Color coded health data: factors related to willingness to share health information in South Asian community members in Canada.

Introduction: Data unavailability poses multiple challenges in many health fields, especially within ethnic subgroups in Canada, who may be hesitant to share their health data with researchers. Since health information availability is controlled by the participant, it is important to understand the willingness to share health information by an ethnic population to increase data availability within ethnocultural communities. Methods: We employed a qualitative descriptive approach to better understand willingness to share health information by South Asian participants and operated through a lens that considered the cultural and sociodemographic aspect of ethnocultural communities. A total of 22 in-depth interviews were conducted between March and July 2020. Results: The results of this study show that health researchers should aim to develop a mutually beneficial information-sharing partnership with communities, with an emphasis on the ethnocultural and socio-ecological aspects of health within populations. Conclusion: The findings support the need for culturally sensitive and respectful engagement with the community, ethically sound research practices that make participants feel comfortable in sharing their information, and an easy sharing process to share health information feasibly.

Development and Implementation of a Medical Respite Program for People Experiencing Homelessness: An Analysis of a Cross-sectoral Partnership.

People with lived experience of homelessness (PWLEH) undergo worse health outcomes despite frequent acute care use, often because their functional and social needs remain unmet. In response, a homeless shelter and the provincial health authority formed a partnership to implement a medical respite program. We describe this collaboration by conducting a qualitative study, interviewing people involved in planning and implementing the program (n=25). Thematic analysis was performed. Stakeholders were motivated by a common desire to address the health inequities experienced by PWLEH, and frontline service providers felt a sense of teamwork. However, due to logistical limitations, an evolution of partnerships, and lack of role clarity, there was no singular program vision, resulting in lack of stakeholder support and conflicts between partner organizations. Health care for PWLEH must be multidisciplinary and cross-sectoral. The synergies and challenges described shed light on how future partnerships can be navigated.

Factors Associated With Willingness to Share Health Information: Rapid Review.

BACKGROUND: To expand research and strategies to prevent disease, comprehensive and real-time data are essential. Health data are increasingly available from platforms such as pharmaceuticals, genomics, health care imaging, medical procedures, wearable devices, and internet activity. Further, health data are integrated with an individual's sociodemographic information, medical conditions, genetics, treatments, and health care. Ultimately, health information generation and flow are controlled by the patient or participant; however, there is a lack of understanding about the factors that influence willingness to share health information. A synthesis of the current literature on the multifactorial nature of health information sharing preferences is required to understand health information exchange. OBJECTIVE: The objectives of this review are to identify peer-reviewed literature that reported factors associated with health information sharing and to organize factors into cohesive themes and present a narrative synthesis of factors related to willingness to share health information. METHODS: This review uses a rapid review methodology to gather literature regarding willingness to share health information within the context of eHealth, which includes electronic health records, personal health records, mobile health information, general health information, or information on social determinants of health. MEDLINE and Google Scholar were searched using keywords such as electronic health records AND data sharing OR sharing preference OR willingness to share. The search was limited to any population that excluded health care workers or practitioners, and the participants aged ≥18 years within the US or Canadian context. The data abstraction process using thematic analysis where any factors associated with sharing health information were highlighted and coded inductively within each article. On the basis of shared meaning, the coded factors were collated into major themes. RESULTS: A total of 26 research articles met our inclusion criteria and were included in the qualitative analysis. The inductive thematic coding process revealed multiple major themes related to sharing health information. CONCLUSIONS: This review emphasized the importance of data generators' viewpoints and the complex systems of factors that shape their decision to share health information. The themes explored in this study emphasize the importance of trust at multiple levels to develop effective information exchange partnerships. In the case of improving precision health care, addressing the factors presented here that influence willingness to share information can improve sharing capacity for individuals and allow researchers to reorient their methods to address hesitation in sharing health information.

Prediction of hypertension using traditional regression and machine learning models: A systematic review and meta-analysis.

OBJECTIVE: We aimed to identify existing hypertension risk prediction models developed using traditional regression-based or machine learning approaches and compare their predictive performance. METHODS: We systematically searched MEDLINE, EMBASE, Web of Science, Scopus, and the grey literature for studies predicting the risk of hypertension among the general adult population. Summary statistics from the individual studies were the C-statistic, and a random-effects meta-analysis was used to obtain pooled estimates. The predictive performance of pooled estimates was compared between traditional regression-based models and machine learning-based models. The potential sources of heterogeneity were assessed using meta-regression, and study quality was assessed using the PROBAST (Prediction model Risk Of Bias ASsessment Tool) checklist. RESULTS: Of 14,778 articles, 52 articles were selected for systematic review and 32 for meta-analysis. The overall pooled C-statistics was 0.75 [0.73-0.77] for the traditional regression-based models and 0.76 [0.72-0.79] for the machine learning-based models. High heterogeneity in C-statistic was observed. The age (p = 0.011), and sex (p = 0.044) of the participants and the number of risk factors considered in the model (p = 0.001) were identified as a source of heterogeneity in traditional regression-based models. CONCLUSION: We attempted to provide a comprehensive evaluation of hypertension risk prediction models. Many models with acceptable-to-good predictive performance were identified. Only a few models were externally validated, and the risk of bias and applicability was a concern in many studies. Overall discrimination was similar between models derived from traditional regression analysis and machine learning methods. More external validation and impact studies to implement the hypertension risk prediction model in clinical practice are required.

Unmet Healthcare Needs Among Migrant Populations in Canada: Exploring the Research Landscape Through a Systematic Integrative Review.

OBJECTIVES: Migrants are a growing part of the Canadian population, yet they encounter many unmet healthcare needs. These needs arise from the difference between the services deemed necessary, often based on their unique socio-cultural background, and the services actually received. Therefore, a systematic integrative review was conducted to (1) identify the literature on unmet healthcare needs among different migrant populations in Canada, and (2) compile the reported factors associated with these unmet needs in various migrant groups. DESIGN: We systematically searched all major databases and grey literature sources. We included original articles that studied unmet healthcare needs among immigrants, refugees, and/or temporary migrants in Canada. RESULTS: Thirty-one studies reported unmet healthcare needs among migrants in Canada. We found five categories of unmet needs across different groups of migrants including immigrants, refugees, and temporary migrants. Immigrants and refugees face unique factors that influence the development of unmet needs, such as socio-cultural differences, communication difficulties, and lack of information. Alternatively, temporary migrants have unmet needs due to factors associated with their immigration clauses, such as healthcare coverage being conditional to work permit renewal or precarious living conditions associated with work-related housing. CONCLUSION: Further research is required on unmet needs of migrants that considers the variation of unmet needs and their causal factors within different groups of migrants, in particular, refugee claimants, foreign workers, international students, and elderly migrants.

Perceived Challenges and Unmet Primary Care Access Needs among Bangladeshi Immigrant Women in Canada.

INTRODUCTION: Understanding barriers in primary health care access faced by Canadian immigrants, especially among women, is important for developing mitigation strategies. The aim of this study was to gain an in-depth understanding of perceived challenges and unmet primary health care access needs of Bangladeshi immigrant women in Canada. METHODS: In this qualitative study, we conducted 7 focus groups among a sample of 42 first-generation immigrant women on their experiences in primary health care access in their preferred language, Bangla. Descriptive analysis was used for their socio-demographic characteristics and inductive thematic analysis was applied to the qualitative data. RESULTS: The hurdles reported included long wait time at emergency service points, frustration from slow treatment process, economic losses resulting from absence at work, communication gap between physicians and immigrant patients, and transportation problem to go to the health care centers. No access to medical records for walk-in doctors, lack of urgent care, and lack of knowledge about Canadian health care systems are a few of other barriers emerged from the focus group discussions. CONCLUSIONS: The community perception about lack of primary health care resources is quite prevalent and is considered as one of the most important barriers by the grassroots community members.

Perceived barriers and primary care access experiences among immigrant Bangladeshi men in Canada.

OBJECTIVE: The study aimed to explore the experience of male members of a rapidly grown community of Bangladeshi immigrants while accessing primary healthcare (PHC) services in Canada. DESIGN: A qualitative research was conducted among a sample of Bangladeshi immigrant men through a community-based participatory research approach. Focus group discussions were conducted to collect the qualitative data where thematic analysis was applied. SETTING: The focus group discussions were held in various community centres such as individual meeting rooms at public libraries, community halls and so on arranged in collaboration with community organisations while ensuring complete privacy. PARTICIPANT: Thirty-eight adults, Bangladeshi immigrant men, living in Calgary were selected for this study and participated in six different focus groups. The sample represents mostly married, educated, Muslim, Bangla speaking, aged over 25 years, full-time or self-employed and living in an urban centre in Canada >5 years. RESULT: The focus groups have highlighted long wait time as an important barrier. Long wait at the emergency room, difficulties to get access to general physicians when feeling sick, slow referral process and long wait at the clinic even after making an appointment impact their daily chores, work and access to care. Language is another important barrier that impedes effective communication between physicians and immigrant patients, thus the quality of care. Unfamiliarity with the healthcare system and lack of resources were also voiced that hinder access to healthcare for immigrant Bangladeshi men in Canada. However, no gender-specific barriers unique to men have been identified in this study. CONCLUSION: The barriers to accessing PHC services for Bangladeshi immigrant men are similar to that of other visible minority immigrants. It is important to recognise the extent of barriers across various immigrant groups to effectively shape public policy and improve access to PHC.

Summarising and synthesising regression coefficients through systematic review and meta-analysis for improving hypertension prediction using metamodelling: protocol.

INTRODUCTION: Hypertension is one of the most common medical conditions and represents a major risk factor for heart attack, stroke, kidney disease and mortality. The risk of progression to hypertension depends on several factors, and combining these risk factors into a multivariable model for risk stratification would help to identify high-risk individuals who should be targeted for healthy behavioural changes and/or medical treatment to prevent the development of hypertension. The risk prediction models can be further improved in terms of accuracy by using a metamodel updating technique where existing hypertension prediction models can be updated by combining information available in existing models with new data. A systematic review and meta-analysis will be performed of hypertension prediction models in order to identify known risk factors for high blood pressure and to summarise the magnitude of their association with hypertension. METHODS AND ANALYSIS: MEDLINE, Embase, Web of Science, Scopus and grey literature will be systematically searched for studies predicting the risk of hypertension among the general population. The search will be based on two key concepts: hypertension and risk prediction. The summary statistics from the individual studies will be the regression coefficients of the hypertension risk prediction models, and random-effect meta-analysis will be used to obtain pooled estimates. Heterogeneity and publication bias will be assessed, along with study quality, which will be assessed using the Prediction Model Risk of Bias Assessment Tool checklist. ETHICS AND DISSEMINATION: Ethics approval is not required for this systematic review and meta-analysis. We plan to disseminate the results of our review through journal publications and presentations at applicable platforms.