Using healthy community design data to monitor and inform planning and public policy.

SETTING: In Ontario, Public Health is mandated to work with municipal partners to inform and collaborate on built environment initiatives. For the Healthy Community Design (HCD) Baseline project, Public Health partnered with three communities (approximately 132,000, 29,000 and 22,000 residents, respectively). INTERVENTION: The HCD Baseline Project created a baseline of HCD indicators containing spatial data and self-reported behaviour and perception data. Tailored indicators were determined collaboratively between Public Health and municipal planning staff. Physical HCD indicator data were collected and mapped spatially, while primary data collected from a Neighbourhood Design Survey provided residents' perceptions of HCD and reported behaviour. OUTCOMES: The HCD Baseline Project produced a data monitoring system to: track progress of HCD indicators as communities grow; measure current community design to identify municipal and public health priorities, including public policy and supportive environments; and assess the impact of future HCD interventions on the community. By compiling spatial and perception data, areas of strength and opportunity guided the collaborative development of tailored recommendations for each community. IMPLICATIONS: Findings from the HCD Baseline Project have created a stronger position for Public Health to support local municipalities. Recommendations are guiding collaborative, evidence-informed initiatives and informing local land use planning and related supportive environment policy. Data collection will be repeated in 5, 10 and 15 years to monitor trends and impact on community design.

RéSUMé: LIEU: En Ontario, la Santé publique est tenue de travailler avec des partenaires municipaux afin d'éclairer et de collaborer à des initiatives sur le cadre bâti. Pour un projet de référence sur l'aménagement communautaire favorisant la santé (ACFS) (Healthy Community Design, HCD), la Santé publique a travaillé en partenariat avec trois municipalités (d'environ 132 000, 29 000 et 22 000 résidents, respectivement). INTERVENTION: L'équipe du projet a créé une base de référence d'indicateurs d'ACFS contenant des données spatiales et des données comportementales et perceptuelles autodéclarées. Des indicateurs adaptés ont été définis de façon concertée par la Santé publique et les employés municipaux chargés de la planification. Les données sur les indicateurs physiques d'ACFS ont été collectées et cartographiées spatialement, et les données primaires, collectées au moyen d'un sondage sur l'aménagement des quartiers, ont permis de connaître les perceptions des résidents à l'égard de l'ACFS et leurs comportements autodéclarés. RéSULTATS: Le projet de référence sur l'ACFS a produit un système de contrôle des données visant à : suivre l'évolution des indicateurs d'ACFS à mesure que les municipalités se développent; mesurer l'aménagement communautaire actuel pour cerner les priorités des municipalités et de la Santé publique, notamment sur les politiques publiques et les milieux favorables; et évaluer l'impact local de futures interventions d'ACFS. Les forces et les possibilités révélées en compilant les données spatiales et perceptuelles ont orienté l'élaboration concertée de recommandations adaptées à chaque municipalité. CONSéQUENCES: Les constatations du projet de référence sur l'ACFS ont créé de meilleures conditions pour que la Santé publique puisse aider les municipalités locales. Les recommandations du projet orientent des initiatives concertées, éclairées par les données probantes, et viennent appuyer les politiques locales d'aménagement du territoire et de création de milieux favorables. La collecte de données sera répétée dans cinq, dix et quinze ans pour surveiller les tendances et l'impact sur l'aménagement communautaire.

Preconception Care: A Technology-Based Model for Delivery in the Primary Care Setting Supported by Public Health.

INTRODUCTION: To improve reproductive, maternal, and child health, preconception health (PCH) care that is innovative and generationally relevant is essential. In response, Wellington-Dufferin-Guelph Public Health (WDGPH) developed and tested an evidence-based PCH electronic intervention delivered in a primary care setting. The purpose of this study was to: (1) identify the prevalence of PCH risks among women of reproductive age, (2) determine the impact of the PCH intervention on knowledge and behaviour, and (3) assess the implementation of the intervention. METHODS: The PCH intervention was designed as a cohort study using a mixed method approach. 300 women aged 15-49 years participated across seven primary care sites. The intervention was implemented using a three-part model. PARTICIPANTS: (1) completed a Risk Assessment (RA) on tablet with results sent to their electronic medical record, (2) discussed results with primary care providers (PCPs), (3) received handout with results and key messages. Data were collected from participants (RA and two surveys), and PCPs (interviews). RESULTS: The RA screened for 34 PCH risk factors. The number of risks identified per participant ranged from 4 to 24, averaging 15. The majority reported a positive experience using the RA and would recommend the intervention. PCPs reported many practice benefits. The study highlights the positive influence that PCPs have around PCH. DISCUSSION: The PCH intervention is the first of its kind in Canada. The intervention is an evidence-based population health approach that may help to improve reproductive, maternal and child health. Further research, evaluation and promotion is needed.

The Effects of Subjective Age and Aging Attitudes on Mid- to Late-Life Sexuality.

This study examined the effects of subjective age and attitudes about aging on frequency of sex and interest in sexual activity among middle-aged and older adults. Data were drawn from two waves of the Midlife in the United States (MIDUS) study (n = 1,170 adults, mean age Time 1 = 53.70 years, SD = 9.08). Regression analyses were used to investigate the effects of subjective age and attitudes about aging on three measures of sexuality: frequency of sex, perceived quality of sexual activity, and interest in sexual activity, over 10 years. The older participants felt and the less positive their views of aging, the less they rated sexual activity as enjoyable over time. Feeling older (though not attitudes about aging) also predicted less interest in sex. Subjective age and beliefs about aging did not have an impact on frequency of sex. Although frequency of sex was not predicted by subjective aging and aging attitudes, the results suggested that subjective age and stereotypic views on aging may shape the experience of sex in later life.

Analyzing exposure, use, and policies related to tobacco use on campus for the development of comprehensive tobacco policies at Canadian post-secondary institutions.

Canadians in their early twenties represent the highest prevalence of reported tobacco use among all age groups. With the majority of Canadian young adults accessing post-secondary education, post-secondary institutions can facilitate targeting of health promotion efforts to curb tobacco use among young adults. Effective targeting requires clear comprehensive campus tobacco policies. However, the development and implementation of comprehensive campus tobacco policies has been lacking among Canadian post-secondary institutions. As the first step towards the development of a comprehensive campus tobacco policy at the University of Guelph, an on-line survey of students, faculty and staff was conducted in November 2012. The objectives of this survey were two-fold: (1) Determine the current level of exposure to second-hand smoke on campus, the type and frequency of tobacco use, opinions on seven different tobacco policy options, and the level of awareness of current tobacco policies and programs and; (2) Determine if any associations between opinions on tobacco policy options and exposure to second-hand smoke and tobacco use existed. The results of this survey demonstrate that tobacco use is associated with opinions on tobacco policy options and that the level of awareness of tobacco policies and programs is relatively low and is not associated with tobacco use. This study represents one of the first studies to examine the association between tobacco use and support of policy options and awareness of tobacco policies and programs. As other post-secondary institutions develop comprehensive tobacco policies, these findings will serve as a comparison for other similar institutions.

Implantable hearing devices.

Implantable hearing devices are becoming more common practice in assisting hearing impaired patients who do not benefit enough from conventional amplification devices such as hearing aids. This article illustrates the benefits obtained by patients who are recipients of the BAHA (Bone Anchored Hearing Aid) or cochlear implants. Patients receive significant hearing benefit from implantable hearing devices and practitioners should be aware of the criteria for referral and the significant benefits that these devices can bring to their patients.