Hasina Samji

Canadian youth experienced profound impacts to mental health (MH) support throughout the COVID-19 pandemic. Given the risk for long-term negative outcomes from unmet MH needs, it is critical to understand access barriers. The purpose of this study was to explore the longitudinal data and personal narratives on MH challenges, needs and access barriers. The Personal Impacts of COVID-19 Survey was administered to parents regarding their youth at baseline (November 2020–July 2021) and follow-up (November 2021–October 2022). Semi-structured interviews of selected youth and parents were conducted. Quantitative data from 507 baseline surveys, 177 follow-up surveys and qualitative data from 35 interviews were included in the study. A modified explanatory sequential/nested mixed methods design was used to analyze the data. Results showed that the use of MH supports among youth increased between timepoints, although 20% had persisting unmet needs for MH supports at follow-up. Youth described waitlist barriers and difficulties finding the “right” therapist, and parents described significant difficulties navigating the MH system that profoundly impacted their families’ ability to access care and mitigate negative MH outcomes. Increased clinician availability, school MH supports, parental education, and tools for navigating the MH system are needed to better support families.

Comprehensive sexuality education1 (CSE) aims to cover a broad range of topics related to sexual health and well-being (e.g. consent and communication, healthy relationships, sexual and gender iden...

The COVID-19 pandemic led to significant challenges for healthcare providers working with pregnant and parenting youth. However, the impacts of the pandemic on this population and healthcare services from the perspective of healthcare providers are not well documented in Canada. We examined the narratives and experiences of healthcare providers regarding these impacts and explored the challenges to service provision. Using a qualitative interpretative description (ID) approach, we recruited 25 health and service providers from Alberta, Ontario, and British Columbia for individual qualitative interviews. Our analysis resulted in three themes: complexities of health service provision during COVID-19, healthcare providers’ accounts of impacts on pregnant and parenting youth, and leveraging challenges into opportunities for service provision. Participants described the influence of pandemic policies and distancing measures on accessibility of health services, availability of healthcare resources and personnel, and well-being of their clients. They also reported increased mental health issues, isolation, and exacerbation of inequities within this population. Providers highlighted the role of telemedicine in ensuring some degree of continuity of care. Additionally, they commented on service adaptations to address the evolving needs of their clients. Our findings underline the need for a resilient and adaptable healthcare system that can better support the needs of vulnerable populations during crises.

To compare the assessment of the impact of secondary health conditions (SHCs) on the quality of life and wellbeing of Canadians living with spinal cord injury (SCI) using four preference-based outcome measures. Secondary analysis of data from a cross-sectional, online survey. Community. Community-dwelling adults (n = 364) living with traumatic or non-traumatic spinal cord injury at least one year post-injury (70% at least 10 years post-injury). A modified version of the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS); three health-related instruments (EQ-5D-5L, Health Utilities Index Mark 3 (HUI3), and the Assessment of Quality of Life 8-dimension questionnaire (AQoL-8D)) and a capability wellbeing instrument (ICEpop CAPability measure for Adults (ICECAP-A)). Across unadjusted and controlled analyses (i.e. controlling for associations between index scores and sociodemographic and impairment characteristics), trends were observed that identified lower levels of quality of life/wellbeing with higher problem ratings for each of the SHCs. Despite the trends, there was considerable variation in mean index scores across instruments, with HUI3 scores the lowest of the health-related instruments and ICECAP-A scores the highest overall. Respiratory problems, depression/mood problems, pressure sores, and autonomic dysreflexia were associated with the lowest levels of quality of life and wellbeing. Higher problem ratings for SHCs are negatively associated with scores derived from preference-based quality of life and wellbeing instruments. Variation in index scores across instruments - including across the health-related instruments alone - highlights the critical importance of assessing the relative merits of preference-based instruments when using (or considering using) these instruments/estimates in comparative effectiveness research and economic evaluation.

COVID-19 breakthrough infection (BTI) can occur despite vaccination. Using a multi-centre, prospective, observational Canadian cohort of people with HIV (PWH) receiving ≥2 COVID-19 vaccines, we compared the SARS-CoV-2 spike (S) and receptor-binding domain (RBD)-specific IgG levels 3 and 6 months post second dose, as well as 1 month post third dose, in PWH with and without BTI. BTI was defined as positivity based on self-report measures (data up to last study visit) or IgG data (up to 1 month post dose 3). The self-report measures were based on their symptoms and either a positive PCR or rapid antigen test. The analysis was restricted to persons without previous COVID-19 infection. Persons without BTI remained COVID-19-naïve until ≥3 months following the third dose. Of 289 participants, 92 developed BTI (31.5 infections per 100 person-years). The median days between last vaccination and BTI was 128 (IQR 67, 176), with the most cases occurring between the third and fourth dose (n = 59), corresponding to the Omicron wave. In analyses adjusted for age, sex, race, multimorbidity, hypertension, chronic kidney disease, diabetes and obesity, a lower IgG S/RBD (log10 BAU/mL) at 1 month post dose 3 was significantly associated with BTI, suggesting that a lower IgG level at this time point may predict BTI in this cohort of PWH.

Introduction: People living with HIV (PLWH) and/or who inject drugs may experience lower vaccine effectiveness (VE) against SARS‐CoV‐2 infection.Methods: A validated algorithm was applied to population‐based, linked administrative datasets in the British Columbia COVID‐19 Cohort (BCC19C) to ascertain HIV status and create a population of PLWH and matched HIV‐negative individuals. The study population was limited to individuals who received an RT‐PCR laboratory test for SARS‐CoV‐2 between 15 December 2020 and 21 November 2021 in BC, Canada. Any history of injection drug use (IDU) was ascertained using a validated administrative algorithm. We used a test‐negative study design (modified case−control analysis) and multivariable logistic regression to estimate adjusted VE by HIV status and history of IDU.Results: Our analysis included 2700 PLWH and a matched population of 375,043 HIV‐negative individuals, among whom there were 351 and 103,049 SARS‐CoV‐2 cases, respectively. The proportion of people with IDU history was much higher among PLWH compared to HIV‐negative individuals (40.7% vs. 4.3%). Overall VE during the first 6 months after second dose was lower among PLWH with IDU history (65.8%, 95% CI = 43.5–79.3) than PLWH with no IDU history (80.3%, 95% CI = 62.7–89.6), and VE was particularly low at 4–6 months (42.4%, 95% CI = −17.8 to 71.8 with IDU history vs. 64.0%; 95% CI = 15.7–84.7 without), although confidence intervals were wide. In contrast, overall VE was 88.6% (95% CI = 88.2–89.0) in the matched HIV‐negative population with no history of IDU and remained relatively high at 4–6 months after second dose (84.6%, 95% CI = 83.8–85.4). Despite different patterns of vaccine protection by HIV status and IDU history, peak estimates were similar (≥88%) across all populations.Conclusions: PLWH with a history of IDU may experience lower VE against COVID‐19 infection, although findings were limited by a small sample size. The lower VE at 4–6 months may have implications for booster dose prioritization for PLWH and people who inject drugs. The immunocompromising effect of HIV, substance use and/or co‐occurring comorbidities may partly explain these findings.

Emerging terms in the literature such as climate anxiety describe heightened concern, fear, and anxiety related to the climate crisis. Recent efforts have attempted to develop and validate scales to measure climate anxiety; however, extant research is largely focused on adults. Consequently, it is unclear whether developed measures are appropriate for adolescent populations, despite disproportionate impacts of the climate crisis experienced by this age group. The purpose of this study was two‐fold; first, we aimed to assess levels of climate concern among Canadian adolescents using the Youth Development Instrument (YDI), a population‐level youth well‐being survey administered in schools with students (ages 15–18). Secondly, we collaborated with adolescents to adapt an existing climate anxiety scale to be included in the YDI survey. We used survey results to validate the adapted scale for use with adolescents and assessed levels of climate anxiety within our sample. In consultation with adolescents, the 13‐item Climate Change Anxiety Scale (CCAS) was adapted to create the Climate Change Anxiety Scale – Short‐form (CCAS‐S) which consists of four‐items adapted from the original CCAS. A total of 2306 respondents were included in analyses. Most adolescents reported feeling climate change concern (75.8%). A smaller proportion reported experiences of climate anxiety (48.7%). Confirmatory factor analysis supported a one‐factor structure for the CCAS‐S, with high internal consistency (Cronbach's alpha = 0.95) and good model fit with error co‐variance. Findings from this study provide construct validity evidence and reliability for the use of the CCAS‐S in adolescent populations.