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Introduction: Patients requiring invasive mechanical ventilation via an artificial airway experience sudden voicelessness placing them at risk for adverse outcomes and increasing provider workload. Infection control precautions during the COVID-19 pandemic, including the use of personal protective equipment (eg, gloves, masks, etc), patient isolation, and visitor restrictions may exacerbate communication difficulty. The objective of this study is to evaluate the acceptability of a codesigned communication intervention for use in the adult intensive care unit when infection control precautions such as those used during COVID-19 are required., Methods and Analysis: This three-phased, prospective study will take place in a medical surgical ICU in a community teaching hospital in Toronto. Participants will include ICU healthcare providers, adult patients and their family members. Qualitative interviews (target n: 20-25) will explore participant perceptions of the barriers to and facilitators for supporting patient communication in the adult ICU in the context of COVID-19 and infection control precautions (phase 1). Using principles of codesign, a stakeholder advisory council of 8-10 participants will iteratively produce an intervention (phase 2). The codesigned intervention will then be implemented and undergo a mixed method acceptability evaluation in the study setting (phase 3). Acceptability, feasibility and appropriateness will be evaluated using validated measures (target n: 60-65). Follow-up semistructured interviews will be analysed using the theoretical framework of acceptability (TFA). The primary outcomes of this study will be acceptability ratings and descriptions of a codesigned COmmunication intervention for use during and beyond the COVID-19 PandEmic., Ethics and Dissemination: The study protocol has been reviewed, and ethics approval was obtained from the Michael Garron Hospital. Results will be made available to healthcare providers in the study setting throughout the study and through publications and conference presentations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To assess the nature, quality and independence of scientific evidence provided in support of claims in industry-authored educational materials in oral health., Design: A content analysis of educational materials authored by the four major multinational oral health product manufacturers., Setting: Acute care settings., Participants: 68 documents focused on oral health or oral care, targeted at acute care clinicians and identified as 'educational' on companies' international websites., Main Outcome Measures: Data were extracted in duplicate for three areas of focus: (a) products referenced in the documents, (b) product-related claims and (c) citations substantiating claims. We assessed claim-citation pairs to determine if information in the citation supported the claim. We analysed the inter-relationships among cited authors and companies using social network analysis., Results: Documents ranged from training videos to posters to brochures to continuing education courses. The majority of educational materials explicitly mentioned a product (59/68, 87%), a branded product (35/68, 51%), and made a product-related claim (55/68, 81%). Among claims accompanied by a citation, citations did not support the majority (91/147, 62%) of claims, largely because citations were unrelated. References used to support claims most often represented lower levels of evidence: only 9% were systematic reviews (7/76) and 13% were randomised controlled trials (10/76). We found a network of 20 authors to account for 37% (n=77/206) of all references in claim-citation pairs; 60% (12/20) of the top 20 cited authors received financial support from one of the four sampled manufacturers., Conclusions: Resources to support clinicians' ongoing education are scarce. However, caution should be exercised when relying on industry-authored materials to support continuing education for oral health. Evidence of sponsorship bias and reliance on key opinion leaders suggests that industry-authored educational materials have promotional intent and should be regulated as such., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)