Australian and Canadian financial wellbeing policy landscape during COVID-19: An equity-informed policy scan.

Background: This targeted and comprehensive policy scan examined how different levels of governments in Australia and Canada responded to the financial crisis brought on by the COVID-19 pandemic. We mapped the types of early policy responses addressing financial strain and promoting financial wellbeing. We also examined their equity considerations. Methods: Through a systematic search, snowballing, and manual search, we identified Canadian and Australian policies at all government levels related to financial strain or financial wellbeing enacted or amended in 2019-2020. Using a deductive-inductive approach, policies were categorized by jurisdiction level, focal areas, and target population groups. Results: In total, 213 and 97 policies in Canada and Australia, respectively, were included. Comparisons between Canadian and Australian policies indicated a more diversified and equity-targeted policy landscape in Canada. In both countries, most policies focused on individual and family finances, followed by housing and employment areas. Conclusions: The policy scan identified gaps and missed opportunities in the early policies related to financial strain and financial wellbeing. While fast, temporary actions addressed individuals' immediate needs, we recommend governments develop a longer-term action plan to tackle the root causes of financial strain and poor financial wellbeing for better health and non-health crisis preparedness. Statement on Ethics and Informed Consent: This research reported in this paper did not require ethical clearance or patient informed consent as the data sources were published policy documents. This study did not involve data collection with humans (or animals), nor any secondary datasets involving data provided by humans (or from animal studies).

An action-oriented public health framework to reduce financial strain and promote financial wellbeing in high-income countries.

BACKGROUND: Perceived financial security impacts physical, mental, and social health and overall wellbeing at community and population levels. Public health action on this dynamic is even more critical now that the COVID-19 pandemic has exacerbated financial strain and reduced financial wellbeing. Yet, public health literature on this topic is limited. Initiatives targeting financial strain and financial wellbeing and their deterministic effects on equity in health and living conditions are missing. Our research-practice collaborative project addresses this gap in knowledge and intervention through an action-oriented public health framework for initiatives targeting financial strain and wellbeing. METHODS: The Framework was developed using a multi-step methodology that involved review of theoretical and empirical evidence alongside input from a panel of experts from Australia and Canada. In an integrated knowledge translation approach, academics (n = 14) and a diverse group of experts from government and non-profit sectors (n = 22) were engaged throughout the project via workshops, one-on-one dialogues, and questionnaires. RESULTS: The validated Framework provides organizations and governments with guidance for the design, implementation, and assessment of diverse financial wellbeing- and financial strain-related initiatives. It presents 17 priority actionable areas (i.e., entry points for action) likely to have long-lasting, positive effects on people's financial circumstances, contributing to improved financial wellbeing and health. The 17 entry points relate to five domains: Government (All Levels), Organizational & Political Culture, Socioeconomic & Political Context, Social & Cultural Circumstances, and Life Circumstances. CONCLUSIONS: The Framework reveals the intersectionality of root causes and consequences of financial strain and poor financial wellbeing, while also reinforcing the need for tailored actions to promote socioeconomic and health equity for all people. The dynamic, systemic interplay of the entry points illustrated in the Framework suggest opportunities for multi-sectoral, collaborative action across government and organizations towards systems change and the prevention of unintended negative impacts of initiatives.

A Policy-Ready Public Health Guidebook of Strategies and Indicators to Promote Financial Well-Being and Address Financial Strain in Response to COVID-19.

INTRODUCTION: The COVID-19 pandemic has adversely affected the financial well-being of populations globally, escalating concerns about links with health care and overall well-being. Governments and organizations need to act quickly to protect population health relative to exacerbated financial strain. However, limited practice- and policy-relevant resources are available to guide action, particularly from a public health perspective, that is, targeting equity, social determinants of health, and health-in-all policies. Our study aimed to create a public health guidebook of strategies and indicators for multisectoral action on financial well-being and financial strain by decision makers in high-income contexts. METHODS: We used a multimethod approach to create the guidebook. We conducted a targeted review of existing theoretical and conceptual work on financial well-being and strain. By using rapid review methodology informed by principles of realist review, we collected data from academic and practice-based sources evaluating financial well-being or financial strain initiatives. We performed a critical review of these sources. We engaged our research-practice team and government and nongovernment partners and participants in Canada and Australia for guidance to strengthen the tool for policy and practice. RESULTS: The guidebook presents 62 targets, 140 evidence-informed strategies, and a sample of process and outcome indicators. CONCLUSION: The guidebook supports action on the root causes of poor financial well-being and financial strain. It addresses a gap in the academic literature around relevant public health strategies to promote financial well-being and reduce financial strain. Community organizations, nonprofit organizations, and governments in high-income countries can use the guidebook to direct initiative design, implementation, and assessment.

Community Lenses Revealing the Role of Sociocultural Environment on Physical Activity.

PURPOSE: To identify perceptions of how sociocultural environment enabled and hindered physical activity (PA) participation. DESIGN: Community-based participatory research. SETTING: Two semirural and two urban communities located in Alberta, Canada. PARTICIPANTS: Thirty-five people (74.3% females, 71.4% aged 25-64 years) across the four communities. METHOD: PhotoVoice activities occurred over 3 months during the spring of 2009. Participants were asked to document perceived environmental attributes that might foster or inhibit PA in their community. Photographs and narratives were shared in one-on-one interviews. Line-by-line coding of the transcripts was independently conducted by two researchers using an inductive approach. Codes were arranged into themes and subthemes, which were then organized into the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. RESULTS: Six main themes (accompanied by subthemes) emerged: sociocultural aesthetics, safety, social involvement, PA motivation, cultural ideas of recreation, and car culture. Representative quotes and photographs illustrate enablers and obstacles identified by participants. CONCLUSION: This PhotoVoice study revealed how aspects of participants' sociocultural environments shaped their decisions to be physically active. Providing more PA resources is only one step in the promotion of supportive environments. Strategies should also account for the beautification and maintenance of communities, increasing feelings of safety, enhancement of social support among community members, popularization of PA, and mitigating car culture, among others.

Understanding key influencers' attitudes and beliefs about healthy public policy change for obesity prevention.

OBJECTIVE: As overweight and obesity is a risk factor for chronic diseases, the development of environmental and healthy public policy interventions across multiple sectors has been identified as a key strategy to address this issue. METHODS: In 2009, a survey was developed to assess the attitudes and beliefs regarding health promotion principles, and the priority and acceptability of policy actions to prevent obesity and chronic diseases, among key policy influencers in Alberta and Manitoba, Canada. Surveys were mailed to 1,765 key influencers from five settings: provincial government, municipal government, school boards, print media companies, and workplaces with greater than 500 employees. A total of 236 surveys were completed with a response rate of 15.0%. RESULTS: Findings indicate nearly unanimous influencer support for individual-focused policy approaches and high support for some environmental policies. Restrictive environmental and economic policies received weakest support. Obesity was comparable to smoking with respect to perceptions as a societal responsibility versus a personal responsibility, boding well for the potential of environmental policy interventions for obesity prevention. CONCLUSIONS: This level of influencer support provides a platform for more evidence to be brokered to policy influencers about the effectiveness of environmental policy approaches to obesity prevention.

How community environment shapes physical activity: perceptions revealed through the PhotoVoice method.

A growing body of evidence shows that community environment plays an important role in individuals' physical activity engagement. However, while attributes of the physical environment are widely investigated, sociocultural, political, and economic aspects of the environment are often neglected. This article helps to fill these knowledge gaps by providing a more comprehensive understanding of multiple dimensions of the community environment relative to physical activity. The purpose of this study was to qualitatively explore how people's experiences and perceptions of their community environments affect their abilities to engage in physical activity. A PhotoVoice method was used to identify barriers to and opportunities for physical activity among residents in four communities in the province of Alberta, Canada, in 2009. After taking pictures, the thirty-five participants shared their perceptions of those opportunities and barriers in their community environments during individual interviews. Using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework, themes emerging from these photo-elicited interviews were organized in four environment types: physical, sociocultural, economic, and political. The data show that themes linked to the physical (56.6%) and sociocultural (31.4%) environments were discussed more frequently than the themes of the economic (5.9%) and political (6.1%) environments. Participants identified nuanced barriers and opportunities for physical activity, which are illustrated by their quotes and photographs. The findings suggest that a myriad of factors from physical, sociocultural, economic, and political environments influence people's abilities to be physically active in their communities. Therefore, adoption of a broad, ecological perspective is needed to address the barriers and build upon the opportunities described by participants to make communities more healthy and active.