Public health approaches to substance use: a scoping review protocol.

OBJECTIVE: The aim of this scoping review is to describe how a public health approach to legal and illegal psychoactive substance use has been previously defined, and to identify its core values, concepts, activities, and goals. INTRODUCTION: Jurisdictions globally are increasingly endorsing a public health approach to addressing psychoactive substance use. However, there is currently no agreed definition of this approach, and this term has been applied inconsistently in the literature, policy, and practice. A critical first step toward advancing a public health approach to substance use is identifying and articulating its core components. INCLUSION CRITERIA: This review will consider all peer-reviewed and gray literature in English focused on conceptualizing, defining, or describing a public health approach to substance use. Our review does not place limitations on populations, psychoactive substance types, or other contextual factors. METHODS: We will search PROSPERO, MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL, and Scopus, as well as health and social science databases; websites of prominent nonprofit, civil society, and government agencies/organizations in public health and substance use fields; and reference lists of included articles. Two independent reviewers will screen titles/abstracts of peer-reviewed literature, and 1 reviewer will screen titles/abstracts of gray literature. Two independent reviewers will conduct the full-text screening. A data extraction sheet will be pilot tested through double extraction. Findings will be presented as a narrative summary supported by tables and diagrams and, if feasible, a conceptual framework for understanding and applying a public health approach to substance use. SCOPING REVIEW REGISTRATION NUMBER: Open Science Framework https://osf.io/sv25e.

Strengthening collaborations at the public health system-academic interface: a call to action.

In Canada and globally, the COVID-19 pandemic has highlighted the importance of reliable and responsive public health systems. The pandemic has required decisive leadership and collaboration across all sectors of society informed by the best available evidence. In this commentary, we argue that in order to create a robust public health system equipped to address current and future public health challenges, we must prioritize and invest in stronger relationships between public health practice and academia. We briefly review key recommendations following the SARS outbreak, particularly those calling for stronger linkages between public health academia and practice settings in Canada. We then propose key actions for strengthening these linkages. Echoing other COVID-19-related calls, which request long-term reinvestment in public health education and training, we recommend the following actions: (1) Improve collaboration between education programs and public health agencies to address system needs (e.g., surge capacity) and persisting health inequities; (2) Fund a pan-Canadian public health training initiative that builds on a renewed set of public health competencies to address priority training needs (e.g., equity-oriented leadership); and (3) Prepare a cadre of certified public health leaders who can progress along public health career pathways, including those already in practice.

RéSUMé: Au Canada et ailleurs dans le monde, la pandémie de COVID-19 a montré qu'il est important d'avoir des systèmes de santé publique fiables et réactifs. La pandémie nécessite un leadership décisif et une collaboration entre tous les secteurs de la société, éclairés par les meilleures preuves disponibles. Dans ce commentaire, nous faisons valoir que pour créer un système de santé publique robuste capable de relever les défis actuels et futurs, il faut privilégier des liens plus forts entre les praticiens de la santé publique et les milieux universitaires et y consacrer les investissements nécessaires. Nous passons brièvement en revue les principales recommandations qui ont suivi la crise du SRAS, en particulier celles qui réclamaient le renforcement des liens entre les facultés de santé publique et les milieux de pratique au Canada. Nous proposons ensuite des mesures clés pour renforcer ces liens. Faisant écho à d'autres appels à l'action liés à la COVID-19, qui préconisent un réinvestissement à long terme dans l'enseignement et la formation en santé publique, nous recommandons les mesures suivantes: 1) Améliorer la collaboration entre les programmes d'enseignement et les organismes de santé publique pour aborder les besoins des systèmes (p. ex. leur capacité d'appoint) et les inégalités persistantes en santé; 2) Financer une initiative pancanadienne de formation en santé publique qui s'appuie sur un ensemble renouvelé de compétences en santé publique pour répondre aux besoins prioritaires en matière de formation (p. ex. le leadership axé sur l'équité); et 3) Préparer un groupe de dirigeants de santé publique agréés pouvant progresser dans les carrières de la santé publique, y compris des personnes qui exercent déjà la profession.

'Communities are attempting to tackle the crisis': a scoping review on community plans to prevent and reduce opioid-related harms.

OBJECTIVES: We sought to understand the implementation of multifaceted community plans to address opioid-related harms. DESIGN: Our scoping review examined the extent of the literature on community plans to prevent and reduce opioid-related harms, characterise the key components, and identify gaps. DATA SOURCES: We searched MEDLINE, Embase, PsycINFO, CINHAL, SocINDEX and Academic Search Primer, and three search engines for English language peer-reviewed and grey literature from the past 10 years. ELIGIBILITY CRITERIA: Eligible records addressed opioid-related harms or overdose, used two or more intervention approaches (eg, prevention, treatment, harm reduction, enforcement and justice), involved two or more partners and occurred in an Organisation for Economic Co-operation and Development country. DATA EXTRACTION AND SYNTHESIS: Qualitative thematic and quantitative analysis was conducted on the charted data. Stakeholders were engaged through fourteen interviews, three focus groups and one workshop. RESULTS: We identified 108 records that described 100 community plans in Canada and the USA; four had been evaluated. Most plans were provincially or state funded, led by public health and involved an average of seven partners. Commonly, plans used individual training to implement interventions. Actions focused on treatment and harm reduction, largely to increase access to addiction services and naloxone. Among specific groups, people in conflict with the law were addressed most frequently. Community plans typically engaged the public through in-person forums. Stakeholders identified three key implications to our findings: addressing equity and stigma-related barriers towards people with lived experience of substance use; improving data collection to facilitate evaluation; and enhancing community partnerships by involving people with lived experience of substance use. CONCLUSION: Current understanding of the implementation and context of community opioid-related plans demonstrates a need for evaluation to advance the evidence base. Partnership with people who have lived experience of substance use is underdeveloped and may strengthen responsive public health decision making.