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The study objective was to identify correlates of tap water consumption among adolescents. French-speaking adolescents from the province of Québec (Canada) were recruited in person and online from March to July 2023 using diverse recruitment strategies. Water consumption was measured using the validated French version of a questionnaire specifically designed to measure adolescents' beverage intake. Participants answered an online survey on their attitude towards tap and bottled water which also measured individual and environmental factors that can influence tap water consumption. A total of 218 adolescents (14-17 years; 55.5% female) completed the survey. On average, 79.2% of adolescents' water intake came from tap and 33.5% of them consumed exclusively tap water. Thinking that bottled water is more convenient than tap water was a significant correlate of adolescents' tap water consumption (OR=0.70; 95% CI: 0.51, 0.95; p=0.0219). Adolescents who believed that bottled water is more convenient than tap water were less likely to consume exclusively tap water. Public health interventions aimed at promoting adolescents' tap water should strive to make tap water intake be perceived as convenient as bottled water, such as encouraging teenagers to always carry along a reusable water bottle, installing drinking fountains in popular public areas, and increasing the visibility of such fountains.
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The objective of this study was to verify if the consumption of different beverages (such as water, 100% pure fruit juice, and sugar-sweetened beverages (SSBs)) is associated with adolescents' sleep quality. French-speaking adolescents were recruited in person and online throughout the province of Québec (Canada) from the end of March to early July 2023. Beverage consumption and sleep quality were measured using French versions of validated questionnaires specifically designed for adolescents. A total of 218 adolescents (14-17 years; 55.5% female) completed the online survey. Among caffeinated SSBs, energy drink (rs = -0.16; p = 0.0197) and sugar-sweetened coffee (rs = -0.33; p < 0.0001) intake was correlated with adolescents' sleep quality. Energy drink consumption (ß = -0.0048; p = 0.0005) and being male (ß = 0.6033; p < 0.0001) were associated with adolescents' sleep quality. There was an interaction between sugar-sweetened coffee intake and biological sex that was associated with adolescents' sleep quality (p = 0.0053). Sugar-sweetened coffee consumption was correlated with adolescent girls' abilities to go to bed (rs = -0.21; p = 0.0203) and fall asleep (rs = -0.28; p = 0.0020), while in boys, it was only significantly correlated with their abilities to go to bed (rs = -0.27; p = 0.0069). Public health interventions aimed at adolescent boys should primarily target lowering energy drink consumption, while those aimed at girls should prioritize sugar-sweetened coffee intake to possibly improve their sleep quality.
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Bebidas Energéticas , Bebidas Adoçadas com Açúcar , Humanos , Adolescente , Feminino , Masculino , Café , Qualidade do Sono , AçúcaresRESUMO
BACKGROUND: With the advent of the COVID-19 pandemic, in-person social interactions and opportunities for accessing resources that sustain health and well-being have drastically reduced. We therefore designed the pan-Canadian prospective COVID-19: HEalth and Social Inequities across Neighbourhoods (COHESION) cohort to provide a deeper understanding of how the COVID-19 pandemic context affects mental health and well-being, key determinants of health, and health inequities. METHODS: This paper presents the design of the two-phase COHESION Study, and descriptive results from the first phase conducted between May 2020 and September 2021. During that period, the COHESION research platform collected monthly data linked to COVID-19 such as infection and vaccination status, perceptions and attitudes regarding pandemic-related measures, and information on participants' physical and mental health, well-being, sleep, loneliness, resilience, substances use, living conditions, social interactions, activities, and mobility. RESULTS: The 1,268 people enrolled in the Phase 1 COHESION Study are for the most part from Ontario (47%) and Quebec (33%), aged 48 ± 16 years [mean ± standard deviation (SD)], and mainly women (78%), White (85%), with a university degree (63%), and living in large urban centers (70%). According to the 298 ± 68 (mean ± SD) prospective questionnaires completed each month on average, the first year of follow-up reveals significant temporal variations in standardized indexes of well-being, loneliness, anxiety, depression, and psychological distress. CONCLUSIONS: The COHESION Study will allow identifying trajectories of mental health and well-being while investigating their determinants and how these may vary by subgroup, over time, and across different provinces in Canada, in varying context including the pandemic recovery period. Our findings will contribute valuable insights to the urban health field and inform future public health interventions.
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COVID-19 , Saúde Mental , Interação Social , Feminino , Humanos , Masculino , COVID-19/epidemiologia , COVID-19/psicologia , Depressão , Ontário , Pandemias , Quebeque , Determinantes Sociais da SaúdeRESUMO
INTRODUCTION: Psychosocial impacts of the coronavirus (COVID-19) pandemic, including those on mental health, are now recognized. However, the experience of the COVID-19 pandemic differs from one individual, group or context to another and solutions to cope with it must be adapted and contextualized. AIM OF THE STUDY: This study aims to identify factors of psychosocial vulnerability in rural populations in Quebec (Canada). METHOD: The approach is adapted from previous work on the prevention and reduction of the psychosocial impacts of climate change in non-metropolitan areas. A descriptive qualitative design based on several data sources was used. The data come from a press review, a review of the scientific literature, semi-structured interviews with key actors in the community and municipal domains. RESULTS: Data triangulation and validation by community organization teams (public health department) identified forty-one (N = 41) factors (e.g., social cohesion, digital literacy) likely to increase or decrease the psychosocial vulnerability of rural populations in the context of a pandemic. These factors are grouped under six categories of determinants: 1) population's knowledge and attitudes towards the pandemic, 2) previous experience of difficult events, 3) community dynamism, social cohesion and solidarity, 4) citizens, municipalities and government authorities' involvement, 5) health and social services and those from their intersectoral partners, and 6) land use planning. CONCLUSION: These results are useful for local and regional public health teams in developing local portraits of psychosocial vulnerabilities to support plans to strengthen community resilience and reduce social and health inequalities accentuated by the pandemic.
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COVID-19 , Pandemias , COVID-19/epidemiologia , Humanos , Saúde Mental , Quebeque/epidemiologia , População RuralRESUMO
INTRODUCTION: The COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and social services to reorganise. This unprecedented crisis forces individuals to make considerable efforts to adapt and will have psychological and social consequences, mainly on vulnerable individuals, that will remain once the pandemic is contained and will most likely exacerbate existing social and gender health inequalities. This crisis also puts a toll on the capacity of our healthcare and social services structures to provide timely and adequate care. The MAVIPAN (Ma vie et la pandémie/ My Life and the Pandemic) study aims to document how individuals, families, healthcare workers and health organisations are affected by the pandemic and how they adapt. METHODS AND ANALYSIS: MAVIPAN is a 5-year longitudinal prospective cohort study launched in April 2020 across the province of Quebec (Canada). Quantitative data will be collected through online questionnaires (4-6 times/year) according to the evolution of the pandemic. Qualitative data will be collected with individual and group interviews and will seek to deepen our understanding of coping strategies. Analysis will be conducted under a mixed-method umbrella, with both sequential and simultaneous analyses of quantitative and qualitative data. ETHICS AND DISSEMINATION: MAVIPAN aims to support the healthcare and social services system response by providing high-quality, real-time information needed to identify those who are most affected by the pandemic and by guiding public health authorities' decision making regarding intervention and resource allocation to mitigate these impacts. MAVIPAN was approved by the Ethics Committees of the Primary Care and Population Health Research Sector of CIUSSS de la Capitale-Nationale (Committee of record) and of the additional participating institutions. TRIAL REGISTRATION NUMBER: NCT04575571.
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COVID-19 , Pandemias , COVID-19/epidemiologia , Saúde Global , Humanos , Estudos Prospectivos , Saúde PúblicaRESUMO
AIM: To describe the state of health of Quebec nursing staff during the pandemic according to their exposure to COVID-19, work-related characteristics and sociodemographic factors (gender, generational age group). State of health was captured essentially by assessing psychological distress, depression symptoms and fatigue. DESIGN AND METHODS: A large-scale cross-sectional study was conducted with 1,708 nurses and licenced practical nurses in Quebec (87% women, mean age of 41 ± 11 years). The survey included several questionnaires and validated health-related scales (psychological distress, depression symptoms and fatigue). The STROBE guidelines were followed in reporting the study's findings. RESULTS: Results showed that the prevalence of psychological distress and depression symptoms was moderate to severe. Women, generation Xers and Yers, nurses who cared for COVID-19 patients and those with a colleague who was infected with COVID-19 at work scored higher for fatigue, psychological distress and depression.
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COVID-19 , Recursos Humanos de Enfermagem , Angústia Psicológica , Adulto , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Quebeque/epidemiologia , SARS-CoV-2RESUMO
Nurses can help improve access to health services and the quality of the care, provided that they fully engage in their field of practice. Conducted in Quebec in a remote region far from any major urban centers, this study aims to 1) measure the actual scope of nursing practice (ASCOP) in community health services and 2) determine the individual and work-based characteristics that influence it. This study uses a transversal description of work.Forty-four (44) nurses practicing in different types of community health services were invited to answer an online questionnaire. The results indicate a suboptimal ASCOP. Activities related to improving the quality and safety of care obtained the lowest scores. Activities with the highest scores were the assessment and planning of care, the education of individuals and their families, and updating and using knowledge. While no characteristics influenced the overall ASCOP, significant differences were found for gender, weekly working time, and sub-regions for certain dimensions of the ASCOP. The findings offer some insight into nursing practices in community health services in remote areas. This portrait helps to formulate recommendations adapted to these contexts.
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Serviços de Saúde Comunitária , Papel do Profissional de Enfermagem , Serviços de Saúde Rural , Humanos , Quebeque , Inquéritos e QuestionáriosRESUMO
The prevalence of common mental disorders (CMD) increases both in Quebec and in the world. Governments, researchers and clinicians are in search of the best practices to improve the services offered to clients with CMD. The data suggest that these services should be primarily offered in primary care, but their current organization in Quebec does not adequately address the needs of people with CMD as well as those of their relatives. Over the next few years, different types of nurses will have an expanded role in primary care and will represent a larger portion of the workforce at this level, potentially improving access to services. Nurses and other clinicians are not always aware of the role of nurses in mental health and their contribution to all phases of the continuum of care. Interprofessional collaboration is fundamental to improving mental primary care services and is based on a fair understanding of roles among all members of a team. The objectives of this article are to: 1) describe best practices in primary care for interprofessional collaboration in mental health; 2) discuss the roles of nurses in CMD; and (3) to present avenues of intervention to extend these roles. A conceptualization of nursing roles well integrated into an multiprofessional primary care practice in mental health is presented in this article.
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Transtornos Mentais/terapia , Papel do Profissional de Enfermagem , Enfermagem de Atenção Primária , Acessibilidade aos Serviços de Saúde , Humanos , Relações InterprofissionaisRESUMO
INTRODUCTION: The overall aim of this project is to help develop knowledge about primary care delivery models likely to improve the accessibility, quality and efficiency of care. Operationally, this objective will be achieved through supporting and evaluating 8 primary care team pilot sites that rely on an expanded nursing role within a more intensive team-based, interdisciplinary setting. METHODS AND ANALYSIS: The first research component is aimed at supporting the development and implementation of the pilot projects, and is divided into 2 parts. The first part is a logical analysis based on interpreting available scientific data to understand the causal processes by which the objectives of the intervention being studied may be achieved. The second part is a developmental evaluation to support teams in the field in a participatory manner and thereby learn from experience. Operationally, the developmental evaluation phase mainly involves semistructured interviews. The second component of the project design focuses on evaluating pilot project results and assessing their costs. This component is in turn made up of 2 parts. Part 1 is a pre-and-post survey of patients receiving the intervention care to analyse their care experience. In part 2, each patient enrolled in part 1 (around 4000 patients) will be matched with 2 patients followed within a traditional primary care model, so that a comparative analysis of the accessibility, quality and efficiency of the intervention can be performed. The cohorts formed in this way will be followed longitudinally for 4 years. ETHICS AND DISSEMINATION: The project, as well as all consent forms and research tools, have been accepted by 2 health sciences research ethics committees. The procedures used will conform to best practices regarding the anonymity of patients.
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Atenção à Saúde/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Protocolos Clínicos , Acessibilidade aos Serviços de Saúde , Humanos , Estudos Longitudinais , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Garantia da Qualidade dos Cuidados de Saúde , QuebequeRESUMO
INTRODUCTION: This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec's remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders. METHODS: Quality indicators were identified from evidence and case studies were reconstructed using data collected in health records over a 2-year observation period. Data collection was developed using a three-step iterative process: (1) feasibility analysis, (2) development of a data collection tool, and (3) application of the data collection method. The adaptation of quality-of-care indicators to remote regions was appraised according to their relevance, measurability and construct validity in this context. RESULTS: As a result of this process, 18 quality indicators were shown to be relevant, measurable and valid for establishing a critical quality appraisal of four recommended dimensions of PHC clinical processes: recognition, assessment, treatment and follow-up. CONCLUSIONS: There is not only an interest in the use of health records to assess the quality of PHC for mental health in remote regions but also a scientific value for the rigorous and meticulous methodological approach developed in this study. From the perspective of stakeholders in the PHC system of care in remote areas, quality indicators are credible and provide potential for transferability to other contexts. This study brings information that has the potential to identify gaps in and implement solutions adapted to the context.
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Transtorno Depressivo/terapia , Transtornos Mentais/terapia , Serviços de Saúde Mental/normas , Atenção Primária à Saúde/normas , População Rural , Registros Eletrônicos de Saúde , Estudos de Viabilidade , Pesquisa sobre Serviços de Saúde , Humanos , Estudos de Casos Organizacionais , Avaliação de Processos e Resultados em Cuidados de Saúde , Atenção Primária à Saúde/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , QuebequeRESUMO
BACKGROUND: Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. OBJECTIVE: In order to target ways of improving the services provided in these contexts to individuals in Nunavik with depression or anxiety disorders, this research examines delays and disruptions in the continuum of care and clinical, individual and organizational characteristics possibly associated with their occurrences. DESIGN: A total of 155 episodes of care involving a common mental disorder (CMD), incident or recurring, were documented using the clinical records of 79 frontline health and social services (FHSSs) users, aged 14 years and older, living in a community in Nunavik. Each episode of care was divided into 7 stages: (a) detection; (b) assessment; (c) intervention; (d) planning the first follow-up visit; (e) implementation of the first follow-up visit; (f) planning a second follow-up visit; (g) implementation of the second follow-up visit. Sequential analysis of these stages established delays for each one and helped identify when breaks occurred in the continuum of care. Logistic and linear regression analysis determined whether clinical, individual or organizational characteristics influenced the breaks and delays. RESULTS: More than half (62%) the episodes of care were interrupted before the second follow-up. These breaks mostly occurred when planning and completing the first follow-up visit. Episodes of care were more likely to end early when they involved anxiety disorders or symptoms, limited FHSS teams and individuals over 21 years of age. The median delay for the first follow-up visit (30 days) exceeded guideline recommendations significantly (1-2 weeks). CONCLUSION: Clinical primary care approaches for CMDs in Nunavik are currently more reactive than preventive. This suggests that recovery services for those affected are suboptimal.
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Continuidade da Assistência ao Paciente/organização & administração , Atenção à Saúde/métodos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Adolescente , Adulto , Fatores Etários , Clima Frio , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Serviços de Saúde Mental/organização & administração , Pessoa de Meia-Idade , Razão de Chances , Avaliação de Programas e Projetos de Saúde , Quebeque , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Adulto JovemRESUMO
Since 2005, the Mental Health Action Plan maps out development and reorganization of mental health services in Québec. With concurrent reforms affecting the overall layout of the health care system, the Action Plan especially seeks to improve the management of common mental disorders. This particular concern calls for transformations at the primary care level. Contextual analysis of contrasting settings allows the identification of the main determinants in this actual process of change and in the ways collaborative issues are addressed.