedan afrontar las barreras impuestas por el lenguaje en los contextos de atención médica y mejorar la salud global, de manera local e internacional

Unregulated health care workers in the care of aging populations: Similarities and differences between Brazil and Canada

Introduction: The world’s population is rapidly aging. Unregulated health care workers (UHCWs) are emerging as a potentially important workforce in the care of older adults. Objective: A review was conducted to identify the activities of UHCWs with respect to contributions and limitations. Methods: A systematic integrative literature review was conducted using online databases (LILACS, PubMed, EMBASE, CINAHL, and grey literature). The inclusion criteria were as follows: (i) description of UHCW activities related to older adults; and (ii) description of UHCW activities performed in Brazil or Canada. Results: Eleven papers were included in this review. In both countries, UHCW activities included health promotion, mental health care, and rehabilitation. In Brazil, UHCWs performed integrated care, while in Canada UHCWs performed personal care and housekeeping. Conclusion: These results highlight the potential and limits of UHCWs who provide care for the aging population. Such information is important to health and social policy making and household decision making

Usability and Efficacy of Artificial Intelligence Chatbots (ChatGPT) for Health Sciences Students: Protocol for a Crossover Randomized Controlled Trial

BackgroundThe integration of artificial intelligence (AI) into health sciences students’ education holds significant importance. The rapid advancement of AI has opened new horizons in scientific writing and has the potential to reshape human-technology interactions. AI in education may impact critical thinking, leading to unintended consequences that need to be addressed. Understanding the implications of AI adoption in education is essential for ensuring its responsible and effective use, empowering health sciences students to navigate AI-driven technologies’ evolving field with essential knowledge and skills. ObjectiveThis study aims to provide details on the study protocol and the methods used to investigate the usability and efficacy of ChatGPT, a large language model. The primary focus is on assessing its role as a supplementary learning tool for improving learning processes and outcomes among undergraduate health sciences students, with a specific emphasis on chronic diseases. MethodsThis single-blinded, crossover, randomized, controlled trial is part of a broader mixed methods study, and the primary emphasis of this paper is on the quantitative component of the overall research. A total of 50 students will be recruited for this study. The alternative hypothesis posits that there will be a significant difference in learning outcomes and technology usability between students using ChatGPT (group A) and those using standard web-based tools (group B) to access resources and complete assignments. Participants will be allocated to sequence AB or BA in a 1:1 ratio using computer-generated randomization. Both arms include students’ participation in a writing assignment intervention, with a washout period of 21 days between interventions. The primary outcome is the measure of the technology usability and effectiveness of ChatGPT, whereas the secondary outcome is the measure of students’ perceptions and experiences with ChatGPT as a learning tool. Outcome data will be collected up to 24 hours after the interventions. ResultsThis study aims to understand the potential benefits and challenges of incorporating AI as an educational tool, particularly in the context of student learning. The findings are expected to identify critical areas that need attention and help educators develop a deeper understanding of AI’s impact on the educational field. By exploring the differences in the usability and efficacy between ChatGPT and conventional web-based tools, this study seeks to inform educators and students on the responsible integration of AI into academic settings, with a specific focus on health sciences education. ConclusionsBy exploring the usability and efficacy of ChatGPT compared with conventional web-based tools, this study seeks to inform educators and students about the responsible integration of AI into academic settings. Trial RegistrationClinicalTrails.gov NCT05963802; https://clinicaltrials.gov/study/NCT05963802 International Registered Report Identifier (IRRID)PRR1-10.2196/5187

Assessing and Comparing Global Health Competencies in Rehabilitation Students

Purpose. Globalization is contributing to changes in health outcomes and healthcare use in many ways, including health professionals’ practices. The objective of this study was to assess and compare global health competencies in rehabilitation students. Method. Online cross-sectional survey of physiotherapy and occupational therapy students from five universities within Ontario. We used descriptive statistics to analyze students’ perceived knowledge, skills, and learning needs in global health. We used Chi-square tests, with significance set at , to compare results across professions. Results. One hundred and sixty-six students completed the survey. In general, both physiotherapy and occupational therapy students scored higher on the “relationship between work and health,” “relationship between income and health,” and “socioeconomic position (SEP) and impact on health” and lower on “Access to healthcare for low income nations,” “mechanisms for why racial and ethnic disparities exist,” and “racial stereotyping and medical decision making.” Occupational therapy students placed greater importance on learning concerning social determinants of health (). Conclusion. This paper highlights several opportunities for improvement in global health education for rehabilitation students. Educators and professionals should consider developing strategies to address these needs and provide more global health opportunities in rehabilitation training programs.Peer Reviewe