Barriers to and strategies to address COVID-19 testing hesitancy: a rapid scoping review.

BACKGROUND: Testing is a foundational component of any COVID-19 management strategy; however, emerging evidence suggests that barriers and hesitancy to COVID-19 testing may affect uptake or participation and often these are multiple and intersecting factors that may vary across population groups. To this end, Health Canada's COVID-19 Testing and Screening Expert Advisory Panel commissioned this rapid review in January 2021 to explore the available evidence in this area. The aim of this rapid review was to identify barriers to COVID-19 testing and strategies used to mitigate these barriers. METHODS: Searches (completed January 8, 2021) were conducted in MEDLINE, Scopus, medRxiv/bioRxiv, Cochrane and online grey literature sources to identify publications that described barriers and strategies related to COVID-19 testing. RESULTS: From 1294 academic and 97 grey literature search results, 31 academic and 31 grey literature sources were included. Data were extracted from the relevant papers. The most cited barriers were cost of testing; low health literacy; low trust in the healthcare system; availability and accessibility of testing sites; and stigma and consequences of testing positive. Strategies to mitigate barriers to COVID-19 testing included: free testing; promoting awareness of importance to testing; presenting various testing options and types of testing centres (i.e., drive-thru, walk-up, home testing); providing transportation to testing centres; and offering support for self-isolation (e.g., salary support or housing). CONCLUSION: Various barriers to COVID-19 testing and strategies for mitigating these barriers were identified. Further research to test the efficacy of these strategies is needed to better support testing for COVID-19 by addressing testing hesitancy as part of the broader COVID-19 public health response.

Assistive technologies that support social interaction in long-term care homes: a scoping review.

OBJECTIVE: The objective of this review was to chart the literature on assistive technologies (excluding robots) that support social interaction of older adults in long-term care homes, and to advance a definition of socially assistive technologies. INTRODUCTION: Loneliness and social isolation have adverse effects on the health and well-being of older adults. Many long-term care homes provide recreational programming intended to entertain or distract residents, yet the evidence of their effectiveness is limited. Absent from the literature are comprehensive reviews of assistive technologies (other than robots) that are used to support social interaction in long-term care homes. INCLUSION CRITERIA: The review considered research studies as well as gray literature that included older adults (≥65 years) living in long-term care homes. The concept of interest was the use of assistive technologies (excluding robots) that support social interaction in long-term care homes. METHODS: The databases were searched on June 26, 2019, and included CINAHL Full Text (EBSCO), MEDLINE (Ovid), PsycINFO (EBSCO), Sociological Abstracts (ProQuest), Embase (Elsevier), and Web of Science (Clarivate). The search for gray literature was conducted in ProQuest Dissertations and Theses Databases and across 11 websites during September and October 2019. The recommended JBI approach to study selection, data extraction, and data synthesis was used. RESULTS: Twenty-five articles were included in this review, with comparable numbers of quantitative (n = 6), qualitative (n = 9), and mixed methods (n = 7) studies, with the remaining articles employing non-empirical designs (n = 3). Technologies were categorized as low (easily recognizable to everyone), medium (more electronics), or high (involves internet). Two studies reported on low-assistive technologies, including videotapes and the telephone. Medium-assistive technologies were identified in nine studies and included videophones; Nintendo Wii; tablet-based games; picture- and video-viewing tools; and CRDL (pronounced "cradle"), a special instrument that translates touch into sound. More than half (n = 14) of the included articles utilized high-assistive technologies, such as computer labs/kiosks, tablet-based applications, social media (eg, Facebook), videoconferencing, and multi-functional systems. Five studies measured whether assistive technologies had an impact on the quantity of long-term care residents' social interaction levels. Qualitative themes were related to residents' social connections and experiences after using various technologies. Four studies systematically incorporated a framework/model, and Social Structuration Theory was considered the most comprehensive. In the absence of a definition of socially assistive technologies, the definition advanced from this review is as follows: Socially assistive technologies are user-appropriate devices and tools that enable real-time connectivity to enhance social interaction. CONCLUSIONS: Included literature reported the benefits of technology use, with considerable variability in engagement and no cost estimates. We recommend that future research continue to advance our definition of socially assistive technologies, make promising assistive technologies available in long-term care homes after studies are completed, report the costs of assistive technologies, and include participants with dementia and culturally and linguistically diverse backgrounds.

How is Etuaptmumk/Two-Eyed Seeing characterized in Indigenous health research? A scoping review.

Our scoping review sought to consider how Etuaptmumk or Two-Eyed Seeing is described in Indigenous health research and to compare descriptions of Two-Eyed Seeing between original authors (Elders Albert and Murdena Marshall, and Dr. Cheryl Bartlett) and new authors. Using the JBI scoping review methodology and qualitative thematic coding, we identified seven categories describing the meaning of Two-Eyed Seeing from 80 articles: guide for life, responsibility for the greater good and future generations, co-learning journey, multiple or diverse perspectives, spirit, decolonization and self-determination, and humans being part of ecosystems. We discuss inconsistencies between the original and new authors, important observations across the thematic categories, and our reflections from the review process. We intend to contribute to a wider dialogue about how Two-Eyed Seeing is understood in Indigenous health research and to encourage thoughtful and rich descriptions of the guiding principle.

Educators' strategies for engaging diverse students in undergraduate nursing education programs: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and chart teaching strategies that educators use in classroom settings to engage diverse students in undergraduate nursing education programs. INTRODUCTION: Student engagement is critical to facilitating academic success and significant learning experiences for undergraduate nursing students. However, students from diverse backgrounds face challenges in undergraduate nursing programs, and these challenges impact their academic engagement and sense of belonging and inclusion. Creating conditions in nursing education that foster engagement by meeting the learning needs of diverse learners could facilitate their success, which ultimately might strengthen the nursing workforce diversity. INCLUSION CRITERIA: This review will consider papers on how educators engage undergraduate nursing students from diverse backgrounds in classroom settings, including online, face-to-face, and blended formats, irrespective of the country. Evidence obtained from all sources including qualitative, quantitative, and mixed methods studies, systematic reviews, as well as gray literature will be considered for inclusion. METHODS: JBI methodology for scoping reviews, which includes a three-step search strategy, will be employed. First, keywords will be identified from relevant articles in CINAHL and ERIC. Second, another search using the identified keywords and index terms across select databases will be conducted. Third, the reference lists of all identified articles will be screened for additional papers. Titles and abstracts will be screened by two independent reviewers, and then followed by the full text review of included articles against the inclusion criteria by two independent reviewers. Data will be extracted from included articles and the findings will be presented in tables, figures, and narratively as appropriate. SCOPING REVIEW PROTOCOL REGISTRATION: Open Science Framework https://osf.io/7bv5p/.

Resilience support to enhance positive health outcomes for police officers in five Anglosphere nations: a scoping review protocol.

INTRODUCTION: Law enforcement involves exposure to threatening situations and traumatic events that place police officers at risk for negative physical and mental health outcomes. Resilience support, among other elements of training, may help mitigate these risks, yet little is known about which aspects of resilience support help officers achieve better health and quality of life outcomes. METHODS AND ANALYSIS: This review will consider all literature that examines the links between resilience support, physical/mental health and quality of life outcomes for police officers in five Anglosphere nations: Canada, the USA, Australia, New Zealand and the UK. This review will include all literature (including those that show null or negative links) involving any public policing agency that has a formal rank structure and includes a localized, uniformed emergency response function. Resilience support may include, but is not limited to: tools, policies, models, frameworks, programmes and organizational features that seek to promote positive, physical/mental health and quality of life outcomes at three levels of resilience: (1) readiness and preparedness, (2) response and adaptation, (3) recovery and adjustment. Peer reviewed and grey literature examining resilience support since 2000 that focuses on police officers are eligible for inclusion. Databases/sources to be searched will include: PsycINFO, Academic Search Premier, CINAHL, Public Affair Index, Campbell Collaboration, ProQuest Dissertations and Theses Global, Business Source Complete, Scopus and Google. Retrieval of full-text, English-language studies (and other literature), data extraction, data synthesis and data mapping will be performed independently by two reviewers, following Joanna Briggs Institute methodology. ETHICS AND DISSEMINATION: Ethics approval is not required for this scoping review, and the literature search will start in November 2020 or upon acceptance of this protocol. The findings of the scoping review will be available [April 2021] and will be published in a peer reviewed journal.

The Retail Food Environment, Store Foods, and Diet and Health among Indigenous Populations: a Scoping Review.

PURPOSE OF THE REVIEW: Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS: Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.

Characteristics of Indigenous healing strategies in Canada: a scoping review.

OBJECTIVE: The objective of this review was to identify the characteristics of Indigenous healing strategies in Canada and culturally relevant approaches within Indigenous contexts. INTRODUCTION: In responding to the Canadian Truth and Reconciliation Commission's Calls to Action, there is increasing interest in Indigenous healing strategies across clinical, policy, and community sectors. The high relevance of Indigenous healing has also encouraged exploration of new approaches to research that are responsive to, and inclusive of, Indigenous contexts. To date, there is no clear understanding of what characterizes Indigenous healing strategies in Canada. INCLUSION CRITERIA: This review considered healing strategies for First Nations, Inuit, and Métis in Canada. Strategies examined included those related to health services and programs, policies and guidelines, models and frameworks, and Indigenous narratives and expert opinion in any service setting. METHODS: This review employed the JBI approach to scoping reviews. Searches were performed in CINAHL Full Text, Sociological Abstracts, PsycINFO, MEDLINE, and Academic Search Premier in December 2018. Searches for gray literature were conducted in iPortal, Canadian Electronic Library, and a list of Canadian government and Indigenous organization websites in February 2019. This review was limited to publications from 2008 onward. Non-English articles and theses and dissertations were excluded. RESULTS: Among the 59 articles included in this review, 41 were journal articles and 28 were published within the previous five years (i.e., 2014 and onward). The healing strategies were most frequently implemented in Ontario (n = 13), British Columbia (n = 8), and Manitoba (n = 5). The majority of strategies were utilized in the health settings (n = 37), which included mainstream treatment modalities as well as community-based healing initiatives. Services and programs (n = 24) were the predominant type of healing strategies, followed by models and frameworks (n = 9), policies and guidelines (n = 8), Indigenous narratives and expert opinion (n = 7), and others (n = 11). The most frequent guiding principles were identified as Honoring Cultures and Traditions (n = 14), Medicine Wheel (n = 12), and Strength-Based/Empowerment (n = 12). The most widely used main components were Artistic Expression (n = 16), Ceremonies (n = 15), and Games and Exercises (n = 12). As for human resources, Community Members (n = 19) were most frequently engaged, followed by Local Agencies (n = 12) and Knowledge Keepers (n = 12). Eight culturally relevant approaches were identified from 29 primary research studies, with the most popular being Consultation/Participatory Research (n = 20) and Indigenous Protocols (n = 5). CONCLUSIONS: The findings of this review collectively support a decolonizing approach that upholds Indigenous knowledge, respects Indigenous rights to self-determination, and recognizes Indigenous resilience and agency. More research is needed with a focus on Inuit or Métis healing, and innovative knowledge synthesis methods inclusive of diverse Indigenous ways of knowing.

Diverse Representation in Nursing Leadership: Developing a Shared Position Statement on Allyship.

Diversity initiatives are being implemented widely within academia and society more broadly; however, the School of Nursing (SoN) at Dalhousie University in Halifax, Nova Scotia, Canada, is taking an innovative approach. Faculty members recognized the need to support students at the graduate and undergraduate levels from Black, Indigenous, LGBTQ2S (Lesbian, Gay, Bisexual, Transgender, Queer, and Two-Spirit), and International communities in a student-led initiative with the mission to promote diversity, inclusion, and equity within the SoN. This coalition seeks to offer students who are often rendered invisible within the academy and society more broadly in relation to dominant cultures and normative expectations an opportunity to build relationships and expose shared histories of oppression in such a way that issues of social justice are uncovered. In response to nursing students and faculty who self-identify as members of dominant groups and who sought inclusion as allies, the leaders of the student community groups recognized a need to develop a position statement on allyship. The collaboration that transpired between the four groups of communities to develop the position statement led to the formation of the Student Equity Coalition. This article begins with the authors' definition of allyship, followed by a description of the context in which this unique initiative is taking place, the rationale behind developing a shared position statement on allyship, and the significance of this work in positioning and supporting nursing students of minority status as emerging nurse leaders.

Characteristics of Indigenous healing strategies in Canada: a scoping review protocol.

OBJECTIVE: The objective of this review is to identify the characteristics of Indigenous healing strategies in Canada and approaches to improving cultural relevance to local Indigenous contexts. INTRODUCTION: In the previous 150 years, Indigenous peoples of Canada have experienced colonization, forced assimilation, cultural oppression and violence, and these are associated with high rates of social distress and health disparities. Today, legacies of colonization continue to marginalize Indigenous peoples, creating healthcare institutions devoid of Indigenous worldviews. Despite the growing number of Indigenous healing strategies currently in existence, literature describing these strategies has not been systematically scoped. To address this gap, this scoping review will identify characteristics of Indigenous healing strategies in Canada, and explore culturally relevant approaches used in research process. INCLUSION CRITERIA: This review will consider literature that describes Indigenous healing strategies in Canada and will include First Nations, Inuit and Métis as the population of interest. Strategies may include, but are not limited to, health services and programs, policies and guidelines, models and frameworks, and Indigenous narratives and expert opinions. Healing strategies delivered in all service settings are eligible for inclusion. METHODS: The databases/sources to be searched will include: CINAHL, Sociological Abstracts, PsycINFO, MEDLINE and Academic Search Premier. Searches for gray literature will be conducted in iPortal, Canadian Electronic Library, and a list of Canadian government and Indigenous organization websites. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. Findings will be summarized in tabular forms accompanied by narrative text.