COVID-19 vaccination intention and vaccine hesitancy among citizens of the Métis Nation of Ontario.

Objective: The study objective is to measure the influence of psychological antecedents of vaccination on COVID-19 vaccine intention among citizens of the Métis Nation of Ontario (MNO).

Methods: A population-based online survey was implemented by the MNO when COVID-19 vaccines were approved in Canada. Questions included vaccine intention, the short version of the "5C" psychological antecedents of vaccination scale (confidence, complacency, constraint, calculation, collective responsibility), and socio-demographics.

COVID-19 vaccine behaviour among citizens of the Métis Nation of Ontario: A qualitative study.

Background: The burden of the current COVID-19 pandemic is not shared equally in Canadian society, with Indigenous Peoples being disproportionately affected. Moreover, there is a lack of research pertaining to vaccination behaviour in Métis communities. This Métis-specific and Métis-led qualitative study endeavours to understand COVID-19 vaccine behaviour among citizens of the Métis Nation of Ontario (MNO).

Uncovering SARS-COV-2 vaccine uptake and COVID-19 impacts among First Nations, Inuit and Métis Peoples living in Toronto and London, Ontario.

Background: First Nations, Inuit and Métis Peoples across geographies are at higher risk of SARS-CoV-2 infection and COVID-19 because of high rates of chronic disease, inadequate housing and barriers to accessing health services. Most Indigenous Peoples in Canada live in cities, where SARS-CoV-2 infection is concentrated. To address gaps in SARS-CoV-2 information for these urban populations, we partnered with Indigenous agencies and sought to generate rates of SARS-CoV-2 testing and vaccination, and incidence of infection for First Nations, Inuit and Métis living in 2 Ontario cities.

Supporting policy and practice in Ontario through ICES' Applied Health Research Question (AHRQ) program.

ICES upholds a strong reputation for generating high-quality evidence to inform policy and practice through its collaborations with a broad range of health system stakeholders including government policymakers and healthcare providers including clinicians. Supported by the Ontario Ministry of Health and Ministry of Long-Term Care, the ICES Applied Health Research Question (AHRQ) Program leverages the data holdings and, scientific and clinical expertise to generate evidence tailored to the information needs of requestors. This paper outlines the approach, process, strengths, challenges and the resulting influence and impact to the healthcare landscape in Ontario.

Diabetes prevalence and complication rates: In individual First Nations communities in the Sioux Lookout region of Ontario.

Objective: To test the feasibility of reporting diabetes indicators at a regional and community level in order to provide feedback to local leaders on health system performance.

Design: Analysis of administrative data from hospital discharges and physician billings.

Setting: Sioux Lookout region of Ontario.

Which Physicians Are Taking Care of People With COPD?

Background: There is limited knowledge on what proportions of patients with COPD receive ambulatory care from primary care physicians, pulmonologists, or other specialists. We evaluated the types and combinations of physicians who provide ambulatory care to patients with COPD.

Methods: We conducted a population-based cross-sectional study using health administrative datasets from Ontario, Canada between April 1, 2014 and March 31, 2015.

Physician Characteristics Associated With Ordering 4 Low-Value Screening Tests in Primary Care.

Importance: Efforts to reduce low-value tests and treatments in primary care are often ineffective. These efforts typically target physicians broadly, most of whom order low-value care infrequently.

Objectives: To measure physician-level use rates of 4 low-value screening tests in primary care to investigate the presence and characteristics of primary care physicians who frequently order low-value care.

Frequency and Associations of Prescription Nonsteroidal Anti-inflammatory Drug Use Among Patients With a Musculoskeletal Disorder and Hypertension, Heart Failure, or Chronic Kidney Disease.

Importance: International nephrology societies advise against nonsteroidal anti-inflammatory drug (NSAID) use in patients with hypertension, heart failure, or chronic kidney disease (CKD); however, recent studies have not investigated the frequency or associations of use in these patients.

Objectives: To estimate the frequency of and variation in prescription NSAID use among high-risk patients, to identify characteristics associated with prescription NSAID use, and to investigate whether use is associated with short-term, safety-related outcomes.

Design, Setting, And Participants: In this retrospective cohort study, administrative claims databases were linked to create a cohort of primary care visits for a musculoskeletal disorder involving patients 65 years and older with a history of hypertension, heart failure, or CKD between April 1, 2012, and March 31, 2016, in Ontario, Canada.

Routine use of chest x-ray for low-risk patients undergoing a periodic health examination: a retrospective cohort study.

Background: Many evidence-based recommendations advocate against the use of routine chest x-rays for asymptomatic, low-risk outpatients; however, it is unclear how regularly chest x-rays are ordered in primary care. Our study aims to describe the frequency of, and variation in, routine chest x-ray use in low-risk outpatients among primary care physicians.

Methods: In this retrospective cohort study, Ontario residents aged 18 years and older with a periodic health examination (PHE) between Apr.

Walking the Path Together: Indigenous Health Data at ICES.

Indigenous data governance principles assert that Indigenous communities have a right to data that identifies their people or communities, and a right to determine the use of that data in ways that support Indigenous health and self-determination. Indigenous-driven use of the databases held at the Institute for Clinical Evaluative Sciences (ICES) has resulted in ongoing partnerships between ICES and diverse Indigenous organizations and communities. To respond to this emerging and complex landscape, ICES has established a team whose goal is to support the infrastructure for responding to community-initiated research priorities.

Electrocardiograms in Low-Risk Patients Undergoing an Annual Health Examination.

Importance: Clinical guidelines advise against routine electrocardiograms (ECG) in low-risk, asymptomatic patients, but the frequency and impact of such ECGs are unknown.

Objective: To assess the frequency of ECGs following an annual health examination (AHE) with a primary care physician among patients with no known cardiac conditions or risk factors, to explore factors predictive of receiving an ECG in this clinical scenario, and to compare downstream cardiac testing and clinical outcomes in low-risk patients who did and did not receive an ECG after their AHE.

Design, Setting, And Participants: A population-based retrospective cohort study using administrative health care databases from Ontario, Canada, between 2010/2011 and 2014/2015 to identify low-risk primary care patients and to assess the subsequent outcomes of interest in this time frame.

Tobacco retail availability and risk of relapse among smokers who make a quit attempt: a population-based cohort study.

Introduction: The availability of tobacco is thought to influence smoking behaviour, but there are few longitudinal studies examining if the location and number of tobacco outlets has a prospective impact on smoking cessation.

Methods: The Ontario Tobacco Survey, a population-representative sample of Ontario adult smokers who were followed every 6 months for up to 3 years, was linked with tobacco outlet location data from the Ontario Ministry of Health. Proximity (distance), threshold (at least one outlet within 500 m) and density (number of outlets within 500 m) with respect to a smokers' home were calculated among urban and suburban current smokers (n=2414).

Frequency of and variation in low-value care in primary care: a retrospective cohort study.

Background: Low-value care, defined as care with a lack of benefit, can lead to higher health care costs, inconvenience to patients and, in some cases, harm to patients. The objectives of this study are to conduct exploratory analyses to understand how frequently selected low-value tests are ordered, to assess the degree of variation in ordering that exists across regions and practices, and to identify services that may warrant further investigation and targeted interventions.

Methods: We conducted a population-based retrospective cohort study using administrative health care databases from Ontario to identify rates of use of the following low-value services between fiscal years 2008/09 and 2012/13: computed tomography (CT) or magnetic resonance imaging (MRI) after a diagnosis of low back pain, Papanicolaou testing in women less than 21 years of age or older than 69 years of age and repeated dual-energy X-ray absorptiometry (DEXA) scanning within 2 years of an index scan.

Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing.

Background: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases misdiagnosis, we sought to determine whether health outcomes differed between patients whose COPD was diagnosed with or without pulmonary function testing.

Methods: We conducted a longitudinal population study of patients with physician-diagnosed COPD from 2005 to 2012 using health administrative data from Ontario, Canada.

Quantifying comorbidity in individuals with COPD: a population study.

Chronic obstructive pulmonary disease (COPD) has been associated with many types of comorbidity. We aimed to quantify the real world impact of COPD on lower respiratory tract infection, cardiovascular disease, diabetes, psychiatric disease, musculoskeletal disease and cancer, and their impact on COPD through health services. A population study using health administrative data from Ontario, Canada, in 2008-2012 was conducted.

Predictors of substance use among young adults transitioning away from high school: a narrative review.

Background: Young adulthood has been shown to be a time of increased substance use. Yet, not enough is known about which factors contribute to initiation and progression of substance use among young adults specifically during the transition year away from high school.

Objectives: A narrative review was undertaken to increase understanding of the predictors of changes in use of tobacco, alcohol, cannabis, other illicit drugs, and mental health problems among young adults during the transition period after high school.

Tobacco retail availability and smoking behaviours among patients seeking treatment at a nicotine dependence treatment clinic.

Background: Availability of tobacco may be associated with increased smoking. Little is known about how proximity to a retail outlet is associated with smoking behaviours among smokers seeking treatment.

Methods: A cross sectional study was conducted using chart data was extracted for 734 new clients of a nicotine dependence clinic in Toronto, Canada who visited during the period April 2008 to June 2010.

Tobacco retail outlets and vulnerable populations in Ontario, Canada.

Interest has been increasing in regulating the location and number of tobacco vendors as part of a comprehensive tobacco control program. The objective of this paper is to examine the distribution of tobacco outlets in a large jurisdiction, to assess: (1) whether tobacco outlets are more likely to be located in vulnerable areas; and (2) what proportion of tobacco outlets are located close to schools. Retail locations across the Province of Ontario from Ministry of Health Promotion data were linked to 2006 Census data at the neighbourhood level.

The prevalence of tobacco use co-morbidities in Canada.

Objectives: Tobacco use co-morbidities, including co-occurring tobacco use, substance use and mental health problems, are a serious public health issue that has implications for treatment and policy. However, not enough is known about the prevalence of various types of tobacco use co-morbidities among the Canadian population. The purpose of this study was to increase understanding of the extent of this issue through an examination of prevalence and correlates of tobacco use co-morbidities in Canada.

Association between use of contraband tobacco and smoking cessation outcomes: a population-based cohort study.

Background: High tobacco prices, typically achieved through taxation, are an evidence-based strategy to reduce tobacco use. However, the presence of inexpensive contraband tobacco could undermine this effective intervention by providing an accessible alternative to quitting. We assessed whether the use of contraband tobacco negatively affects smoking cessation outcomes.

Transitions in smoking status over time in a population-based panel study of smokers.

Introduction: Few studies have examined the transitions of smokers in the general population through multiple periods of daily, occasional smoking, or abstinence over time. Transitions from daily to occasional smoking are particularly of interest as these may be steps toward cessation.

Methods: The Ontario Tobacco Survey panel study followed 4,355 baseline smokers, semiannually for up to 3 years.

Street connectivity is negatively associated with physical activity in Canadian youth.

Street connectivity, defined as how well streets connect to one and other and the density of intersections, is positively associated with active transportation in adults. Our objective was to study the relation between street connectivity and physical activity in youth. Study participants consisted of 8,535 students in grades 6-10 from 180 schools across Canada who completed the 2006 Health Behaviour in School-aged Children (HBSC) survey.

Neighbourhood street connectivity and injury in youth: a national study of built environments in Canada.

Background: The influence of the built environment on health is of contemporary societal interest. The design of streets in neighbourhood settings may contribute positively to the health of populations through increased physical activity, but it may also have injury consequences.

Methods: We conducted a national cross-sectional study to describe the injury experiences of 9021 students from 180 Canadian schools that participated in the 2006 Health Behaviour in School-Aged Children survey.