Evaluation of the readability, understandability, and actionability of COVID-19 public health messaging in Atlantic Canada

IntroductionEffective communication of COVID-19 information involves clear messaging to ensure that readers comprehend and can easily apply behavioral recommendations. This study evaluated the readability, understandability, and actionability of public health resources produced by the four provincial governments in Atlantic Canada (New Brunswick, Newfoundland and Labrador, Nova Scotia, and Prince Edward Island). MethodsA total of 400 web-based resources were extracted in June 2022 and evaluated using the Flesch-Kincaid Grade Level, CDC Clear Communication Index, and the Patient and Education Materials Assessment Tool. Descriptive statistics and a comparison of mean scores were conducted across provinces and type of resources (e.g., text, video). ResultsOverall, readability of resources across the region exceeded recommendations, requiring an average Grade 11 reading level. Videos and short form communication resources, including infographics, were the most understandable and actionable. Mean scores across provinces differed significantly on each tool;Newfoundland and Labrador produced materials that were most readable, understandable, and actionable, followed by New Brunswick. DiscussionRecommendations on improving clarity of COVID-19 resources are described. Careful consideration in the development of publicly available resources is necessary in supporting COVID-19 knowledge uptake, while reducing the prevalence of misinformation.

Revelation of mindlines in the setting of crisis.

During the devastating early months of the unfolding COVID-19 pandemic in New York, healthcare systems and clinicians dynamically adapted to drastically changing everyday practice despite having little guidance from formal research evidence in the face of a novel virus. Through new, silo-breaking networks of communication, clinical teams transformed and synthesized provisional recommendations, rudimentary published research findings and numerous other sources of knowledge to address the immediate patient care needs they faced during the pandemic surge. These experiences illustrated underlying social processes that are always at play as clinicians integrate information from various sources, including research and published guidelines, with their own tacit knowledge to develop shared yet personal approaches to practice. In this article, we provide a narrative account of personal experience during the COVID-19 surge. We draw on the concept of mindlines as developed by Gabbay and Le May as a conceptual framework for interpreting that experience from the standpoint of how early information from research and guidelines was drawn on and transformed in the course of day-to-day struggle with the crisis in New York City emergency rooms. Finally, briefly referencing the challenges to conventional models of healthcare knowledge creation and translation through research and guideline production posed by COVID-19 crisis, we offer a provisional perspective on current and future developments.

The 2022 ParticipACTION Report Card on Physical Activity for Children and Youth: Focus on the COVID-19 pandemic impact and equity-deserving groups.

Introduction: The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive national assessment of physical activity and related behaviors, characteristics, and opportunities for children and youth. The 2022 Report Card assigned grades based on data gathered during the COVID-19 pandemic to reflect this extraordinary time-period in Canada. Further, while not graded, efforts were made to summarize key findings for early years children and those identifying as: having a disability, Indigenous, 2SLGBTQ+, newcomers to Canada, racialized, or girls. The purpose of this paper is to summarize the 2022 ParticipACTION Report Card on Physical Activity for Children and Youth. Methods: The best available physical activity data captured during the whole COVID-19 pandemic was synthesized across 14 different indicators in four categories. The 2022 Report Card Research Committee assigned letter grades (i.e., A-F) based on expert consensus of the evidence. Synthesis: Grades were assigned for: Daily Behaviors (Overall Physical Activity: D; Active Play: D-; Active Transportation: C-; Organized Sport: C+; Physical Education: Incomplete [INC]; Sedentary Behaviors: F; Sleep: B; 24-Hour Movement Behaviors: F), Individual Characteristics (Physical Literacy: INC; Physical Fitness: INC), Spaces and Places (Household: C, School: B-, Community and Environment: B), and Strategies and Investments (Government: B-). Compared to the 2020 Report Card, the COVID-19 specific grades increased for Active Play and Active Transportation; and decreased for Overall Physical Activity, Sedentary Behaviors, Organized Sport, and Community and Environment. There were many data gaps for equity-deserving groups. Conclusion: During the COVID-19 pandemic, the grade for Overall Physical Activity decreased from a D+ (2020) to a D, coinciding with decreases in grades reflecting fewer opportunities for sport and community/facility-based activities as well as higher levels of sedentary behaviors. Fortunately, improvements in Active Transportation and Active Play during COVID-19 prevented a worse shift in children's health behaviors. Efforts are needed to improve physical activity for children and youth during and post-pandemic, with a greater emphasis on equity-deserving groups.

COVID vaccine evaluation of barriers and resources among families of children with diagnosed allergies.

Background: We aimed to determine vaccine hesitancy and the main barriers associated with the 2019 novel coronavirus, SARS-CoV-2 (COVID-19) vaccination among families of children diagnosed with food/drug/environmental allergies. Methods: Between May and June 2021, we approached 146 families seen at the outpatient allergy clinic at the Montreal Children's Hospital and a community allergy practice were invited to complete an anonymous online survey on COVID-19 and vaccination attitudes and behaviour. Uni and multivariable logistic regressions were compared to estimate factors associated with vaccine hesitancy. Results: Among all patients, 24.1% reported vaccine hesitancy. The large majority of parents (95.2%) believed that vaccines work. The most common barrier to vaccination was fear of adverse side effects (57.0%). One-third of participants (31.5%) reported that a history of food, venom and drug allergy was a contraindication for COVID-19 vaccination. Fifty-nine (60.8%) participants stated that the dissemination of additional information would increase their willingness to be vaccinated. Most (96.9%) parents reported that their children's vaccinations were up to date. Hesitant families were more likely to be parents of children aged 6-10 years, be of Asian descent, report that mRNA vaccines are riskier than traditional vaccines, and report that the vaccine should not be given if the child has a history of allergic reaction to vaccines. Conclusion: Vaccine hesitancy exists mainly among certain ethnic groups and families with young children. Allergies to food, venom and drug allergy are commonly perceived as contraindications for COVID-19 vaccination. Knowledge translation activities addressing parental concerns will help increase vaccination rates.

Examining public health practitioners' perceptions and use of behavioural sciences to design health promotion interventions.

BACKGROUND: Behavioural sciences have been shown to support the development of more effective interventions aimed at promoting healthy lifestyles. However, the operationalization of this knowledge seems to be sub-optimal in public health. Effective knowledge transfer strategies are thus needed to optimize the use of knowledge from behavioural sciences in this field. To this end, the present study examined public health practitioners' perceptions and use of theories and frameworks from behavioural sciences to design health promotion interventions. METHODS: This study adopted an exploratory qualitative design. Semi-structured interviews were conducted among 27 public health practitioners from across Canada to explore current intervention development processes, the extent to which they integrate theory and framework from behavioural sciences, and their perceptions regarding the use of this knowledge to inform intervention design. Practitioners from the public sector or non-profit/private organizations who were involved in the development of interventions aimed at promoting physical activity, healthy eating, or other healthy lifestyle habits (e.g., not smoking) were eligible to participate. RESULTS: Public health practitioners generally agreed that behaviour change is an important goal of public health interventions. On the other hand, behavioural science theories and frameworks did not appear to be fully integrated in the design of public health interventions. The main reasons were (1) a perceived lack of fit with current professional roles and tasks; (2) a greater reliance on experiential-produced knowledge rather than academic knowledge (mainly for tailoring interventions to local setting characteristics); (3) the presence of a fragmented knowledge base; (4) the belief that theories and frameworks require too much time and resources to be operationalized; and 4) the belief that using behavioural sciences might undermine partnership building. CONCLUSIONS: This study provided valuable insights that may inform knowledge transfer strategies that could be optimally designed to support the integration of behavioural sciences theories and frameworks into public health practices.

Patient public involvement (PPI) in health literacy research: Engagement of adults with literacy needs in the co-creation of a hospital-based health literacy plan.

BACKGROUND: People with literacy needs can experience many challenges in accessing, understanding and using health services and health information. Such challenges can adversely impact patient-provider interactions and ultimately, health outcomes. Healthcare providers need to be aware of health literacy (HL) to address the demands of healthcare systems, improve their interactions with communities and patients and promote patient engagement for improved health outcomes. METHODS: This paper reports on a process of patient and public involvement (PPI) with participants in an adult literacy programme acting as PPI contributors to identify priority areas for a local hospital HL action plan and to develop a protocol for a PPI process with other groups. A qualitative community-based participatory research study design informed by principles of PPI was undertaken, drawing on the tools of participatory and visual methods, open discussion and workshop format to facilitate a process of co-creation. Three workshops with six PPI contributors took place to identify issues to be included in the hospital action plan. PPI contributors identified issues and grouped these into priority areas using discussion and ranking procedures. RESULTS: Key areas prioritised for HL action by the PPI contributors were: verbal communication, emphasising the patient's right to understand, and improved understanding of medication use. These were incorporated into the action plan. The workshop format and process were deemed acceptable to the group and input on improvements will be incorporated into further work in this area. CONCLUSION: PPI acts as a lever in the knowledge translation process. Genuine engagement with service users can meaningfully contribute to relevant and sustainable changes to services as well as foster the empowerment of service users. PATIENT OR PUBLIC CONTRIBUTION: Members of the public with literacy needs actively participated in the co-creation of a HL action plan for a local hospital and in the development of a protocol for a patient and public process for HL research.

Translation in Global Health Emergencies

The link between translation and global health is an important yet under-researched topic. COVID-19 has opened a significant responsibility and a vast space for translation scholars in approaching this topic. Starting from a brief survey of research on translation and global health, this article examines the roles of translators and interpreters in knowledge translation, and thus in the combat against COVID-19 pandemic by investigating two cases, i.e., Handbook of COVID-19 Prevention and Treatment and Jin Ji's interpreting service in Italy. It is revealed that translators and interpreters have functioned as initiators, messengers, and co-producers of COVID-19 knowledge and they, in collaboration with other actors (health practitioners, medical researchers, policymakers, etc.), have contributed to the empowerment of patients and ordinary citizens in the fight. The author argues that translation plays an indispensable part in the transcendence of frontiers (sectorial, disciplinary, cultural, and geographic) in knowledge translation, especially during global health emergencies.

The BIGG-REC database makes available all WHO/PAHO evidence informed recommendations.

OBJECTIVE: To build and maintain a living database of the Pan American Health Organization/World Health Organization (PAHO/WHO) recommendations developed using GRADE. STUDY DESIGN AND SETTING: Guidelines are identified from WHO and PAHO databases. We periodically extract recommendations, according to the health and wellbeing targets of Sustainable Development Goal 3. RESULTS: As of March 2022, the BIGG-REC (https://bigg-rec.bvsalud.org/en) database hosted 2682 recommendations contained in 285 WHO/PAHO guidelines. Recommendations were classified as follows: communicable diseases (1,581), children's health (1,182), universal health (1,171), sexual and reproductive health (910), non-communicable diseases (677), maternal health (654), COVID-19 (224), use of psychoactive substances (99), tobacco (14) and road and traffic accidents (16). BIGG-REC allows searching by SDG-3, condition or disease, type of intervention, institution, year of publication and age. CONCLUSION: Recommendation maps provide an important resource for health professionals, organizations and Member States that use evidence-informed guidance to make better decisions, providing a source for the adoption or adaptation of recommendations to meet their needs. This one-stop shop database of evidence-informed recommendations built with intuitive functionalities undoubtedly represents a long-needed tool for decision-makers, guideline developers and the public at large.

Decision-makers' experiences with rapid evidence summaries to support real-time evidence informed decision-making in crises: a mixed methods study.

BACKGROUND: There is a clear need for research evidence to drive policymaking and emergency responses so that lives are saved and resources are not wasted. The need for evidence support for health and humanitarian crisis is even more pertinent because of the time and practical constraints that decision-makers in these settings face. To improve the use of research evidence in policy and practice, it is important to provide evidence resources tailored to the target audience. This study aims to gain real-world insights from decision-makers about how they use evidence summaries to inform real-time decision-making in crisis-settings, and to use our findings to improve the format of evidence summaries. METHODS: This study used an explanatory sequential mixed method study design. First, we used a survey to identify the views and experiences of those who were directly involved in crisis response in different contexts, and who may or may not have used evidence summaries. Second, we used the insights generated from the survey to help inform qualitative interviews with decision-makers in crisis-settings to derive an in-depth understanding of how they use evidence summaries and their desired format for evidence summaries. RESULTS: We interviewed 26 decision-makers working in health and humanitarian emergencies. The study identified challenges decision-makers face when trying to find and use research evidence in crises, including insufficient time and increased burden of responsibilities during crises, limited access to reliable internet connection, large volume of data not translated into user friendly summaries, and little information available on preparedness and response measures. Decision-makers preferred the following components in evidence summaries: title, target audience, presentation of key findings in an actionable checklist or infographic format, implementation considerations, assessment of the quality of evidence presented, citation and hyperlink to the full review, funding sources, language of full review, and other sources of information on the topic. Our study developed an evidence summary template with accompanying training material to inform real-time decision-making in crisis-settings. CONCLUSIONS: Our study provided a deeper understanding of the preferences of decision-makers working in health and humanitarian emergencies about the format of evidence summaries to enable real-time evidence informed decision-making.

Creative and visual communication of health research: development of a graphic novel to share children's neighbourhood perspectives of COVID-19 lockdowns in Aotearoa New Zealand

Research dissemination to target stakeholders including communities, policymakers and practitioners is a fundamental element of successful research projects. For many of these stakeholders, however, barriers to access and uptake exist, including time taken to publish, academic jargon, language barriers, paywalled articles and time taken to consume and understand academic outputs. Ultimately these barriers could prevent research from reaching target audiences or could severely delay the uptake of key research messages. Creative and visual dissemination approaches as a complement to traditional academic outputs offer numerous advantages and may improve real-world uptake in a timely manner. In this practitioner piece, the authors present detailed methods for the development of a graphic novel using research findings from an online survey that asked children what they liked about their neighbourhood during COVID-19 lockdowns in Aotearoa New Zealand. Here, they share critical reflections from the process of developing and disseminating this creative communication, with the aim of informing and supporting future creative and visual dissemination of research findings. © The Author(s) 2023.

Current state and future directions for youth sport evaluation practices: an empirical study

Rationale: : The study purpose was to understand the current state and future directions of evaluation within the youth-serving sport sector, given the changing circumstances brought about by the COVID-19 pandemic. Methodology: : Using an exploratory approach, semi-structured interviews were conducted with 28 stakeholders who provide or support sport-based youth programming across community to national levels in the Canadian sport context. Findings: : Analyses revealed five themes related to evaluation practices before and amid the pandemic. First, an overview of the state of evaluation in the sport sector was provided. The three subsequent themes outlined how organizations pivoted their evaluation priorities and practices throughout the pandemic in planning, implementation, and dissemination. The final theme provides stakeholders' reflections on how to strengthen evaluation practices in the sport sector moving forward. Practical implications: : Findings are important for highlighting where the field of youth sport is moving toward evaluation and capacity gaps that remain. This research has and will continue to inform future knowledge mobilization and capacity-building opportunities of evaluation best practices. Research contributions: : This research advances the science of program evaluation by being the first to offer sport-specific perspectives on facilitators and barriers to evaluation both generally and during unprecedented times (e.g. global pandemic). © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Another implementation science is possible: engaging an 'intelligent public' in knowledge translation.

As the world contends with the COVID-19 pandemic, scientific expertise has permeated political discourse and the phrase 'following the science' is being used to build trust and justify government decision-making. This phrase reflects a problematic assumption that there is one objective science to follow and that the use of scientific knowledge in decision-making is inherently neutral. In this article, we examine more closely the dense and intricate relationships, values, politics, and interests that determine whose knowledge counts, who gets to speak, who is spoken for, and with what consequences, in the translation of scientific knowledge. Drawing key insights from Stengers' Manifesto for Slow Science, we argue that implementation science has a central role to play in problematising the historic dominance of certain voices and institutional structures that have come to symbolise trust, rigour, and knowledge. Yet to date, implementation science has tended to overlook these economic, social, historical, and political forces. Fraser's conception of social justice and Jasanoff's 'technologies of humility' are introduced as useful frameworks to extend the capacity of implementation science to engage the broader public as an 'intelligent public' in the translation of knowledge, during and beyond the pandemic.

Using a Nominal Group Technique to Develop a Science Communication Curriculum for Health Professionals and Clinical Researchers.

Effective science communication is fundamental to closing the gap from research and innovation to clinical implementation. Existing paradigms of science communication are often challenged by a lack of skill and engagement, particularly from those who progress the science. Currently, a standardized curriculum on science communication, with global applicability, does not exist. The purpose of this project is to address the gap in training by health professionals and clinical researchers through the development of a globally relevant curriculum for science communication. The nominal group technique (NGT) was used whereby a convenience sample of eleven science communication experts from across the globe generated, discussed, and arrived at a consensus on topics that should be included in a standardized science communication curriculum. Experts represented diverse backgrounds within the health sciences. Due to the COVID-19 pandemic and geographical constraints, the NGT was conducted virtually. The consensus-building methodology allowed for each expert to equally present ideas and collaborate with one another to create a robust and comprehensive curriculum for effective science communication. Expert panelists reached a consensus on 10 essential components of a standardized global science communication curriculum. Following the refinement of the curriculum topic areas, a virtual meeting with project co-investigators was held to review the topics and discuss relevance, applicability, and appeal to the local contexts. A standardized science communication curriculum is needed for health professionals and clinical researchers. The NGT achieved expert consensus on the core topics. The next steps are to develop the course ensuring optimal participation from learners across the globe.

Enhancing Veteran Community Reintegration Research (ENCORE): Protocol for a Mixed Methods and Stakeholder Engagement Project.

BACKGROUND: Veteran community reintegration (CR) has been defined as participation in community life, including employment or other productive activities, independent living, and social relationships. Veteran CR is a Veterans Health Administration priority, as a substantial proportion of veterans report difficulties with veteran CR following discharge from military service. OBJECTIVE: Enhancing Veteran Community Reintegration Research (ENCORE) is a project funded by Veterans Health Administration's Health Service Research and Development Service. The goal of ENCORE is to maximize veteran and family reintegration by promoting innovative research and knowledge translation (KT) that informs and improves equitable Department of Veterans Affairs (VA) policies, programs, and services. Overall, 2 strategic objectives guide ENCORE activities: mobilize veteran CR research and promote innovation, relevance, and acceleration of veteran CR research and KT. METHODS: ENCORE uses a mixed methods and stakeholder-engaged approach to achieve objectives and to ensure that the KT products generated are inclusive, innovative, and meaningful to stakeholders. Project activities will occur over 5 years (2019-2024) in 5 phases: plan, engage, mobilize, promote, and evaluate. All activities will be conducted remotely owing to the ongoing COVID-19 pandemic. Methods used will include reviewing research funding and literature examining the gaps in veteran CR research, conducting expert informant interviews with VA program office representatives, and assembling and working with a Multistakeholder Partnership (MSP). MSP meetings will use external facilitation services, group facilitation techniques adapted for virtual settings, and a 6-step group facilitation process to ensure successful execution of meetings and accomplishment of goals. RESULTS: As of December 2022, data collection for ENCORE is ongoing, with the team completing interviews with 20 stakeholders from 16 VA program offices providing veteran CR-related services. ENCORE developed and assembled the MSP, reviewed the VA funding portfolio and veteran CR research literature, and conducted a scientific gap analysis. The MSP developed a veteran CR research agenda in 2021 and continues to work with the ENCORE team to prepare materials for dissemination. CONCLUSIONS: The goal of this program is to improve the impact of veteran CR research on policies and programs. Using a stakeholder-engaged process, insights from key stakeholder groups are being incorporated to set a research agenda that is more likely to result in a relevant and responsive veteran CR research program. Future products will include the development of an effective and relevant dissemination plan and the generation of innovative and relevant dissemination products designed for rapid KT. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42029.

Creating a provincial post COVID-19 interdisciplinary clinical care network as a learning health system during the pandemic: Integrating clinical care and research.

Introduction: Coronavirus Disease-2019 (COVID-19) affects multiple organ systems in the acute phase and also has long-term sequelae. Research on the long-term impacts of COVID-19 is limited. The Post COVID-19 Interdisciplinary Clinical Care Network (PC-ICCN), conceived in July 2020, is a provincially funded resource that is modelled as a Learning Health System (LHS), focused on those people with persistent symptoms post COVID-19 infection. Methods: The PC-ICCN emerged through collaboration among over 60 clinical specialists, researchers, patients, and health administrators. At the core of the network are the post COVID-19 Recovery Clinics (PCRCs), which provide direct patient care that includes standardized testing and education at regular follow-up intervals for a minimum of 12 months post enrolment. The PC-ICCN patient registry captures data on all COVID-19 patients with confirmed infection, by laboratory testing or epi-linkage, who have been referred to one of five post COVID-19 Recovery Clinics at the time of referral, with data stored in a fully encrypted Oracle-based provincial database. The PC-ICCN has centralized administrative and operational oversight, multi-stakeholder governance, purpose built data collection supported through clinical operations geographically dispersed across the province, and research operations including data analytics. Results: To date, 5364 patients have been referred, with an increasing number and capacity of these clinics, and 2354 people have had at least one clinic visit. Since inception, the PC-ICCN has received over 30 research proposal requests. This is aligned with the goal of creating infrastructure to support a wide variety of research to improve care and outcomes for patients experiencing long-term symptoms following COVID-19 infection. Conclusions: The PC-ICCN is a first-in-kind initiative in British Columbia to enhance knowledge and understanding of the sequelae of COVID-19 infection over time. This provincial initiative serves as a model for other national and international endeavors to enable care as research and research as care.

Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project.

BACKGROUND: Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project. METHODS: This was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). RESULTS: The incidence of early SSIs decreased from 2.5% in years 1-2 to 1.1% in years 4-5. Similar results were observed for sepsis (2.7% to 1.3%) and urinary tract infections (14.2% to 4.2%). The multivariable regression results suggest that, for every observed year, the odds of early SSIs decreased. Male gender, procedure time, sepsis and preoperative skin damage increased the odds significantly. CONCLUSIONS: Our preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements. TRIAL REGISTRATION: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016-Retrospectively registered.

Predictors of Decision Regret among Caregivers of Older Canadians Receiving Home Care: A Cross-Sectional Online Survey.

Background. In Canada, caregivers of older adults receiving home care face difficult decisions that may lead to decision regret. We assessed difficult decisions and decision regret among caregivers of older adults receiving home care services and factors associated with decision regret. Methods. From March 13 to 30, 2020, at the outbreak of the COVID-19 pandemic, we conducted an online survey with caregivers of older adults receiving home care in the 10 Canadian provinces. We distributed a self-administered questionnaire through Canada's largest and most representative private online panel. We identified types of difficult health-related decisions faced in the past year and their frequency and evaluated decision regret using the Decision Regret Scale (DRS), scored from 0 to 100. We performed descriptive statistics as well as bivariable and multivariable linear regression to identify factors predicting decision regret. Results. Among 932 participants, the mean age was 42.2 y (SD = 15.6 y), and 58.4% were male. The most frequently reported difficult decisions were regarding housing and safety (75.1%). The mean DRS score was 28.8/100 (SD = 8.6). Factors associated with less decision regret included higher caregiver age, involvement of other family members in the decision-making process, wanting to receive information about the options, and considering organizations interested in the decision topic and health care professionals as trustworthy sources of information (all P < 0.001). Factors associated with more decision regret included mismatch between the caregiver's preferred option and the decision made, the involvement of spouses in the decision-making process, higher decisional conflict, and higher burden of care (all P < 0.001). Discussion. Decisions about housing and safety were the difficult decisions most frequently encountered by caregivers of older adults in this survey. Our results will inform future decision support interventions. Highlights: This is one of the first studies to assess decision regret among caregivers of older adults receiving home and community care services and to identify their most frequent difficult decisions.Difficult decisions were most frequently about housing and safety. Most caregivers of older adults in all 10 provinces of Canada experienced decision regret.Factors associated with less decision regret included higher caregiver age, the involvement of other family members in the decision-making process, wanting to receive information about the options, considering organizations interested in the decision topic, and health care professionals as trustworthy sources of information. Factors associated with more decision regret included mismatch between the caregiver's preferred option and the decision made, the involvement of spouses in the decision-making process, higher decisional conflict, and higher burden of care.

Government and public health measures in response to COVID-19 pandemic and impacts on fisheries and aquaculture in Thailand

COVID-19 pandemic has impacted global fisheries and aquaculture sector including Thailand. Shrimp and seafood industries have a massive number of workers who live and work in close contact with others. They are highly vulnerable to COVID-19. Thailand has been facing the impact of COVID-19 pandemic. Infected patients are not much compared with many countries. Thailand is recognized as one of the safe countries from COVID-19 due to the great controlling measures. The successful driver is village health volunteers (VHVs), which has been implemented in Thailand for at least four decades. The VHVs serve as an integral part of the health system, and were a critical component of the national COVID-19 response. This chapter describes the potential of the VHVs associated with a framework for knowledge translation to develop the opportunities for increasing the resilience in COVID-19 pandemic in fisheries and the aquaculture sector. The coping strategies and recommendations are discussed. © 2022 Elsevier Inc. All rights reserved.

Building capacity for integrated knowledge translation: a description of what we can learn from trainees' experiences during the COVID-19 pandemic.

The use of collaborative health research approaches, such as integrated knowledge translation (IKT), was challenged during the COVID-19 pandemic due to physical distancing measures and transition to virtual platforms. As IKT trainees (i.e. graduate students, postdoctoral scholars) within the Integrated Knowledge Translation Research Network (IKTRN), we experienced several changes and adaptations to our daily routine, work and research environments due to the rapid transition to virtual platforms. While there was an increased capacity to communicate at local, national and international levels, gaps in equitable access to training and partnership opportunities at universities and organizations have emerged. This essay explores the experiences and reflections of 16 IKTRN trainees during the first 2 years of the COVID-19 pandemic at the micro (individual), meso (organizational) and macro (system) levels. The micro level, or individual experiences, focuses on topics of self-care (taking care of oneself for physical and mental well-being), maintaining research activities and productivity, and leisure (social engagement and taking time for oneself), while conducting IKT research during the pandemic. At the meso level, the role of programmes and organizations explores whether and how institutions were able to adapt and continue research and/or partnerships during the pandemic. At the macro level, we discuss implications for policies to support IKT trainees and research, during and beyond emergency situations. Themes were identified that intersected across all levels, which included (i) equitable access to training and partnerships; (ii) capacity for reflexivity; (iii) embracing changing opportunities; and (iv) strengthening collaborative relationships. These intersecting themes represent ways of encouraging sustainable and equitable improvements towards establishing and maintaining collaborative health research approaches. This essay is a summary of our collective experiences and aims to provide suggestions on how organizations and universities can support future trainees conducting collaborative research. Thus, we hope to inform more equitable and sustainable collaborative health research approaches and training in the post-pandemic era.