Tuberculosis related barriers and facilitators among immigrants in Atlantic Canada: A qualitative study.

Tuberculosis (TB) is a disease caused by the bacterium Mycobacterium tuberculosis and affects approximately one-quarter of the world's population. Immigrant populations in Canada are disproportionately affected by TB. Canada's immigration medical examinations include screening for active TB but not latent TB infection (LTBI). In LTBI, the bacterium remains dormant within the host but can reactivate and cause disease. Once active, TB can be transmitted to close contacts sharing confined spaces leading to the possibility of outbreaks in the broader community. This study aimed to 1) assess the current TB knowledge, perceived risk, and risk behaviors of immigrants in Atlantic Canada as well as 2) identify barriers and facilitators to testing and treatment of TB among this population. Three focus group discussions were conducted with a total of 14 non-Canadian born residents of New Brunswick aged 19 years and older. Data were analyzed using inductive thematic analysis. Four themes were identified from the data relating to barriers to testing and treatment of LTBI: 1) Need for education, 2) stigma, 3) fear of testing, treatment, and healthcare system, and 4) complacency. Results included reasons individuals would not receive TB testing, treatment, or seek help, as well as facilitators to testing and treatment. These findings may inform the implemention of an LTBI screening program in Atlantic Canada and more broadly across the country.

Remember the past, plan for the future: How interactions between risk perception and behavior during the COVID-19 pandemic can inform future Canadian public health policy.

The ongoing COVID-19 pandemic necessitated the implementation of numerous temporary public health policies, including social distancing, masking, and movement limitations. These types of measures require most citizens to follow them to be effective at a population level. This study examined population adherence to emergency public health measures using early data collected in the Spring of 2020, when all Canadian jurisdictions were under relatively strict measures. In total, 1,369 participants completed an online questionnaire package to assess adherence, perceptions of government response, and perceptions of COVID-19 risk. Results indicated that most Canadians were pleased with the government's handling of the early phases of the pandemic and immediately engaged new public health mandates. Willingness to change behaviors was unrelated to satisfaction with the government response. Similarly, behavioral adherence was also unrelated to satisfaction with government, or personal risk perceptions; however, adherence to public health guidelines was related to elevated psychological distress. As the pandemic continues, public health officials must balance the mental health of the population with the physical health concerns posed by COVID-19 when applying public health mandates.

Evaluating the mental health and well-being of Canadian healthcare workers during the COVID-19 outbreak.

During the COVID-19 pandemic, healthcare systems have been under extreme levels of stress due to increases in patient distress and patient deaths. While additional research and public health funding initiatives can alleviate these systemic issues, it is also important to consider the ongoing mental health and well-being of professionals working in healthcare. By surveying healthcare workers working in Canada during the COVID-19 pandemic, we found that there was an elevated level of depressive symptomatology in that population. We also found that when employees were provided with accurate and timely information about the pandemic, and additional protective measures in the workplace, they were less likely to report negative effects on well-being. We recommend that healthcare employers take these steps, as well as providing targeted mental health interventions, in order to maintain the mental health of their employees, which in turn will provide better healthcare at the population level.