Relationships between water quality and mosquito presence and abundance: a systematic review and meta-analysis.

Mosquito-borne diseases (MBDs) are emerging in response to climate and land use changes. As mosquito (Diptera: Culicidae) habitat selection is often contingent on water availability for egg and larval development, studies have recognized water quality also influences larval habitats. However, underlying species-, genera-, and mosquito level preferences for water quality conditions are varied. This systematic review and meta-analysis aimed to identify, characterize, appraise, and synthesize available global data on the relationships between water quality and mosquito presence and abundance (MPA); with the goal to further our understanding of the geographic expansion of MBD risks. A systematic review was conducted to identify studies investigating the relationships between water quality properties and MPA. Where appropriate, random-effects meta-analyses were conducted to provide pooled estimates for the association between the most reported water quality properties and MPA. The most reported water quality parameters were pH (87%), nitrogen concentrations (56%), turbidity (56%), electrical conductivity (54%), dissolved oxygen (43%), phosphorus concentrations (30%), and alkalinity (10%). Overall, pH (P = 0.05), turbidity (P < 0.0001), electrical conductivity (P = 0.005), dissolved oxygen (P < 0.0001), nitrogen (P < 0.0001), and phosphorus (P < 0.0001) showed significantly positive pooled correlations with MPA, while alkalinity showed a nonsignificant null pooled correlation (P = 0.85). We observed high heterogeneity in most meta-analyses, and climate zonation was shown to influence the pooled estimates. Linkages between MPA and water quality properties will enhance our capacity to predict MBD risks under changing environmental and land use changes.

A qualitative study of university students' perspectives of hope during the COVID-19 pandemic.

Background: Students in higher education commonly experience mental health problems. There is an ongoing need to explore potential intervention targets to focus on mental health promotion among students. Hopefulness may alleviate or be protective against various negative mental health conditions such as depression, anxiety, suicide, and trauma-related disorders. Objective: To explore postsecondary students' meanings and experiences of hope during the COVID-19 pandemic and identify factors affecting hopefulness during crises. Methods: Purposive sampling was used to recruit participants for online semi-structured interviews in a university located in Southwestern Ontario, Canada. Data were analyzed using thematic analysis. Results: In total, 12 participants were interviewed, and 4 themes were generated: (1) hope is a complex concept with an associated set of behaviors, (2) cognitive framing of hope as a means of student resilience, (3) COVID-19 as an antagonist which amplifies preexisting student concerns and issues, and (4) the social and physical environments serve as barriers and enablers to hope and well-being. Hope was perceived as a positive mental trait, external events and the environment were reported to impact hope, and those who were generally more hopeful adjusted better mentally when unexpected circumstances arose. Conclusions: Findings shed light on the interconnectedness and complex nature of hope, its sources, and enablers. Novel findings include the ways in which hope was affected during the COVID-19 pandemic. Recommendations for individual- and community-based interventions include targeting enablers to hopefulness by promoting social support systems, offering virtual extracurricular activities, and delivering alternative approaches to teaching and learning.

A mixed-methods assessment of community-engaged learning in a Master of Public Health program.

Objective: Community-engaged learning is used in Master of Public Health programs to enhance student training, connect with communities, help solve societal issues, develop competencies, and build partnerships. However, it is unclear how much community-engaged learning components supplement existing Master of Public Health programs and prepare students in developing these competencies. Thus, the aim of this study was to apply an explanatory mixed-methods study design to evaluate a Canadian Master of Public Health program's community-engaged learning activities and propose recommendations to strengthen public health training and course delivery. Methods: We conducted a questionnaire among Master of Public Health students (n = 25), focus group discussion with a subset of these students (n = 7), and one-on-one semi-structured telephone interviews with community partners who had previously hosted Master of Public Health students for practicum placements (n = 11). Results: Community-engagement enhanced learning among Master of Public Health students, with the practicum placement, and program development capstone resulting in the largest self-reported development. Students in the focus group indicated community engagement provided skill and professional development, but also identified wanting additional curriculum coverage on various statistical software and qualitative research methods. Interviews with community partners revealed benefits of practicum placements such as mutual knowledge transfer, increased organizational capacity, and strengthened academic-community partnerships. Community partners also commented on challenges with recruitment, training, and aligning student-organization goals. Conclusion: The findings from this study suggest that an update to the Master of Public Health program curriculum, its core competencies, a combination of community-engagement activities, and future evaluations will be needed to advance education delivery.

Risk and protective factors associated with hopelessness among Canadian postsecondary students.

Hopelessness has been linked to several negative mental health outcomes among young adults and the prevalence of it has increased in recent years. The aim was to identify factors associated with hopelessness among Canadian postsecondary students using a socioecological model as a framework. A set of factors for investigation were identified using previously published literature and proxy questions from the American College Health Association's National College Health Assessment II (n = 48,584). A multivariable logistic regression model was fitted to examine these potential associations. Overall, modifiable factors such as belonging to a community, general health, academic performance, and life stressors were found to be associated with hopelessness. In contrast, hopelessness was also associated with some negative health outcomes: loneliness, depression, and suicide ideation. The findings provide preliminary evidence for integrating hope into well-being programming and campus-based interventions aimed at improving postsecondary student mental health. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-023-01050-w.

A Cross-Sectional Study and Observational Assessment of Shoppers' COVID-19 Prevention Behaviors in Southwestern Ontario, Canada.

OBJECTIVE: The aim of this study was to observe the level of alcohol-based sanitizer, mask use, and physical distancing across indoor community settings in Guelph, ON, Canada, and to identify potential barriers to practicing these behaviors. METHODS: Shoppers were observed in June 2022 across 21 establishments. Discrete in-person observations were conducted and electronically recorded using smartphones. Multilevel logistic regression models were fitted to identify possible covariates for the 3 behavioral outcomes. RESULTS: Of 946 observed shoppers, 69% shopped alone, 72% had at least 1 hand occupied, 26% touched their face, 29% physically distanced ≥ 2 m, 6% used hand sanitizer, and 29% wore masks. Sanitizer use was more commonly observed among people who wore masks and in establishments with coronavirus disease (COVID-19) signage posted at the entrance. Mask use was more commonly observed during days without precipitation and in establishments with some or all touch-free entrances. Shoppers more commonly physically distanced ≥ 2 m when they were shopping alone. CONCLUSIONS: This supports evidence for environmental context influencing COVID-19 preventive behaviors. Intervention efforts aimed at visible signage, tailored messaging, and redesigning spaces to facilitate preventive behaviors may be effective at increasing adherence during outbreaks.

Environmental determinants of infectious and chronic disease prevention behaviours: A systematic review and thematic synthesis of qualitative research.

Regulatory health policies facilitate desired health behaviours in communities, and among them, smoke-free policies and COVID-19 restrictions have been widely implemented. Qualitative research studies have explored how these measures and other environmental influences shape preventive behaviours. The objective of this systematic review was to synthesize previously published qualitative research, generate across-study themes, and propose recommendations for behaviour change interventions. We used a comprehensive search strategy, relevance screening and confirmation, data extraction, quality assessment, thematic synthesis, and quality-of-evidence assessment. In total, 87 relevant studies were identified. Findings were grouped under six overarching themes and mapped under three categories: (i) the political environment, (ii) the sociocultural environment, and (iii) the physical environment. These findings provide insights into the environmental influences of behaviour and indicate future interventions may be more effective by considering moral norms, community norms, policy support, and group identity.

Subsequent pregnancy after stillbirth: a qualitative narrative analysis of Canadian families' experiences.

BACKGROUND: In Canada, nearly nine pregnancies end in stillbirth daily. Most of these families will go on to have subsequent pregnancies, but research into how best to care for these parents is lacking. This study explores the lived experiences and the most important aspects of person-centred care for Canadian families experiencing a pregnancy after a stillbirth. METHODS: This qualitative descriptive design used secondary data collected from an online, international survey for bereaved parents who reported having experienced a pregnancy subsequent to a stillbirth. Only parents who identified as Canadian were included in this study. Three open text questions were asked about parents' experiences in their subsequent pregnancy. An inductive thematic analysis approach was used with open coding and a constant comparative method. RESULTS: Families' responses fell into six main themes that identified what they would have preferred for high quality, excellent care. These included: (1) recognizing anxiety throughout the subsequent pregnancy, (2) wanting one's voices and concerns to be heard and taken seriously, (3) needing additional and specific clinical care for reassurance, (4) desiring kindness and empathy from caregivers and others, (5) seeking support from others who had also experienced pregnancy after stillbirth; and (6) addressing mixed emotions including guilt, continuity of care and carer, positive thoughts versus more realistic ones, and poignant feelings of self-blame. CONCLUSIONS: Participants' responses identified that pregnancy after stillbirth is an extremely stressful time requiring patient-oriented care and support, both physically and psychologically. Families were able to articulate specific areas that would have improved the experience of their subsequent pregnancy. Parents asked for high-quality clinical and psychosocial prenatal care that was specific to them having experienced a prior stillbirth. They also requested connections to others experiencing this similar scenario. Further research is needed to delineate what supports and resources would be needed to ensure this care would be available to all families experiencing pregnancy after stillbirth across Canada and their caregivers.

Public Health Messaging to Address Indoor Tanning: A Scoping Review.

Indoor tanning (IT) is an avoidable skin cancer risk. Although numerous communication interventions have been assessed for IT deterrence, less attention has been paid to the persuasive messages within these interventions. This scoping review summarizes the current peer-reviewed literature on persuasive messages for IT. Overall, 20 articles (21 studies) were included. Most were experimental or quasi-experimental and conducted in the US. Participants were mostly young women who had tanned indoors before. Few studies evaluated persuasive theme; in those that did, health and appearance themes were effective. Narrative and statistical evidence formats were also effective. The included studies also supported normative messages, loss-framed messages, and images. Improved reporting on message design and evaluation would be beneficial for future evidence synthesis. Our understanding of persuasive messages for IT has expanded in recent years, but more research is needed to optimize them.

"I Can Sense When My Hands Need Washing": A Qualitative Study and Thematic Analysis of Factors Affecting Young Adults' Hand Hygiene.

Handwashing is one of the most effective and low-cost public health measures. However, it is often not practiced frequently enough or correctly by the public. Young adults in particular have poorer intentions to wash their hands, frequency of handwashing, and sanitizer use compared to other age groups. Therefore, there is a need to identify barriers and facilitators affecting hand hygiene within this group. The objective of this qualitative study was to apply the Theoretical Domains Framework to explore factors which influence hand hygiene among young adults aged 18 to 25 years old. An online questionnaire (n = 37) and thematic analysis were used to generate 3 overarching themes. The main findings indicated internal factors such as knowledge and intentions; interpersonal factors such as social norms; and environmental factors such as reminders, cues, accessibility, and cleanliness of handwashing facilities determined the level of hand hygiene practiced among young adults. The findings suggest that behavior change techniques such as social comparisons and tailored messaging to suit the needs of young adults may be more effective at increasing hand hygiene.

A qualitative study exploring healthcare providers' and trainees' barriers to COVID-19 and influenza vaccine uptake.

Background: Vaccines are effective biological interventions which reduce health burdens and protect healthcare providers from vaccine-preventable diseases. However, there are concerns about varying levels of vaccination coverage of influenza and COVID-19 vaccines among those working in healthcare. The aim of this study was to identify barriers and facilitators to COVID-19 and influenza vaccinations among healthcare providers and trainees using the Theoretical Domains Framework (TDF). Methods: Semi-structured interviews (n = 18) were carried out with healthcare providers and trainees in Canada. A thematic analysis approach was used to code interview transcripts and match findings to TDF domains and broader categories. Results: Three overarching themes were generated from six TDF domains and three inductively generated categories: (1) making informed health decisions with an added responsibility to protect oneself and patients; (2) a pro-vaccine social network, widespread accessibility, and pursuing a sense of normalcy; and (3) seeking a more nuanced, respectful, and calculated approach to vaccine communication and policy implementation. Conclusion: These findings help to identify factors associated with influenza and COVID-19 vaccine uptake among individuals in the healthcare field. Addressing these factors may improve healthcare provider sentiments surrounding vaccines, lead to better patient education, and increased uptake of vaccinations with the potential for seasonal booster doses.

A Review and Analysis of the Literature on Public Health Emergency Communication Practices.

A systematic review using structured and transparent methods was carried out to collect and review the qualitative literature investigating trust in crisis communication during emerging infectious diseases. Qualitative synthesis was conducted using a descriptive thematic analysis approach. The GRADE-CERQual assessment was used to determine the confidence in each thematic finding to support decisions when implementing review findings. Overall, 13 studies were included in the review, resulting in 10 thematic categories that describe characteristics associated with crisis communication information and sources of crisis communication that can enhance or maintain public trust. The results of this review suggest the public judges the trustworthiness of crisis communication based on the information characteristics, including consistency, repetition, and timeliness, and especially transparency and uncertainty. Public health is a trusted source of crisis communication when the presenting spokesperson is a health official, the information is not perceived as politicized, and is timely. Community leaders, such as family doctors, are also trusted sources of crisis communication, whereas media and government officials face distrust because of perceived sensationalized information, and defensiveness and unreliable information respectively. Qualitative data in this area is limited, especially involving the public and priority populations, and should be the focus of future research.

A qualitative program evaluation of the Publicly Available International Foodborne Outbreak Database.

BACKGROUND: The Publicly Available International Foodborne Outbreak Database (PAIFOD) is a regularly updated repository that contains international outbreak data collected from multiple surveillance systems and sources. As of February 2020, the database contained more than 13,000 entries spanning over 20 years. PAIFOD is the only known database that captures international foodborne outbreak data. OBJECTIVE: To explore user perceptions and identify potential directions for PAIFOD and make recommendations for databases with food safety information. METHODS: Between January and March 2020, 16 semistructured telephone interviews were conducted with 24 previous, current and potential PAIFOD users. Interviewees were asked about their knowledge of and experience of using PAIFOD as well as about its strengths and limitations and recommendations for the database. An inductive thematic analysis approach was used to analyze qualitative data and generate themes. RESULTS: Four main themes were generated based on the 24 interviewees' accounts of their experience with and recommendations for PAIFOD: participants viewed PAIFOD as a useful tool; they weren't familiar with its contents or purpose; they stated it should become an open-access platform or linked with another information-sharing initiative; and they considered that PAIFOD had the potential to enhance the Agency's reputation by becoming widely recognized and used. CONCLUSION: This work, along with the ever-changing landscape of foodborne surveillance, supports the need to ensure that PAIFOD is updated to meet the modern-day demands of food safety experts.

Psychosocial and organizational determinants of safe food handling at retail and food service establishments: a systematic review and meta-analysis.

Various psychosocial and organizational factors have been investigated as determinants of food handlers' food safety behaviours. A systematic review and meta-analysis of studies in this area was conducted to identify and synthesize the key behavioural determinants. Standard systematic review steps were followed: comprehensive search strategy; relevance screening; article characterization; risk of bias assessment; data extraction; and random-effects meta-analysis. Sixty-two relevant studies were identified, and knowledge was the most commonly investigated behavioural determinant (n = 51). Increased knowledge was consistently associated with safe food handing behaviours across both correlation (r = 0.30; 95% confidence interval [CI]: 0.12, 0.46; n = 24 studies; I2 = 98%) and odds ratio (OR) measures (adjusted OR = 1.85; 95% CI: 1.27, 2.70; n = 3; I2 = 0%). Seven other behavioural determinant categories were also consistently associated with various food safety behaviour outcomes. In contrast, no association was found between food handler experience and behaviour. The findings can inform the development of targeted training initiatives for food handlers.

A systematic review and meta-regression of the knowledge, practices, and training of restaurant and food service personnel toward food allergies and Celiac disease.

BACKGROUND: Up to 3-5% of adults may be affected by food allergies, while approximately 1% are affected by Celiac disease (CD). Food allergy reactions can be severe and potentially fatal, while CD can result in various symptoms. Restaurant and food service establishment staff have an important role in helping to prevent food allergy and CD risks among affected customers. OBJECTIVES: A systematic review was undertaken to identify, characterize, and synthesize published research on the prevalence of food allergy and CD knowledge, practices, and training among restaurant and food service personnel. The population of interest included any personnel in these settings who prepare, handle, or serve food. Outcomes included the prevalence of food allergy and CD knowledge, practices, and training. METHODS: The review was conducted using standardized methods, including: a comprehensive search strategy; relevance screening of abstracts; characterization of relevant articles; data extraction; and risk of bias assessment. Outcomes were stratified into comparable subgroups and descriptively analyzed to examine prevalence trends across studies. Meta-regression was conducted on selected outcomes to identify possible sources of variability in prevalence estimates across studies. RESULTS: Thirty-eight relevant studies were identified; most were conducted in the United States (50%) and focused on food allergies (90%). Significant variability was identified across studies for most outcomes. Participants generally had a higher knowledge, self-efficacy, and use of practices related to preparing and serving allergen-free meals compared to food allergy emergency response. Participants' reported use of various risk prevention and response practices was generally low. Most participants across studies had not received prior food allergy training (median prevalence of 65% across 12 studies). IMPLICATIONS: Key knowledge and practice gaps were identified that could be targeted by future training programs. Research gaps were also identified, including a need for more experimental studies to evaluate food allergy and CD training interventions.

Explaining the food safety behaviours of food handlers using theories of behaviour change: a systematic review.

Theories of behaviour change can explain the factors affecting food handlers' use of food safety practices. A systematic review was conducted on this topic to identify which theories have been applied in this area and to determine which theories are the most consistent predictors of food handlers' behaviours. Standard systematic review procedures were followed: comprehensive search strategy; relevance screening of abstracts; article characterization; data extraction; risk-of-bias assessment; and descriptive analysis. Among 19 relevant studies, the most commonly investigated theories were the Theory of Planned Behaviour (n = 9 studies) and Health Belief Model (n = 5). All investigated theories were useful to explain food handlers' behavioural intentions and behaviours related to food safety across different settings, and could serve as useful frameworks for future research and practice. However, there was wide variability in the predictive ability of the theories and their specific constructs, indicating theories should be adapted to the local context of application.

Food Safety at Farmers' Markets: A Knowledge Synthesis of Published Research.

Farmers' markets are increasingly popular venues in North America for the sale of fresh produce and other foods. However, the nature of their operation can present possible food safety issues, challenges, and risks to consumers. A knowledge synthesis was conducted to identify, characterize, and summarize published research on the microbial food safety issues and implications associated with farmers' markets. A scoping review was conducted using the following steps: comprehensive search strategy, relevance screening of abstracts, and characterization of relevant articles. Two subsets of data were prioritized for more detailed systematic review (data extraction and risk-of-bias assessment) and meta-analysis: (i) studies comparing the microbial safety of foods from farmers' markets versus other sources and (ii) studies evaluating the use of food safety practices at farmers' markets. Overall, 83 relevant studies were identified. The majority of studies were published as journal articles (64%), used a cross-sectional design (81%), and were conducted in the United States (78%). Most studies (39%; n = 32) investigated stakeholder, mostly consumer (n = 22), attitudes toward food safety at farmers' markets. Limited but heterogeneous evidence indicated a higher prevalence of Campylobacter and Salmonella in chicken meat from farmers' markets versus other retail sources, but there was no difference in the microbial contamination of fresh produce. Studies evaluating the use of food safety practices at farmers' markets identified some gaps; for example, the average prevalence of vendor hand washing was 4% (95% confidence interval: 0 to 11%; I2 = 27%; n = 5 studies). Twelve foodborne outbreaks and case reports were identified, resulting in a total of 411 illnesses, 38 hospitalizations, and two deaths from 1994 to 2016. Only five intervention studies were identified. Key knowledge gaps and areas warranting future research, training, and education are highlighted and discussed.