Shamara Baidoobonso

Background: In Canada, racialized communities, including African, Caribbean, and Black (ACB) people, are disproportionately affected by HIV and COVID-19. Experiencing multiple forms of discrimination in healthcare settings compromises care engagement and health outcomes. The objective of this study was to assess the forms of discrimination ACB people experienced during the COVID-19 pandemic, discrimination levels experienced before and during the pandemic and the demographic factors associated with the increased experiences of discrimination among ACB people when accessing healthcare services during the pandemic. Methods: Data were collected via an online survey co-led by the Public Health Agency of Canada, University of Ottawa, ACB community leaders and researchers across Canada. Participants were recruited via email contact. To be eligible, a participant had to be living in Canada, be aged 18 years or older, be able to read English or French, and self-identify as an ACB individual. The survey captured information on access to health services and experiences of multiple forms of discrimination before and during the pandemic. We used multivariable logistic regression to identify factors associated with discrimination. Results: Of 1556 participants, 39.6% were aged 25–39, 42.7% were resident in Ontario, and 63.2% were of African origin. Prior to the COVID-19 pandemic, 62.1% reported having experienced at least one form of discrimination in a healthcare setting. During the COVID-19 pandemic, over 66% reported having experienced at least a form of discrimination, with 25% reporting a perceived increase in the frequency with which they experienced discrimination. The perceived increase in the frequency of discrimination was 10.8%, 15.3%, 15.9%, 17.0%, 18.1%, 18.7%, and 31.2% among participants who reported having experienced sexual orientation-, gender-, substance use-, disability-, age-, economic status-, and race-based discrimination, respectively. In the multivariate logistic regression, the odds of reporting increased experiences of discrimination in participants aged 50 and above were 0.38 times (95%CI: 0.21, 0.69) those in participants who were 31–40 years of age. Conclusions: The proportion of participants who reported an increased experience of discrimination during the pandemic was high. Although there is variation in levels of experienced discrimination, the different forms of discrimination (race-, gender-, sexual orientation-, substance use-, economic status-, disability- and age-based discrimination) that participants experienced are alarming. This underscores the need for concerted efforts to address multiple forms of discrimination in healthcare settings to improve care engagement and health equity among ACB communities. There was a significant association between perceived increased experience of discrimination and only one sociodemographic factor—older age (50 and above); other factors contributing to participants’ perceived increased experience of discrimination when accessing healthcare services need to be explored.

This cross‑sectional study examined HIV/AIDS knowledge as a determinant of preventative and self‑protective sexual behaviour. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) is one of the most widely used HIV knowledge scales. The objective of this study was to test the psychometric properties of the HIV-KQ-18 in Black people in Ontario. We analyzed the data from 1302 participants who completed the HIV-KQ-18 in a study conducted among Black people in Ontario. We estimated the internal consistency of this scale using Cronbach’s alpha. We analyzed the construct validity of the scale, testing hypotheses about HIV knowledge and age, education, employment status, gender, language and city using one-way ANOVA and independent sample t-tests. Cronbach’s alpha for the scale was 0.82 (95% CI: 0.80–0.84) suggesting good internal consistency. We observed significant differences in HIV knowledge scores across age, employment status, education, and gender. Higher HIV knowledge scores were also observed among participants residing in Toronto compared to Ottawa and among those who completed the questionnaire in English compared to French. The HIV-KQ-18 is a valid instrument to assess the level of HIV/AIDS knowledge among Black Ontarians, with robust internal consistency and construct validity. The HIV-KQ-18 identified important differences in HIV knowledge based on the characteristics examined, indicating the need for targeted initiatives to increase HIV-related knowledge.

Background: In Canada, racialized communities, including African, Caribbean, and Black (ACB) people, are disproportionately affected by HIV and COVID-19. Experiencing multiple forms of discrimination in healthcare settings compromises care engagement and health outcomes. The objective of this study was to assess the various forms of discrimination experienced by ACB people during the COVID-19 pandemic, changes in the levels of discrimination experienced before and during the pandemic and the demographic factors associated with increased experience of discrimination among ACB people when accessing healthcare services during the pandemic. Methods: Data were collected via an online survey co-led by the Public Health Agency of Canada, University of Ottawa, ACB community leaders and researchers across Canada. Participants were recruited via email contact. Eligibility criteria included living in Canada at the time of the survey, aged 18 years or older, ability to read English or French, and self-identifying as African, Caribbean or Black. The survey queried access to health services, and experiences of multiple forms of discrimination when accessing healthcare services before and during the COVID-19 pandemic. Multivariable logistic regression was used to identify factors associated with discrimination. Results: Of 1,556 participants, 39.6% were aged 25-39, 42.7% were resident in Ontario, and 63.2% were of African origin. Prior to the COVID-19 pandemic, 75% experienced at least one form of discrimination in a healthcare setting. During the COVID-19 pandemic, over 66% experienced at least a form of discrimination, with 25% reporting a perceived increase in the frequency with which they experienced discrimination. The perceived increase in the frequency of discrimination was 10.8%, 15.3%, 15.9%, 17.0%, 18.1%, 18.7%, and 31.2% among participants who experienced sexual orientation, gender, substance use, disability, age-based, economic status, and race-based discrimination, respectively. In the multivariate logistic regression, the odds of experiencing discrimination in participants aged 50 and above was 0.38 times (95%CI:0.21, 0.69) that in participants who were 31-40 years of age. Conclusion: The proportion of participants with perceived increased experience of discrimination when accessing healthcare services during the COVID-19 pandemic was high. Although there is variation in levels of experienced discrimination, the different forms of discrimination participants experienced (race, gender, sexual orientation, substance use, economic status, disability and age-based discrimination) are alarming. This underscores the need for concerted efforts to address multiple forms of discrimination in healthcare settings to improve care engagement and health equity among ACB communities. There was a significant association between perceived increased experience of discrimination and only one sociodemographic factor - older age (50 and above), other factors that could possibly contribute to participants perceived increased experience of discrimination when accessing healthcare services needs to be explored.

Background: African, Caribbean, and Black (ACB) communities in high-income countries continue to experience persistent health inequities, driven by systemic anti-Black racism, socioeconomic disadvantage, and exclusion from health decision-making. Historically, data have been extracted from ACB communities without transparency, accountability, or community ownership. These inequitable practices have produced data systems that reinforce harm rather than promote equity. Equitable data governance, which promotes community ownership over data collection, access, and use, is increasingly recognized as a critical but underresearched determinant of health equity. Objective: This protocol outlines the methodology of a scoping review to identify and synthesize evidence on the determinants of equitable data governance in health research involving ACB communities in high-income countries. Methods: The review follows the 6-stage Arksey and O’Malley methodological framework, supplemented with updated guidance from the Joanna Briggs Institute. The searches were conducted in the Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, APA PsycInfo, and Scopus databases. Peer-reviewed articles are considered, with no limits placed on study design, publication type, or date. Multiple reviewers will independently extract data by using a standardized form. A 3-phase thematic mapping process, conceptually informed by critical race theory, intersectionality, and community-based participatory research principles, will be conducted to analyze the data, generate themes, and interpret findings. Results: The final comprehensive database searches were completed on December 17, 2024. The search strategy targeted literature on data management, governance, sharing, security, and ethical principles in relation to ACB populations in high-income countries. A total of 4365 records were screened at the title and abstract level, after deduplication, of which 247 studies were deemed potentially relevant and advanced to full-text screening. Following full-text screening and reference list searching a total of 15 articles were deemed eligible for analysis. The data extraction stage is scheduled to overlap and occur between November 2025 and February 2026. The thematic mapping and stakeholder consultations processes are scheduled between December 2025 and February 2026. The final review and manuscript submission are expected by March 2026, with dissemination activities planned for mid-2026. Conclusions: This review will synthesize existing information on key pillars, barriers, facilitators, promising data governance policies and practices, and recommendations relevant to ACB communities. The findings may inform the expansion of Ontario’s Engagement, Governance, Access, and Protection guidelines and support tailored research and national data governance frameworks. The review is expected to contribute to policy, research, and community-led data initiatives. Dissemination will occur through academic publications, conferences, and community-based knowledge-sharing events. As the review relies solely on publicly available data, ethics approval is not required. Trial Registration: OSF Registries 10.17605/OSF.IO/Z82AY; https://osf.io/z82ay International Registered Report Identifier (IRRID): PRR1-10.2196/82403

Intervention: Live Well PEI provides individuals and organizations in PEI with information and tools to support healthy behaviours. This paper describes the development of the Live Well PEI community-mobilization intervention, consisting of a website and integrated community granting program for health promotion initiatives. Research questions: (1) What is an effective design of a web-based community-mobilization intervention for community-led health promotion and (2) what lessons can be learned and shared for community-engaged, evidence-informed public health intervention development? Methods: Intervention development followed the Six Steps in Quality Intervention Development (6SQuID) process. Through literature reviews, jurisdictional scans, expert consultations, and community engagement, evidence for conditions that foster community mobilization was gathered and used to inform development of intervention components. The intervention was refined through iterative expert and community consultations. Results: Four conditions that foster community-led health promotion were identified: accessibility of grant funding, availability of community data, resources to enhance capacity, and community collaboration. These conditions informed outputs of a Theory of Change. Intervention design that supports these conditions included website elements such as collections of evidence-informed health promotion interventions, stories of prior community-led projects, and community health status and needs information. The granting program integrates research and community feedback on project eligibility, grant administration and support for awardees. Findings from an evaluability assessment support pilot-testing implementation of the intervention. Conclusion: Development of the community-mobilization intervention provides a prime case example of evidence-informed, community-engaged public health intervention co-design. Learnings are applicable to community-focused health promotion initiatives across Canada.

BACKGROUND African, Caribbean, and Black (ACB) communities in high-income countries continue to experience persistent health inequities, driven by systemic anti-Black racism, socioeconomic disadvantage, and exclusion from health decision-making. Historically, data have been extracted from ACB communities without transparency, accountability, or community ownership. These inequitable practices have produced data systems that reinforce harm rather than promote equity. Equitable data governance, which promotes community ownership over data collection, access, and use, is increasingly recognized as a critical but underresearched determinant of health equity. OBJECTIVE This protocol outlines the methodology of a scoping review to identify and synthesize evidence on the determinants of equitable data governance in health research involving ACB communities in high-income countries. METHODS The review follows the 6-stage Arksey and O’Malley methodological framework, supplemented with updated guidance from the Joanna Briggs Institute. The searches were conducted in the Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, APA PsycInfo, and Scopus databases. Peer-reviewed articles are considered, with no limits placed on study design, publication type, or date. Multiple reviewers will independently extract data by using a standardized form. A 3-phase thematic mapping process, conceptually informed by critical race theory, intersectionality, and community-based participatory research principles, will be conducted to analyze the data, generate themes, and interpret findings. RESULTS The final comprehensive database searches were completed on December 17, 2024. The search strategy targeted literature on data management, governance, sharing, security, and ethical principles in relation to ACB populations in high-income countries. A total of 4365 records were screened at the title and abstract level, after deduplication, of which 247 studies were deemed potentially relevant and advanced to full-text screening. Following full-text screening and reference list searching a total of 15 articles were deemed eligible for analysis. The data extraction stage is scheduled to overlap and occur between November 2025 and February 2026. The thematic mapping and stakeholder consultations processes are scheduled between December 2025 and February 2026. The final review and manuscript submission are expected by March 2026, with dissemination activities planned for mid-2026. CONCLUSIONS This review will synthesize existing information on key pillars, barriers, facilitators, promising data governance policies and practices, and recommendations relevant to ACB communities. The findings may inform the expansion of Ontario’s Engagement, Governance, Access, and Protection guidelines and support tailored research and national data governance frameworks. The review is expected to contribute to policy, research, and community-led data initiatives. Dissemination will occur through academic publications, conferences, and community-based knowledge-sharing events. As the review relies solely on publicly available data, ethics approval is not required. CLINICALTRIAL OSF Registries 10.17605/OSF.IO/Z82AY; https://osf.io/z82ay INTERNATIONAL REGISTERED REPORT PRR1-10.2196/82403

A growing body of evidence points to persistent health inequities within racialized minority communities, and the effects of racial discrimination on health outcomes and health care experiences. While much work has considered how anti-Black racism operates at the interpersonal and institutional levels, limited attention has focused on internalized racism and its consequences for health care. This study explores patients' attitudes towards anti-Black racism in a Canadian health care system, with a particular focus on internalized racism in primary health care. This qualitative study employed purposive maximal variation and snowball sampling to recruit and interview self-identified Black persons aged 18 years and older who: (1) lived in Montréal during the COVID-19 pandemic, (2) could speak English or French, and (3) were registered with the Québec health insurance program. Adopting a phenomenological approach, in-depth interviews took place from October 2021 to July 2022. Following transcription, data were analyzed thematically. Thirty-two participants were interviewed spanning an age range from 22 years to 79 years (mean: 42 years). Fifty-nine percent of the sample identified as women, 38% identified as men, and 3% identified as non-binary. Diversity was also reflected in terms of immigration experience, financial situation, and educational attainment. We identified three major themes that describe mechanisms through which internalized racism may manifest in health care to impact experiences: (1) the internalization of anti-Black racism by Black providers and patients, (2) the expression of anti-Black prejudice and discrimination by non-Black racialized minority providers, and (3) an insensitivity towards racial discrimination. Our study suggests that multiple levels of racism, including internalized racism, must be addressed in efforts to promote health and health care equity among racialized minority groups, and particularly within Black communities.

Black people comprise 4.3% of Ontario’s population but 19% of HIV-positive people in the province. The “Keep it alive!” social marketing campaign was developed to promote HIV prevention and raise awareness about HIV among Ontario’s Black communities. This article evaluates the campaign’s reception. A convenience sample of 243 Black people completed a cross-sectional self-administered survey in three cities. We assessed the campaign’s reception based on survey responses about campaign exposure, appeal, and importance, and whether the campaign raised awareness. Our results show that reception was more favorable among participants who tested for HIV previously, discussed the campaign with others, demonstrated a superior knowledge of HIV, visited the campaign website, were of Caribbean or African background, and were male. In addition, reception varied by city and according to participants’ language (English or French). These results may inform future campaigns, although how campaigns are received may reflect issues related to their implementation.