Primary prevention of human papillomavirus (HPV) through vaccination is a high priority in Canada's cancer prevention efforts. All Canadian provinces and territories have introduced publicly funded, school-based vaccination programs against HPV, but vaccine uptake remains suboptimal in some jurisdictions. We conducted a descriptive qualitative study to better understand the determinants of low HPV vaccine uptake and identify strategies to enhance vaccine acceptance using the socioecological model. In Quebec, interviews and focus groups were held in 2015-2016 with 70 key informants including immunization managers, school nurses, school principals, teachers and parents of Grade 4 students (9 years of age).Our findings showed that HPV vaccine uptake was dependent on many interrelated factors at the individual and interpersonal level (e.g. knowledge and attitudes of the different players involved in the vaccination system), at the community level (e.g. social group values and norms, media coverage around the HPV vaccine), at the organizational level (e.g. allocated resources, information provision, consent process, immunization setting and environment) and at the policy level (e.g. changes in provincial HPV vaccine program). We are using the data collection and interpretation tools and approaches developed by our team and used in Quebec to expand our study to four other provinces (British Columbia, Alberta, Ontario and Nova Scotia). We are conducting environmental scans, semi-structured interviews and a survey to better understand the determinants of low HPV vaccine uptake and identify strategies to enhance vaccine acceptance. Having an in-depth understanding of the determinants of HPV vaccination in school settings is critical in order to identify root causes of the suboptimal vaccine uptake and to develop tailored interventions to address these on both supply-and demand-side issues.

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Mixed race scholarship considers the deployment of the term '

BackgroundFollowing institutionalization of a relative with Alzheimer disease and related dementias (ADRD), family carers continue to provide care. They must learn to negotiate with staff and navigate the system all of which can affect their mental health. A web-based intervention, My Tools 4 Care-In Care (MT4C-In Care) was developed by the research team to aid carers through the transitions experienced when their relative/friend with ADRD resides in a long-term care (LTC) facility. The purpose of this study was to evaluate MT4C-In Care for feasibility, acceptability, ease of use, and satisfaction, along with its potential to help decrease carer’s feelings of grief and improve their hope, general self-efficacy, and health-related quality of life.MethodsThe study was a mixed-methods single-arm repeated measures feasibility study. Participants accessed MT4C-In Care over a 2-month period. Data were collected at baseline and 1 and 2 months. Using a checklist, participants evaluated MT4C-In Care for ease of use, feasibility, acceptability, and satisfaction. Measures were also used to assess the effectiveness of the MT4C-In Care in improving hope (Herth Hope Index), general self-efficacy (GSES), loss and grief (NDRGEI), and health-related quality of life (SF12v2) of participants. Qualitative data were collected at 2 months and informed quantitative findings.ResultsThe majority of the 37 participants were female (65%; 24/37), married (73%; 27/37), and had a mean age of 63.24 years (SD = 11.68). Participants reported that MT4C-In Care was easy to use, feasible, and acceptable. Repeated measures ANOVA identified a statistically significant increase over time in participants hope scores (p = 0.03) and a significant decrease in grief (< 0.001). Although significant differences in mental health were not detected, hope (r = 0.43, p = 0.03) and grief (r = − 0.66, p < 0.001) were significantly related to mental health quality of life.ConclusionMT4C-In Care is feasible, acceptable, and easy to use and shows promise to help carers of family members with ADRD residing in LTC increase their hope and decrease their grief. This study provides the foundation for a future pragmatic trial to determine the efficacy of MT4C-In Care.Trial registrationClinicalTrials.gov NCT03571165. June 30, 2018 (retrospectively registered).

Not being read or identified by others as “Canadian” was a common thread in semi-structured in-depth interviews I conducted with 19 young adults of mixed race in a Western Canadian urban context. In this paper, I address moments of (in)ability for people of mixed race to claim “Canadian.” Mixed race people have a complex relationship with identifying and narrating their identities as “Canadian” through the operation of race and ethnicity in the Canadian context, and because of ambivalent and contradictory readings of their bodies. I found that they deploy the term in three ways: by expressing a sense of being “Canadian-first,” by stating that there exists an understanding that “Canadian means white,” and by strategically using the term “Canadian” in their interactions with others, signaling an active appropriation of the term. However, none of these deployments are mutually exclusive: they overlap and bleed into each other, playing off and impacting one another. This paper adds to nascent Canadian Critical Mixed Race studies and also redresses a gap in the literature on “Canadian identity” by examining how the ability to claim “Canadian” is racialized through a consideration of the experiences of mixed race people. Le fait de ne pas être lus ou identifiés par d’autres comme “Canadiens” était le dénominateur commun dans les entrevues semi-structurés que j’ai menées en profondeur avec 19 jeunes adultes de races mixtes dans un contexte urbain de l’Ouest Canadien. Dans cet article, je mets en exergue les moments d’ (in)aptitude des personnes de races mixtes de se réclamer “Canadiens”. Les gens de races mixtes ont une relation complexe avec l’identification et la narration de leurs identités en tant que “Canadiens”, à cause des perceptions ambivalentes et contradictoires de leurs corps. J’ai trouvé que ceux-ci déploient leur terme de trois façons: en exprimant le sens d’être “Canadien en premier”, en affirmant qu’il existe une compréhension du “Canadien qui veut dire Blanc” et en usant stratégiquement du terme “Canadien” dans leur interactions avec les autres, signalant une appropriation active du ce terme. Cependant, aucuns de ces déploiements ne s’excluent mutuellement: ils se chevauchent et s’empiètent entre eux, jouant au large et s’impactant l’un de l’autre. Ce papier s’ajoute aux études critiques canadiennes naissantes sur les races mixtes et répare aussi une lacune dans la littérature des “identités canadiennes”, en examinant comment l’aptitude de se réclamer “Canadien” est radicalisée à travers une considération des expériences des personnes de races mixtes.