Exploring children's perceptions of barriers and facilitators to physical activity in rural Northwestern Ontario, Canada

INTRODUCTION

Low levels of physical activity among children are a significant public health concern in several industrialized nations. The current research body has failed to gather adequate information on various geographic regions. Understanding barriers and facilitators in different rural regions is imperative for creating successful physical activity interventions for children in rural areas. The purpose of this study is to explore rural children's perspectives on physical activity and to discuss barriers or facilitators to physical activity participation in rural Northwestern Ontario, Canada.

METHODS

Children (n=84) in Grades 4-8 (ages 8-14 years) in rural Northwestern Ontario participated in focus groups to discuss barriers and facilitators to physical activity. Twenty focus groups were conducted in schools. The focus groups were audio-recorded and transcribed verbatim. Transcripts were analyzed using thematic analysis. Subthemes were created based on the explicit content of the data and grouped to form broader themes.

RESULTS

Three key themes were identified: environment, social environment, and perceptions of safety. Environmental features include weather and the built environment. Social environment includes the role of friends and adults to either facilitate or restrict children's play. The fear of wildlife was pervasive across all focus groups and resulted in restricted independent mobility and physical activity.

CONCLUSION

Rural children are typically under-represented in physical activity research. The findings of this study reveal that rural children experience some barriers to physical activity that are distinct from those of urban children. The findings suggest that researchers need to understand contextual nuances of the rural environment. Specific to the setting of Northwestern Ontario, these rural children could benefit from the addition of a skate park, indoor places to play, and more wildlife education.

Perinatal care experiences of Muslim women in Northwestern Ontario, Canada: A qualitative study

PROBLEM AND BACKGROUND

Although the number of Muslim women in Canada and northwestern Ontario (NWO) is increasing, few studies have focused on their experiences of perinatal health care. Extant research has highlighted discrimination and care that lacks respect for cultural and religious norms. These factors may limit access to health services and increase unfavorable maternal and child health outcomes.

AIM

To explore the perinatal health care experiences of Muslim women in NWO.

METHODS

A qualitative, descriptive study used purposive and snowball sampling to recruit a sample of 19 Muslim mothers. Ssemistructured interviews were conducted, audio recorded, transcribed verbatim, and analyzed thematically.

FINDINGS

The mothers' experiences were categorized into four themes: women's choices and preferences of health care providers (HCPs); attitudes toward prenatal classes and education; husbands' involvement and support in the birthing process; and challenges to optimal care.

DISCUSSION AND CONCLUSION

The findings show that NWO Muslim women's experiences were generally positive and their care choices and preferences were shaped by their religious beliefs and cultural practices. Factors that enhanced their experiences were HCPs' awareness of and respect for the women's religious and cultural beliefs and practices. However, the women lacked personal knowledge of a range of care options and services. Respecting Muslim women's religious and cultural beliefs and practices will enhance their experience of care. Equity in access to quality services, care, and outcomes can be further enhanced if Muslim women are informed about the range of care options and services as early in their pregnancies as possible.

Epidemiology of invasive pneumococcal disease in indigenous and non-indigenous adults in northwestern Ontario, Canada, 2006-2015

BACKGROUND

Despite the use of pneumococcal vaccines, indigenous populations are consistently disproportionately affected by invasive pneumococcal disease (IPD). With recent changes in Ontario's provincial pneumococcal vaccination program, we sought to evaluate the epidemiology and burden of IPD in northwestern Ontario (NWO) Canada - a region that contains a substantial (19.2%) indigenous population.

METHODS

We retrospectively reviewed all adult cases of IPD that were reported to the Thunder Bay District Health Unit, in Thunder Bay, Ontario, Canada, over a 10-year period (2006-2015). Patients admitted to the Thunder Bay Regional Health Sciences Centre with IPD had their charts reviewed to abstract clinical data. Statistical analysis, including incidence rates of IPD, was performed.

RESULTS

Two hundred sixty-two cases of IPD occurred over the 10-year observation period and clinical data was available for 182 cases. Fifty-three of 182 (29.1%) patients were indigenous. 73 of 182 (40.1%) of patients were immunocompromised. Indigenous patients with IPD were more likely to be immunocompromised than non-indigenous patients (p < 0.001). Serotype data was available for 159 cases of IPD; PCV7, PCV13, and PPV23 covered 5.7%, 28.3%, and 79.2% of isolates, respectively, while 29 (20.8%) were non-vaccine serotypes. The annual incidence rate of IPD ranged from 8.9 to 25.9 per 100,000 among adults 18-64 years old; among adults 65 years of age and older the annual incidence of IPD ranged from 18.5 to 60.7 per 100,000.

CONCLUSION

Among adults in NWO, Canada, there is a high incidence of IPD. Immunocompromised indigenous adults in NWO may benefit from pneumococcal vaccination coverage. Emerging non-vaccine serotypes of Streptococcus pneumoniae warrant the consideration of the provincial pneumococcal vaccination program.

Blastomycosis in northwestern Ontario, 2004 to 2014

Blastomycosis is an invasive fungal disease caused by Blastomyces dermatitidis and the recently discovered Blastomyces gilchristii. The medical charts of 64 patients with confirmed cases of blastomycosis in northwestern Ontario during a 10-year period (2004 to 2014) were retrospectively reviewed. The number of patients diagnosed with blastomycosis in Ontario was observed to have increased substantially compared with before 1990, when blastomycosis was removed from the list of reportable diseases. Aboriginals were observed to be disproportionately represented in the patient population. Of the patients whose smoking status was known, 71.4% had a history of smoking. 59.4% of patients had underlying comorbidities and a higher comorbidity rate was observed among Aboriginal patients. The case-fatality rate from direct complications of blastomycosis disease was calculated to be 20.3%; this case-fatality rate is the highest ever to be reported in Canada and more than double that of previously published Canadian studies. The clinical characteristics of 64 patients diagnosed with blastomycosis are summarized.