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Simpson AN, Baxter NN, Sorvari A, Boury H, Shore EM, Bogler T, Campbell D, Gagliardi AR. Strategies to support maternal and early childhood wellness: insight from parent and provider qualitative interviews during the COVID-19 pandemic. BMJ Open 2024; 14:e079479. [PMID: 38272559 PMCID: PMC10824034 DOI: 10.1136/bmjopen-2023-079479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/12/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic resulted in rapid changes to the delivery of maternal and newborn care. Our aim was to gain an understanding from parents and healthcare professionals (HCPs) of how the pandemic and associated public health restrictions impacted the peripartum and postpartum experience, as well as longer-term health and well-being of families. DESIGN Qualitative study through focus groups. SETTING Ontario, Canada. PARTICIPANTS HCPs and parents who had a child born during the COVID-19 pandemic. INTERVENTIONS Semistructured interview guide, with questions focused on how the pandemic impacted their care/their ability to provide care, and strategies to improve care and support now or in future situations with similar healthcare restrictions. OUTCOME MEASURES Thematic analysis was used to describe participant experiences and recommendations. RESULTS We included 11 HCPs and 15 parents in 6 focus groups. Participants described their experiences as 'traumatic', with difficulties in accessing prenatal and postpartum services, and feelings of distress and isolation. They also noted delays in speech and development in children born during the pandemic. Key recommendations included the provision of partner accompaniment throughout the course of care, expansion of available services for young families (particularly postpartum), and special considerations for marginalised groups, including access to technology for virtual care or the option of in-person visits. CONCLUSIONS Our findings may inform the development of healthcare system and organisational policies to ensure the provision of maternal and newborn care in the event of future public health emergencies. Of primary importance to the participants was the accommodation of antenatal, intrapartum and postpartum partner accompaniment, and the provision of postpartum services.
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Affiliation(s)
- Andrea N Simpson
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, Ontario, Canada
- St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Nancy N Baxter
- The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Anne Sorvari
- St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Himani Boury
- Toronto General Hospital, Toronto, Ontario, Canada
| | - Eliane M Shore
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, Ontario, Canada
- St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Tali Bogler
- St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Family Medicine, University of Toronto, Toronto, ON, Canada
| | - Douglas Campbell
- St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Boury H, Albert M, Chen RHC, Chow JCL, DaCosta R, Hoffman MM, Keshavarz B, Kontos P, McAndrews MP, Protze S, Gagliardi AR. Exploring the merits of research performance measures that comply with the San Francisco Declaration on Research Assessment and strategies to overcome barriers of adoption: qualitative interviews with administrators and researchers. Health Res Policy Syst 2023; 21:43. [PMID: 37277824 DOI: 10.1186/s12961-023-01001-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/16/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND In prior research, we identified and prioritized ten measures to assess research performance that comply with the San Francisco Declaration on Research Assessment, a principle adopted worldwide that discourages metrics-based assessment. Given the shift away from assessment based on Journal Impact Factor, we explored potential barriers to implementing and adopting the prioritized measures. METHODS We identified administrators and researchers across six research institutes, conducted telephone interviews with consenting participants, and used qualitative description and inductive content analysis to derive themes. RESULTS We interviewed 18 participants: 6 administrators (research institute business managers and directors) and 12 researchers (7 on appointment committees) who varied by career stage (2 early, 5 mid, 5 late). Participants appreciated that the measures were similar to those currently in use, comprehensive, relevant across disciplines, and generated using a rigorous process. They also said the reporting template was easy to understand and use. In contrast, a few administrators thought the measures were not relevant across disciplines. A few participants said it would be time-consuming and difficult to prepare narratives when reporting the measures, and several thought that it would be difficult to objectively evaluate researchers from a different discipline without considerable effort to read their work. Strategies viewed as necessary to overcome barriers and support implementation of the measures included high-level endorsement of the measures, an official launch accompanied by a multi-pronged communication strategy, training for both researchers and evaluators, administrative support or automated reporting for researchers, guidance for evaluators, and sharing of approaches across research institutes. CONCLUSIONS While participants identified many strengths of the measures, they also identified a few limitations and offered corresponding strategies to address the barriers that we will apply at our organization. Ongoing work is needed to develop a framework to help evaluators translate the measures into an overall assessment. Given little prior research that identified research assessment measures and strategies to support adoption of those measures, this research may be of interest to other organizations that assess the quality and impact of research.
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Affiliation(s)
- Himani Boury
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Mathieu Albert
- The Institute for Education Research, University Health Network, Toronto, Canada
| | - Robert H C Chen
- Research Solutions and Services, University Health Network, Toronto, Canada
| | - James C L Chow
- Techna Institute, University Health Network, Toronto, Canada
| | - Ralph DaCosta
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Michael M Hoffman
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Behrang Keshavarz
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Pia Kontos
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | | | - Stephanie Protze
- McEwen Stem Cell Institute, University Health Network, Toronto, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
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Gagliardi AR, Chen RHC, Boury H, Albert M, Chow J, DaCosta RS, Hoffman M, Keshavarz B, Kontos P, Liu J, McAndrews MP, Protze S. DORA-compliant measures of research quality and impact to assess the performance of researchers in biomedical institutions: Review of published research, international best practice and Delphi survey. PLoS One 2023; 18:e0270616. [PMID: 37172046 PMCID: PMC10180594 DOI: 10.1371/journal.pone.0270616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/07/2022] [Indexed: 05/14/2023] Open
Abstract
OBJECTIVE The San Francisco Declaration on Research Assessment (DORA) advocates for assessing biomedical research quality and impact, yet academic organizations continue to employ traditional measures such as Journal Impact Factor. We aimed to identify and prioritize measures for assessing research quality and impact. METHODS We conducted a review of published and grey literature to identify measures of research quality and impact, which we included in an online survey. We assembled a panel of researchers and research leaders, and conducted a two-round Delphi survey to prioritize measures rated as high (rated 6 or 7 by ≥ 80% of respondents) or moderate (rated 6 or 7 by ≥ 50% of respondents) importance. RESULTS We identified 50 measures organized in 8 domains: relevance of the research program, challenges to research program, or productivity, team/open science, funding, innovations, publications, other dissemination, and impact. Rating of measures by 44 panelists (60%) in Round One and 24 (55%) in Round Two of a Delphi survey resulted in consensus on the high importance of 5 measures: research advances existing knowledge, research plan is innovative, an independent body of research (or fundamental role) supported by peer-reviewed research funding, research outputs relevant to discipline, and quality of the content of publications. Five measures achieved consensus on moderate importance: challenges to research productivity, potential to improve health or healthcare, team science, collaboration, and recognition by professional societies or academic bodies. There was high congruence between researchers and research leaders across disciplines. CONCLUSIONS Our work contributes to the field by identifying 10 DORA-compliant measures of research quality and impact, a more comprehensive and explicit set of measures than prior efforts. Research is needed to identify strategies to overcome barriers of use of DORA-compliant measures, and to "de-implement" traditional measures that do not uphold DORA principles yet are still in use.
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Affiliation(s)
- Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Rob H C Chen
- UHN Research Solutions and Services, University Health Network, Toronto, Ontario, Canada
| | - Himani Boury
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Mathieu Albert
- The Institute for Education Research, University Health Network, Toronto, Ontario, Canada
| | - James Chow
- Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Ralph S DaCosta
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Michael Hoffman
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Behrang Keshavarz
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Ontario, Canada
| | - Pia Kontos
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Ontario, Canada
| | - Jenny Liu
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Mary Pat McAndrews
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Stephanie Protze
- McEwen Stem Cell Institute, University Health Network, Toronto, Ontario, Canada
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Boury H, Hall W, Fischer B. Developments and Changes in Primary Public Health Outcome Indicators Associated with the Legalization of Non-Medical Cannabis Use and Supply in Canada (2018): A Comprehensive Overview. Int J Ment Health Addict 2022:1-15. [PMID: 36589471 PMCID: PMC9794107 DOI: 10.1007/s11469-022-00986-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/28/2022] Open
Abstract
Canada legalized non-medical cannabis use and supply for adults in 2018. We examined developments and changes associated with the legalization policy reform on key indicators for public health, namely cannabis (including frequent/problematic) use prevalence, cannabis-related hospitalizations, cannabis-impaired driving, and cannabis sourcing. We identified peer-reviewed and "grey" study data that featured population-level or other quasi-representative samples and comparable outcome data for pre- and post-legalization periods, including possible trends of changes over time. Cannabis use has increased in select population groups, with use modes shifting away from smoking. Evidence on cannabis-related hospitalizations (e.g., for mental health) is mixed. The prevalence of cannabis-impaired driving appears to be generally steady but THC exposure among crash-involved drivers may have increased. Increasing proportions of users obtain cannabis products from legal sources but some-especially regular-users continue to use illicit sources. Overall, data suggest a mixed and inconclusive picture on cannabis legalization's impacts on essential public health indicators, including select extensions in trends from pre-legalization.
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Affiliation(s)
- Himani Boury
- Faculty of Health Sciences, Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Suite 2400, 515 W. Hastings Street, Vancouver, BC V6B 5K3 Canada
- School of Public Health, Queens University, Kingston, Canada
| | - Wayne Hall
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, University of Queensland, 17 Upland Road, St Lucia, Australia
| | - Benedikt Fischer
- Faculty of Health Sciences, Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Suite 2400, 515 W. Hastings Street, Vancouver, BC V6B 5K3 Canada
- School of Population Health, University of Auckland, 85 Park Road, Auckland, New Zealand
- Department of Psychiatry, Federal University of Sao Paulo, R. Sena Madureira, São Paulo, 1500 Brazil
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5S2S1 Canada
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Abstract
COVID-19 is a global pandemic with over 25 million cases worldwide. Currently, treatments are limited, and there is no approved vaccine. Interventions such as handwashing, masks, social distancing, and "social bubbles" are used to limit community transmission, but it is challenging to choose the best interventions for a given activity. Here, we provide a quantitative framework to determine which interventions are likely to have the most impact in which settings. We introduce the concept of "event R," the expected number of new infections due to the presence of a single infectious individual at an event. We obtain a fundamental relationship between event R and four parameters: transmission intensity, duration of exposure, the proximity of individuals, and the degree of mixing. We use reports of small outbreaks to establish event R and transmission intensity in a range of settings. We identify principles that guide whether physical distancing, masks and other barriers to transmission, or social bubbles will be most effective. We outline how this information can be obtained and used to reopen economies with principled measures to reduce COVID-19 transmission.
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Affiliation(s)
- Paul Tupper
- Department of Mathematics, Simon Fraser University, Burnaby, BC V5A1S6, Canada;
| | - Himani Boury
- Faculty of Health Science, Simon Fraser University, Burnaby, BC V5A1S6, Canada
| | - Madi Yerlanov
- Department of Mathematics, Simon Fraser University, Burnaby, BC V5A1S6, Canada
| | - Caroline Colijn
- Department of Mathematics, Simon Fraser University, Burnaby, BC V5A1S6, Canada
- Department of Mathematics, Imperial College London, London SW7 2AZ, United Kingdom
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