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Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to assess the extent to which the LEADS Framework guided health-care leaders through organizational change and the COVID-19 pandemic in a western Canadian province. Design/methodology/approach: A qualitative exploratory inquiry assessed the extent to which health leaders applied competencies that aligned with the LEADS Framework. A purposeful sample of 22 health-care leaders participated in the study representing senior, mid-level and front-line health-care leaders in various health-care organizations to ensure diverse representation of leader competencies. The authors conducted semi-structured interviews to collect the data and used Braun and Clarke's (2006) six-phase approach to guide data analysis. Findings: The analysis suggests that health-care leaders found Engaging with Others and Developing Coalitions were the most critical themes of the LEADS Framework for change management and for navigating the COVID-19 pandemic. Findings reveal that during transformational change and a crisis context, leaders embrace relational approaches to adapt and improve performance in dynamic organizations. Practical implications: These findings have implications for a relational approach to improve teamwork and decrease emotional strain; a focus on mobilizing and sharing power with nurses; and educational programs to advance relational and self-management skills, shared leadership, communication, change management, human resource and talent development as critical learning components for current and future health-care leaders. Originality/value: The LEADS Framework is used to examine how health-care leaders responded to transformational change in the organization while situated in a pandemic context. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic has had an impact on all aspects of the health system. Little is known about how the activities and experiences of patient, family and caregiver partners, as a large group across a variety of settings within the health system, changed due to the substantial health system shifts catalysed by the pandemic. This paper reports on the results of a survey that included questions about this topic. Methods: Canadian patient, family and caregiver partners were invited to participate in an online anonymous survey in the Fall of 2020. A virtual snowballing approach to recruitment was used. Survey invitations were shared on social media and emailed to health system and governmental organizations with the request that they share the survey with patient partners. This paper focuses on responses to two questions related to patient partner experiences during the COVID‐19 pandemic. Results: The COVID‐19 questions were completed by 533 respondents. Over three quarters of respondents (77.9%, n = 415) indicated their patient engagement activities had been impacted by COVID‐19. The majority (62.5%, n = 230) experienced at least a temporary or partial reduction in their patient engagement activities. Some respondents did see increases in their patient engagement activities (11.4%, n = 42). Many respondents provided insights into their experience with virtual platforms for engagement (n = 194), most expressed negative or mixed experiences with this shift. Conclusions: This study provides a snapshot of Canadian patient, family and caregiver partners' perspectives on the impact of COVID‐19 on their engagement activities. Understanding how engagement unfolded during a crisis is critical for our future planning if patient engagement is to be fully integrated into the health system. Identifying how patient partners were engaged and not engaged during this time period, as well as the benefits and challenges of virtual engagement opportunities, offers instructive lessons for sustaining patient engagement, including the supports needed to engage with a more diverse set of patient, family and caregiver partners. Patient Contribution: Patient partners were important members of the Canadian Patient Partner Study research team. They were engaged from the outset, participating in all stages of the research project. Additional patient partners were engaged to develop and pilot test the survey, and all survey respondents were patient, family or caregiver partners. The manuscript is coauthored by two patient partners. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted the importance of immigrant health workers in OECD nations, and intensified debates about the current and future supply and distribution of such workers, particularly nurses. This review paper considers internationally educated nurses in the case of Ontario, Canada, and the policy responses developed during the pandemic to address the increased utilization of immigrant health workers. To further consider the evolving place of migrant workers within health, the broader issue of the future of health care work is examined to imagine what a sustainable and resilient health workforce agenda that integrates internationally educated nurses might look like. [ABSTRACT FROM AUTHOR]

National responses to COVID-19 depend in part on national health care financing arrangements. Yet the pandemic itself has not only strained system capacity, it has – through subsequent economic shocks – strained revenue sources that prop up these arrangements. In federal countries, fiscal pressures are particularly pronounced. As this paper argues, however, federal health financing regimes differ in ways that are shaping the agenda for post-pandemic reforms. The analysis, which focuses on health care financing in three federal countries (Canada, the United States, and Mexico), explores the current and potential future impact of COVID-19 on existing policy legacies. [ABSTRACT FROM AUTHOR]

Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care. [ABSTRACT FROM AUTHOR]

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Background: Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to address needs. Methods: Our study was informed by the Levesque et al.'s (2013) "conceptual framework of access to health care." We used Interpretive Description, a qualitative approach partly aimed at informing clinical decisions. We recruited participants across five settings. Participants engaged in one-time, semi-structured, virtual interviews. Interviews were transcribed verbatim. We used reflexive thematic analysis. Best practice to ensure methodological rigour was employed. Results: Three key themes were generated from 56 interviews. The first theme illustrated the rollercoaster-like nature of participants' Long COVID symptoms and the resulting impact on function and health. The second theme highlighted participants' attempts to access Long COVID services. Guidance received from healthcare professionals and self-advocacy impacted initial access. When navigating Long COVID services within the broader system, participants encountered barriers to access around stigma; appointment logistics; testing and 'normal' results; and financial precarity and affordability of services. The third theme illuminated common factors participants liked and disliked about Long COVID services. We framed each sub-theme as the key lesson (stemming from all likes and dislikes) that, if acted upon, the health system can use to improve the quality of Long COVID services. This provides tangible ways to improve the system based directly on what we heard from participants. Conclusion: With Long COVID services continuously evolving, our findings can inform decision makers within the health system to better understand the lived experiences of Long COVID and tailor services and policies appropriately. [ABSTRACT FROM AUTHOR]

Background: Vaccine hesitancy exists on a continuum ranging between complete adherence and complete refusal due to doubts or concerns within a heterogeneous group of individuals. Despite widespread acknowledgement of the contextual factors influencing attitudes and beliefs shaping COVID-19 vaccine hesitancy, qualitative research with equity-deserving groups, accounting for unique lived experiences, remains a gap in the literature. We aim to identify and begin to understand and document the unique contextual factors shaping hesitancy by equity-deserving groups as it relates to relationships with government and health authorities. Methods: Participants were recruited and interviewed between Aug-Dec 2021. Semi-structured interviews using a convergent interviewing technique were conducted with individuals from the general population, as well as individuals who identify as First Nations, Métis, or Inuit, members of the LGBT2SQ + community, low-income Canadians, Black Canadians, and newcomers. Interviews were audio recorded and transcribed by a team of researchers. Memos were written following interviews and used to complement the thematic analysis of the interview data. Themes are presented in the results section. Results: The rationale for hesitancy among equity-deserving groups is consistent with literature documenting hesitancy in the general population. Contextual factors surrounding equity-deserving groups' attitudes and beliefs, however, are unique and relate to a history of oppression, discrimination, and genocide. We identified factors unique to subgroups; for example, religious or fatalistic beliefs among participant who identify as FNMI, fear associated with lack of testing and speed of vaccines' production among participants who identify as FNMI, Black, and LGBT2SQ + , distrust of the healthcare system for LGBT2SQ + and Black Canadians, and distrust of the government and opposition to vaccine mandates for participating who identify as LGBT2SQ + , low-income, FNMI, or Black Canadian. Newcomers stood out as very trusting of the government and accepting of COVID-19 vaccination. Conclusions: While our data on vaccine hesitancy largely mirror concerns reported in the vast body of literature citing rationale for COVID-19 hesitancy in high-income countries, the contextual factors identified in our work point to the need for wider systemic change. Our results may be used to support efforts, beyond tailored promotion campaigns, to support the confident acceptance of vaccines for COVID-19 and the acceptance of novel vaccines as future infectious diseases emerge. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this qualitative research study is to explore health-care providers' perspectives and experiences with a specific focus on supports reported to be effective during the COVID-19 pandemic. The overarching goal of this study is to inform leaders and leadership regarding provision of supports that could be implemented during times of crisis and in the future beyond the pandemic. Design/methodology/approach: Data were collected by semi-structured, conversational interviews with a sample of 33 health-care professionals, including Registered Nurses, Nurse Practitioners, Registered Psychologists, Registered Dieticians and an Occupational Therapist. Findings: Three major themes emerged from the interview data: (1) professional and personal challenges for health-care providers, (2) physical and mental health impacts on health-care providers and (3) providing supports for health-care providers. The third theme was further delineated into three sub-theses: formal resources and supports, informal resources and supports and leadership strategies. Originality/value: Health-care leaders are advised to pay attention to the voices of the people they are leading. It is important to know what supports health-care providers need in times of crisis. Situating the needs of health-care providers in the Carter and Bogue Model of Leadership Influence for Health Professional Wellbeing (2022) can assist leaders to deliberately focus on aspects of providers' wellbeing and remain cognizant of the supports needed both during a crisis and when circumstances are unremarkable. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had significant impacts on violence against women (VAW), including increased prevalence and severity, and on VAW service delivery. The purpose of this research was to study women's experiences with VAW services in the first stages of the pandemic and describe their fears and concerns. This cross-sectional study was conducted from May through October 2020. Our VAW agency partners across Ontario, Canada invited women using outreach services to participate in a study about their experiences during the pandemic. In total, 49 women from 9 agencies completed an online survey. Quantitative data were analyzed with descriptive statistics and open-ended responses are presented to supplement findings. Women's experiences with VAW services during the pandemic varied greatly; some found technology-facilitated services (phone, video, text) more accessible, while others hoped to return to in-person care. Over half of women reported poorer wellbeing, access to health care, and access to informal supports. Many women reported increased relationship-related fears, some due specifically to COVID-19 factors. Our results support providing a variety of technology-based options for women accessing VAW services when in-person care options are reduced. This research also adds to the scant literature examining how some perpetrators capitalized on the pandemic by using new COVID-19-specific forms of coercive control. Although the impacts of the pandemic on women varied, our findings highlight how layers of difficulty, such as less accessible formal and informal support, as well as increased fear – can compound to make life for women experiencing abuse exceptionally difficult. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted and exacerbated inequities in health for structurally marginalised Canadians. Their location on society's hierarchies constrained their ability to access healthcare and follow recommended health behaviours. The aim of this article is to identify, from the perspective of marginalised populations, factors influencing the acceptance or rejection of COVID-19 countermeasures by structurally marginalised Canadians. Interviews were conducted with Canadians 18 + who identified as Black (n = 8), First Nations, Métis, or Inuit (n = 7) and low-income (<40,000 annual household income) (n = 8) between August and December 2021. Measures were said to impact well-being and interfere with revenue generating activities. Longstanding unfavourable living and environmental conditions as they relate to structural marginalisation was said to fuel anger toward the government and lead to a greater reluctance to accept countermeasures. Participants described concerns about government decisions being made without considering their unique contexts, or knowledge of the experiences of the population for whom these decisions were being made. Effective proactive action from government is important to foster trust with marginalised populations to support acceptance of health information and address growing inequities. Action that demonstrates government competence and commitment to the interests of marginalised populations is critical. [ABSTRACT FROM AUTHOR]

Background: Little is known about the experience of receiving in-person and virtual clinical health care services during the COVID-19 pandemic for Canadian children with developmental disabilities and delays facing multiple layers of vulnerability (e.g., low income, low educational attainment families). We examined the relationship between socio-demographic factors and the receipt of these services (physical and mental health services) during COVID-19 for Canadian children with these conditions.Methods: Data collected in Canada for the Global Report on Developmental Delays, Disorders and Disabilities were used. The survey: (1) was developed and disseminated in collaboration with caregivers of children with disabilities, (2) included topics such as response to the pandemic and receipt of services and supports, and (3) documented the experiences of a non-random convenience sample of caregivers of children (any age) with these conditions during and prior to the pandemic. We used four logistic regression models to assess the association between socio-demographic factors and receipt of services.Results: Being a single parent, having low educational attainment (high school or less), having low income (making less than $40,000 per year), working less than full time (working part-time, working reduced hours due to COVID, retired, stay home parent or student), as well as male gender and older age of the child with disability were factors associated with decreased likelihood of receiving services.Conclusion: Our findings point to the need for tailoring services for families of children with disabilities, particularly low socioeconomic status families, to ensure continuity of care during public health emergencies. [ABSTRACT FROM AUTHOR]

Background Individuals with chronic conditions have higher levels of health care usage and may be at higher risk of more severe outcomes from COVID-19. Therefore, they may have experienced greater difficulty accessing health care during the pandemic because of restrictions on health care services. Data and methods Data from the Survey on Access to Health Care and Pharmaceuticals During the Pandemic were used to estimate the proportion of individuals in Canada, with and without chronic conditions, who experienced difficulties accessing health care services during the pandemic. Multivariate analyses examined associations between demographic, socioeconomic and health characteristics and the likelihood of experiencing difficulties accessing health care during the pandemic. Results Nearly one-third (32.0%) of individuals who self-reported having one or more chronic conditions and 24.2% of those who reported no conditions had one or more medical appointments cancelled, rescheduled or delayed because of COVID-19. Smaller proportions of individuals with (19.5%) and without (16.8%) chronic conditions delayed contacting a medical professional because of fear of exposure to COVID-19 in health care settings. Individuals who were younger or had a disability were also more likely than older individuals or those without a disability, respectively, to have had a medical appointment cancelled, rescheduled or delayed because of the pandemic. Women, immigrants, and individuals with multiple chronic conditions were more likely than their counterparts (men, Canadian-born individuals, and individuals with no chronic conditions, respectively) to have delayed contacting a medical professional because of fear of exposure to COVID-19. Interpretation Individuals with chronic conditions were more likely than those with no chronic conditions to have experienced difficulties accessing health care during the pandemic. Consequently, these individiuals may be at greater risk of experiencing health challenges in the future. [ABSTRACT FROM AUTHOR]

In this study, we examined feasibility, acceptability, and preliminary efficacy of a telepsychological positive parenting intervention (I–InTERACT-North, Internet-basedInteracting Together Everyday: Recovery After Childhood Traumatic Brain Injury) during the COVID-19 pandemic among Canadian families of children at-risk for neurodevelopmental challenges given congenital or neonatal conditions. I–InTERACT-North was developed to improve behavioral and emotional outcomes in children with neurological conditions by utilizing and adapting parenting strategies from several established family-focused programmes. A pragmatic prospective pre-post single-site pilot study design was used to assess feasibility, acceptabilty, and preliminary efficacy of I-InTERACT North during the COVID-19 pandemic. Thirty-five families of children ages three to nine years were referred between March 2020 and January 2021. Eighteen families enrolled, and 12 (67% adherence) completed the programme. Parents reported strong therapeutic alliance and programme acceptability with barriers due to competing time demands. Therapists reported high acceptability but perceived parental burnout. Parenting confidence (d = 0.70), and child behavior (d = 1.30) improved following the intervention. Results demonstrate the programme's value to families during the pandemic, while underscoring unique participation barriers. Future research and clinicial implications are discussed. [ABSTRACT FROM AUTHOR]

Background: COVID-19 and its public health response are having a profound effect on people's mental health. To provide support during these times, Canada's largest mental health and addiction teaching hospital (Centre for Addiction and Mental Health [CAMH]) launched the Mental Health and COVID-19 Pandemic website on March 18, 2020. This website was designed to be a nonstigmatizing psychoeducational resource for people experiencing mild to moderate distress due to COVID-19 and the public health response to the pandemic. Objective: The aim of this study was to examine the reach, usability, and user perceptions of the CAMH Mental Health and COVID-19 Pandemic website. Methods: This study used a mixed methods sequential explanatory design approach, which consisted of the following 2 distinct phases: (1) quantitative data collection and analysis and (2) qualitative semistructured interviews. In phase 1, we analyzed Google Analytics data to understand how many people visited the website and which were the most visited pages. We conducted a survey to identify users' sociodemographic backgrounds, and assess the usability of the website using the System Usability Scale and users' subjective stress levels using the Perceived Stress Scale (PSS-10). For phase 2, we conducted semistructured interviews to explore user experiences; user motivation, engagement, satisfaction, and perception of the stress reduction strategies; reflections of the website's functionality, ease of use, navigation, and design; and recommendations for improvement. Results: Google Analytics results showed 146,978 unique users from June 2020 to March 2021. Most users were from Canada (130,066, 88.5%). Between February 20, 2021, and June 4, 2021, 152 users completed the survey. Most users identified as white, female, and having at least a college degree. Based on the PSS-10 scores, most participants were experiencing moderate to high stress when they visited the website. Users rated the usability of the website as acceptable. Ten users completed in-depth interviews between May 2021 and June 2021. Positive feedback related to the content was that the website was a trustworthy source of mental health information with helpful evidence-based stress reduction strategies. Areas for improvement included the text heavy design of the website, wider dissemination/marketing, and greater accessibility of the website to meet the needs of diverse populations. Conclusions: Adding stress reduction resources to a website from a well-respected institution may be a practical method to increase awareness and access to evidence-based stress reduction resources during times of crisis, where there is severe disruption to usual health care contacts. Efforts to ensure that these resources are more widely accessed, especially by diverse populations, are needed. [ABSTRACT FROM AUTHOR]

Purpose: This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the health and social care system. Specifically, the objectives were to determine what effective leadership practices Canadian health leaders have used through the first wave of the COVID-19 pandemic, to explore how these differ from pre-crisis practices; and to identify what leadership practices might be leveraged to create the desired health and care systems of the future. Design/methodology/approach: The authors used an action research methodology. In the first phase, reported here, the authors conducted one-on-one, virtual interviews with 18 health leaders from across Canada and across leadership roles. Data were analyzed using grounded theory methodology. Findings: Five key practices emerged from the data, within the core dimension of disrupting entrenched structures and leadership practices. These were, namely, responding to more complex emotions in self and others. Future practice identified to create more psychologically supportive workplaces. Agile and adaptive leadership. Future practice should allow leaders to move systemic change forward more quickly. Integrating diverse perspectives, within and across organizations, leveling hierarchies through bringing together a variety of perspectives in the decision-making process and engaging people more broadly in the co-creation of strategies. Applying existing leadership capabilities and experience. Future practice should develop and expand mentorship to support early career leadership. Communication was increased to build credibility and trust in response to changing and often contradictory emerging evidence and messaging. Future practice should increase communication. Research limitations/implications: The project was limited to health leaders in Canada and did not represent all provinces/territories. Participants were recruited through the leadership networks, while diverse, were not demographically representative. All interviews were conducted in English; in the second phase of the study, the authors will recruit a larger and more diverse sample and conduct interviews in both English and French. As the interviews took place during the early stages of the pandemic, it may be that health leaders' views of what may be required to re-define future health systems may change as the crisis shifts over time. Practical implications: The sponsoring organization of this research – the Canadian Health Leadership Network and each of its individual member partners – will mobilize knowledge from this research, and subsequent phases, to inform processes for leadership development and, succession planning across, the Canadian health system, particularly those attributes unique to a context of crisis management but also necessary in post-crisis recovery. Social implications: This research has shown that there is an immediate need to develop innovative and influential leadership action – commensurate with its findings – to supporting the evolution of the Canadian health system, the emotional well-being of the health-care workforce, the mental health of the population and challenges inherent in structural inequities across health and health care that discriminate against certain populations. Originality/value: An interdisciplinary group of health researchers and decision-makers from across Canada who came together rapidly to examine leadership practices during COVID-19's first wave using action research study design. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to understand the experiences of nurse managers during the COVID‐19 pandemic. Background: There is a growing body of knowledge about the experiences of clinical nurses during COVID‐19. However, there is less evidence about the experiences of nurse managers during the pandemic. Methods: Eight nurse managers, from acute care and outpatient settings, completed semistructured interviews about how their roles had changed during the pandemic, how they felt about these changes, and what had gone well or been difficult. Each participant was interviewed once, for 20–60 min. We used thematic analysis methods to analyse the interview transcripts. Findings Nurse managers had to coordinate care in a context of uncertainty and guidance that changed frequently. Participants found that their roles and responsibilities either expanded to include more duties, or they were asked to take on a completely new role, with no orientation or training. Nurse managers were expected to provide support to their staff and patients, but did not necessarily receive support themselves. Participants were expected to plan simultaneously for care during the pandemic and for a return to normal working conditions. These factors contributed to challenging and difficult participant experiences of managing during COVID‐19. Conclusion: Nurse managers' experiences during COVID‐19 are influenced by changes to their roles and the support they received. Nurse managers continue to support high‐quality care despite working a difficult context. Implications for nursing management: Where possible, nurse managers can be supported to extend their roles or receive additional education and support if they are required to take on new responsibilities. Nurse managers require support in order to be a resource for their staff. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and associated public health preventive measures such as lockdown and home confinement have posed unique challenges to female sex workers (FSW) globally, including in Canada where the sex trade is not formally recognized. In this commentary, we discuss the unintended consequences the pandemic has had on various social determinants of health among FSW. We draw on a review of scholarly and grey literature, complemented by our experience with the Exit Doors Here program, a sex work exiting program implemented in Toronto, Canada. Due to COVID-19, many FSW suddenly lost their main source of income, work conditions became riskier, and sheltering-in-place presented challenges for women with no safe housing. The slowdown of social and health care services also meant FSW were not receiving the required attention. We make recommendations for intersectoral mitigation strategies to limit the short- and long-term impacts of COVID-19 on FSW health and livelihoods. Recommendations focus on addressing women's marginalizing circumstances and speak to a gender transformative approach to the COVID-19 recovery. Our recommendations are relevant to FSW and other marginalized groups, in the current context and in the context of future health, social, and economic crises. [ABSTRACT FROM AUTHOR]

Background: Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams' delivery of mental health care. Methods: A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results: We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions: From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care's capacity for mental health care for the duration of the pandemic and beyond. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has spread rapidly, requiring health delivery systems to undertake dramatic transformations. To evaluate these system changes, we undertook one of the first Canadian health delivery system reviews and the first Canadian cancer centre evaluation of pandemic system modifications. Methods: Questionnaires were distributed to the Canadian Association of Provincial Cancer Agencies (CAPCA) members in order to assess changes to cancer centre services and patient management. Documentation relating to COVID-19 from the CAPCA electronic space was accessed, and all publicly available cancer centre documentation related to COVID-19 was reviewed. Results: Seven provinces completed the questionnaire and had documentation available from the CAPCA electronic space. All screening programs across Canada were suspended. In most provinces surveyed, ≥50% of outpatient appointments were occurring virtually, with <25% using video platforms. Generally, the impact on diagnostic imaging and new patient referrals correlated with the impact of COVID-19. Most provinces had a reduction in operating room availability, with chemotherapy and radiation treatments continuing. Public health modification, including personal protective equipment and screening staff, varied across the country. Conclusion: Canadian cancer centres underwent a rapid and aggressive transformation of services in response to COVID-19, with many similarities and differences across provinces. In part, this response was facilitated by communication under a national association, which in Canada remains unique to cancer. This response may serve to inform changes in other jurisdictions or disease states now and in future waves of the pandemic, as well as a record of changes for future health services and patient outcome research. [ABSTRACT FROM AUTHOR]