Cynthia G. Jardine

Strength-based approaches are regarded as being effective in research with communities but there are minimal examples of application as a research approach, particularly in health, with Indigenous populations, and with youth. Systemic racism manifested through colonization, including in academic institutions, has contributed to historical and ongoing traumas by supporting the overuse of deficit-based approaches with Indigenous populations in many disciplines, including health. We present our creation and application of a strength-based methodological approach to research in health alongside Dene First Nation youth. It was developed on principles consistent with the strength-based paradigms in social work, psychology, and education. We share four main components of strength-based research approach: 1) identifying strengths, 2) prioritizing and creating descriptions of strengths, 3) refining strengths by gathering contextual examples, and 4) depicting strengths to plan future research. Each component included qualitative methods (such as asset-mapping, nominal group technique, storytelling interviews, and participatory 360-degree video) that reflected aspects of strength-based approaches and emphasized active participation, multiple knowledge sources, and empowerment. Utilizing this approach promoted connectivity to the larger environment, inclusivity of multi-knowledge sources, agency and voice, increased empowerment, and practicality in action. We share challenges and lessons learned from exploring a strength-based approach in health research and provide insights for researchers interested in applying a strength-based approach to research, particularly in Indigenous health.

The COVID-19 pandemic triggered extreme preventive measures, including economic and social lockdowns. Many experts and commentators, however, have argued in favor of a harm reduction approach, givi...

Risk prevention measures are more likely to be accepted if people trust risk managers and their ability to handle the crisis, which often depends on who communicates with the public. During the COVID-19 pandemic, some Canadian officials became the main spokespersons of pandemic response in their jurisdiction, speaking almost daily to the public. We evaluated how the primary official for each jurisdiction chose to communicate about epidemiological modeling with the public and how they used modeling data to support their pandemic decisions. We conducted textual and visual analyses of press conferences held in British Columbia, Manitoba, and Ontario. Then, we asked focus group participants who they trusted the most and the least for information on COVID-19. We identified two main communication styles: compassionate-informative and condescending-evasive. Spokespersons following the former demonstrate a trust-building effort by providing straightforward answers, demonstrating expertise, while showing empathy and risk management competence. Those who followed the latter style predominantly offered superficial and defensive responses, engaging in blame-shifting and politicizing risk. Focus group participants trusted most the spokespersons who follow a compassionate-informative style are considered trustworthy, which could increase compliance with public health measures. However, those who use the condescending-evasive style were seen as less trustworthy. Our results underscore, first, the importance of disassociating political agendas from risk communication and emergency response during public health crises. Second, spokespersons should be trained in risk and crisis communication to engage with reporters and the public positively. Finally, crisis communication should emphasize the scientific evidence behind guidelines, while acknowledging scientific uncertainty.

Objectives: Our study aimed to (1) identify barriers to equitable access to COVID-19 vaccines for Canadians with disabilities and (2) present recommendations made by study participants to improve immunization programs in terms of inclusivity and equitable access. Methods: We invited Manitobans living with disabilities to participate in online focus groups. Focus groups were conducted across multiple disability experiences, although one focus group was advertised explicitly as offering simultaneous American Sign Language interpretation to encourage people who are d/Deaf or hard of hearing to participate. Participants were asked about their perspectives on the management of COVID-19 public health measures and vaccination program rollout. Participants were also asked about barriers and facilitators of their vaccination experiences and if they had recommendations for improvement. Results: The participants identified three areas where they encountered routine barriers in accessing the COVID-19 vaccines: (1) vaccine information and appointment booking, (2) physical access to vaccination clinics, and (3) vaccination experience. While participants identified specific recommendations to improve vaccine accessibility for people with disabilities, the single most crucial advice consistently identified was to involve people with disabilities in developing accessible immunization programs. Conclusion: Meaningful engagement with people living with disabilities in immunization program planning would help ensure that people with disabilities, who already face significant challenges due to COVID-19, are offered the same protections as the rest of the population. These recommendations could be easily transferred to the administration of other large-scale immunization campaigns (e.g., influenza vaccines).

Moral panics are moments of intense and widespread public concern about a specific group, whose behaviour is deemed a moral threat to the collective. We examined public health guidelines in the first months of the COVID-19 pandemic in Canadian newspaper editorials, columns and letters to the editor, to evaluate how perceived threats to public interests were expressed and amplified through claims-making processes. Normalization of infection control behaviours has led to a moral panic about lack of compliance with preventive measures, which is expressed in opinion discourse. Following public health guidelines was construed as a moral imperative and a civic duty, while those who failed to comply with these guidelines were stigmatized, shamed as “covidiots,” and discursively constructed as a threat to public health and moral order. Unlike other moral panics in which there is social consensus about what needs to be done, Canadian commentators presented a variety of possible solutions, opening a debate around infection surveillance, privacy, trust, and punishment. Public health communication messaging needs to be clear, to both facilitate compliance and provide the material conditions necessary to promote infection prevention behaviour, and reduce the stigmatization of certain groups and hostile reactions towards them.

Background: The COVID-19 pandemic brought the production of scientific knowledge onto the public agenda in real-time. News media and commentators analysed the successes and failures of the pandemic response in real-time, bringing the process of scientific inquiry, which is also fraught with uncertainty, onto the public agenda. We examine how Canadian newspapers framed scientific uncertainty in their initial coverage of the COVID-19 pandemic and how journalists made sense of the scientific process. Methods: We conducted a framing analysis of 1143 news stories and opinion during the first two waves of the COVID-19 pandemic. Using a qualitative analysis software, our analysis focused, first, on how scientific uncertainty was framed in hard news and opinion discourse (editorial, op-ed). Second, we compared how specialist health and science reporters discussed scientific evidence versus non-specialist reporters in hard news and columns. Results: Uncertainty emerged as a “master frame” across the sample, and four additional framing strategies were used by reporters and commentators when covering the pandemic: (1), evidence -focusing on presence or absence of it-; (2) transparency and leadership -focusing on the pandemic response-; (3) duelling experts – highlighting disagreement among experts or criticizing public health decisions for not adhering to expert recommendations-; and (4) mixed messaging -criticizing public health communication efforts. While specialist journalists understood that scientific knowledge evolves and the process is fraught with uncertainty, non-specialist reporters and commentators expressed frustration over changing public health guidelines, leading to the politicization of the pandemic response and condemnation of elected officials’ decisions. Conclusions: Managing scientific uncertainty in evolving science-policy situations requires timely and clear communication. Public health officials and political leaders need to provide clear and consistent messages and access to data regarding infection prevention guidelines. Public health officials should quickly engage in communication course corrections if original messages are missing the intended mark, and clearly explain the shift. Finally, public health communicators should be aware of and more responsive to a variety of media reporters, who will bring different interpretative frames to their reporting. More care and effort are needed in these communication engagements to minimize inconsistencies, uncertainty, and politicization.

The H1N1 global pandemic of 2009–10 was moderate in its severity, which led many members of the public to denounce news organizations for ‘hyping’ the threat posed by the virus. This outcome was troubling as it portended a potentially cynical public audience in the event of a future emerging infectious disease. As we face a new Public Health Emergency of International Concern (PHEIC) with COVID-19, public trust in public health information and mediated messaging is more important than ever. Health authorities aim to inform the public through various avenues, particularly by engaging news media as a bridge to deliver pertinent information. We draw on the Trust, Confidence, and Cooperation (TCC) Model to examine how citizens and health officers evaluated news coverage of the H1N1 pandemic in Canada and the impact it had on public trust in public health recommendations. Following the H1N1 pandemic, we conducted interviews (n = 28) with senior health officials in Canadian federal and provincial jurisdictions and focus groups with general population Canadians (n = 130) in three provinces. Findings showed that many health officials and members of the public considered that the pandemic H1N1 was hyped in news coverage and that the immunization campaign was portrayed as chaotic, potentially affecting trust in pandemic messaging and response activities. Our results highlight the key role of news coverage in pandemic communication. Further, we recommend that health authorities complement their media engagement with direct communication with citizens; and increased training for public health officers to engage with news media and promote public trust. The lessons of this study remain crucially relevant given that legacy news media continue to be important sources of health information as the world fights to control the COVID-19 pandemic.

Social determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts. Relationships, interconnectivity, and community are fundamental to these determinants. Understanding these determinants from the perspective of Indigenous youth is vital to identifying means of alleviating future inequities. In 2016, fifteen Yellowknives Dene First Nation (YKDFN) youth in the Canadian Northwest Territories participated in the 'On-the-Land Health Leadership Camp'. Using a strength- and community-based participatory approach through an Indigenous research lens, the YKDFN Wellness Division and university researchers crafted the workshop to provide opportunities for youth to practice cultural skills, and to capture the youth’s perspectives of health and health agency. Perspectives of a healthy community, health issues, and health priorities were collected from youth through sharing circles, PhotoVoice, mural art, and surveys. The overall emerging theme was that a connection to the land is an imperative determinant of YKDFN health. Youth identified the importance of a relationship to land including practicing cultural skills, Elders passing on traditional knowledge, and surviving off the land. The youth framed future health research to include roles for youth and an on-the-land component that builds YKDFN culture, community relations, and traditional knowledge transfer. Youth felt that a symbiotic relationship between land, environment, and people is fundamental to building a healthy community. Our research confirmed there is a direct and critical relationship between structural context and determinants of Indigenous Peoples’ health, and that this should be incorporated into health research and interventions.

Recent infectious disease outbreaks have resulted in renewed recognition of the importance of risk communication planning and execution to public health control strategies. Key to these efforts is public access to information that is understandable, reliable and meets their needs for informed decision-making on protective health behaviours. Learning from the trends in sources used in previous outbreaks will enable improvements in information access in future outbreaks. Two separate random-digit dialled telephone surveys were conducted in Alberta, Canada, to explore information sources used by the public, together with their perceived usefulness and credibility, during the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic (n = 1209) and 2009–2010 H1N1 pandemic (n = 1206). Traditional mass media were the most used information sources in both surveys. Although use of the Internet increased from 25% during SARS to 56% during H1N1, overall use of social media was not as high as anticipated. Friends and relatives were commonly used as an information source, but were not deemed very useful or credible. Conversely, doctors and health professionals were considered credible, but not consulted as frequently. The use of five or more information sources increased by almost 60% between the SARS and H1N1 surveys. There was a shift to older, more educated and more affluent respondents between the surveys, most likely caused by a decrease in the use of landlines amongst younger Canadians. It was concluded that people are increasingly using multiple sources of health risk information, presumably in a complementary manner. Subsequently, although using online media is important, this should be used to augment rather than replace more traditional information channels. Efforts should be made to improve knowledge transfer to health care professionals and doctors and provide them with opportunities to be more accessible as information sources. Finally, the future use of telephone surveys needs to account for the changing demographics of the respondents accessed through such surveys.