Building the field of food systems research: commentary on a research funder's role.

BACKGROUND: The Food, Environment, and Health (FEH) program of the International Development Research Centre (IDRC) aims to improve the health of low- and middle-income country populations by generating evidence, innovations, and policies that reduce the health and economic burdens of preventable chronic and infectious diseases. A predominant focus of the FEH program is research related to consumer food environments that promote or enable healthy and sustainable shifts in consumption. An evaluation of the FEH program, led by the University of Toronto, provided an opportunity to analyse the approach and role of a development funder in building the field of food systems research. DISCUSSION: In this commentary, we provide an external evaluator's perspective on the IDRC's contributory role in building the field of food systems research, based on a secondary analysis of findings from a recent FEH program evaluation. We used the field-building framework outlined in Di Ruggiero et al. (Health Res Policy System, 2017) to highlight the strengths and challenges of the FEH's approach to field-building and determined that the program aligns with six of the seven features of the framework. The FEH program has enhanced support and awareness for food systems research, provided organized funding and capacity-building opportunities, multilevel activity to support research and its use, and strong scientific leadership, and set significant standards and exemplars. However, we also found that not all sociopolitical environments have fully recognized or valued food systems research and its use for policy change. CONCLUSION: The FEH program's field-building approach can be situated within the field-building framework, and it has been successful in laying the groundwork for building the field of food systems, particularly consumer food environments research. However, supportive external environments and further investments may be needed to achieve a critical mass of capacity, continue building communities of practice, and influence policy. The FEH program approach may serve as an exemplar and comparator for other research funding agencies looking to develop strategic research programming in the field of food systems research.

Real-world vaping experiences and smoking cessation among cigarette smoking adults.

INTRODUCTION: E-cigarettes may have the potential to be an effective cessation aid for some cigarette smokers. However, the extent to which smokers' experiences using e-cigarettes (vaping) to quit smoking impact their cessation outcomes is unclear. In this cross-sectional survey study, we develop a multidimensional measure of vaping experiences in adults who quit smoking by vaping and test its association with perceived success in smoking cessation. METHODS: In 2019, recruitment invitations were emailed to adult past-year smokers who had accessed cessation services across Ontario, Canada. Respondents who tried vaping to quit smoking in the past year completed a detailed online survey. Factor analysis was performed on ratings of 45 vaping experiences items to identify dimensions of vaping experiences. Factor scores were entered into logistic regressions to test if vaping experiences dimensions had differential impact on perceived success in smoking cessation. RESULTS: Of the 889 participants, 56.0% were female, 81.1% were Caucasian, and the mean age was 37.7 ± 11.9 years. Twenty percent (19.6%) reported having successfully quit smoking by vaping in the past year. Among the six vaping experiences factors, better experiences in five factors-Relationships, Flexibility of Vaping, Side Effects, Vaping Devices, and Sensory Functions-were each independently and positively associated with improved odds of successful quitting. Notably, Relationships [OR = 2.01, 95% CI: 1.61-2.64] and Side Effects [OR = 1.95; 95% CI 1.54-2.29] were the strongest correlates of perceived success in smoking cessation. CONCLUSIONS: These findings indicate an opportunity to increase cessation rates by improving the experiences of smokers who vape to quit smoking.

Is vaping cessation like smoking cessation? A qualitative study exploring the responses of youth and young adults who vape e-cigarettes.

INTRODUCTION: Young people are now seeking help to quit vaping. However, little is known about vaping cessation. To bridge the gap between the current state of research and the urgent need for interventions, practitioners have drawn upon smoking cessation models under the assumption that vaping and smoking are fairly similar. In this study, we sought to understand the nature and extent to which vaping is similar to smoking in order to inform the development of vaping cessation interventions for young people. METHODS: Seven focus groups were conducted between November 2019 and February 2020 among youth (ages 16-18) and young adults (ages 19-29) living in the Greater Toronto Area who self-identified as e-cigarette vapers and expressed interest in vaping cessation (n = 41). Focus groups were audio recorded, transcribed verbatim, and analyzed using thematic analysis methods. RESULTS: Perceived similarities between vaping and smoking emerged from participant narratives: three themes relating to barriers to quitting (social benefits, stress reduction, sensory and behavioural gratification), and three relating to reasons for quitting (financial loss, industry influence, dependence). However, there were also perceived differences that emerged: three themes relating to barriers to quitting vaping (enjoyment of flavours, convenience and discreetness, lack of self-awareness of vaping behaviours), and two relating to reasons for quitting vaping (lack of trusted information, perceived social acceptability). CONCLUSIONS: Although there is significant overlap between vaping and smoking, understanding perceived differences in barriers to quitting and reasons for quitting is critical to advancing vaping cessation research and practice among young people.

What matters most to patients about primary healthcare: mixed-methods patient priority setting exercises within the PREFeR (PRioritiEs For Research) project.

OBJECTIVES: To identify patient-generated priority topics for future primary care research in British Columbia (BC), Canada within a diverse patient population. DESIGN: Mixed-methods priority setting exercises framed by the dialogue model, using the nominal group technique (rank-ordered scoring) and province-wide online surveys capturing importance ratings of the top 10 primary healthcare topics from patients and primary care providers. SETTING: BC, Canada. PARTICIPANTS: Topic identification was completed by 10 patient partners (7 female, 3 male) from the BC Primary Health Care Research Network Patient Advisory; online surveys were completed by 464 patients and 173 primary care providers. RESULTS: The 10 members recruited to the patient advisory provided over 80 experiences of what stood out for them in BC primary care, which were grouped thematically into 18 topics, 10 of which were retained in province-wide surveys. Top-rated survey topics for both patients (n=464) and providers (n=173) included being unable to find a regular family doctor/other primary healthcare provider, support for living with chronic conditions, mental health resources and information sharing, including electronic medical records. However, all 10 topics were rated important, on average, by both groups. CONCLUSIONS: The current project activities demonstrate the feasibility of including patients in priority setting exercises for primary healthcare in general, rather than focusing on a condition-specific population or disease area. There was considerable overlap between patient-generated topics and topics previously identified by other stakeholders, but patients identified two additional topics (mental health resources, improve and strengthen patient-provider communication). More similarities than differences in topic importance between patients and providers emerged in the online surveys. The project activities that follow (rapid literature reviews, multistakeholder dialogue) will highlight under-researched topics and inform the development of specific research questions.