"I Want People to Be Able to Make an Informed Choice": How Quebec naturopaths discuss vaccination in their practice.

Health care providers' recommendations can play an important role in individuals' vaccination decisions. Despite being one of the most popular complementary and alternative medicine (CAM), naturopathy is understudied in relation to vaccination decisions. We sought to address this gap through this study of vaccination perspectives of naturopathy practitioners in the province of Quebec, Canada. We conducted in-depth interviews with 30 naturopaths. Thematic analysis was conducted. Main themes were developed deductively (i.e., based on prior literature) and expanded through inductive coding of the data. Participants noted that they discuss vaccination in their practice, but only when clients asked questions or wanted advice. Naturopaths described refraining from explicitly recommending for or against vaccination. Instead, they focus on empowering their clients to make their own informed decision regarding vaccination. Most participants noted that they direct clients towards sources of information so that clients could decide for themselves, but some mentioned they discussed with clients what they considered to be risks associated with vaccination, as well as its benefits. These discussions were framed through a personalized and individual approach with clients.

Public health communication during the COVID-19 pandemic: perspectives of communication specialists, healthcare professionals, and community members in Quebec, Canada.

OBJECTIVES: Communication during a pandemic is key in ensuring adoption of preventive behaviours and limiting disease transmission. The aim of the study was to explore how communication specialists working in health and governmental institutions and healthcare professionals have communicated about COVID-19, and how different groups of the public have perceived official communications on COVID-19. METHODS: We conducted an exploratory qualitative study. Data were collected via individual semi-structured interviews and focus-group discussions. The Crisis and Emergency Risk Communication (CERC) model was used as a theoretical framework to guide data interpretation. RESULTS: We interviewed 6 communication specialists and 5 healthcare professionals. Three focus groups were held with 23 participants (8 young adults, 9 Quebecers of Asian ethnicity, and 6 Quebecers who suffered harshly from economic consequences of the pandemic and measures). Although daily press conferences were rapidly implemented in Quebec, participants highlighted several communication challenges, including accuracy and credibility of information in a context of uncertainties and rapidly evolving knowledge. Participants also identified paternalism, stigmatization of some communities, and issues with promoting action and mobilization of some subpopulations as communication challenges. CONCLUSION: Our study showed that the six core CERC principles have not all been applied systematically in communication interventions in Quebec. Despite some limitations, messages about COVID-19 risk were clearly and consistently communicated and were generally well understood by most Quebecers.

RéSUMé: OBJECTIFS: La communication en temps de pandémie joue un rôle clé dans l'adoption des comportements préventifs et le contrôle de la transmission de la maladie. Cette étude visait à explorer comment les spécialistes de la communication travaillant dans les institutions gouvernementales et de santé et les professionnels de la santé ont communiqué sur la COVID-19 et comment les différents groupes du public ont perçu les communications officielles sur la COVID-19. MéTHODE: Les données de cette étude qualitative exploratoire ont été recueillies à l'aide d'entretiens individuels semi-structurés et de groupes de discussion. Le modèle de la communication des risques en situation de crise et d'urgence (CERC) a été utilisé comme cadre théorique pour guider l'interprétation des données. RéSULTATS: Nous avons rencontré 6 experts en communication et 5 professionnels de la santé. Trois groupes de discussion ont eu lieu avec 23 participants (8 jeunes adultes, 9 Québécois d'origine asiatique et 6 Québécois ayant subi des conséquences financières importantes à cause de la pandémie et des mesures sanitaires). Bien que des conférences de presse quotidiennes aient été rapidement mises en place au Québec, les participants ont souligné plusieurs défis de communication, notamment en ce qui concerne l'exactitude et la crédibilité de l'information dans un contexte d'incertitudes et d'évolution rapide des connaissances. Les participants ont également identifié le paternalisme, la stigmatisation de certaines communautés et les problèmes de promotion de l'action et de mobilisation au sein de certaines sous-populations comme des défis de communication. CONCLUSION: Notre étude a démontré que les six principes fondamentaux du CERC n'ont pas tous été appliqués systématiquement dans les interventions de communication au Québec. Malgré certaines limites, les messages sur le risque lié à la COVID-19 ont été communiqués de manière claire et cohérente et ont été généralement bien compris par la plupart des Québécois.

"I don't think there's a point for me to discuss it with my patients": exploring health care providers' views and behaviours regarding COVID-19 vaccination.

BACKGROUND: Health care providers' knowledge and attitudes about vaccines are important determinants of their own vaccine uptake, their intention to recommend vaccines, and their patients' vaccine uptake. This qualitative study' objective was to better understand health care providers' vaccination decisions, their views on barriers to COVID-19 vaccine acceptance and proposed solutions, their opinions on vaccine policies, and their perceived role in discussing COVID-19 vaccination with patients. METHODS: Semi-structured interviews on perceptions of COVID-19 vaccines were conducted with Canadian health care providers (N = 14) in spring 2021. A qualitative thematic analysis using NVivo was conducted. RESULTS: Participants had positive attitudes toward vaccination and were vaccinated against COVID-19 or intended to do so once eligible (two delayed their first dose). Only two were actively promoting COVID-19 vaccination to their patients; others either avoided discussing the topic or only provided answers when asked questions. Participants' proposed solutions to enhance COVID-19 vaccine uptake in the public were in relation to access to vaccination services, information in multiple languages, and community outreach. Most participants were in favor of mandatory vaccination policies and had mixed views on the potential impact of the Canadian vaccine-injury support program. CONCLUSIONS: While health care providers are recognized as a key source of information regarding vaccines, participants in our study did not consider it their role to provide advice on COVID-19 vaccination. This is a missed opportunity that could be avoided by ensuring health care providers have the tools and training to feel confident in engaging in vaccine discussions with their patients.

Whether, when, how, and how much? General public's and cancer patients' views about the disclosure of genomic secondary findings.

BACKGROUND: Data on the modalities of disclosing genomic secondary findings (SFs) remain scarce. We explore cancer patients' and the general public's perspectives about disclosing genomic SFs and the modalities of such disclosure. METHODS: Sixty-one cancer patients (n = 29) and members of the public (n = 32) participated in eight focus groups in Montreal and Quebec City, Canada. They were asked to provide their perspectives of five fictitious vignettes related to medically actionable and non-actionable SFs. Two researchers used a codification framework to conduct a thematic content analysis of the group discussion transcripts. RESULTS: Cancer patients and members of the public were open to receive genomic SFs, considering their potential clinical and personal utility. They believed that the right to know or not and share or not such findings should remain the patient's decision. They thought that the disclosure of SFs should be made mainly in person by the prescribing clinician. Maintaining confidentiality when so requested and preventing genetic discrimination were considered essential. CONCLUSION: Participants in this study welcomed the prospect of disclosing genomic SFs, as long as the right to choose to know or not to know is preserved. They called for the development of policies and practice guidelines that aim to protect genetic information confidentiality as well as the autonomy, physical and psychosocial wellbeing of patients and families.