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Background: Participation in on-the-land programs that encourage traditional cultural activities may improve health and well-being. The Income Security Program (ISP) - a financial incentive-based on-the-land program - for Eeyouch (Cree) hunters and trappers in Eeyou Istchee was created as a result of the 1975 James Bay and Northern Quebec Agreement to help mitigate the effects of hydroelectric development on the Cree people of northern Quebec, Canada. Beyond the ISP's financial incentives, little is known about the health measures of those who are eligible to participate in the ISP (i.e. spent ≥120 days on-the-land during the previous year). Therefore, this paper's objective was to assess the health measures of northern Quebec Cree, who were eligible for participation in the ISP.Methods: Using participant data (n = 545) compiled from the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health Study, we assessed 13 different health measures in generalized linear models with the independent variable being the eligibility to participate in the ISP.Results: Participants in the present study who were eligible for the ISP had significantly higher levels of vigorous and moderate activity per week, and higher concentrations of omega-3 polyunsaturated fatty acids in the blood compared to those ineligible for the ISP (i.e. spent ≤119 days on-the-land during the previous year). Encouragingly, following model adjustment for age and sex, participants eligible for the ISP did not have higher blood concentrations of mercury than those who were not eligible for the ISP.Conclusions: Our results suggest that the participants eligible for participation in the ISP are likely to be healthier than those who are ineligible to participate - and are promising for on-the-land programs for Indigenous peoples beyond a financial incentive - with no apparent higher risk of increasing contaminant body burden through traditional on-the-land-activities (e.g. fish consumption). [ABSTRACT FROM AUTHOR]

Access to transport is key to people's movement in cities, their social participation, and personal development. People with mobility disabilities (PMDs) face additional barriers when using public transport. The objective of this study is to identify the dilemmas that PMDs face in their daily mobility practices and their coping strategies, in particular the ways in which these dilemmas and strategies are influenced by both personal and environmental characteristics. We conducted ethnographic research, utilizing narrative interviews, life stories, focus groups, and participant observations. Our aim was to analyse multiple experiences of mobility in situations of disability in Quebec City, Canada. This study engages the following research question: how do PMDs navigate their social environment, considering the impact of personal, social, and physical landscape factors on their mobility strategies? Depending on the accessibility of fixed-route public buses and the availability of public paratransit services, what are the dilemmas that PMDs face and how do they shape their mobility strategies? Using the three-dimensional model of narrative analysis, we present a narrative ethnography of participants' dilemmas and strategies about their experiences on public transport. Five dilemmas are examined. Through this methodology, we propose to extend the study of "constellations of mobility" by including the notion of strategies as an experiential outcome between personal and physical landscape factors, practices, and meanings of mobility. This offers new research perspectives both in disability and mobility studies and in the understanding of urban accessibility experiences in situations of disability. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic entailed significant changes in accompaniment, end-of-life, and bereavement experiences. In some countries, public health measures prevented or restricted family caregivers from visiting their dying loved ones in residences, long-term care institutions, and hospitals. As a result, family members were faced with critical decisions that could easily lead to ethical dilemmas and moral distress. Aim: This study aimed to understand better the experience of ethical dilemmas among family caregivers who lost a loved one. Methds: We interviewed twenty bereaved family caregivers and analysed their narratives using Interpretative phenomenological analysis. Results: Our analysis suggests that family caregivers struggled with their multiple responsibilities (collective, relational, and personal) and had to deal with the emotional cost of their choices. Results display three emerging themes describing the experience of ethical struggles: (1) Flight or fight: Struggling with collective responsibility; (2) Being torn apart: Assuming relational responsibility and (3) "Choosing" oneself: The cost of personal responsibility. Discussion/Conclusion: Results are discussed and interpreted using an ethical, humanistic, and existential conceptual framework. [ABSTRACT FROM AUTHOR]

Objective: To translate and validate the Child Three-Factor Eating Questionnaire (CTFEQr17), assessing cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE), among French-speaking Canadian young individuals.Design: Phase 1 comprised a translation and the evaluation of the comprehension of the questionnaire. Phase 2 comprised a confirmatory factor analysis (CFA), the evaluation of internal consistency (Cronbach's α), test-retest reliability (intra-class correlation coefficients (ICC)) and construct validity, including correlations among the CTFEQr17 and Eating Attitudes Test (EAT-26), anthropometrics, dietary intake and diet quality.Setting: Primary and secondary schools, Québec City, Canada.Participants: Phases 1 and 2 included 20 (40 % boys, mean age 11·5 (sd 2·4) years) and 145 (48 % boys, mean age 11·0 (sd 1·9) years) participants, respectively.Results: Phase 1 resulted in the questionnaire to be used in Phase 2. In Phase 2, the CFA revealed that the seventeen item, three-factor model (CTFEQr17) provided an excellent fit. Internal consistency was good (Cronbach's α: 0·81-0·90). Test-retest reliability was moderate to good (ICC = 0·59, (95 % CI 0·48, 0·70), ICC = 0·78, (95 % CI 0·70, 0·84), ICC = 0·50, (95 % CI 0·38, 0·62) for CR, UE and EE, respectively). CR correlated with EAT-26 score (r = 0·43, P < 0·0001). UE and EE correlated negatively with BMI Z-scores (r = -0;·26, P = 0·003; r = -0;·19, P = 0·03, respectively). CR correlated with the proportion of energy intake from protein and diet quality (r = 0·18, P = 0·04; r = 0·20, P = 0·02, respectively).Conclusion: The CTFEQr17 is suitable to use among French-speaking Canadian young individuals. [ABSTRACT FROM AUTHOR]

Homelessness is an ongoing societal and public health problem in Canada and other countries. Housing services help homeless individuals along the transition towards stable housing, yet few studies have assessed factors that predict change in individual housing trajectories. This study identified predictors of change in housing status over 12 months for a sample of 270 currently or formerly homeless individuals using emergency shelters, temporary housing (TH) or permanent housing (PH) resources in Quebec. Participants recruited from 27 community or public organisations were interviewed between January and September 2017, and again 12 months later. Sociodemographic variables, housing history, health conditions, service use and client satisfaction were measured. Directors and programme coordinators from the selected organisations also completed a baseline questionnaire measuring strictness in residential codes of living/conduct, interorganisational collaboration and overall budget. Independent variables were organised into predisposing, enabling and needs factors, based on the Gelberg‐Andersen Behavioral Model. Multilevel logistic regressions were used to test associations with the dependent variable: change in housing status over 12 months, whether positive (e.g. shelter to TH) or negative (e.g. PH to shelter). Predictors of positive change in housing status were as follows: residing in PH, being female, having children (predisposing factors); having consulted a psychologist, higher frequency in use of public ambulatory services (enabling factors); and not having physical illnesses (needs factor). The findings support strategies for helping this clientele obtain and maintain stable housing. They include deploying case managers to promote access to public ambulatory services, mainly among men or individuals without children who are less likely to seek help; greater use of primary care mental health teams; the establishment of more suitable housing for accommodating physical health problems; and reinforcing access to subsidised PH programmes. [ABSTRACT FROM AUTHOR]

Background: Social participation is restricted for approximately half the older adult population but is critical in fostering community vitality, promoting health, and preventing disabilities. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural regional county municipality.Methods: A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada, with a convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, community partners and key informants.Results: Facilitators and barriers to social participation are related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine older adults' needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6-9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation).Conclusions: To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The first part of this action research will be followed by community selection and implementation of initiatives designed to ultimately foster their social participation. [ABSTRACT FROM AUTHOR]

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Background: Short instruments measuring frequency of specific foods, such as fruit and vegetable (FV), are increasingly used in interventions. The objective of the study was to verify the validity and test-retest reliability of such an instrument among pregnant women.Methods: Pregnant women from the region of Quebec City, Quebec, Canada, were recruited through e-mails sent to female students and employees of the local university from October 2014 to April 2015. To assess the validity of the fruit and vegetable questionnaire (FVQ) developed by Godin et al. (Can J Public Health 99: 494-498, 2008), pregnant women were asked in a first mailing to complete the FVQ assessing FV intake over the past 7 days and a 3-day estimated food record. A subsample (n = 33) also gave a fasting blood sample and completed a validated semi-quantitative FFQ administered by a trained registered dietitian during a visit at the research center. FV intakes for all instruments were calculated in terms of servings of FV based on Canada's Food Guide definition of a serving of fruit or vegetable. In order to assess its test-retest reliability, respondents were asked to complete the FVQ 14 days later in a second mailing.Results: Forty-eight pregnant women from all three trimesters completed the questionnaires in the first mailing. FV intake assessed using the FVQ was correlated to FV consumption measured using the food record (r = 0.34, p = 0.0180) and the FFQ (r = 0.61, p = 0.0002). Results were similar when controlling for energy intake and the experience of nausea in the past month. Only β-cryptoxanthin was significantly correlated to FV intake assessed by the FFQ when adjusted for the presence of nausea (r = 0.35, p = 0.0471). Data on the test-retest reliability was available for 44 women and the intra-class coefficient for the FVQ was 0.72 at a mean 28-day interval.Conclusions: The FVQ has acceptable validity and test-retest reliability values, but seems to underestimate FV servings in pregnant women. It represents an interesting alternative for researchers or clinicians interested in estimating quickly FV intake among pregnant women, such as in large trials or during prenatal visits. The FVQ should however be coupled with other self-reported measures, such as a food record, for assessing precise individual FV intake. [ABSTRACT FROM AUTHOR]