BackgroundAccess to primary care is a challenge for many Canadians. Models of primary care vary widely among provinces, including arrangements for same-day and after-hours access. Use of walk-in clinics and emergency departments (EDs) may also vary, but data sources that allow comparison are limited.ObjectiveWe used Google Trends to examine the relative frequency of searches for walk-in clinics and EDs across provinces and over time in Canada. We correlated provincial relative search frequencies from Google Trends with survey responses about primary care access from the Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries and the 2016 Canadian Community Health Survey.MethodsWe developed search strategies to capture the range of terms used for walk-in clinics (eg, urgent care clinic and after-hours clinic) and EDs (eg, emergency room) across Canadian provinces. We used Google Trends to determine the frequencies of these terms relative to total search volume within each province from January 2011 to December 2018. We calculated correlation coefficients and 95% CIs between provincial Google Trends relative search frequencies and survey responses.ResultsRelative search frequency of walk-in clinic searches increased steadily, doubling in most provinces between 2011 and 2018. Relative frequency of walk-in clinic searches was highest in the western provinces of British Columbia, Alberta, Saskatchewan, and Manitoba. At the provincial level, higher walk-in clinic relative search frequency was strongly positively correlated with the percentage of survey respondents who reported being able to get same- or next-day appointments to see a doctor or a nurse and inversely correlated with the percentage of respondents who reported going to ED for a condition that they thought could have been treated by providers at usual place of care. Relative search frequency for walk-in clinics was also inversely correlated with the percentage of respondents who reported having a regular medical provider. ED relative search frequencies were more stable over time, and we did not observe statistically significant correlation with survey data.ConclusionsHigher relative search frequency for walk-in clinics was positively correlated with the ability to get a same- or next-day appointment and inversely correlated with ED use for conditions treatable in the patient’s regular place of care and also with having a regular medical provider. Findings suggest that patient use of Web-based tools to search for more convenient or accessible care through walk-in clinics is increasing over time. Further research is needed to validate Google Trends data with administrative information on service use.

Leading institutional pedagogies and practices tend to approach increasing international student populations from a deficit-based model, which focuses on the adaptation, acculturation, and assimilation of international students to the dominant host culture. We believe a better approach to improve international and domestic students’ interaction is to move to models of mutual engagement. In this article, as practitioners, we explore four common grounds that seem to be producing positive engagements: common experience, cultural celebrations, faith, and common challenges, in which students are encouraged to meaningfully engage with each other as equals in a spirit of mutuality. The resulting discussion explores how each contributes to a culture of collaboration within institutional departments while improving and enriching the interactions between all students.

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Access to primary care is crucial to immigrant health and may be shaped by sex and gender, but research is limited and inconclusive. We identified measures that reflect access to primary care using 2015–2018 Canadian Community Health Survey data. We used multivariable logistic regression models to estimate adjusted odds of primary care access and to explore interaction effects between sex and immigration group (recent immigrant: < 10 years in Canada, long-term immigrant: 10 + years, non-immigrant). Recency of immigration and being male were negatively associated with access to primary care, with significantly lower odds of having a usual place for immediate care among male recent immigrants (AOR: 0.36, 95% CI 032–0.42). Interaction effects between immigration and sex were pronounced, especially for having a regular provider or place of care. Results underscore the need to examine approachability and acceptability of primary care services, especially for male recent immigrants.

BACKGROUND Access to primary care is a challenge for many Canadians. Models of primary care vary widely across provinces, including arrangements for same day and after-hours access. Use of walk-in clinics and emergency departments may also vary, but data sources that allow comparison are limited. OBJECTIVE We use Google Trends to examine searches for walk-in clinics and emergency departments across provinces and over time in Canada, and compare results to other information about primary care access. METHODS We developed search strategies to capture the range of terms used for walk-in clinics (e.g. urgent care clinic, after-hours clinic) and emergency departments (e.g. ER, emergency room) across Canadian provinces. We used Google Trends to determine the frequencies of these terms relative to total search volume, and standardized search frequencies to allow comparisons across provinces and over time (2011-2018). We explored how care seeking captured by Google Trends correlates with other sources of data on primary care access by province. RESULTS Manitoba, British Columbia, and Nova Scotia had highest search frequency for emergency departments, and Saskatchewan, Alberta, and Ontario had the lowest. Searches for walk-in clinics were most common in the western provinces of British Columbia, Alberta, and Saskatchewan. Relative search frequency for walk-in clinics increased steadily, doubling in most provinces between 2011 and 2018. Higher search frequency for walk-in clinics was correlated with ability to get a same or next-day appointment and inversely correlated with both ED use for conditions treatable in patients’ regular place of care and having a regular medical provider. Emergency department searches were not correlated with survey data. CONCLUSIONS Search frequencies may reflect patient care seeking but may also be impacted by news coverage and other events, especially in the case of emergency department searches. We observe substantial interprovincial variation, and marked growth in the frequency of searches for walk-in clinics. Google Searches for walk-in clinics correlate with other measures of access, and appear to correspond to differences in policies related to walk-in clinics, advanced access, and after-hours care between provinces.