Youth-developed Recommendations on Public Health Planning for Future Pandemics or Public Health Emergencies: A National Delphi Study (preprint)

Background. In Canada, multiple studies reported an increase in youth-reported anxiety, depression, and substance use over the course of the COVID-19 pandemic. As the country has decreased restrictions, it is important to consider public health planning for future pandemics and emergencies, in light of the associated youth mental health and substance use burden. To prevent youth from falling further behind, we need to focus on public health planning recommendations to optimize Canada’s future response. The objective of the study was to generate concrete, youth-derived recommendations for government, policymakers, and service planners to support public health planning for the next pandemic or public health emergency. Methods. Using a virtual, modified Delphi, Youth Delphi Expert Panel Members rated recommendation items over three rounds, with the option to create their own recommendations items. “Consensus” was defined a priori if ≥ 70% of the entire group, or subgroups of youth (e.g., age, race/ethnicity, gender and sexual identities), rated items at a 6 or 7 (on a 7-point Likert scale). Items that did not achieve consensus were dropped in subsequent rounds. Content analysis was used for qualitative responses in Rounds 1 and 2. Youth were engaged as members of an expert advisory committee throughout the design, implementation, and interpretation of findings. Results. A total of n=40 youth participated in Round 1 with good retention (>95%) in subsequent rounds. Youth endorsed eleven recommendations to support public health planning for the next pandemic or public health emergency. Youth prioritized easily accessible, clear, and understandable information about pandemics; and equitably and efficiently distributed vaccines. They also prioritized increased awareness of timely and accessible mental health and substance use services in schools, workplaces and communities; greater investment in free or inexpensive MHSU services; and health professionals and scientists leading pandemic-related policy decisions. Conclusions. For Canada to move forward in a relevant, efficient, and ethically sound manner, decisions must be guided by the population that these decisions affect. These recommendations can be used to guide Canada’s strategies and policies to prepare for future public health emergencies and pandemics, prioritizing the needs of youth, families/caregivers, and communities.

Supporting young people through the COVID-19 pandemic and beyond: A multi-site qualitative longitudinal study (preprint)

Throughout the COVID-19 pandemic, youth have experienced substantial stress due to abrupt changes in education, finances, and social life, compounding pre-existing stressors. With youth (ages 15-26) often at critical points in development, they are vulnerable to long-term mental health challenges brought on by pandemic trauma. To identify youth experiences throughout the pandemic and examine changes over time, we conducted semi-structured interviews among n=141 youth in two Canadian provinces (Ontario and British Columbia) and across the country of Ireland at three time points over the course of more than one year (August 2020-October 2021). We conducted a qualitative longitudinal analysis using an inductive content approach. Categories identified were (1) coping with hardship; (2) opportunities for growth; (3) adapting to new ways of accessing services; (4) mixed views on the pandemic: attitudes, behaviour, and perception of policy response; (5) navigating COVID-19 information; (6) transitioning to life after the pandemic; and (7) youth-led recommendations for government and service response. The findings also reveal trends in health and wellness in accordance with prolonged periods of lockdown, changes in weather, and return to normalcy after the availability of COVID-19 vaccines. Key recommendations from youth include incorporating youth voice into decision making, communicating public health information effectively to youth, enhancing service delivery post-pandemic, and planning for future pandemics. These results provide insights into the extensive longitudinal impacts of the COVID-19 pandemic on young people across three geographical locations. Including youth in decision making for future pandemics or public health emergencies is critical.