Monitoring Cardiovascular Disease in Métis Citizens Across Ontario, 2012-2020.

Background: Population-based analyses of Métis-specific health outcomes in Canada are limited. This study aimed to address this gap and examine cardiovascular disease outcomes in citizens of the Métis Nation of Ontario (MNO) over a 9-year period. Methods: Under a data governance and sharing agreement between the MNO and ICES, registered MNO citizens aged ≥ 20 years were linked to administrative health data in Ontario. Existing algorithms were used to determine the burden of heart failure and hypertension. In the most recent year, prevalence rates were compared for income quintiles, age, and sex. Results: Age-adjusted prevalence rates of hypertension decreased, and age-adjusted prevalence rates of heart failure increased in MNO citizens from 2012 to 2020. A larger decrease in prevalence of hypertension was observed for female citizens, by 12% from 28.9 per 100 (confidence interval [CI]: 27.6-30.2) in 2012 to 25.4 per 100 (CI: 24.5-26.3) in 2020. As for heart failure, the age-adjusted prevalence rates for male citizens had the largest increase, by 47% from 2.6 per 100 (CI: 2.1-3.1) in 2012 to 3.8 per 100 (CI: 3.3-4.2) in 2020. Hypertension and heart failure were more prevalent in male citizens, those of advanced age, and those living in areas within the lowest income quintile. Conclusions: This study is the first in nearly 10 years to investigate trends in cardiovascular outcomes among MNO citizens. Understanding this burden is critical to the MNO's ability to guide program and policy planning, as well as to advocate within and beyond the health system for Métis-specific needs.

Contexte: Les analyses basées sur la santé des citoyens métis sont limitées au Canada. Cette étude visait à combler cette lacune et à examiner les résultats des maladies cardiovasculaires chez les citoyens de la Nation métisse de l'Ontario (NMO) sur une période de 9 ans. Méthodes: Dans le cadre d'un accord de gouvernance et de partage des données entre la NMO et ICES, les citoyens inscrits de la NMO âgés de 20 ans et plus ont été reliés aux données de santé administrative en Ontario. Des algorithmes existants ont été utilisés pour déterminer le fardeau de l'insuffisance cardiaque et de l'hypertension. Au cours de l'année la plus récente, les taux de prévalence ont été comparés pour les quintiles de revenu, ainsi que pour les sous-groupes selon l'âge et le sexe. Résultats: Les taux de prévalence ajustés selon l'âge de l'hypertension ont diminué tandis que les taux de prévalence ajustés selon l'âge de l'insuffisance cardiaque ont augmenté chez les citoyens de la NMO de 2012 à 2020. Une plus forte diminution de la prévalence de l'hypertension a été observée chez les femmes, de 12 % passant de 28,9 pour 100 (IC : 27,6-30,2) en 2012 à 25,4 pour 100 (IC : 24,5-26,3) en 2020. En ce qui concerne l'insuffisance cardiaque, les taux de prévalence ajustés selon l'âge chez les hommes ont connu la plus forte augmentation, de 47 % passant de 2,6 pour 100 (IC : 2,1-3,1) en 2012 à 3.8 pour 100 (IC : 3,3-4,2) en 2020. L'hypertension et l'insuffisance cardiaque étaient plus prévalentes chez les hommes, les personnes âgées et celles vivant dans des zones du quintile de revenu le plus bas. Conclusion: Il s'agit de la première étude en presque 10 ans à examiner les tendances des résultats cardiovasculaires chez les citoyens de la Nation métisse de l'Ontario. Comprendre ce fardeau est crucial pour la NMO afin de guider la planification des programmes et des politiques, ainsi que la défense des besoins spécifiques aux Métis au sein du système de santé.

Hepatitis C (HCV) prevalence in citizens of the Métis Nation of Ontario.

BACKGROUND: Hepatitis C virus (HCV) infection is a major global concern, with Indigenous Peoples bearing the highest burden. Previous studies exploring HCV prevalence within Indigenous populations have predominantly used a pan-Indigenous approach, consequently resulting in limited availability of Métis-specific HCV data. The Métis are one of the three recognized groups of Indigenous Peoples in Canada with a distinct history and language. The Métis Nation of Ontario (MNO) is the only recognized Métis government in Ontario. This study aims to examine the prevalence of self-reported HCV testing and positive results among citizens of the MNO, as well as to explore the association between sociodemographic variables and HCV testing and positive results. METHODS: A population-based online survey was implemented by the MNO using their citizenship registry between May 6 and June 13, 2022. The survey included questions about hepatitis C testing and results, socio-demographics, and other health related outcomes. Census sampling was used, and 3,206 MNO citizens responded to the hepatitis C-related questions. Descriptive statistics and bivariate analysis were used to analyze the survey data. RESULTS: Among the respondents, 827 (25.8%, CI: 24.3-27.3) reported having undergone HCV testing and 58 indicated testing positive, resulting in a prevalence of 1.8% (CI: 1.3-2.3). Respondents with a strong sense of community belonging, higher education levels, and lower household income were more likely to report having undergone HCV testing. Among those who had undergone testing, older age groups, individuals with lower education levels, and retired individuals were more likely to test positive for HCV. CONCLUSION: This study is the first Métis-led and Métis-specific study to report on HCV prevalence among Métis citizens. This research contributes to the knowledge base for Métis health and will support the MNO's health promotion program and resources for HCV. Future research will examine the actual HCV incidence and prevalence among MNO citizens.

Landscape of Métis health and wellness: protocol for a scoping review.

INTRODUCTION: In Canada, Métis people are one of three distinct Indigenous peoples whose rights are recognised and affirmed in Section 35 of the federal Constitution Act, 1982. In line with Métis people having a unique culture, history, language and way of life, a distinctions-based approach is critical to understand the current landscape of Métis-specific health. In this paper, we present a scoping review protocol to describe this research landscape in Canada led by the Métis Nation of Ontario (MNO). METHODS AND ANALYSIS: This scoping review protocol is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews reporting guidelines and follows Arksey and O'Malley's scoping review methodology. We will search electronic databases (Scopus, MEDLINE, Embase, Web of Science, CINAHL, APA PsycINFO, Anthropology Plus, Bibliography of Indigenous Peoples of North America, Canadian Business and Current Affairs, Indigenous Studies Portal, Informit Indigenous Collection, Collaborative Indigenous Garden, PubMed, ProQuest), grey literature sources and reference lists from selected papers. Two reviewers (HMB and SK) will double-blind screen all titles/abstracts and full-text studies for inclusion. Any health-related study or health report that includes a Métis-specific health, well-being or Métis social determinant of health outcome will be included. Relevant variables will be extracted following an iterative process whereby the data charting will be reviewed and updated. ETHICS AND DISSEMINATION: Findings from this scoping review will be shared back through the MNO's existing community-based communication channels. Traditional academic dissemination will also be pursued. Research ethics board approval is not required, since data are from peer-reviewed publications or publicly shared health reports and knowledge translation products.

COVID-19 vaccination intention and vaccine hesitancy among citizens of the Métis Nation of Ontario.

OBJECTIVE: The study objective is to measure the influence of psychological antecedents of vaccination on COVID-19 vaccine intention among citizens of the Métis Nation of Ontario (MNO). METHODS: A population-based online survey was implemented by the MNO when COVID-19 vaccines were approved in Canada. Questions included vaccine intention, the short version of the "5C" psychological antecedents of vaccination scale (confidence, complacency, constraint, calculation, collective responsibility), and socio-demographics. Census sampling via the MNO Registry was used achieving a 39% response rate. Descriptive statistics, bivariate analyses, and multinomial logistic regression models (adjusted for sociodemographic variables) were used to analyze the survey data. RESULTS: The majority of MNO citizens (70.2%) planned to be vaccinated. As compared with vaccine-hesitant individuals, respondents with vaccine intention were more confident in the safety of COVID-19 vaccines, believed that COVID-19 is severe, were willing to protect others from getting COVID-19, and would research the vaccines (Confident OR = 19.4, 95% CI 15.5-24.2; Complacency OR = 6.21, 95% CI 5.38-7.18; Collective responsibility OR = 9.83, 95% CI 8.24-11.72; Calculation OR = 1.43, 95% CI 1.28-1.59). Finally, respondents with vaccine intention were less likely to let everyday stress prevent them from getting COVID-19 vaccines (OR = 0.47, 95% CI 0.42-0.53) compared to vaccine-hesitant individuals. CONCLUSION: This research contributes to the knowledge base for Métis health and supported the MNO's information sharing and educational activities during the COVID-19 vaccines rollout. Future research will examine the relationship between the 5Cs and actual uptake of COVID-19 vaccines among MNO citizens.

RéSUMé: OBJECTIF: Nous avons cherché à mesurer l'influence des antécédents psychologiques de vaccination sur l'intention de se faire vacciner contre la COVID-19 chez les citoyennes et citoyens de la Nation métisse de l'Ontario (NMO). MéTHODE: Un sondage populationnel en ligne a été mis en œuvre par la NMO quand des vaccins contre la COVID-19 ont été approuvés au Canada. Les questions posées ont porté sur l'intention de se faire vacciner, la version abrégée du modèle « 5C ¼ de l'échelle de vaccination (Confiance, Contraintes, Complaisance, Calcul et responsabilité Collective) et le profil sociodémographique. Nous avons utilisé l'échantillonnage fondé sur le recensement via le registre de la NMO pour obtenir un taux de réponse de 39 %. Des statistiques descriptives, des analyses bivariées et des modèles de régression logistique multinomiale (ajustés selon les variables sociodémographiques) ont servi à analyser les données du sondage. RéSULTATS: La majorité (70,2 %) des citoyennes et citoyens de la NMO prévoyaient se faire vacciner. Comparativement aux personnes réticentes à l'égard de la vaccination, les personnes ayant l'intention de se faire vacciner avaient plus confiance en l'innocuité des vaccins contre la COVID-19, considéraient la COVID-19 comme une maladie grave, étaient disposées à protéger les autres contre la COVID-19 et cherchaient à se renseigner au sujet des vaccins (Confiance : RC = 19,4, IC95% 15,5­24,2; Complaisance : RC = 6,21, IC95% 5,38­7,18; responsabilité Collective : RC = 9,83, IC95% 8,24­11,72; Calcul : RC = 1,43, IC95% 1,28­1,59). Enfin, les répondantes et les répondants ayant l'intention de se faire vacciner étaient moins susceptibles de laisser le stress quotidien les empêcher de se faire vacciner contre la COVID-19 (RC = 0,47, IC95% 0,42­0,53) comparativement aux personnes réticentes à l'égard de la vaccination. CONCLUSION: Cette étude contribue à la base de connaissances sur la santé des Métis et a appuyé les activités de sensibilisation et d'échange d'informations de la NMO pendant le déploiement des vaccins contre la COVID-19. Une étude future portera sur la relation entre les « 5C ¼ et le recours réel aux vaccins contre la COVID-19 chez les citoyennes et citoyens de la NMO.

COVID-19 vaccine behaviour among citizens of the Métis Nation of Ontario: A qualitative study.

BACKGROUND: The burden of the current COVID-19 pandemic is not shared equally in Canadian society, with Indigenous Peoples being disproportionately affected. Moreover, there is a lack of research pertaining to vaccination behaviour in Métis communities. This Métis-specific and Métis-led qualitative study endeavours to understand COVID-19 vaccine behaviour among citizens of the Métis Nation of Ontario (MNO). METHODS: Data was collected via one-on-one interviews. Participants were recruited via the MNO's existing social media channels. Participants filled out a screening survey indicating their intention to vaccinate against COVID-19 as yes, no, or unsure. Sixteen participants (9 yes, 3 unsure, 4 no) were interviewed. Interviews averaged 30 min, and the questions and probes were developed in collaboration with the MNO. The interviewer received Métis-specific cultural safety training. Interviews were transcribed verbatim and uploaded to NVivo 12. RESULTS: A deductive analysis using the Social Ecological Model framework (SEM) for vaccine behaviour and two blinded coders was used to understand the data. An additional factor, COVID-19 public health measures, was added to the framework to better capture the experiences of participants during the COVID-19 pandemic. Overall, the factors with the greatest number of coded references included Vaccine roll-out and availability, Organization of the public into priority groups, Public discourse, Interpersonal influences, Interface with health professionals, Knowledge state, Trust, and Vaccine risk perception. Bandwagoning (following others' behaviour) and Freeloading (perceiving enough people have been vaccinated), both factors of the SEM, were not discussed. Yes, no, and unsure participant groups were compared to understand the influences of each factor based on COVID-19 vaccination intention. CONCLUSIONS: MNO citizens COVID-19 vaccine behaviour was negatively and positively influenced by a number of factors. This information will allow the MNO and public health units to better tailor their messaging for COVID-19 vaccine uptake campaigns and future pandemic emergencies.

Virtual Reality Bell-Ringer: The Development and Testing of a Stereoscopic Application for Human Gross Anatomy.

As post-secondary education migrates online, developing and evaluating new avenues for assessment in anatomy is paramount. Three-dimensional (3D) visualization technology is one area with the potential to augment or even replace resource-intensive cadaver use in anatomical education. This manuscript details the development of a smartphone application, entitled "Virtual Reality Bell-Ringer (VRBR)," capable of displaying monoscopic two-dimensional (2D) or stereoscopic 3D images with the use of an inexpensive cardboard headset for use in spot examinations. Cadaveric image use, creation, and pinning processes are explained, and the source code is provided. To validate this tool, this paper compares traditional laboratory-based spot examination assessment stations against those administered using the VRBR application to test anatomical knowledge. Participants (undergraduate, n = 38; graduate, n = 13) completed three spot examinations specific to their level of study, one in each of the modalities (2D, 3D, laboratory) as well as a mental rotation test (MRT), Stereo Fly stereotest, and cybersickness survey. Repeated measures ANCOVA suggested participants performed significantly better on laboratory and 3D stations compared to 2D stations. Moderate to severe cybersickness symptoms were reported by 63% of participants in at least one category while using the VRBR application. Highest reported symptoms included: eye strain, general discomfort, difficulty focusing, and difficulty concentrating. Overall, the VRBR application is a promising tool for its portability, affordability, and accessibility. Due to reported cybersickness and other technical limitations, the use of VRBR as an alternative to cadaveric specimens presents several challenges when testing anatomy knowledge that must be addressed before widespread adoption.