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BackgroundHerd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated. ObjectiveThis study aims to design a web application about community immunity and optimize it based on users’ cognitive and emotional responses. MethodsOur multidisciplinary team developed a web application about community immunity to communicate epidemiological evidence in a personalized way. In our application, people build their own community by creating an avatar representing themselves and 8 other avatars representing people around them, for example, their family or coworkers. The application integrates these avatars in a 2-min visualization showing how different parameters (eg, vaccine coverage, and contact within communities) influence community immunity. We predefined communication goals, created prototype visualizations, and tested four iterative versions of our visualization in a university-based human-computer interaction laboratory and community-based settings (a cafeteria, two shopping malls, and a public library). Data included psychophysiological measures (eye tracking, galvanic skin response, facial emotion recognition, and electroencephalogram) to assess participants’ cognitive and affective responses to the visualization and verbal feedback to assess their interpretations of the visualization’s content and messaging. ResultsAmong 110 participants across all four cycles, 68 (61.8%) were women and 38 (34.5%) were men (4/110, 3.6%; not reported), with a mean age of 38 (SD 17) years. More than half (65/110, 59.0%) of participants reported having a university-level education. Iterative changes across the cycles included adding the ability for users to create their own avatars, specific signals about who was represented by the different avatars, using color and movement to indicate protection or lack of protection from infectious disease, and changes to terminology to ensure clarity for people with varying educational backgrounds. Overall, we observed 3 generalizable findings. First, visualization does indeed appear to be a promising medium for conveying what community immunity is and how it works. Second, by involving multiple users in an iterative design process, it is possible to create a short and simple visualization that clearly conveys a complex topic. Finally, evaluating users’ emotional responses during the design process, in addition to their cognitive responses, offers insights that help inform the final design of an intervention. ConclusionsVisualization with personalized avatars may help people understand their individual roles in population health. Our app showed promise as a method of communicating the relationship between individual behavior and community health. The next steps will include assessing the effects of the application on risk perception, knowledge, and vaccination intentions in a randomized controlled trial. This study offers a potential road map for designing health communication materials for complex topics such as community immunity.

The purpose of this paper is to examine the utility of linking systems between public health resource and user organizations for health promotion dissemination and capacity building, and to identify factors related to the success of linking systems. The design is a parallel-case study using key informant interviews and content analysis of project reports (synthesized qualitative and quantitative data) of three provincial dissemination projects of the Canadian Heart Health Initiative-Dissemination Phase. Each provincial project used linking activities with public health user groups including meetings, skill building, resources, collaboration, networking and research feedback to facilitate capacity building for and implementation of heart health promotion activities. This paper presents empirical examples of linking system designs, activities, and qualitative and quantitative changes in the public health user groups' health promotion capacity, program delivery and sustainability. The findings indicate enhanced health promotion skills, partnerships, resources, infrastructure, and increased programming and sustainability in the targeted public health organizations of all three provincial projects. Identified barriers to the success of linking systems included lack of appropriately skilled personnel, funds, buy-in and leadership. We conclude that linking systems can be flexibly used to build capacity and disseminate health promotion innovations, and suggest conditions for success.

This article presents an interpretive analysis of the narratives of 15 men and women who have been diagnosed with multiple sclerosis (MS) living in the city of Ottawa, Ontario, Canada. Relatively little is known about how people who are affected by MS tope with the challenges posed by social and physical barriers in their environment. Our research investigates two objectives: (1) to explore how those who have developed MS cope with their disease and resulting impairments, both in terms of the bodily experiences of becoming a chronically ill person and in terms of how they cope with changing relationships, changing identities and challenges in their physical environment; and (2) how they engage in the process of disablement over time and space as a result of these changing social and spatial relationships. We argue that the physical body and its social placings in public and private spaces are intertwined and both affect experiences of health, ability, impairment, disability and chronic illness. We further argue that these relationships are experienced across time and space, and in place, as people who have developed a chronic illness, such as MS, engage in, with and through the process of disablement. This article demonstrates the need for researchers to pay more attention to the role and significance of the simultaneity of space, place and time in shaping the experiences of people with disabilities and chronic illnesses, as it has been shown that these variables played a significant role in regulating the everyday experiences of this study's respondents. Cette etude presente une analyse interpretative du cas narratif de quinze hommes et femmes de la ville d'Ottawa, Ontario, Canada diagnostiques avec la sclerose en plaques. Nous en connaissons relativement peu sur la facon dont les personnes atteintes de cette maladie degendrative font face aux defis imposes par les barrieres sociales et physiques de leur environnement. Notre recherche poursuit deux objectifs: 1) explorer comment ceux qui ont developpe la sclerose en plaques font face a cette maladie et les incapacites qui en resultent, en terme de leurs experiences individuelles corporelles et des changements effectues dans leurs identites, leurs relations sociales et leurs environnements physiques; et 2) explorer comment ceux-ci s'engagent dans ce processus d'incapacite de maniere temporelle et spatiale, en tenant compte des changements dans leurs relations sociospatiales. Nous argumentons que le corps physique et son emplacement social ou le public et le prive sont inter-relies, vont influencer directement les experiences d'un individu sur le plan de sa sante, de sa capacite, de ses facultes affaiblies, de son incapacite et de sa maladie chronique. Nous avancons que ces experiences sont vecues sous un axe temporel, spatial et local et de plus, que les gens qui ont developpe une maladie chronique, tel la sclerose en plaques, sont profondement engages dans ce processus d'incapacite. Cette etude demontre qu'il existe un besoin important de poursuivre la recherche sur le role et la signification du phenomene de la simultaneite de l'espace, de l'endroit et du temps, puisque ces variables ont joue un role predominant dans la determination des experiences quotidiennes du groupe cible. Mot cle: Sclerose en plaques, processus d'incapacite, incapacite, construction d'une identite, spatio-temporelle., Introduction Multiple sclerosis (MS) is a progressively worsening chronic disease of unknown etiology for which there is as yet no cure. It affects primarily the central nervous system and has [...]

Ethical research practice within community-based research involves many dimensions, including a commitment to return results to participants in a timely and accessible fashion. Often, current Indigenous community-based research is driven by a partnership model; however, dissemination of findings may not always follow this approach. As a result, products may not be as useful to participants who were motivated to be involved in the research process. We conducted a seven-week workshop on three occasions with different First Nations and Metis women and girls (age 8-12) in Winnipeg, Manitoba. The workshop explored participants' perspectives around health, safety, and family wellbeing using a strength-based, participatory approach. Participants noted that a key challenge they face when interacting with researchers, policy makers, and program staff is the lack of tailored dissemination materials. Returning results in a format that meets the expressed desire of participants is an ethical necessity to ensure that research is not perpetuating past colonial practices. Doing so quickly and with meaningful content requires careful execution and consideration, especially when working within intergenerational contexts. We describe in this paper how results were returned to families in an accessible way outlining the role that integrated knowledge exchange can play in the process of healing. [ABSTRACT FROM AUTHOR]

Abstract Background Maps and mapping tools through geographic information systems (GIS) are highly valuable for turning data into useful information that can help inform decision-making and knowledge translation (KT) activities. However, there are several challenges involved in incorporating GIS applications into the decision-making process. We highlight the challenges and opportunities encountered in implementing a mapping innovation as a KT strategy within the non-profit (public) health sector, reflecting on the processes and outcomes related to our KT innovations. Methods A case study design, whereby the case is defined as the data analyst and manager dyad (a two-person team) in selected Ontario Early Year Centres (OEYCs), was used. Working with these paired individuals, we provided a series of interventions followed by one-on-one visits to ensure that our interventions were individually tailored to personal and local decision-making needs. Data analysis was conducted through a variety of qualitative assessments, including field notes, interview data, and maps created by participants. Data collection and data analysis have been guided by the Ottawa Model of Research Use (OMRU) conceptual framework. Results Despite our efforts to remove all barriers associated with our KT innovation (maps), our results demonstrate that both individual level and systemic barriers pose significant challenges for participants. While we cannot claim a causal association between our project and increased mapping by participants, participants did report a moderate increase in the use of maps in their organization. Specifically, maps were being used in decision-making forums as a way to allocate resources, confirm tacit knowledge about community needs, make financially-sensitive decisions more transparent, evaluate programs, and work with community partners. Conclusions This project highlights the role that maps can play and the importance of communicating the importance of maps as a decision support tool. Further, it represents an integrated knowledge project in the community setting, calling to question the applicability of traditional KT approaches when community values, minimal resources, and partners play a large role in decision making. The study also takes a unique perspective--where research producers and users work as dyad-pairs in the same organization--that has been under-explored to date in KT studies.

Abstract Background Local Ontario Early Years Centres (OEYCs) collect timely and relevant local data, but knowledge translation is needed for the data to be useful. Maps represent an ideal tool to interpret local data. While geographic information system (GIS) technology is available, it is less clear what users require from this technology for evidence-informed program planning. We highlight initial challenges and opportunities encountered in implementing a mapping innovation (software and managerial decision-support) as a knowledge translation strategy. Methods Using focus groups, individual interviews and interactive software development events, we taped and transcribed verbatim our interactions with nine OEYCs in Ontario, Canada. Research participants were composed of data analysts and their managers. Deductive analysis of the data was based on the Ottawa Model of Research Use, focusing on the innovation (the mapping tool and maps), the potential adopters, and the environment. Results Challenges associated with the innovation included preconceived perceptions of a steep learning curve with GIS software. Challenges related to the potential adopters included conflicting ideas about tool integration into the organization and difficulty with map interpretation. Lack of funds, lack of availability of accurate data, and unrealistic reporting requirements represent environmental challenges. Conclusion Despite the clear need for mapping software and maps, there remain several challenges to their effective implementation. Some can be modified, while other challenges might require attention at the systemic level. Future research is needed to identify barriers and facilitators related to using mapping software and maps for decision-making by other users, and to subsequently develop mapping best practices guidelines to assist community-based agencies in circumventing some challenges, and support information equity across a region.

Abstract Background Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for non-specialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool. Methods A case study design is being used whereby the case is defined as the data analyst and manager dyad (a two person team) in selected Ontario Early Year Centres (OEYCs). Multiple cases are used to support the reliability of findings. With nine producer/user pair participants, the goal in Phase 1 was to identify barriers to map production, and through the participatory design process, develop a web-based GIS tool suited for data analysts and their managers. This study has been guided by the Ottawa Model of Research Use (OMRU) conceptual framework. Results Due to wide variations in OEYC structures, only some data analysts used mapping software and there was no consistency or standardization in the software being used. Consequently, very little sharing of maps and data occurred among data analysts. Using PD, this project developed a web-based mapping tool (EYEMAP) that was easy to use, protected proprietary data, and permit limited and controlled sharing between participants. By providing data analysts with training on its use, the project also ensured that data analysts would not break cartographic conventions (e.g. using a chloropleth map for count data). Interoperability was built into the web-based solution; that is, EYEMAP can read many different standard mapping file formats (e.g. ESRI, MapInfo, CSV). Discussion Based on the evaluation of Phase 1, the PD process has served both as a facilitator and a barrier. In terms of successes, the PD process identified two key components that are important to users: increased data/map sharing functionality and interoperability. Some of the challenges affected developers and users; both individually and as a collective. From a development perspective, this project experienced difficulties in obtaining personnel skilled in web application development and GIS. For users, some data sharing barriers are beyond what a technological tool can address (e.g. third party data). Lastly, the PD process occurs in real time; both a strength and a limitation. Programmatic changes at the provincial level and staff turnover at the organizational level made it difficult to maintain buy-in as participants changed over time. The impacts of these successes and challenges will be evaluated more concretely at the end of Phase 2. Conclusion PD approaches, by their very nature, encourage buy-in to the development process, better addresses user-needs, and creates a sense of user-investment and ownership.

Historical trauma and the negative effects of colonialism continue to be played out within Canadian culture. These processes have a deleterious effect on physical and psychological health outcomes among Indigenous Peoples. Through the creation of a safe space as part of a decolonizing, participatory activity program spanning 7 weeks, First Nations and Metis women and girls (aged 8-12) were able to begin to unpack what it means to be happy, healthy, and safe, and what is needed to actualize these goals. A community engaged, assetbased workshop approach provided a forum for participants to discuss the impact of traumatic experiences on the ability of adults to model a positive image of strength, independence, and confidence for their daughters, while creating a space to discuss change. [ABSTRACT FROM AUTHOR]

Background: Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour.Methods: Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance. Interviews were recorded and transcribed verbatim. Transcripts were content analysed using the TDF and themes were framed as belief statements. Domains potentially key to changing fetal surveillance behaviour and informing intervention design were identified by noting the frequencies of beliefs, content, and their reported influence on the use of IA.Results: We interviewed 12 birthing unit nurses. Seven of the 12 TDF domains were perceived to be key to changing birthing unit nurses' behaviour The nurses reported that competing tasks, time constraints and the necessity to multitask often limit their ability to perform IA (domains Beliefs about capabilities; Environmental context and resources). Some nurses noted the decision to use IA was something that they consciously thought about with every patient while others stated it their default decision as long as there were no risk factors (Memory, attention and decision processes, Nature of behaviour). They identified positive consequences (e.g. avoid unnecessary interventions, mother-centered care) and negative consequences of using IA (e.g. legal concerns) and reported that the negative consequences can often outweigh positive consequences (Beliefs about consequences). Some reported that hospital policies and varying support from care teams inhibited their use of IA (Social influences), and that support from the entire team and hospital management would likely increase their use (Social influences; Behavioural regulation).Conclusion: We identified potential influences on birthing unit nurses' use of IA as their primary method of fetal surveillance. These beliefs suggest potential targets for behaviour change interventions to promote IA use. [ABSTRACT FROM AUTHOR]