Search

SETTING: The Inuit community of Rigolet experiences greater rates of self-reported acute gastrointestinal illness (AGI) compared to southern Canada. INTERVENTION: A whiteboard video tool was collaboratively developed by Rigolet youth, community members, the research team and key regional stakeholders to share public health recommendations for reducing the risk of AGI. The video debuted in Rigolet at a community event in August 2016 and was later provided online for community members and local and regional health departments. Interviews and focus group discussions were used to evaluate the ability of the video to communicate public health information to community members in Rigolet. OUTCOMES: Community and government viewers reported that the whiteboard video was novel and engaging. Evaluation participants believed the video was suitable for promoting Inuit health because of the use of locally relevant visuals and narrative, which reflect Inuit art and storytelling traditions. Furthermore, participants indicated that the video co-development process was critical to ensuring community relevance of the video. Short-term outcome results suggest the video can reinforce health knowledge and potentially encourage behavioural change. IMPLICATIONS: The results suggest this whiteboard video was an effective tool to share information and could increase intention to change behaviours to reduce the risk of AGI in Rigolet. While tools like the whiteboard video are gaining popularity, the participatory approach was used to develop the video, and its use in an Inuit context illustrates its innovation and novelty. This tool may be a useful health promotion tool among Indigenous communities in Canada.

Private security guards occupy an increasingly prominent role in the policing of private and public spaces. There are growing concerns regarding security guards’ potential to shape violence, discrimination, and adverse health outcomes among vulnerable populations, including people who use drugs (PWUD). This is relevant in Vancouver, Canada, where private security guards have increasingly been employed by private organizations to manage public and private spaces, including those within urban drug scenes. This qualitative study sought to understand interactions between PWUD and private security guards and explore their impacts on health care access, risks, and harms among PWUD. Semi-structured interviews were conducted with 30 PWUD recruited from two ongoing prospective cohort studies. Interviews were transcribed and analyzed using a coding framework comprised of a priori and emergent categories. Study data indicate that participants experience pervasive, discriminatory profiling and surveillance by security guards, which exacerbates existing social marginalization and structural vulnerability, particularly among PWUD of Aboriginal ancestry. Participants reported that security guards restrict PWUD’s access to public and private spaces, including pharmacies and hospitals. PWUD also reported that their interactions with security guards often involved interpersonal violence and aggression, experiences that served to increase their vulnerability to subsequent risks and harms. Our findings highlight that private security forces contribute significantly to the everyday violence experienced by PWUD within drug scenes and elsewhere and do so in a manner very similar to that of traditional police forces. These findings point to the urgent need for greater oversight and training of private security guards in order to protect the health and safety of PWUD.

Nicole Markwick , Ryan McNeil , Solanna Anderson , Will Small , Thomas Kerr * a British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608 – 1081 Burrard Street, Vancouver, BC V6T 1Z1, Canada b School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z9, Canada c Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

People who inject drugs (IDU) face unique systemic, social and individual barriers to conventional HIV voluntary counselling and testing (VCT) programmes. Peer-delivered approaches represent a possible alternative to improve rates of testing among this population.Cross-sectional data from a prospective cohort of IDU in Vancouver, Canada, were collected between December 2011 and May 2012. Bivariate statistics and multivariate logistic regression were used to identify the prevalence of and factors associated with willingness to receive peer-delivered VCT.Of 600 individuals, 51.5% indicated willingness to receive peer-delivered pretest counselling, 40.7% to receive peer-delivered rapid HIV testing and 42.8% to receive peer-delivered post-test counselling. Multivariate analyses found significant positive associations between willingness for pretest counselling and having used Vancouver's supervised injection facility, Insite, or being a member of VANDU (a local drug user organisation) (all p0.05). Daily crack smoking and having used Insite were positively associated with willingness to receive peer-delivered HIV testing (p0.05). Willingness to receive peer-delivered post-test counselling was positively associated with male gender, daily crack smoking, having used Insite and being a member of VANDU (p0.05).While not universally acceptable, peer-delivered VCT approaches may improve access to HIV testing among IDU.