Recherche à Santé Publique Ottawa

La gonorrhée est une infection bactérienne transmissible sexuellement (ITS) qui peut toucher n'importe qui. À Ottawa, cette infection est le plus souvent diagnostiquée chez des jeunes de 20 à 29 ans. 

La tendance à la hausse des cas de gonorrhée résistante aux antimicrobiens observée actuellement porte à croire que l'on pourrait bientôt faire face à des infections multirésistantes impossibles à traiter. En raison de l'évolution rapide des courbes de résistance, les recommandations concernant le traitement de la gonorrhée changent fréquemment au Canada et en Ontario. 

Les patients atteints de gonorrhée sont vus et pris en charge dans une variété de milieux de soins, allant des cliniques de santé sexuelle et de traitement des ITS aux centres de soins primaires en milieu communautaire où les cas d'ITS sont peu nombreux. Or, la vitesse à laquelle les recommandations de traitement changent pose problème, car il est difficile pour les cliniciens, et particulièrement ceux qui traitent rarement la gonorrhée, de se familiariser sans cesse avec de nouvelles lignes directrices cliniques.

Cette étude a pour but de déterminer dans quelle mesure on se conforme aux lignes directrices pour le traitement de la gonorrhée en Ontario en tenant compte des changements apportés à celles-ci. Nous avons analysé les données de traitement pour tous les cas de gonorrhée déclarés en Ontario de 2006 à 2014 et déterminé si le traitement de première ligne reçu respectait les lignes directrices cliniques en vigueur en Ontario au moment de l'intervention. Nos résultats révèlent que la conformité au traitement de première ligne recommandé pour la gonorrhée en Ontario avait diminué conséquemment à la modification des lignes directrices cliniques. Si les petits changements avaient peu d'effet sur la conformité, nous avons noté, à l'inverse, que les changements majeurs entraînaient une baisse substantielle du taux d'adhésion au traitement recommandé. Ces diminutions étaient significatives tant d'un point de vue statistique que clinique, en ce sens qu'après chaque modification importante des lignes directrices cliniques, moins de 50 % des cas recevaient le traitement recommandé. Après l'introduction de ces changements, le taux de conformité aux lignes directrices cliniques a graduellement augmenté, mais demeurait encore en mai 2014 bien en dessous des taux enregistrés avant 2011.

Jusqu'ici, la diffusion des lignes directrices canadiennes et ontariennes en matière de traitement des ITS a fait largement appel à des stratégies passives telles que comptes rendus dans les revues scientifiques, webinaires, conférences, contenu Web et applications mobiles. La lente appropriation des nouvelles recommandations en matière de traitement révélée par cette étude laisse entendre que des stratégies actives de diffusion et de mise en application des nouvelles recommandations de pratique clinique sont peut-être nécessaires.

Dickson, C., Taljaard, M., Friedman, D. S., Metz, G., Wong, T., & Grimshaw, J. M. (2017). The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis. Sex Transm Infect.‎

"Abstract:

BACKGROUND:
Clinical guidelines help ensure consistent care informed by current evidence. As shifts in antimicrobial resistance continue to influence first-line treatment, up-to-date guidelines are important for preventing treatment failure. A guideline's development process will influence its recommendations and users' trust.

OBJECTIVE:
To assess the quality of current gonorrhoea guidelines' development processes.

DATA SOURCES:
Multiple databases.

STUDY ELIGIBILITY CRITERIA:
Original and current English-language guidelines targeting health professionals and containing treatment recommendations for uncomplicated gonorrhoea in the general adult population.

STUDY APPRAISAL AND SYNTHESIS METHODS:
Two appraisers assessed the guidelines independently using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Scores were combined as per the AGREE II users' manual.

RESULTS:
We identified 10 guidelines meeting the inclusion criteria. The quality of the gonorrhoea treatment guidelines varied. Most scored poorly on Rigour of Development; information on the evidence review process and methods for formulating recommendations was often missing. The WHO Guidelines for the Treatment of Neisseria gonorrhoeae and UK National Guideline for the Management of Gonorrhoea in Adults scored the highest on Rigour of Development. Methods to address conflicts of interest were often not described in the materials reviewed. Implementation of recommendations was often not addressed.

LIMITATIONS:
By limiting our study to English-language guidelines, a small number of guidelines we identified were excluded. Our analysis was limited to either published or online materials that were readily available to users. We could not differentiate between items addressed in the development process but not documented from items that were not addressed.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS:
Gonorrhoea treatment guidelines may slow antimicrobial resistance. Many current guidelines are not in line with the current guideline development best practices; this might undermine the perceived trustworthiness of guidelines. By identifying current limitations, this study can help improve the quality of future guidelines."

Dickson C, Arnason T, Friedman DS, Metz G, Grimshaw JM. A systematic review and appraisal of the quality of practice guidelines for the management of Neisseria gonorrhoeae infections. Sex Transm Infect2017 Nov;93(7):487-492. doi: 10.1136/sextrans-2016-052939. Epub 2017 Mar 30. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28360378.

 "Abstract:

OBJECTIVE:

This study assessed adherence with first-line gonorrhoea treatment recommendations in Ontario, Canada, following recent guideline changes due to antibiotic resistance.

METHODS:

We used interrupted times-series analyses to analyse treatment data for cases of uncomplicated gonorrhoea reported in Ontario, Canada, between January 2006 and May 2014. We assessed adherence with first-line treatment according to the guidelines in place at the time and the use of specific antibiotics over time. We used the introduction of new recommendations in the Canadian Guidelines for Sexually Transmitted Infections in 2008 and 2011 and the release of the province of Ontario's Guidelines for the Treatment and Management of Gonococcal Infections in Ontario in 2013 as interruptions in the time-series analysis.

RESULTS:

Overall, 34 287 gonorrhoea cases were reported between 1 January 2006 and 31 May 2014. Treatment data were available for 32 312 (94.2%). Our analysis included 32 272 (94.1%) cases without either a conjunctival or disseminated infection. Following the release of the 2011 recommendations, adherence with first-line recommendations immediately decreased to below 30%. Adherence slowly increased but did not reach baseline levels before the 2013 guidelines were released. Following release of the 2013 guidelines, adherence again decreased; adherence is slowly recovering but by May 2014, was only approximately 60%.

CONCLUSIONS:

Due to concerns about antibiotic resistance, gonorrhoea treatment guidelines need to be updated regularly and rapidly adopted in practice. Our study showed poor adherence following dissemination of updated guidelines. Over a year after the latest Ontario guidelines were released, 40% of patients did not receive first-line treatment, putting them at risk of treatment failure and potentially promoting further drug resistance. Greater attention should be devoted to dissemination and implementation of new guidelines."

Dickson C, Arnason T, Friedman DS, Metz G, Grimshaw JM. A systematic review and appraisal of the quality of practice guidelines for the management of Neisseria gonorrhoeae infections. Sex Transm Infect2017 Nov;93(7):487-492. doi: 10.1136/sextrans-2016-052939. Epub 2017 Mar 30. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28360378.

  "Abstract:

BACKGROUND:

The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM).

OBJECTIVE:

The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase.

METHODS:

We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation.

RESULTS:

Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis).

CONCLUSIONS:

Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings."

Gilbert M, Salway T, Haag D, Fairley CK, Wong J, Grennan T, Uddin Z, Buchner CS, Wong T, Krajden M, Tyndall M, Shoveller J, Ogilvie G. Use of GetCheckedOnline, a Comprehensive Web-based Testing Service for Sexually Transmitted and Blood-Borne Infections. J Med Internet Res. 2017 Mar 20;19(3):e81. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28320690.

Texte gratuit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379018/

"Abstract:

SETTING:

The majority of Canadians' food acquisition occurs in retail stores. Retail science has become increasingly sophisticated in demonstrating how consumer environments influence population-level diet quality and health status. The retail food environment literature is new but growing rapidly in Canada, and there is a relative paucity of evidence from intervention research implemented in Canada.

INTERVENTION:

The healthy corner store model is a comprehensive complex population health intervention in small retail stores, intended to transform an existing business model to a health-promoting one through intersectoral collaboration. Healthy corner store interventions typically involve conversions of existing stores with the participation of health, community, and business sector partners, addressing business fundamentals, merchandising, and consumer demand.

OUTCOMES:

This article introduces pioneering experiences with the healthy corner store intervention in Canada. First, we offer a brief overview of the state of evidence within and outside Canada. Second, we discuss three urban and one rural healthy corner store initiatives, led through partnerships among community food security organizations, public health units, academics, and business partners, in Manitoba, Ontario, and Newfoundland and Labrador. Third, we synthesize the promising practices from these local examples, including aspects of both intervention science (e.g., refinements in measuring the food environment) and community-based practice (e.g., dealing with unhealthy food items and economic impact for the retailer).

IMPLICATIONS:

This article will synthesize practical experiences with healthy corner stores in Canada. It offers a baseline assessment of promising aspects of this intervention for health and health equity, and identifies opportunities to strengthen both science and practice in this area of retail food environment work."

Mah CL, Minaker LM, Jameson K, Rappaport L, Taylor K, Graham M, et al. An introduction to the healthy corner store intervention model in Canada. Can J Public Health. 2017 Sep 14;108(3):e320-e4. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28910256.

"Abstract:

BACKGROUND:

In 2012, Ottawa Public Health (OPH) partnered with the City of Ottawa Municipal Child Care (MCC) Services to develop Healthy Eating and Active Living (HEAL) Guidelines.

SETTING:

The Guidelines aim to promote consistent standards of practice in child care settings related to healthy environments and food, physical activity, physical literacy, decreased sedentary behaviours, and positive role modeling by staff. The Guidelines targeted 498 children aged 18 months to 5 years, attending MCC centres. Resources and training were provided to 10 supervisors, 63 child care educators and 9 cooks.

INTERVENTION:

Components of the Guidelines were piloted in 5 MCC sites prior to being launched in 10 MCC sites across Ottawa, Ontario. Two project Advisory Groups supported the development of the Guidelines. Staff training, resources, recipes and menus were provided. An evaluation was conducted and has informed the Guidelines' subsequent community implementation. In 2015, accompanying web-based resources and e-modules were developed.

OUTCOMES:

The evaluation demonstrated environmental and programming changes. Parent satisfaction was high and preliminary findings showed no real changes in food costs. Following implementation, the cooks reported high compliance to the 6-week menu plans provided, and the number of sites offering 120 minutes or more of daily physical activity increased.

IMPLICATIONS:

Through novel intersectoral partnerships, OPH was able to implement and evaluate HEAL Guidelines in tandem. The interdisciplinary project Advisory Groups, training of cooks, and engagement of the Ontario Coaches Association were all innovative elements of this project and may influence future public health activity in this area."

McKay K, Nigro S. Policy at play: The implementation of Healthy Eating and Active Living Guidelines in municipal child care settings. Can J Public Health. 2017 Mar 01;107(6):e556-e61. Disponible en ligne: http://www.ncbi.nlm.nih.gov/pubmed/28252375.

"Abstract:

HIV medications can be used as post-exposure prophylaxis to efficaciously prevent an HIV-negative person who has come into contact with HIV from becoming HIV-positive. Traditionally, these medications have been available in emergency departments, which have constituted a barrier for the members of many minority groups who are greatly affected by HIV transmission (i.e. gay, bisexual and other men who have sex with men, and persons who use injection drugs). From 5 September 2013 through 4 September 2015, we sought to increase the use of HIV post-exposure prophylaxis by having registered nurses provide these medications, when indicated, in community clinics in Ottawa, Canada. We undertook a chart review of patients who accessed services for HIV post-exposure prophylaxis in this period. Over the two years of data collection, 112 persons requested HIV post-exposure prophylaxis and 64% (n = 72) initiated these medications. Most (93%, or n = 67, of the 72 initiations) were among men, with 88% (n = 59) of these men reporting same sex sexual partners. Among these 58 men, 31% (n = 18) had sexual contact with other men known to be HIV-positive. Among women (n = 8), five initiated post-exposure prophylaxis: three after needle-sharing contact or sexual contact with a male partner who reportedly shared needles, and two after unprotected vaginal sex with a male partner known to be HIV-positive. Overall, no one was diagnosed with HIV at the four-month HIV testing follow-up, although six persons were diagnosed with HIV from the baseline HIV testing, and an additional four were diagnosed with HIV during routine HIV testing one year after completing post-exposure prophylaxis. In total, nine persons in our sample were thus diagnosed with HIV during the study period, which accounted for 9.4% (n = 10 of 106) of all reported HIV diagnoses in Ottawa during this time. We conclude that nurse-initiated HIV post-exposure prophylaxis can be an effective way to provide HIV prevention services to persons who are at high-risk for HIV."

O'Byrne P, MacPherson P, Roy M, Orser L. Community-based, nurse-led post-exposure prophylaxis: results and implications. Int J STD AIDS. 2017 Apr;28(5):505-11. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/27405581.

"Abstract:

BACKGROUND:

In Ontario, Canada, breastfeeding in public is a protected right, yet even with these laws, attitudes toward breastfeeding in public can serve as a barrier to breastfeeding. Research aim: This study assesses public support for breastfeeding in public among adults in Ottawa, Ontario, and examines sociodemographic associations with negative attitudes toward public breastfeeding.

METHODS:

Data from the 2015 Rapid Risk Factor Surveillance System (RRFSS), a population health telephone survey, were obtained for Ottawa. Adults ages 18 years and older were asked whether it was acceptable for a mother to breastfeed her baby in a restaurant and shopping mall ( n = 1,276). Descriptive statistics and regression were used to describe sociodemographic characteristics associated with negative attitudes.

RESULTS:

Overall, 75% of respondents agreed that it was acceptable for a mother to breastfeed her baby in both a restaurant and shopping mall (restaurant: 78%; shopping mall: 81%). Respondents who did not have children at home, were less educated, had a mother tongue language other than French or English and who were retirees were less likely to support breastfeeding in restaurants and shopping malls. In addition, women and immigrants living in Canada for more than 15 years were less likely to support breastfeeding in shopping malls.

CONCLUSION:

Despite a law to support public breastfeeding in Ontario, there is room to improve attitudes toward public breastfeeding. Increased public support for public breastfeeding can support women and children to achieve their feeding goals, particularly for those wanting to exclusively breastfeed."

Russell K, Ali A. Public Attitudes Toward Breastfeeding in Public Places in Ottawa, Canada. J Hum Lact. 2017 May;33(2):401-8. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28418805.

"Abstract:

This study surveyed awareness of, and adherence to, six national fall prevention recommendations among community-dwelling older adults (n = 1050) in Ottawa. Although 76 per cent of respondents agreed falling is a concern and preventable, fewer perceived susceptibility to falling (63%). Respondents had high awareness that home modifications and physical activity can prevent falls. Reported modifications included grab bars (50%), night lights (44%), and raised toilet seats (19%). Half met aerobic activity recommendations; 38 per cent met strength recommendations. Respondents had lower awareness that an annual medication review, annual eye and physical examination, and daily vitamin D supplementation could reduce fall risk. However, reported annual medication review (79%) and eye examination (75%) was high. Nearly half met recommendations for vitamin D intake. These findings suggest a gap in knowledge of awareness and adherence to national recommendations, highlighting the ones that may require attention from those who work to prevent falls."

Russell K, Taing D, Roy J. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home. Can J Aging. Dec;36(4):522-535. doi: 10.1017/S0714980817000332. Epub 2017 Sep 14. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28903796.

Texte gratuit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729851/

Perceptions and attitudes about body weight and adherence to the physical activity recommendation among adolescents: the moderating role of body mass index.

"Abstract:

OBJECTIVE:

We examined the associations between perceptions and attitudes about body weight and adherence to the physical activity recommendation (PAR) for adolescents to achieve ≥60 min/day of moderate-to-vigorous physical activity and tested whether body mass index (BMI) was a moderator of these relationships.

STUDY DESIGN:

Cross-sectional survey.

METHODS:

Self-reported data from Canadian adolescents (n = 4299) who participated in the 2013 Ontario Student Drug Use and Health Survey were analysed.

RESULTS:

Dissatisfaction with body weight was associated with lower odds of adherence to the PAR (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.55-0.99). More specifically, those who perceived themselves as overweight/obese had lower odds of adherence to the PAR (OR: 0.59; 95% CI: 0.42-0.81) compared with those who think they were about the right weight. Those who were trying to gain weight were more likely to adhere to the PAR (OR: 1.92; 95% CI: 1.29-2.86) compared to those who were doing nothing about their body weight. BMI was a significant moderator of the association between dissatisfaction with body weight and adherence to the PAR. At low BMI, there were no differences in the adherence to the PAR between adolescents who were dissatisfied with their body weight or not. At high BMI, adolescents who were dissatisfied with their body weight were less likely to adhere to the PAR than those who were not dissatisfied with their weight. Results were not different between males and females.

CONCLUSIONS:

Results suggest that adolescents who are dissatisfied with their body weight have lower adherence to the PAR, particularly those who are overweight or obese."

Sampasa-Kanyinga H, Hamilton HA, Willmore J, Chaput JP. Perceptions and attitudes about body weight and adherence to the physical activity recommendation among adolescents: the moderating role of body mass index. Public Health. 2017 May;146:75-83. doi: 10.1016/j.puhe.2017.01.002. Epub 2017 Feb 8. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28404477.

Sampasa-Kanyinga H, Hamilton HA. Eating breakfast regularly is related to higher school connectedness and academic performance in Canadian middle- and high-school students. Public Health. 2017 Apr;145:120-123. doi: 10.1016/j.puhe.2016.12.027. Epub 2017 Jan 25. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28359379.

"Abstract:

SETTING:

Falls incur significant health and economic costs, particularly among older adults. Physical activity has been found to be the single most important fall prevention behaviour an older adult can do. This manuscript describes Ottawa Public Health's (OPH) experience implementing the Better Strength, Better Balance! (BSBB) program, a fall prevention exercise program for older adults, through an innovative partnership with the local Recreation, Cultural & Facility Services (RCFS) Department. BSBB aims to reach 1300 community-dwelling adults (aged 65 years and older) per year through approximately 86-130 exercise programs. Designed as a universal program, BSBB addresses participation barriers such as transportation, cost and location. BSBB was enabled with funding from the Champlain Local Health Integration Network, and coincided with the implementation of an Older Adult Plan for the City of Ottawa.

INTERVENTION:

BSBB is a beginner-level, fall prevention exercise and education program that takes place twice a week, over 12 weeks. Certified RCFS instructors delivered the exercise components of the program and OPH staff incorporated fall prevention messaging and conducted the evaluation.

OUTCOMES:

The formative evaluation indicated that participants experienced improved strength and balance, decreased fear of falling and the intent to adopt new fall prevention behaviours following the program. The partnership between OPH and RCFS allowed both partners to leverage their unique and mutual strengths to continually improve the program.

IMPLICATIONS:

Improving access to strength and balance programming is an important public health strategy to reduce falls. The recreation sector is an ideal partner to help public health in this pursuit."

Taing D, McKay K. Better Strength, Better Balance! Partnering to deliver a fall prevention program for older adults. Can J Public Health. 2017  Sep 14;108(3):e314-e319. doi: 10.17269/cjph.108.5901. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28910255.

"Abstract:

OBJECTIVES:

Alcohol-related morbidity and mortality are significant public health issues. The purpose of this study was to describe the prevalence and trends over time of alcohol consumption and alcohol-related morbidity and mortality; and public attitudes of alcohol use impacts on families and the community in Ottawa, Canada.

METHODS:

Prevalence (2013-2014) and trends (2000-2001 to 2013-2014) of alcohol use were obtained from the Canadian Community Health Survey. Data on paramedic responses (2015), emergency department (ED) visits (2013-2015), hospitalizations (2013-2015) and deaths (2007-2011) were used to quantify the acute and chronic health effects of alcohol in Ottawa. Qualitative data were obtained from the "Have Your Say" alcohol survey, an online survey of public attitudes on alcohol conducted in 2016.

RESULTS:

In 2013-2014, an estimated 595,300 (83%) Ottawa adults 19 years and older drank alcohol, 42% reported binge drinking in the past year. Heavy drinking increased from 15% in 2000-2001 to 20% in 2013-2014. In 2015, the Ottawa Paramedic Service responded to 2,060 calls directly attributable to alcohol. Between 2013 and 2015, there were an average of 6,100 ED visits and 1,270 hospitalizations per year due to alcohol. Annually, alcohol use results in at least 140 deaths in Ottawa. Men have higher rates of alcohol-attributable paramedic responses, ED visits, hospitalizations and deaths than women, and young adults have higher rates of alcohol-attributable paramedic responses. Qualitative data of public attitudes indicate that alcohol misuse has greater repercussions not only on those who drink, but also on the family and community.

CONCLUSIONS:

Results highlight the need for healthy public policy intended to encourage a culture of drinking in moderation in Ottawa to support lower risk alcohol use, particularly among men and young adults.

Willmore J, Marko TL, Taing D, Sampasa-Kanyinga H. The burden of alcohol-related morbidity and mortality in Ottawa, Canada. PloS one. 2017;12(9):e0185457. Disponible en ligne: https://www.ncbi.nlm.nih.gov/pubmed/28957368.

Texte gratuit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5619783/

Avant l'arrivée de bébé : une stratégie innovatrice. 

Dirigé par le Programme régional des soins à la mère et au nouveau-né de Champlain (CMNRP) et appuyé par l'équipe de Croissance et développement sains de SPO, ce projet pilote évalue l'efficacité de la liste de contrôle prénatale mise au point récemment par le CMNRP dans le but d'aider les parents à se préparer à leur nouveau rôle de parent avant l'arrivée de bébé.

Surveillance des tendances au chapitre de la prévalence du VIH, des facteurs comportementaux, sociodémographiques et systémiques associés et de l'utilisation des services de santé au sein des populations originaires d'Afrique et des Caraïbes de première et de deuxième génération résidant à Toronto et à Ottawa.

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par le Service de la protection de la santé de SPO, cette recherche vise à combler les lacunes de connaissances relatives à la prévalence du VIH, à l'accès et à l'utilisation des services de santé et aux facteurs systémiques susceptibles de provoquer des infections au VIH dans les communautés noires, africaines et caribéennes de Toronto et d'Ottawa.

Gestion communautaire des infections transmises sexuellement et par le sang dans la ville d'Ottawa : une évaluation des besoins communautaires. 

Dirigée par l'Unité des maladies infectieuses et des services de santé sexuelle de SPO, cette initiative examine les outils dont ont besoin les praticiens en santé communautaire eu égard aux infections transmises sexuellement. L'évaluation des besoins communautaires comporte une recherche documentaire exhaustive, une enquête et des entrevues qualitatives menées auprès de praticiens en santé communautaire dans la ville d'Ottawa. 

Déterminer des indicateurs et des procédures pour le partage de données locales sur l'équité en santé entre partenaires communautaires (projet de collaboration dirigé à l'échelle locale) 

Dirigée par la circonscription sanitaire de la région de Niagara et appuyée par le Service de la protection de la santé de SPO, cette initiative vise à répertorier les pratiques exemplaires en matière de sélection, d'analyse et de diffusion de données clés sur le comportement et la santé afin de soutenir les efforts déployés dans le milieu pour assurer l'équité en santé. Elle s'appuie sur une approche de collaboration pour encourager le leadership chez les partenaires communautaires et stimuler les possibilités de partage de données durables entre les organismes locaux de santé publique et leurs partenaires.

Répercussions de l'activité physique et de l'alimentation durant la grossesse (PLACENTA). 

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par l'équipe Croissance et développement sains de SPO, cette initiative examine dans son ensemble le rôle de l'activité physique durant la grossesse pour réguler l'expression des gènes et les fonctions métaboliques dans le placenta. 

Consultation publique sur la publicité destinée aux enfants et aux jeunes : consultation auprès des jeunes.

Dirigée par le Service de prévention des maladies chroniques de SPO, cette initiative s'inscrit dans une vaste consultation publique à l'échelle de la collectivité entourant la publicité sur les aliments et les boissons destinée aux enfants et aux jeunes; des jeunes âgés de 12 à 19 ans ont été invités à discuter de cette question.  

Renforcer l'approche axée sur la santé de la population pour la planification du système de santé. 

Dirigée par les Services de la planification, de la qualité et de l’échange de connaissances de SPO, cette recherche vise à répondre à la question suivante : quels sont les principaux facteurs pour assurer une collaboration réussie, comme l'exige la Loi de 2016 donnant la priorité aux patients, entre les bureaux de santé publique et les réseaux locaux d'intégration des services de santé (RLISS) afin d'améliorer le système de santé en Ontario à l'aide d'une approche axée sur la santé de la population?

Groupe de discussion sur la transition des soins à la mère et au nouveau-né de l'hôpital à la communauté.

Dirigée par le Programme régional des soins à la mère et au nouveau-né de Champlain (CMNRP) et appuyée par l'équipe Croissance et développement sains de SPO, cette initiative vise à créer un parcours de soins intégrés pour les soins à la mère et au nouveau-né (de la grossesse à la période postnatale) et à apprendre des principaux intervenants de la communauté et du milieu hospitalier.

Alimentation saine et vie active chez les jeunes enfants en garderie. 

Dirigée par des chercheurs de l'Université McMaster et appuyée par l'Unité de prévention des maladies chroniques et des traumatismes de SPO, cette recherche examine l’incidence des Lignes directrices pour une saine alimentation et une vie active à l’aide d’un plan d’étude aléatoire dont certains volets sont mis en œuvre avant et après l’évaluation proprement dite. Le groupe témoin sera constitué de garderies placées sur une liste d’attente.

Page Facebook « Être parent à Ottawa » : étude de cas.  

Dirigée par des chercheurs de l'Université Carleton et appuyée par l'Unité d’information du public et de communication en santé de SPO, cette évaluation de la page Facebook  « Être parent à Ottawa » de Santé publique Ottawa décrit comment cette page et les médias sociaux sont utilisés par SPO comme outil de communication dans les deux sens pour promouvoir la santé.

Validation d’un test d’amplification des acides nucléiques (TAAN) sur des prélèvements rectaux et pharyngés pour la détection des bactéries Neisseria gonorrhoeae et Chlamydia trachomatis.

Dirigée par Santé publique Ontario et appuyée par l'Unité des maladies infectieuses et des services de santé sexuelle de SPO, cette étude vise à valider le test d’amplification des acides nucléiques (TAAN) pour détecter les infections à Neisseria gonorrhoeae et Chlamydia trachomatis transmises sexuellement à la gorge et au rectum. S'il est démontré que le test TAAN est plus efficace pour détecter les infections à la gorge et au rectum, la collectivité aura accès à de meilleurs soins de santé.

Outils d'évaluation des risques pour la santé publique des maladies à transmission vectorielle émergentes.*

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par les Services de protection de la santé de SPO, cette étude lancée en 2016 utilise des données de SPO sur la surveillance de la tique pour déterminer les facteurs de risque, produire des modèles de risques environnementaux et cartographier les risques reliés au virus du Nil occidental et à la maladie de Lyme dans la ville d'Ottawa. 

Expériences d'allaitement de mères primipares plus âgées : étude constructiviste fondée sur la théorie.*

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par les Services de promotion de la santé du SPO, cette étude lancée en 2016 examine les facteurs ayant une incidence sur les attentes, les expériences et les décisions à l'égard de l'allaitement des mères plus âgées dont c'est le premier enfant. 

Réponse en matière de santé publique au VIH/SIDA en Ontario : analyse ethnographique critique des soins infirmiers et de la gestion de cas.*

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par l'Unité des maladies infectieuses et des services de santé sexuelle de SPO, cette étude lancée en 2016 examine les stratégies actuelles pour gérer les cas de VIH/SIDA et les facteurs qui influencent la prise de décision et l'expérience des clients dans le but de déterminer les stratégies les plus efficaces pour aider les gestionnaires de cas à inciter les personnes vivant avec le VIH ou à risque d'être infectées par le VIH à subir des tests, se faire traiter et recevoir des services de soutien.

Division des grappes : Intégration du séquençage du génome entier à des données de surveillance accrue et élaboration d’algorithmes d’études de cas pour les grandes grappes de souches associées à la tuberculose.**

Dirigée par les Services de laboratoire de Santé publique Ontario et appuyée par l’équipe de l’épidémiologie et des données probantes de SPO, cette étude lancée en 2015 vise à découvrir des polymorphismes mononucléotidiques d’isolats cliniques de Mycobacterium tuberculosis appartenant aux souches Manille, en utilisant le séquençage du génome entier, ainsi qu’à identifier des sous-grappes et les corréler avec les données épidémiologiques, géographiques et cliniques du cas.

Réduction des vulnérabilités au VIH et promotion de la résilience chez les hommes s'étant identifiés comme noirs, africains et caribéens en Ontario.**

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par l'Unité des maladies infectieuses et des services de santé sexuelle de SPO, cette étude lancée en 2016 porte sur les hommes hétérosexuels s'étant identifiés comme noirs, africains et caribéens. Elle examine leurs conditions socioculturelles et sociopolitiques qui contribuent aux disparités en matière de santé reliées au VIH et leurs vulnérabilités au VIH et elle dégage les facteurs qui développent la résilience et réduisent les risques et les vulnérabilités reliés au VIH. 

Sensibiliser et encourager l'application dans la pratique des connaissances en matière de prévention du cancer.**

Dirigée par l'Université McMaster et appuyée par l’Unité de médecine de santé publique de SPO, cette initiative vise à sensibiliser et à encourager l'utilisation des résultats de recherches de grande qualité sur la prévention du cancer parmi les professionnels en santé publique canadiens en mettant en œuvre certaines stratégies de transfert du savoir. 

L'acceptabilité et les taux d'observance du nouveau traitement de douze (12) doses (trois mois) comparativement au traitement classique pour traiter l'infection tuberculeuse latente (ITL) à Iqaluit au Nunavut et à Ottawa en Ontario.**

Dirigée par des chercheurs de l'Université d'Ottawa et appuyée par l'équipe de Gestion des cas de maladie transmissible et l’Unité de médecine de santé publique de SPO, cette étude lancée en 2015 vise principalement à déterminer l'efficacité d'un nouveau traitement sur trois mois de la tuberculose comparativement au traitement habituel sur neuf mois, ses éventuels effets secondaires et les facteurs influençant l'observance des patients.