Ill-Informed Consent? A Content Analysis of Physical Risk Disclosure in School-Based HPV Vaccine Programs

This study examines the accuracy completeness and consistency of human papilloma virus HPV vaccine related physical risks disclosed in documents available to parents legal guardians and girls in Canadian jurisdictions with schoolbased HPV vaccine program

An epidemiological survey of chlamydial & gonococcal infections in a Canadian Arctic community : determinants of sexually transmitted infections among remote Inuit populations

Research Problem Sexually transmitted infections (STIs) pose serious health problems for Canadian Inuit people. This is compounded by ineffective screening and disease prevention strategies. Programs will have little impact on reducing infection rates if they do not target accurate disease prevalence and key determinants of transmission. Methods A cross-sectional survey (Part A) was conducted among Inuit males and females (ages 15-65 years) in a Baffin community. Participants (n = 181; mean age = 29.6) were screened for chlamydia/gonorrhea and interviewed. The questionnaire, which followed the Theories of Reasoned Action and Planned Behaviour, was used to collect information on demographics, use of health services, sexual histories, STI and contraceptive knowledge, high-risk behaviours, perceived risk and barriers of condom use. A random sample (n = 100) was selected from Part A for the longitudinal cohort. Individuals were followed every two months post baseline for four follow-up visits. At each visit, participants were screened for chlamydia/gonorrhea and questioned about their sexual/social networks and condom use. Networks were developed through "snowball"sampling. Results Overall, 35 cases of chlamydia were detected, with 21 detected at baseline and 14 during followup. The combined cases gave an overall prevalence of 15.6% in comparison with 2.7% that was previously estimated. No gonorrhea was detected. The strongest predictors for STIs included: female gender (OR 2.45, CI: 0.55, 10.89), recent STI (OR 9.82, CI: 2.70, 35.77) and a history of greater than 2 previous STIs (OR 1. 47, 0.92, 2.30). Chlamydia prevalence decreased by at least 22% post baseline screening and treatment intervention. Major barriers to condom use included: embarrassed to purchase condoms, discussing condom use, and fear of giving a bad impression. There were no significant differences between males and females (p = 0.73) and between the age groups (p = 0.67) regarding condom use. Conclusion Consistent with the literature, the results support universal screening use in populations with greater then 1 0% chlamydia prevalence. Screening should especially target individuals with prior history of chlamydia and/or gonorrhea. Universal screening, prompt treatment and comprehensive contact tracing are strongly recommended for STI prevention in all Inuit communities.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat

Ill-Informed Consent? A Content Analysis of Physical Risk Disclosure in School-Based HPV Vaccine Programs

This study examines the accuracy, completeness and consistency of human papilloma virus (HPV) vaccine related physical risks disclosed in documents available to parents, legal guardians, and girls in Canadian jurisdictions with school-based HPV vaccine programs

Ill-Informed Consent? A Content Analysis of Physical Risk Disclosure in School-Based HPV Vaccine Programs

This study examines the accuracy, completeness and consistency of human papilloma virus (HPV) vaccine related physical risks disclosed in documents available to parents, legal guardians, and girls in Canadian jurisdictions with school-based HPV vaccine programs

Identifying and addressing the impacts of the COVID-19 pandemic on school-based immunisation programmes in the Canadian Maritimes: a mixed methods study protocol

Introduction The COVID-19 pandemic highlighted the importance of keeping up to date on routine vaccinations. Throughout the pandemic, many routine vaccine programmes in Canada were paused or cancelled, including school-based immunisation programmes (SBIP). This resulted in decreased coverage for many vaccine-preventable diseases. While the effects of the pandemic on SBIP have been described in other provinces, its effects in the Maritime region (ie, Nova Scotia, New Brunswick and Prince Edward Island) have yet to be understood. We aim to determine how these programmes were affected by COVID-19 and associated public health measures in the Canadian Maritimes by (1) identifying and describing usual and interim catch-up programmes; (2) exploring stakeholders’ perceptions of SBIP through interviews; and (3) designing recommendations with stakeholders to address gaps in SBIP and vaccine coverage.Methods and analysis A sequential, explanatory mixed methods study design will be used to address the objectives during the study period (September 2022–December 2023). First, an environmental scan will describe changes to SBIP and vaccine coverage over a period of five school years (2018/2019–2022/2023). Findings will inform semistructured interviews (n=65) with key stakeholders (eg, health officials, healthcare providers, school officials and parents and adolescents) to explore perceptions of SBIP and changes in parental vaccine hesitancy during the pandemic. These data will be integrated to design recommendations to support SBIP during two stakeholder engagement meetings. Analysis will be guided by the behaviour change wheel, a series of complementary tools and frameworks to simplify behaviour diagnosis and analysis in public health research.Ethics and dissemination Ethics approval for this study has been obtained from Dalhousie University’s Health Sciences Research Ethics Board (Ref: 2022-6395). Informed consent will be obtained from participants prior to participating in an interview or stakeholder engagement meeting. Study findings will be disseminated through conference presentations, publications and infographics

Do the feeding practices and nutrition status among HIV-exposed infants less than 6 months of age follow the recommended guidelines in Bomet County, Kenya?

BACKGROUND: Globally, about 1.5 million pregnancies are among women living with the Human Immuno-deficiency Virus (HIV). In 2013, an estimated overall HIV prevalence of 0.34 % was reported in antenatal women in Kenya, with 13,000 new HIV infections among children. Appropriate feeding practices and good nutrition status are important for the survival, growth, development and health of HIV-exposed infants, as well as the wellbeing of their mothers. The purpose of this study was to determine the feeding practices and nutrition status of HIV-exposed infants 0–5 months of age, attending the paediatric clinic in a mission hospital in Bomet County, Kenya. METHODS: This was a cross-sectional study with quantitative and qualitative techniques in data collection and analysis. A comprehensive sample of 118 mothers/caregivers with HIV-exposed infants 0–5 months of age participated in the study. The data was analysed using SPSS software. Statistical significance was set at p values less than 0.05. RESULTS: Exclusive breastfeeding was practiced by the majority of the participants (73.7 %), 14.4 % practiced exclusive replacement feeding and 11.9 % mixed fed their infants. More than half the infants had normal length for age (57.7 %), weight for age (60.2 %) and weight for length (76.3 %). About a third (38.1 %) of the infants were stunted, 39 % were underweight and 19.5 % were wasted. Infants on mixed feeding were more likely to be stunted (OR = 2.401; 95 % CI: 0.906–5.806; p = 0.001) or underweight (OR = 2.001; 95 % CI: 0.328–6.124; p = 0.001) compared to those on exclusive breastfeeding. There was however, no significant difference in the likelihood for wasting among infants on exclusive breastfeeding, compared to those on exclusive replacement feeding (OR = 0.186; 95 % CI: 0.011–3.130; p = 0.996) or mixed feeding (OR = 1.528; 95 % CI: 0.294–7.954; p = 0.614). No significant differences were observed in the likelihood for malnutrition among infants on exclusive breastfeeding, compared to those on exclusive replacement feeding. CONCLUSION: Most mothers/caregivers fed their infants as recommended. The 11.9 % who did not observe the recommendations were however, at risk for contracting HIV. We recommend that the Ministry of Health and National AIDS and STI Control Programme develop a policy to support infants who qualify for exclusive replacement feeding but whose mothers/caregivers face constraints in compliance

Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the Theoretical Domains Framework and COM-B model

Abstract Background University students are within the age group at highest risk for acquiring sexually transmitted infections and other negative health outcomes. Despite the availability of sexual health services at university health centres to promote sexual health, many students delay or avoid seeking care. This study aimed to identify the perceived barriers and enablers to sexual health service use among university undergraduate students. Methods We used a qualitative descriptive design to conduct semi-structured focus groups and key informant interviews with university students, health care providers, and university administrators at two university health centres in Nova Scotia, Canada. The semi-structured focus group and interview guides were developed using the Theoretical Domains Framework and COM-B Model. Data were analyzed using a directed content analysis approach, followed by inductive thematic analysis. Results We conducted 6 focus groups with a total of 56 undergraduate students (aged 18–25) and 7 key informant interviews with clinicians and administrators. We identified 10 barriers and enablers to sexual health service use, under 7 TDF domains: knowledge; memory, attention and decision-making processes; social influences; environmental context and resources; beliefs about consequences; optimism; and emotion. Key linkages between students’ social opportunity and motivation were found to influence students’ access of sexual health services. Conclusions We identified barriers and enablers related to students’ capability, opportunity and motivation that influence sexual health service use. We will use these findings to design an intervention that targets the identified barriers and enablers to improve students’ use of sexual health services, and ultimately, their overall health and well-being

A Behavioral analysis of nurses’ and pharmacists’ role in addressing vaccine hesitancy: scoping review

The purpose of this review was to identify, characterize, and map the existing knowledge on a) nurses’ and pharmacists’ perceived barriers and enablers to addressing vaccine hesitancy among patients; and b) strategies or interventions for nurses and pharmacists to address vaccine hesitancy in their practice. Our comprehensive search strategy targeted peer-reviewed and grey literature. Two independent reviewers screened papers and extracted data. We coded narrative descriptions of barriers and enablers and interventions using the Behavior Change Wheel. Sixty-six records were included in our review. Reported barriers (n = 9) and facilitators (n = 6) were identified in the capability, opportunity and motivation components. The majority of the reported interventions were categorized as education (n = 47) and training (n = 26). This current scoping review offers a detailed behavioral analysis of known barriers and enablers for nurses and pharmacists to address vaccine hesitancy and interventions mapped onto these behavioral determinants

Additional file 1: of Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the Theoretical Domains Framework and COM-B model

Focus group and interview guides. (DOCX 20 kb

Stigma and blame related to COVID-19 pandemic: A case-study of editorial cartoons in Canada

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