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IntroductionResearch characterizing substance use disparities between gender minority youth (GMY) and non-GMY (i.e. girls and boys) is limited. The aim of this study was to examine the differences in substance use behaviours among gender identity (GI) groups and identify associated risk and protective factors. MethodsCross-sectional data from Canadian secondary school students (n = 42 107) that participated in Year 8 (2019/20) or Year 9 (2020/21) of the COMPASS study were used. Hierarchal logistic regression models estimated current substance use (cigarettes, e-cigarettes, binge drinking, cannabis and nonmedical prescription opioids [NMPOs]). Predictor variables included sociodemographics, other substances, mental health outcomes, school connectedness, bullying and happy home life. Interaction terms were used to test mental health measures as moderators in the association between GI and substance use. ResultsCompared to non-GMY, GMY reported a higher prevalence for all substance use outcomes. In the adjusted analyses, GMY had higher odds of cigarette, cannabis and NMPO use and lower odds for e-cigarette use relative to non-GMY. The likelihood of using any given substance was higher among individuals who were involved with other substances. School connectedness and happy home life had a protective effect for all substances except binge drinking. Bullying victimization was associated with greater odds of cigarette, e-cigarette use and NMPOs. Significant interactions between GI and all mental health measures were detected. ConclusionFindings highlight the importance of collecting a GI measure in youth population surveys and prioritizing GMY in substance use–related prevention, treatment and harm reduction programs. Future studies should investigate the effects of GI status on substance use onset and progression among Canadian adolescents over time.

IntroductionLes travaux de recherche caractérisant les disparités en matière de consommation de substances entre les jeunes faisant partie de minorités de genre et les jeunes ne faisant pas partie de minorités de genre, c’est-à-dire les filles et les garçons, sont limités. L’objectif de cette étude était d’explorer les différences dans les comportements liés à la consommation de substances entre groupes d’identité de genre et de déterminer les facteurs de risque et les facteurs de protection correspondants. MéthodologieNous avons utilisé les données transversales associées aux élèves canadiens du secondaire (n = 42 107) qui avaient participé à l’année 8 (2019-2020) ou à l’année 9 (2020-2021) de l’étude COMPASS. Des modèles de régression logistique hiérarchiques nous ont permis d’estimer la consommation de substances (cigarettes, cigarettes électroniques, consommation excessive d’alcool, cannabis et opioïdes à des fins non médicales). Les variables prédictives comprenaient les caractéristiques sociodémographiques, la consommation d’autres substances, les résultats en matière de santé mentale, les liens avec l’école, l’intimidation et une vie familiale heureuse. Nous avons utilisé des termes d’interaction pour tester les mesures de la santé mentale en tant que modérateurs de l’association entre l’identité de genre et la consommation de substances. RésultatsComparativement aux jeunes ne faisant pas partie de minorités de genre, les jeunes faisant partie de minorités de genre avaient une prévalence plus élevée pour tous les résultats liés à la consommation de substances. Dans les analyses ajustées, les jeunes faisant partie de minorités de genre avaient une probabilité plus élevée de fumer des cigarettes, de consommer du cannabis et d’utiliser des opioïdes à des fins non médicales et une probabilité plus faible d’utiliser des cigarettes électroniques par rapport aux autres jeunes. La probabilité de consommer une substance donnée était plus élevée chez ceux qui consommaient d’autres substances. La connexion à l’école et une vie familiale heureuse avaient un effet protecteur contre toutes les substances, sauf la consommation excessive d’alcool. La victimisation par intimidation était associée à une plus grande probabilité d’usage de cigarettes, de cigarettes électroniques et d’opioïdes à des fins non médicales. Nous avons observé des interactions statistiquement significatives entre l’identité de genre et l’ensemble des mesures de la santé mentale. ConclusionNos constatations soulignent l’importance de recueillir une mesure de l’identité de genre dans les enquêtes sur les jeunes et de prioriser les jeunes faisant partie de minorités de genre dans les programmes de prévention, de traitement et de réduction des méfaits liés à la consommation de substances. Les études ultérieures devraient porter sur les effets de l’identité de genre sur le début et l’évolution de la consommation de substances chez les adolescents canadiens au fil du temps.

Abstract Background The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). Methods Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin ‘top 10’ lists of the most important research needs. Results From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. Conclusions Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.

Abstract Background Oral health plays a role in overall health, indicating the need to identify barriers to accessing oral care. The objective of this study was to identify barriers to accessing oral health care and examine the association between socioeconomic, psychosocial, and physical measures with access to oral health care among older Canadians. Methods A cross-sectional study was conducted using data from the Canadian Longitudinal Study on Aging (CLSA) follow-up 1 survey to analyze dental insurance and last oral health care visit. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between socioeconomic, psychosocial, and physical measures with access to oral care, measured by dental insurance and last oral health visit. Results Among the 44,011 adults included in the study, 40% reported not having dental insurance while 15% had not visited an oral health professional in the previous 12 months. Several factors were identified as barriers to accessing oral health care including, no dental insurance, low household income, rural residence, and having no natural teeth. People with an annual income of

Abstract Background The COVID-19 pandemic disrupted access to healthcare services in Canada. Research prior to the pandemic has found that depression and anxiety symptoms were associated with increased unmet healthcare needs. The primary objective of this study was to examine if mental health was associated with perceived access to healthcare during the pandemic Methods A cross-sectional study was conducted using data from 23,972 participants (aged 50-96) in the Canadian Longitudinal Study on Aging COVID-19 Exit Survey (Sept-Dec 2020). We used logistic regression to estimate how the presence of depression and anxiety symptoms, defined using scores of ≥10 on the Center for Epidemiologic Studies Depression Scale and ≥10 on the Generalized Anxiety Disorder Scale, were associated with the odds of reporting: 1) challenges accessing healthcare, 2) not going to a hospital or seeing a doctor when needed, 3) experiencing barriers to COVID-19 testing. Models were adjusted for sex, age, region, urban/rural residence, racial background, immigrant status, income, marital status, work status, chronic conditions, and pre-pandemic unmet needs. Results The presence of depressive (aOR=1.96; 95% CI=1.82, 2.11) and anxiety symptoms (aOR=2.33; 95% CI=2.04, 2.66) compared to the absence of these symptoms were independently associated with higher odds of challenges accessing healthcare. A statistically significant interaction with sex suggested stronger associations in females with anxiety. Symptoms of depression (aOR=2.88; 95% CI=2.58, 3.21) and anxiety (aOR=3.05; 95% CI=2.58, 3.60) were also associated with increased odds of not going to a hospital or seeing a doctor when needed. Lastly, depressive (aOR=1.99; 95% CI=1.71, 2.31) and anxiety symptoms (aOR=2.01; 95% CI=1.58, 2.56) were associated with higher odds of reporting barriers to COVID-19 testing. There was no significantly significant interaction with sex for the latter two outcomes. Conclusion The presence of depression and anxiety symptoms were strongly associated with perceived unmet healthcare needs during the COVID-19 pandemic. Interventions to improve healthcare access for adults with depression and anxiety during the pandemic may be necessary.

IntroductionAs a largely social behaviour, substance use may have decreased for some youth overall in Canada during the COVID-19 pandemic; however, continued use may indicate nonadherence to pandemic-related restrictions and social distancing measures. In a sample of Canadian adolescents (aged 12–19 years), our objective was to examine how substance use (cannabis, binge drinking, cigarettes, vaping) is associated with perceptions of, and adherence to, early COVID-19-related public health measures, taking into consideration sociodemographic factors. MethodsCross-sectional data were retrieved from online data collected during Year 8 of the COMPASS school-based study, during the early months of the COVID-19 pandemic (May–July 2020) in British Columbia, Ontario and Quebec. We fitted two models using generalized estimating equations to examine how substance use was associated with separate measures of (1) perceptions of, and (2) adherence to early COVID-19 restrictions. ResultsIn our sample, 10% of adolescents perceived COVID-19 restrictions as too weak and 14% perceived them as too strict. Nearly half (46%) reported taking restrictions very seriously, and 5% did not take them seriously at all. Binge drinking, cigarette use and vaping were associated with perceptions that restrictions were too strict and with nonadherence. However, adolescents who used cannabis were less likely to perceive COVID-19-related restrictions as too strict. ConclusionThis study highlights the association of adolescent substance use with perceptions of, and adherence to, COVID-19-related public health restrictions in Canada. Our findings emphasize a need for continual monitoring of substance use behaviours during the COVID-19 pandemic to better characterize adolescent risk and further inform targeted public health strategies accordingly.

IntroductionDans la mesure où la consommation de substances est un comportement principalement social, elle est susceptible d’avoir diminué chez certains jeunes partout au Canada pendant la pandémie de COVID-19, et le maintien d’une consommation est susceptible d’indiquer un non-respect des restrictions liées à la pandémie et des mesures de distanciation physique. Notre objectif était d’analyser, dans un échantillon composé d’adolescents canadiens (de 12 à 19 ans), la manière dont la consommation de substances (cannabis, consommation excessive d’alcool, cigarettes, produits de vapotage) est associée aux perceptions et au respect des premières mesures de santé publique liées à la COVID-19, en tenant compte de facteurs sociodémographiques. MéthodologieDes données transversales ont été extraites des données en ligne recueillies au cours de la huitième année de l’étude réalisée en milieu scolaire COMPASS, pendant les premiers mois de la pandémie de COVID-19 (mai à juillet 2020) en Colombie-Britannique, en Ontario et au Québec. Nous avons ajusté deux modèles à l’aide d’équations d’estimation généralisées afin d’analyser la manière dont la consommation de substances était associée à deux mesures : celle des perceptions à l’égard des premières restrictions liées à la COVID-19 et celle du respect de ces restrictions. RésultatsDans notre échantillon, 10 % des adolescents ont perçu les restrictions liées à la COVID-19 comme étant trop faibles et 14 % les ont perçues comme étant trop strictes. Près de la moitié (46 %) des répondants ont déclaré avoir pris les restrictions très au sérieux, et 5 % ne les ont aucunement prises au sérieux. La consommation excessive d’alcool (« binge drinking »), l’usage de la cigarette et le vapotage ont été associés à des perceptions selon lesquelles les restrictions étaient trop strictes et au non-respect de ces restrictions. Toutefois, les adolescents consommant du cannabis étaient moins susceptibles de percevoir les restrictions liées à la COVID-19 comme trop strictes. ConclusionCette étude fait ressortir le lien entre la consommation de substances chez les adolescents et leurs perceptions et leur respect à l’égard des restrictions de santé publique liées à la COVID-19 au Canada. Nos constatations mettent en évidence la nécessité d’assurer une surveillance continue des comportements de consommation de substances pendant la pandémie de COVID-19 afin de mieux caractériser les risques à l’adolescence et de guider en conséquence les stratégies de santé publique ciblées.

The COVID-19 pandemic and associated public health measures have exacerbated many known risk factors for depression that may be particularly concerning for individuals with chronic health conditions, such as peptic ulcer disease (PUD). In a large longitudinal sample of older adults with PUD, the current study examined the incidence of depression during the pandemic among those without a pre-pandemic history of depression (n = 689) and the recurrence of depression among those with a history of depression (n = 451). Data came from four waves of the Canadian Longitudinal Study on Aging (CLSA). Multivariate logistic regression analyses were conducted to identify factors associated with incident and recurrent depression. Among older adults with PUD and without a history of depression, approximately 1 in 8 (13.0%) developed depression for the first time during the COVID-19 pandemic. Among those with a history of depression, approximately 1 in 2 (46.6%) experienced depression during the pandemic. The risk of incident depression and recurrent depression was higher among those who were lonely, those with functional limitations, and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among women, individuals whose income did not satisfy their basic needs, those who were themselves ill and/or those whose loved ones were ill or died during the pandemic, and those who had disruptions to healthcare access during the pandemic. The risk of recurrent depression only was higher among those with chronic pain and those who had difficulty accessing medication during the pandemic. Implications for interventions are discussed.

Background: Multiple characteristics of the urban environment have been shown to influence population health and health-related behaviours, though the distribution and combined effects of these characteristics on health is less understood. A composite measure of multiple environmental conditions would allow for comparisons among different urban areas; however, this measure is not available in Canada. Objectives: To develop an index of environmental quality for Canada’s largest urban areas and to assess the influence of population size on index values. Methods: We conducted a systematic search of potential datasets and consulted with experts to refine and select datasets for inclusion. We identified and selected nine datasets across five domains (outdoor air pollution, natural environments, built environments, radiation, and climate/weather). Datasets were chosen based on known impacts on human health across the life course, complete geographic coverage of the cities of interest, and temporal alignment with the 2016 Canadian census. Each dataset was then summarized into dissemination areas (DAs). The Canadian Environmental Quality Index (Can-EQI) was created by summing decile ranks of each variable based on hypothesized relationships to health outcomes. Results: We selected 30 cities with a population of more than 100,000 people which included 28,026 DAs and captured approximately 55% of the total Canadian population. Can-EQI scores ranged from 21.1 to 88.9 out of 100, and in Canada’s largest cities were 10.2 (95% CI: −10.7, −9.7) points lower than the smallest cities. Mapping the Can-EQI revealed high geographic variability within and between cities. Discussion: Our work demonstrates a valuable methodology for exploring variations in environmental conditions in Canada’s largest urban areas and provides a means for exploring the role of environmental factors in explaining urban health inequalities and disparities. Additionally, the Can-EQI may be of value to municipal planners and decision makers considering the allocation of investments to improve urban conditions.

IntroductionHaving a better understanding of individual factors associated with e-cigarette initiation can help improve prevention efforts. Therefore, this study aimed to (1) identify baseline characteristics associated with e-cigarette initiation, and (2) determine whether changes in these baseline characteristics were associated with e-cigarette initiation. MethodsThis study used data from Year 6 (2017/18, baseline) and Year 7 (2018/19, follow-up) of the COMPASS study. The final sample included 12 315 students in Grades 9 to 11 who reported never having tried e-cigarettes at baseline. Students reported demographic information, other substance use, school behaviours, physical activity, sedentary behaviour, sleep, symptoms of anxiety and depression, and emotional regulation and flourishing scores. Hierarchical GEE models, stratified by gender, examined the association between (1) baseline characteristics and e-cigarette initiation at follow-up and (2) changes in baseline characteristics and e-cigarette initiation at follow-up. ResultsIn total, 29% of students who had not yet initiated e-cigarette use reported initiating e-cigarette use at follow-up. Students in Grades 10 and 11 were less likely to initiate e-cigarette use. Other substance use, skipping school and meeting the physical activity guidelines at baseline and one-year changes to these behaviours were associated with e-cigarette initiation among both male and female students. Additionally, some differences were noted between females and males. ConclusionGiven that other health behaviours were associated with e-cigarette initiation, prevention approaches should target multiple health-risk behaviours to help prevent youth e-cigarette use. Additionally, school-based approaches may benefit by being implemented at the beginning of high school or in junior high school.

IntroductionUne meilleure compréhension des facteurs individuels associés à l’initiation à la cigarette électronique contribuerait à l’amélioration des mesures de prévention. Ainsi, cette étude vise à 1) relever les caractéristiques de départ associées à l’initiation à la cigarette électronique et 2) déterminer si des changements dans ces caractéristiques sont associés à l’initiation à la cigarette électronique chez les adolescents canadiens. MéthodologieCette étude a utilisé les données de l’année 6 (2017-2018, année de référence) et de l’année 7 (2018-2019, année de suivi) de l’étude COMPASS. L’échantillon final comprenait 12 315 élèves de la 9e à la 11e année qui avaient déclaré ne jamais avoir essayé la cigarette électronique au cours de l’année de référence. Les renseignements fournis par les élèves portaient sur leurs caratéristiques individuelles, la consommation d’autres substances, les comportements scolaires, l’activité physique, les comportements sédentaires, les troubles du sommeil, les symptômes d’anxiété et de dépression, la régulation émotionnelle et l’épanouissement. Des modèles hiérarchiques faisant appel aux équations d’estimation généralisées (EEG), stratifiés selon le sexe, ont permis d’analyser l’association entre 1) les caractéristiques de départ et l’initiation à la cigarette électronique lors de l’année de suivi et 2) des changements dans les caractéristiques de départ et l’initiation à la cigarette électronique lors de l’année de suivi. RésultatsAu total, 29 % des élèves qui n’avaient encore jamais essayé la cigarette électronique ont déclaré en avoir fait l’usage au moment du suivi. Les élèves de 10e et 11e année étaient proportionnellement moins nombreux à avoir essayé la cigarette électronique. La consommation d’autres substances, l’école buissonnière et le respect des directives en matière d’activité physique pendant l’année de référence ainsi que des changements vers ces comportements mesurés au moment du suivi ont été associés à l’initiation à la cigarette électronique à la fois chez les garçons et chez les filles. Certaines différences ont été observées entre les filles et les garçons. ConclusionÉtant donné que d’autres comportements liés à la santé ont été associés à l’initiation à la cigarette électronique, les stratégies de prévention devraient cibler les combinaisons de comportements à risque pour la santé afin de prévenir l’usage de la cigarette électronique chez les jeunes. De plus, mettre en œuvre des approches en milieu scolaire au début ou pendant le premier cycle du secondaire serait certainement bénéfique.

IntroductionOver the last decade, e-cigarette use has been on the rise but with growing health concerns. The objective of this systematic review was to update findings for chronic health outcomes associated with e-cigarette use from the 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report.MethodsThree bibliographic databases were searched to identify studies comparing the chronic health effects of e-cigarette users (ECU) to non-smokers (NS), smokers, and/or dual users indexed between 31 August 2017 and 29 January 2021. Two independent reviewers screened abstracts and full texts. Data were extracted by one reviewer and verified by a second one. Outcomes were synthesized in a narrative manner using counts and based on statistical significance and direction of the association stratified by study design and exposure type. Risk of bias and certainty of evidence was assessed. The protocol was prospectively registered on Open Science Framework https://osf.io/u9btp.ResultsA total of 180 articles were eligible. This review focused on 93 studies for the 11 most frequently reported outcomes and from which 59 reported on daily e-cigarette use. The certainty of evidence for all outcomes was very low because of study design (84% cross-sectional) and exposure type (27% reported on exclusive ECU, i.e., never smoked traditional cigarettes). Overall, the summary of results for nearly all outcomes, including inflammation, immune response, periodontal and peri-implant clinical parameters, lung function, respiratory symptoms, and cardiovascular disease, suggested either non-significant or mixed results when daily ECU was compared to NS. This was also observed when comparing exclusive ECU to NS. The only notable exception was related to oral health where most (11/14) studies reported significantly higher inflammation among daily ECU vs. NS. Compared to the smokers, the exclusive-ECUs had no statistically significant differences in inflammation orperiodontal clinical parameters but had mixed findings for peri-implant clinical parameters.ConclusionsThis review provides an update to the 2018 NASEM report on chronic health effects of e-cigarette use. While the number of studies has grown, the certainty of evidence remains very low largely because of cross-sectional designs and lack of reporting on exclusive e-cigarette exposure. There remains a need for higher quality intervention and prospective studies to assess causality, with a focus on exclusive e-cigarette use.

Background Falls are a leading cause of injury-related hospitalizations among adults aged 65 years and older and may result in social isolation.Objective To summarise evidence on falls and subsequent social isolation and/or loneliness in older adults through a scoping review.Eligibility criteria Studies were eligible for inclusion if the population had a mean age of 60 years or older, they examined falls and subsequent social isolation, loneliness, fear of falling or risk factors and were primary studies (eg, experimental, quasi-experimental, observational and qualitative).Sources of evidence MEDLINE, CINAHL, Embase, Ageline and grey literature from inception until 11 January 2021.Charting methods A screening and charting form was developed and pilot-tested. Subsequently, two reviewers screened citations and full-text articles, and charted the evidence.Results After screening 4993 citations and 304 full-text articles, 39 studies were included in this review. Participants had a history of falling (range: 11% to 100%). Most studies were conducted in Europe (44%) and North America (33%) and were of the cross-sectional study design (66.7%), in the community (79%). Studies utilised 15 different scales. Six studies examined risk factors for social isolation and activity restriction associated with fear of falling. Six studies reported mental health outcomes related to falls and subsequent social isolation.Conclusions Consistency in outcome measurement is recommended, as multiple outcomes were used across the included studies. Further research is warranted in this area, given the ageing population and the importance of falls and social isolation to the health of older adults.Scoping review registration number 10.17605/OSF.IO/2R8HM.

Background: Using a nationally representative cohort of Canadian adults, we assessed associations between neighbourhood walkability and cause-specific mortality and investigated whether they differed by socioeconomic status. Methods: The study population was drawn from the 2001 Canadian Census Health and Environment Cohort, which contains individual-level data from a random sample of 20% of Canadian households mandated to complete the long-form census. We included those aged ≥ 25 years at baseline who lived in urban and suburban areas. The national death registry was used to ascertain annual vital status. Linkages to annual income tax data provided place of residence. The Canadian Active Living Environments, a national index that summarizes walkability across Canadian neighbourhoods, was assigned to individuals’ residential history. The Cox proportional hazards model was used to assess associations between walkability and cause-specific mortality. Results: A total of 1.8 million participants (52.5% female) accrued 27.3 million person-years and 265 710 deaths during the 15-year follow-up. The adjusted hazard ratio (HR) for living in a highly walkable neighbourhood relative to living in the least walkable neighbourhoods was associated with a 9% (HR: 0.91 [0.88, 0.95]) and 3% (HR: 0.97 [0.94, 0.99]) reduced risk of cardiovascular and all non-accidental mortality, respectively. The strongest benefits of walkability were found among individuals within the lowest education and household income categories, and who lived in the most deprived neighbourhoods. There were no significant associations (most [class 5] versus least [class 1] walkable HR: 0.84 [0.61–1.16]) seen for accidental traffic mortality. Conclusions: Canadian adults who live in walkable neighbourhoods have lower rates of cardiovascular and non-accidental mortality, with the greatest benefits seen in those from the lowest socioeconomic groups.

Objectives The objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall.Design Systematic review.Data sources MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Ageline were searched (from inception to February 2020).Methods Studies were eligible if they described any intervention for social isolation in older adults living in a community setting who experienced a fall, and reported outcomes related to social isolation or loneliness.Two independent reviewers screened citations, abstracted data and appraised risk of bias using the Cochrane risk of bias tool. The results were summarised descriptively.Results After screening 4069 citations and 55 full-text articles, four studies were included. The four studies varied in study design, including a randomised controlled trial, non-randomised controlled trial, an uncontrolled before-after study and a quasiexperimental study. Interventions varied widely, and included singing in a choir, a patient-centred, interprofessional primary care team-based approach, a multifactorial assessment targeting fall risk, appropriate medication use, loneliness and frailty, and a community-based care model that included comprehensive assessments and multilevel care coordination. Outcome measures varied and included scales for loneliness, social isolation, social interaction, social networks and social satisfaction. Mixed results were found, with three studies reporting no differences in social isolation or loneliness after the intervention. Only the multifactorial assessment intervention demonstrated a small positive effect on loneliness compared with the control group after adjustment (B=−0.18, 95% CI −0.35 to −0.02).Conclusions Few studies examined the interventions for social isolation or loneliness in older adults who experienced a fall. More research is warranted in this area.PROSPERO registration number CRD42020198487.

Introduction: Following cannabis legalization in Canada, a better understanding of the prevalence of unprompted cannabis use reduction and subsequent effects on youth academic outcomes is needed to inform harm reduction and health promotion approaches. Methods: We analyzed a longitudinally linked sample (n = 91774) from the COMPASS prospective cohort study of Canadian high school students attending Grades 9–12 in Ontario and Alberta between 2013–2014 and 2016–2017. We investigated the prevalence of spontaneous cannabis use reduction and cessation between grade transitions (Grades 9–10, 10–11, 11–12) and the effect of cessation on academic achievement (current or recent math and English course marks) and rigour (usual homework completion and past-month truancy). Results: Only 14.8% of cannabis users decreased their use between grades. Of these, two-thirds made only incremental downward changes, a pattern which held true for all three transitions. Cessation rates from daily and weekly use decreased every year. After cessation, students had better odds than continuing users (OR = 1.23, 95% CI: 1.03– 1.48) and worse odds than never-users (OR = 0.55, 95% CI: 0.31–0.97) for some subcategories of math performance. Students who quit cannabis universally improved class attendance (OR = 2.48, 95% CI: 1.93–3.19) and homework completion (OR = 2.32, 95% CI: 1.85–2.92) compared to continuing users. Conclusion: Increased academic rigour may underlie any improvements seen in academic performance after cannabis cessation. High school students who use cannabis likely need targeted support to facilitate reduction or cessation and subsequent academic recovery. This indicates that a school-based focus on cannabis harm reduction is justified.

Introduction: This study examined the associations of micro-level factors with current alcohol use and binge drinking among a large sample of Canadian youth. Methods: This descriptive-analytical study was conducted among high school students enrolled in the COMPASS study between 2012/13 and 2017/18. We used generalized estimating equations modelling to determine associations between micro-level factors and likelihood of current versus non-current alcohol use and binge drinking among respondents. Results: Students reporting current cannabis use were more likely to report current alcohol use over never use (odds ratio [OR] = 4.46, 95% confidence interval [CI]: 4.33–4.60) compared to students reporting non-current cannabis use. Students reporting current smoking of tobacco products were more likely to report current binge drinking over never binge drinking (OR = 2.52, 95% CI: 2.45–2.58), compared to non-smoking students. Students reporting weekly disposable incomes of more than $100 were more likely to report current over never binge drinking (OR = 2.14, 95% CI: 2.09–2.19), compared to students reporting no weekly disposable income. Conclusion: Higher disposable incomes, smoking of tobacco products and use of cannabis were associated with current alcohol use and binge drinking among youth. Findings may inform design of polysubstance use prevention efforts in high schools.

Currently, 1 in 3 Canadian seniors meet the criteria for successful aging, which include low probability of disease and disability, high cognitive and physical ability and active engagement in life. The sociodemographic characteristic of living alone can identify high-risk seniors, due to its association with lower social support and interactions, thus increasing susceptibility to negative health outcomes in older age. However, limited data exists on the living arrangements of Canadian seniors. In this analysis, we present sociodemographic characteristics and measures of health and social well-being of seniors by living arrangement. This information should be used to identify and support vulnerable seniors and increase the prevalence of healthy aging among Canadians.

Introduction. Cette étude a permis d’examiner les associations entre microfacteurs et consommation d’alcool ainsi que consommation excessive d’alcool au sein d’un vaste échantillon de jeunes Canadiens. Méthodologie. Cette étude descriptive et analytique a porté sur les élèves du secondaire ayant participé à l’étude COMPASS entre 2012-2013 et 2017-2018. Nous avons utilisé la modélisation par équations d’estimation généralisées pour déterminer chez les répondants les associations entre les microfacteurs et la probabilité de consommer de l’alcool et de consommer de l’alcool de manière excessive plutôt que ne pas consommer d’alcool. Résultats. Les élèves ayant déclaré consommer du cannabis étaient plus susceptibles de déclarer consommer de l’alcool plutôt que n’en avoir jamais consommé (rapport de cotes [RC] = 4,46; intervalle de confiance [IC] à 95 % : 4,33 à 4,60), comparativement aux élèves ayant indiqué ne pas consommer de cannabis. Les élèves ayant déclaré fumer du tabac étaient plus susceptibles de déclarer consommer de l’alcool de manière excessive plutôt que ne l’avoir jamais fait (RC = 2,52; IC à 95 % : 2,45 à 2,58), comparativement aux élèves non-fumeurs. Les élèves ayant déclaré disposer d’un revenu hebdomadaire de plus de 100 $ étaient plus susceptibles de déclarer consommer de l’alcool de manière excessive plutôt que de ne l’avoir jamais fait (RC = 2,14; IC à 95 % : 2,09 à 2,19), comparativement aux élèves ayant indiqué ne disposer d’aucun revenu hebdomadaire. Conclusion. Un revenu disponible plus élevé, l’usage du tabac et la consommation de cannabis étaient associés à une consommation d’alcool et à une consommation excessive d’alcool chez les jeunes. Ces résultats peuvent éclairer la mise en place de mesures de prévention de l’usage de plusieurs substances dans les écoles secondaires.

À l’heure actuelle, au Canada, un aîné sur trois répond aux critères d’un vieillissement réussi, soit une faible probabilité de maladie et d’incapacité, des aptitudes cognitives et physiques élevées et une participation active à la vie. Les caractéristiques sociodémographiques des personnes vivant seules permettent de cibler les aînés à risque élevé, étant donné l’association avec un soutien et des interactions sociales souvent plus faibles, ce qui rend cette population plus susceptible de souffrir de problèmes de santé à un âge avancé. Il existe pourtant peu de données sur les conditions de logement des aînés canadiens. Dans cette analyse, nous présentons les caractéristiques sociodémographiques et les mesures de la santé et du bien-être social des personnes âgées en fonction de leurs conditions de logement. Ces données devraient servir à identifier et à soutenir les aînés vulnérables et à accroître la prévalence d’un vieillissement en santé chez les Canadiens.

Introduction. La légalisation du cannabis au Canada requiert une meilleure compréhension de la prévalence de la réduction volontaire de la consommation de cannabis et des effets subséquents sur les résultats scolaires des jeunes, afin d’éclairer les approches de réduction des méfaits et de promotion de la santé. Méthodologie. Nous avons analysé les données longitudinales jumelées d’un échantillon (n = 91 774) tiré de l’étude de cohorte prospective COMPASS menée auprès d’élèves canadiens de la 9e à la 12e année de différentes écoles secondaires de l’Ontario et de l’Alberta, entre 2013­2014 et 2016­2017. Nous avons étudié la prévalence de la réduction et de l’abandon spontanés de la consommation de cannabis d’une année scolaire à l’autre (de la 9e à la 10e année, de la 10e à la 11e année, de la 11e à la 12e année), ainsi que l’effet de l’abandon sur la réussite scolaire (notes actuelles ou récentes obtenues en mathématiques et en anglais) et la rigueur (fréquence de réalisation des devoirs et absentéisme au cours des derniers mois). Résultats. Seulement 14,8 % des consommateurs de cannabis ont réduit leur consommation d’une année scolaire à l’autre. De ce nombre, les deux tiers n’ont apporté que des changements progressifs à la baisse, une tendance qui s’est maintenue au fil des trois changements d’année scolaire. Les taux d’abandon à la suite d’une consommation quotidienne et hebdomadaire ont diminué d’une année à l’autre. Les élèves qui ont cessé de consommer du cannabis ont obtenu de meilleurs résultats que ceux qui ont continué à en consommer (rapport de cotes [RC] = 1,23, intervalle de confiance [IC] à 95 % : 1,03 à 1,48) et ils ont obtenu de moins bons résultats, dans certaines souscatégories de rendement en mathématiques, que ceux qui n’en ont jamais consommé (RC = 0,55, IC à 95 % : 0,31 à 0,97). Comparativement aux élèves qui ont continué à consommer du cannabis, ceux qui ont cessé ont tous amélioré leur assiduité aux cours (RC = 2,48, IC à 95 % : 1,93 à 3,19) et la réalisation de leurs devoirs (RC = 2,32, IC à 95 % : 1,85 à 2,92). Conclusion. Une plus grande rigueur scolaire pourrait être à l’origine des améliorations constatées dans le rendement scolaire après l’abandon du cannabis. Les élèves du secondaire qui consomment du cannabis auront probablement besoin d’un soutien ciblé afin de favoriser la réduction ou l’abandon de la consommation et le rétablissement scolaire subséquent. Il paraît donc justifié de mettre l’accent sur la réduction des effets nocifs du cannabis en milieu scolaire.

Objective: As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how school-aged youth are coping with COVID-19-related changes and disruptions to daily life. Among a sample of Canadian youth, our objective was to examine the mental health factors associated with using substances to cope with COVID-19-related changes, taking account of expected sex differences. Methods: We used online data collected from 7150 students in the COMPASS study, during the early months of the COVID-19 pandemic (May–July 2020) in British Columbia, Ontario, and Quebec, Canada. We specified a sex-stratified, generalized linear mixed model to estimate the likelihood of engagement in substance-related coping behaviours, while testing for the effects of students’ mental health, individual characteristics, and school neighborhood characteristics. Results: Twelve percent of students (13.4% of females, 9.9% of males) in our sample reported using cannabis, alcohol, cigarettes, and/or vaping to help cope with COVID-19-related changes. Regardless of sex, students with greater depressive symptoms were more likely to engage in substance-related coping (aORFemale = 1.04, 95 %CI[1.01–1.07]; aORMale = 1.06, 95 %CI[1.013–1.11]). Among females, better psychosocial wellbeing was protective against engagement in substance related-coping (aOR = 0.96, 95 %CI[0.94–0.98]), controlling for current substance use. Conclusions: Canadian school-aged youth with generally poor mental health may be more likely to have engaged in substance use to help cope with COVID-19-related changes during the first wave of the pandemic, and female youth may be at disproportionate risk of engaging in the behaviour. Ongoing evaluation of the impacts of COVID-19 on youth health is required.

Introduction: This study investigates the influence of age at first use of alcohol on current alcohol use and associated behaviours in a large sample of Canadian youth. Methods: This descriptive-analytical study was conducted among Ontario Grade 12 students enrolled in the COMPASS Host Study between 2012 and 2017. We used generalized estimating equations (GEE) modelling to determine associations between age at first alcohol use and likelihood of current versus non-current alcohol use, binge drinking and mixing of alcohol with energy drinks among respondents. Results: Students reporting an age at first alcohol use between ages 13 and 14 years were more likely to report current alcohol use versus non-current use (OR = 2.80, 95% CI: 2.26–3.45) and current binge drinking versus non-current binge drinking (OR = 3.22, 95% CI: 2.45–4.25) compared to students reporting first alcohol use at age 18 years or older. Students who started drinking at 8 years of age or younger were more likely to report current versus non-current alcohol use (OR = 3.54, 95% CI: 2.83–4.43), binge drinking (OR = 3.99, 95% CI: 2.97–5.37), and mixing of alcohol with energy drinks (OR = 2.26, 95% CI: 1.23–4.14), compared to students who started drinking at 18 years or older. Conclusion: Starting to drink alcohol in the early teen years predicted current alcohol use, current binge drinking and mixing of alcohol with energy drinks when students were in Grade 12. Findings indicate a need for development of novel alcohol prevention efforts.

In response to the current opioid crisis in Canada, establishing safe injection services (SIS) in high risk communities has become more prevalent. In November 2017, The Trailer opened in Ottawa, Canada and tracks client use, overdose treatment and overdoses reversed. We analyzed data collected between November 2017 and August 2018. During peak hours, demand for services consistently exceeded The Trailer’s capacity. Overdoses treated and reversed in this facility increased substantially during this period. Results suggest The Trailer provided an important though not optimal (due to space restrictions) harm reduction service to this high-risk community.

L’établissement de services d’injection supervisée (SIS) est devenu courant dans les collectivités à risque élevé afin de réagir à la crise des opioïdes qui sévit actuellement au Canada. Le service de La Roulotte (The Trailer), qui a ouvert ses portes en novembre 2017 à Ottawa (Canada), suit de près la consommation des clients, le traitement des surdoses et l'inversion des effets d’une surdose. Nous avons analysé les données recueillies entre novembre 2017 et août 2018 par ce service. Aux heures de pointe, la demande de services a constamment dépassé la capacité de La Roulotte. Le nombre de traitements de surdoses et d'inversions des effets d’une surdose a considérablement augmenté au cours de la période. D’après les résultats, La Roulotte a fourni un service important – quoique non optimal (en raison de contraintes d’espace) – de réduction des méfaits dans cette collectivité à risque élevé.

Introduction. Cette étude vise à examiner l’incidence de l’âge de la première consommation d’alcool sur la consommation actuelle d’alcool et les comportements connexes chez un large échantillon de jeunes Canadiens. Méthodologie. Cette étude descriptive et analytique a été réalisée auprès d’élèves de 12e année de l’Ontario ayant participé à l’étude de référence COMPASS de 2012 à 2017. Nous avons eu recours à la modélisation par équations d’estimation généralisées (EEG) pour établir le lien entre l’âge de la première consommation d’alcool chez les répondants et la probabilité d’une consommation ou d’une absence de consommation d’alcool, d’une consommation excessive d’alcool et du mélange d’alcool et de boissons énergisantes. Résultats. Les élèves ayant indiqué avoir consommé de l’alcool pour la première fois entre 13 et 14 ans étaient plus susceptibles de déclarer consommer de l’alcool plutôt que de ne pas en consommer (RC = 2,80, intervalle de confiance [IC] à 95 % : 2,26 à 3,45) et étaient plus susceptibles de déclarer consommer de l’alcool de façon excessive plutôt que de ne pas en consommer de façon excessive (RC = 3,22, IC à 95 % : 2,45 à 4,25) comparativement aux élèves ayant déclaré avoir consommé de l’alcool pour la première fois à 18 ans ou plus. Les élèves ayant commencé à consommer de l’alcool à 8 ans ou moins étaient plus susceptibles de déclarer consommer de l’alcool plutôt que de ne pas en consommer (RC = 3,54, IC à IC à 95 % : 2,83 à 4,43), avoir une consommation excessive d’alcool (RC = 3,99, IC à IC à 95 % : 2,97 à 5,37) et mélanger alcool et boissons énergisantes (RC = 2,26, IC à IC à 95 % : 1,23 à 4,14) comparativement aux élèves ayant commencé à consommer de l’alcool à 18 ans ou plus. Conclusion. La consommation d’alcool pendant les premières années de l’adolescence permet de prédire la consommation d’alcool, la consommation excessive d’alcool ainsi que la tendance à mélanger alcool et boissons énergisantes lorsque les élèves arrivent en 12e année. Ces résultats soulignent le besoin de déployer de nouveaux efforts de prévention de la consommation d’alcool.

Introduction: The objective of this study was to examine the association between participation in school sports and substance use behaviors in both male and female high school students. Methods: The current study used cross-sectional data from 60,601 students from Year 6 (2017–2018) of the COMPASS study. Students reported their school physical activity participation (none, intramurals only, varsity only, both) and past 30-day substance use (binge drinking, cannabis use, cigarette use, e-cigarette use). Hierarchical logistic regression models predicted the odds of substance use, by sex. Results: 55% of students did not participate in any school sports and 32% reported substance use. Intramurals were negatively associated with cannabis use and cigarette use among all students and e-cigarette use among females. Varsity sports were associated with lower odds of cigarette use among all students and cannabis use among males. In contrast, participating in varsity sports was associated with increased odds of binge drinking and e-cigarette use among all students. Participating in both intramurals and varsity sports was associated with increased odds of binge drinking and e-cigarette use but with decreased odds of cannabis use and cigarette use. Conclusions: Intramurals were found to be protective against cannabis use and cigarette use among all students and e-cigarette use among females. Although varsity sports were protective against cannabis and cigarette use, they were found to be a risk factor for binge drinking and e-cigarette use. Substance use prevention efforts should be a focus among school varsity sports teams, especially for binge drinking and e-cigarette use.

Intramurals are an important part of the physical activity offerings in secondary schools; however, it is not well understood how co-ed and gender-specific intramural programs impact intramural participation among male and female students. Therefore, the objective of this research was to examine if the number of co-ed, male-only, and female-only intramurals offered at a school was associated with student participation in intramurals.A large sample of Canadian secondary school students (N = 59,370) completed the COMPASS survey in 2017–2018. School staff reported the number of co-ed, male-only, and female-only intramurals offered at each school. Students reported whether they participated in school intramurals. Hierarchical models were used to assess associations.Intramural participation was marginally higher among male students (36%) than female students (32%; p

Background: Canadian youth are among the top users of cannabis globally. The Canadian federal government identified protecting youth from cannabis-related harms as a key public health objective aligned with the legalization and strict regulation of cannabis. While there are well-established associations between screen time sedentary behaviour (STSB) and alcohol and tobacco use, the association with cannabis use is understudied. The purpose of this study is to examine the association between various types of STSBs and cannabis use in a large sample of Canadian youth. Methods: Using cross-sectional data from 46,957 grade 9 to 12 students participating in year 5 of the COMPASS host study (2016–2017), four gender-stratified ordinal logistic regression models were used to examine how total STSB and four different types of STSBs (watching/streaming TV shows/movies, playing video games, Internet use, emailing/messaging/texting) are associated with frequency of cannabis use. Results: One-quarter of participants (24.9%) reported using cannabis in past 12 months; the largest proportion of this group (37.9%) reported rare/sporadic use. Overall, participants spent an average 7.45 ( ±5.26) hours/day on STSBs. Total STSB was positively associated with more frequent cannabis use, and when separated by type, internet use and messaging were significant. Playing video games and watching TV/movies were also significantly associated with more frequent cannabis use, but only for females. Conclusions: The associations between frequency of cannabis use and various measures of STSBs suggest that screen time may be a risk factor for cannabis use among youth. This association may be mediated by youths’ mental wellbeing, given emerging evidence that STSB is a risk factor for poor mental health, and the tendency for individuals to use substances as a coping mechanism. Further, the ubiquity of pro-substance use content on the internet may also contribute to increased exposure to and normalization of cannabis, further promoting its use. Keywords: Youth health, Substance use, Risk behaviours, Cannabis, Screen time

Introduction: Poly-substance use, increasingly understood as a behaviour with uniquely adverse consequences, is on the rise among Canadian youth. High levels of e-cigarette vaping and the recent legalization of recreational cannabis use may result in an acceleration of this trend. The aim of this work was to characterise changes in youth poly-substance use over time, generate baseline data for future investigations, and highlight areas of interest for policy action. Methods: Descriptive statistics and regression models explored patterns and trends in concurrent use of multiple substances (alcohol, cigarettes, cannabis, and e-cigarettes) among Canadian high school students taking part in the COMPASS prospective cohort study during Y2 (2013/2014; n = 45,298), Y3 (2014/2015, n = 42,355), Y4 (2015/2016; n = 40,436), Y5 (2016/2017; n = 37,060), and Y6 (2017/2018; n = 34,879). Results: Poly-substance use increased significantly over time, with over 50% of students who used substance reporting past-year use of multiple substances by 2017/2018. Male and Indigenous students were significantly more likely to report poly-substance use than female and white students respectively. E-cigarette vaping doubled from Y5 to Y6 and was included in all increasingly prevalent substance use combinations. Conclusions: Youth poly-substance use, rising since 2012/2013, saw a particularly steep increase after 2016/2017. Differential effects were observed for distinct demographic subpopulations, indicating tailored interventions may be required. E-cigarette vaping surged in parallel with the observed increase, suggesting a key role for this behaviour in shaping youth poly-substance use. Keywords: Youth, Poly-substance use, Cigarette smoking, E-cigarettes, Alcohol, Cannabis

Introduction: Exposure to bisphenol A (BPA) has been shown to affect lipid metabolism and promote weight gain in animal studies. Recent epidemiological studies also support a link between BPA and obesity in human populations, although many were limited to a single adiposity measure or have not considered potential confounding by dietary factors. The purpose of this study is to examine associations between urinary BPA and adiposity measures in a nationally representative sample of Canadian adults. Methods: We performed analyses using biomonitoring and directly measured anthropometric data from 4733 adults aged 18 to 79 years in the Canadian Health Measures Survey (2007–2011). We used multinomial and binary logistic regression models to estimate associations of urinary BPA with body mass index (BMI) categories (overweight vs. under/normal weight; obesity vs. under/normal weight) and elevated waist circumference (males: ≥ 102 cm; females: ≥ 88 cm), respectively, while controlling for potential confounders. Linear regression analyses were also performed to assess associations between urinary BPA and continuous BMI and waist circumference measures. Results: Urinary BPA was positively associated with BMI-defined obesity, with an odds ratio of 1.54 (95% confidence interval [CI]: 1.002–2.37) in the highest (vs. lowest) BPA quartile (test for trend, p = .041). Urinary BPA was not associated with elevated waist circumference defined using standard cut-offs. Additionally, each natural-log unit increase in urinary BPA concentration was associated with a 0.33 kg/m2 (95% CI: 0.10–0.57) increase in BMI and a 1.00 cm (95% CI: 0.34–1.65) increase in waist circumference. Conclusion: Our study contributes to the growing body of evidence that BPA is positively associated with obesity. Prospective studies with repeated measures are needed to address temporality and improve exposure classification.

Introduction: The Public Health Agency of Canada adapted a Finnish diabetes screening tool (FINDRISC) to create a tool (CANRISK) tailored to Canada's multi-ethnic population. CANRISK was developed using data collected in seven Canadian provinces. In an effort to extend the applicability of CANRISK to northern territorial populations, we completed a study with the mainly Inuit population in the Kitikmeot region of Nunavut. Methods: We obtained CANRISK questionnaires, physical measures and blood samples from participants in five Nunavut communities in Kitikmeot. We used logistic regression to test model fit using the original CANRISK risk factors for dysglycemia (prediabetes and diabetes). Dysglycemia was assessed using fasting plasma glucose (FPG) alone and/or oral glucose tolerance test. We generated participants' CANRISK scores to test the functioning of this tool in the Inuit population. Results: A total of 303 individuals participated in the study. Half were aged less than 45 years, two-thirds were female and 84% were Inuit. A total of 18% had prediabetes, and an additional 4% had undiagnosed diabetes. The odds of having dysglycemia rose exponentially with age, while the relationship with BMI was U-shaped. Compared with lab test results, using a cut-off point of 32 the CANRISK tool achieved a sensitivity of 61%, a specificity of 66%, a positive predictive value of 34% and an accuracy rate of 65%. Conclusion: The CANRISK tool achieved a similar accuracy in detecting dysglycemia in this mainly Inuit population as it did in a multi-ethnic sample of Canadians. We found the CANRISK tool to be adaptable to the Kitikmeot region, and more generally to Nunavut.

Introduction : Des études chez l’animal ont révélé que l’exposition au bisphénol A (BPA) affecte le métabolisme des lipides et favorise la prise de poids. Des études épidémiologiques récentes appuient aussi l’existence d’un lien entre le BPA et l’obésité chez l’humain, mais la plupart d’entre elles se limitent à une seule mesure de l’adiposité ou ne tiennent pas compte des facteurs de confusion alimentaires possibles. Cette étude vise à examiner les associations entre les concentrations urinaires de BPA et les mesures de l’adiposité dans un échantillon national représentatif des adultes canadiens. Méthodologie : Nous avons réalisé des analyses à l’aide de données de biosurveillance et de données anthropométriques mesurées directement auprès de 4 733 adultes de 18 à 79 ans dans le cadre de l’Enquête canadienne sur les mesures de la santé (2007-2011). Nous avons utilisé des modèles de régression logistique multinomiale et binaire pour estimer les associations entre, d’une part, les concentrations urinaires de BPA et, d’autre part, les diverses catégories d’indice de masse corporelle (IMC) (embonpoint par opposition à poids insuffisant ou normal; obésité par opposition à poids insuffisant ou normal) et un tour de taille élevé (102 cm ou plus pour les hommes; 88 cm ou plus pour les femmes) en tenant compte des facteurs de confusion possibles. Des analyses de régression linéaire ont aussi été effectuées pour évaluer les associations entre les concentrations urinaires de BPA et des mesures de l’IMC et du tour de taille. Résultats : On a pu associer positivement la concentration urinaire de BPA et l’obésité (définie par l’IMC). Le rapport de cotes s’est situé à 1,54 (intervalle de confiance [IC] à 95 % : 1,002 à 2,37) dans le quartile de BPA le plus élevé par rapport au plus bas (test de tendance, p = 0,041). La concentration urinaire de BPA n’a pas été associée au tour de taille pour les valeurs seuils courantes. Enfin, chaque unité d’augmentation du log naturel de la concentration urinaire de BPA a été associée à une hausse de 0,33 kg/m2 (IC à 95 % : 0,10 à 0,57) de l’IMC et de 1,00 cm (IC à 95 % : 0,34 à 1,65) du tour de taille. Conclusion : Notre étude vient enrichir le corpus croissant de données probantes sur l’association positive entre BPA et obésité. Des études prospectives comportant un suivi de mesures sont nécessaires pour définir la dimension temporelle de l’association et améliorer la classification de l’exposition.

Introduction : L'Agence de la santé publique du Canada a adapté un outil finlandais de dépistage du diabète (FINDRISC) dans le but de créer un outil, CANRISK, conçu sur mesure pour la population multiethnique du Canada. Cet outil a été élaboré à partir de données recueillies dans sept provinces canadiennes. Dans le but d'élargir son applicabilité aux populations des territoires nordiques, nous avons réalisé une étude auprès de la population majoritairement inuite de la région de Kitikmeot (Nunavut). Méthodologie : Nous avons recueilli des questionnaires CANRISK, des mesures physiques et des échantillons de sang auprès de participants vivant dans cinq collectivités de la région de Kitikmeot. Nous avons utilisé une régression logistique pour évaluer l'ajustement du modèle à l'aide des facteurs de risque de l'outil CANRISK d'origine associés à la dysglycémie (prédiabète et diabète). La dysglycémie a été évaluée au moyen d'un test de glycémie plasmatique à jeun (GPJ) administré seul ou avec une épreuve d'hyperglycémie provoquée par voie orale. Nous avons mis au point les scores CANRISK des participants pour tester le fonctionnement de cet outil au sein d'une population inuite. Résultats : Au total, 303 personnes ont participé à l'étude. La moitié d'entre elles avaient moins de 45 ans, les deux tiers étaient des femmes et 84 % étaient inuites. Sur les 303 participants, 18 % étaient atteints de prédiabète et 4 % avaient un diabète non diagnostiqué. La probabilité de présenter un état dysglycémique augmentait de façon exponentielle avec l'âge et la relation avec l'indice de masse corporelle (IMC) suivait une courbe en U. Par rapport aux résultats d'analyse en laboratoire, l'outil CANRISK avec un seuil de 32 points a présenté une sensibilité de 61 %, une spécificité de 66 %, une valeur prédictive positive de 34 % et un taux d'exactitude de 65 %. Conclusion : L'outil CANRISK a permis de détecter la dysglycémie au sein de cette population très majoritairement inuite avec une exactitude comparable à celle obtenue avec un échantillon de Canadiens présentant une diversité multiethnique. L'outil CANRISK est donc utilisable pour la région de Kitikmeot, et plus généralement au Nunavut.

Aim. To assess the effect of various lifestyle risk factors on the risk of salivary gland cancer in Canada using data from a population-based case-control study. Methods. Data from a population-based case-control study of 132 incident cases of salivary gland cancer and 3076 population controls were collected through self-administered questionnaire and analysed using unconditional logistic regression. Results. Four or more servings/week of processed meat product was associated with an adjusted odds ratio (OR) and corresponding 95% confidence interval (CI) of 1.62 (1.02–2.58). Nonsignificantly increased ORs were also related to obesity, >7 drinks/week of alcohol consumption, and occupational exposure to radiation. Furthermore, nonsignificantly decreased ORs were found to be associated with high education level (>12 years) (OR=0.65), high consumption of spinach/squash (OR=0.62) and all vegetables/vegetable juices (OR=0.75), and >30 sessions/month of recreational physical activity (OR=0.78). Conclusions. This study suggests positive associations with consumption of processed meat, smoking, obesity, alcohol drinking, and occupational exposure to radiation as well as negative associations with higher education, consumption of spinach/squash, and physical activity, which suggest a role of lifestyle factors in the etiology of salivary gland cancer. However, these findings were based on small number of cases and were nonsignificant. Further larger studies are warranted to confirm our findings.