Community- and Patient-Partner Engagement in Women's Cardiovascular Disease Research: A Rapid Review of the Evidence.

The primary objective of this rapid review is to describe community-partner and patient-partner engagement in women's cardiovascular disease (CVD) research. Secondary objectives are to: (i) describe the phase of the research in which community and patient partners were engaged; (ii) define the level of engagement at each research phase; and (iii) make recommendations for future engagement of community and/or patient partners in women's CVD research. Rapid review guidelines recommended by the Cochrane Rapid Reviews Methods Group and Tricco et al. were used to search 5 databases using medical subject headings (MeSH) and/or keywords. Participants included women (cis and trans) aged > 18 years who had ischemic heart disease, heart failure, or stroke. A risk of bias assessment was not undertaken. Findings are summarized and/or clustered as community-based participatory research, or patient-oriented and/or patient-partner research. Our search yielded 39,998 titles and abstracts. Of these, 35 were included in a final narrative synthesis, comprising data from 474 community and/or patient partners, including 417 (88%) women. Over 85% of community partners collaborated in the design and/or planning and implementation of women's CVD research; most originated in the US; only one originated in Canada. Most patient-oriented and patient-partner research originated in Canada. However, less than 50% of patient partners collaborated in any phase of research. Sex, gender, race, and ethnicity were rarely reported. Results suggest negligible community and inadequate patient-oriented and/or patient-partner engagement in women's CVD research in Canada. Improved CVD outcomes for women may be achieved with better community- and patient-partner collaboration across all phases of research, genders, race, and ethnicities.

L'objectif principal de cette brève revue de littérature est de décrire l'engagement des partenaires communautaires et des patients partenaires dans la recherche sur les maladies cardiovasculaires (MCV) chez les femmes. Les objectifs secondaires sont les suivants (i) décrire la phase de la recherche dans laquelle la communauté et les patients partenaires ont été impliqués; (ii) définir le niveau d'engagement à chaque phase de la recherche; et (iii) formuler des recommandations pour l'engagement futur des partenaires communautaires et/ou des patients partenaires dans la recherche sur les MCV chez les femmes. Les lignes directrices pour effectuer des revues de littérature rapides recommandées par le Cochrane Rapid Reviews Methods Group et Tricco et coll. ont été utilisées pour effectuer des recherches dans 5 bases de données à l'aide de rubriques médicales sous-jacentes (MeSH) et/ou de mots-clés. Les participants étaient des femmes (cis et trans) âgées de plus de 18 ans et ayant eu une cardiopathie ischémique, une insuffisance cardiaque ou un accident vasculaire cérébral. Aucune évaluation du risque de biais n'a été entreprise. Les résultats sont résumés et/ou regroupés en tant que recherche communautaire participative, ou recherche orientée vers le patient et/ou recherche avec partenariat patient. Notre recherche a collecté 39 998 titres et résumés. Parmi ceux-ci, 35 ont été inclus dans une synthèse narrative finale, comprenant des données provenant de 474 partenaires communautaires et/ou patients, dont 417 (88%) femmes. Plus de 85% des partenaires communautaires ont collaboré à la conception et/ou à la planification et à la mise en œuvre de la recherche sur les MCV chez les femmes; la plupart étaient originaires des États-Unis; une étude seulement était originaire du Canada. La plupart des recherches axées sur le patient et sur les patients partenaires ont été menées au Canada. Cependant, moins de 50 % des patients partenaires ont collaboré à l'une ou l'autre phase de la recherche. Le sexe, le genre, la race et l'origine ethnique étaient rarement rapportés. Les résultats suggèrent un engagement négligeable des communautés et un engagement insuffisant des patients et/ou des patients partenaires dans la recherche sur les MCV chez les femmes au Canada. Une meilleure collaboration entre la communauté et les patients partenaires à toutes les étapes de la recherche, quel que soit le sexe, la race ou l'origine ethnique, permettrait d'améliorer les résultats de la recherche sur les MCV chez les femmes.

From a Criminal to a Human-Rights Issue: Re-Imagining Policy Solutions to Homelessness.

Criminalizing homelessness is ineffective, costly, and immoral; yet it remains a dominant feature in the management of this global social issue. There has been little analysis investigating why punitive homeless policies have remained popular despite their ineffectiveness. In applying Bacchi's What's the Problem Represented to Be (WPR) framework to a Canadian encampment bylaw, our analysis demonstrated that public policies criminalizing homelessness continue to prevail because homelessness is fundamentally understood as a problem of deviant, criminal individual behavior. We argue that reframing understandings of homelessness from one of criminality to a human rights issue gives way to more dignified, just, and effective solutions, such as the Housing First Model. We suggest that community health nurses can serve a key role in disrupting these criminalizing discourses across domains of policy, research, and practice by advocating for holistic, rights-based, and equity-oriented policy solutions related to homelessness.

Mental health and well-being of unpaid caregivers: a cross-sectional survey protocol.

INTRODUCTION: Unpaid caregiving, care provided by family/friends, is a public health issue of increasing importance. COVID-19 worsened the mental health conditions of unpaid caregivers, increasing substance/drug use and early development of chronic disease. The impact of the intersections of race and ethnicity, sex, age and gender along with unpaid care work and caregivers' health and well-being is unknown. The aim of this study is to describe the inequities of caregiver well-being across the intersections of race and ethnicity, sex, age and gender using a cross-sectional survey design. METHODS AND ANALYSIS: We are collaborating with unpaid caregivers and community organisations to recruit a non-probability sample of unpaid caregivers over 18 years of age (n=525). Recruitment will focus on a target sample of 305 South Asian, Chinese and Black people living in Canada, who represent 60% of the Canadian racial and ethnic populations. The following surveys will be combined into one survey: Participant Demographic Form, Caregiver Well-Being Index, interRAI Self-report of Carer Needs and the GENESIS (GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond-Premature Acute Coronary Syndrome) PRAXY Questionnaire. Sample characteristics will be summarised using descriptive statistics. The scores from the Caregiver Well-Being Index will be dichotomised into fair/poor and good/excellent. A two-stage analytical strategy will be undertaken using logistic regression to model fair/poor well-being and good/excellent well-being according to the following axes of difference set a priori: sex, race and ethnicity, gender identity, age, gender relations, gender roles and institutionalised gender. The first stage of analysis will model the main effects of each factor and in the second stage of analysis, interaction terms will be added to each model. ETHICS AND DISSEMINATION: The University of Toronto's Health Sciences Research Ethics Board granted approval on 9 August 2022 (protocol number: 42609). Knowledge will be disseminated in pamphlets/infographics/email listservs/newsletters and journal articles, conference presentation and public forums, social media and through the study website. TRIAL REGISTRATION NUMBER: This is registered in the Open Sciences Framework with a Registration DOI as follows: https://doi.org/10.17605/OSF.IO/PB9TD.