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Common ground is necessary for developing collaboration as part of building resilience for public health preparedness. While the importance of common ground as an essential component of collaboration has been well described, there is a need for studies to identify how common ground develops over time, across individual and group dimensions, and the contexts that influence its development. This paper studied common ground development in three Canadian communities between October 2010 and March 2011 through a project on capacity building for disaster management. Disaster management requires the integration of paid and volunteer participants across public and private sectors and is therefore a good domain to study common ground development. We used directed qualitative content analysis to develop a model of common ground development over time that describes its progression through coordinative, cooperative and collaborative common ground. We also identified how common ground develops at micro (individual) and macro (group) levels, as well as how agency, technology and geographical contexts influence its development. We then use the four phases of disaster management to illustrate how our model can support longitudinal common ground development. Our findings provide useful insight to enable proactive development of common ground in collaborative health communities. [ABSTRACT FROM AUTHOR]

Complexity is a useful frame of reference for disaster management and understanding population health. An important means to unraveling the complexities of disaster management is to recognize the interdependencies between health care and broader social systems and how they intersect to promote health and resilience before, during and after a crisis. While recent literature has expanded our understanding of the complexity of disasters at the macro level, few studies have examined empirically how dynamic elements of critical social infrastructure at the micro level influence community capacity. The purpose of this study was to explore empirically the complexity of disasters, to determine levers for action where interventions can be used to facilitate collaborative action and promote health among high risk populations. A second purpose was to build a framework for critical social infrastructure and develop a model to identify potential points of intervention to promote population health and resilience. A community-based participatory research design was used in nine focus group consultations ( n = 143) held in five communities in Canada, between October 2010 and March 2011, using the Structured Interview Matrix facilitation technique. The findings underscore the importance of interconnectedness of hard and soft systems at the micro level, with culture providing the backdrop for the social fabric of each community. Open coding drawing upon the tenets of complexity theory was used to develop four core themes that provide structure for the framework that evolved; they relate to dynamic context, situational awareness and connectedness, flexible planning, and collaboration, which are needed to foster adaptive responses to disasters. Seven action recommendations are presented, to promote community resilience and population health. [ABSTRACT FROM AUTHOR]

The Physical Activity Counseling randomized controlled trial integrated a physical activity (PA) counselor into a primary care practice to provide intensive counseling to sedentary patients following brief counseling from their regular health care provider. This article presents the voices of 15 patients, who through a series of 3 interviews, described their experience with this 3-month combined provider PA counseling intervention. Patient satisfaction was a dominant emergent theme, and the patients were particularly positive about the quality of care and educational support for lifestyle change. They favored the tailored approach and felt the strategies for overcoming PA barriers were helpful. [ABSTRACT FROM AUTHOR]

Primary care is a promising venue to build patient motivation and confidence to increase physical activity (PA). Physician PA counselling has demonstrated some success; however, maintenance of behaviour change appears to require more intensive interventions. In reality, most physicians do not have the necessary training nor the time for this type of counselling. The purpose of this paper is to outline the rationale, methods, and interventions for the ongoing physical activity counselling (PAC) randomized controlled trial (RCT), which aims to assess the impact of integrating a PA counsellor into a primary care practice. This RCT has 2 arms: (i) brief PA counselling (2–4 min) from a health care provider and (ii) brief PA counselling + intensive PA counselling from a PA counsellor (3 months). The impact of this intervention is being evaluated using the comprehensive RE-AIM framework. One hundred twenty insufficiently active adult patients, aged 18 to 69 y and recruited during regular primary care visits have been randomized. Dependent measures include psychological mediators, PA participation, quality of life, and physical and metabolic outcomes. The PAC project represents an innovative, theoretically-based approach to promoting PA in primary care, focusing on psychological mediators of change. We anticipate that key lessons from this study will be useful for shaping future public health interventions, theories, and research. [ABSTRACT FROM AUTHOR]

We conducted a constructivist grounded theory approach in which discourse analysis was used to explore how Canadian news media portrays older adults and aging in a disaster context. We analyzed 119 articles covering five Canadian disasters and identified four themes: (a) stereotypes of older adults are presented on a positive–negative continuum in journalistic coverage of disasters, (b) journalistic coverage tends to exclude perspectives of older adults from relevant discourse, (c) journalists assess the value of losses for older adults—"home" as a central concept, and (d) disasters are framed as disrupting retirement ideals. A model was created to provide an overview of the journalistic coverage of older adults in disaster contexts. Understanding how old age and aging are presented by the media in a disaster context is important because it has further implications for informing and structuring disaster risk reduction policies. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic continues to demonstrate the risks and profound health impacts that result from infectious disease emergencies. Emergency preparedness has been defined as the knowledge, capacity and organizational systems that governments, response and recovery organizations, communities and individuals develop to anticipate, respond to, or recover from emergencies. This scoping review explored recent literature on priority areas and indicators for public health emergency preparedness (PHEP) with a focus on infectious disease emergencies. Methods: Using scoping review methodology, a comprehensive search was conducted for indexed and grey literature with a focus on records published from 2017 to 2020 onward, respectively. Records were included if they: (a) described PHEP, (b) focused on an infectious emergency, and (c) were published in an Organization for Economic Co-operation and Development country. An evidence-based all-hazards Resilience Framework for PHEP consisting of 11 elements was used as a reference point to identify additional areas of preparedness that have emerged in recent publications. The findings were analyzed deductively and summarized thematically. Results: The included publications largely aligned with the 11 elements of the all-hazards Resilience Framework for PHEP. In particular, the elements related to collaborative networks, community engagement, risk analysis and communication were frequently observed across the publications included in this review. Ten emergent themes were identified that expand on the Resilience Framework for PHEP specific to infectious diseases. Planning to mitigate inequities was a key finding of this review, it was the most frequently identified emergent theme. Additional emergent themes were: research and evidence-informed decision making, building vaccination capacity, building laboratory and diagnostic system capacity, building infection prevention and control capacity, financial investment in infrastructure, health system capacity, climate and environmental health, public health legislation and phases of preparedness. Conclusion: The themes from this review contribute to the evolving understanding of critical public health emergency preparedness actions. The themes expand on the 11 elements outlined in the Resilience Framework for PHEP, specifically relevant to pandemics and infectious disease emergencies. Further research will be important to validate these findings, and expand understanding of how refinements to PHEP frameworks and indicators can support public health practice. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to report the physical activity and health outcomes results from the Physical Activity Counselling (PAC) trial. Patients ( n = 120, mean age 47.3 ± 11.1 years, 69.2% female) who reported less than 150 min of physical activity per week were recruited from a large community-based Canadian primary care practice. After receiving brief physical activity counselling from their provider, they were randomized to receive 6 additional patient-centered counselling sessions over 3 months from a physical activity counsellor (intensive-counselling group; n = 61), or no further intervention (brief-counselling group; n = 59). Physical activity (self-reported and accelerometer) was measured every 6 weeks up to 25 weeks (12 weeks postintervention). Quality of life was also assessed, and physical and metabolic outcomes were evaluated in a randomly selected subset of patients (33%). In the intent-to-treat analyses of covariance, the intensive-counselling group self-reported significantly higher levels of physical activity at 6 weeks ( p = 0.009) and 13 weeks ( p = 0.01). There were no differences in self-reported physical activity between the groups after the intervention in the follow-up period, nor was there any increase in accelerometer-measured physical activity. Finally, the intensive-counselling patients showed greater decreases in percent body fat and total fat mass from 13 weeks to 25 weeks. Results for physical activity depended on the method used, with positive short-term results with self-report and no effects with the accelerometers. Between-group differences were found for body composition in that the intensive-counselling patients decreased more. A multisite randomized controlled trial with a longer intensive intervention and follow-up is warranted. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The PA Counseling (PAC) trial tested a primary care intervention using Self-Determination Theory (SDT) as the guiding framework. This paper presents specific results related to SDT constructs in a physical activity (PA) context. Specifically, whether patients who received both brief autonomy supportive PA counseling from their health-care provider and intensive (3 month) autonomy supportive counseling from a PA counselor would report greater levels of autonomy support, autonomous motivation, perceived competence and PA adoption, than patients receiving only brief counseling. In addition, we tested Williams’ SDT process model in the context of PA adoption. Method: Measures of autonomous motivation and perceived competence for PA were measured at baseline and 6 weeks. PA was assessed at baseline and 13 weeks. An autonomy support index was calculated by multiplying minutes of counseling by perceptions of autonomy support. Group differences in autonomy support, autonomous motivation, perceived competence and PA were examined. The SDT process model of PA adoption was tested via path analysis. Results: The results showed higher autonomy support and autonomous motivation at 6 weeks and higher PA levels at 13 weeks for the experimental group. The SDT process model for PA adoption showed that autonomous motivation and perceived competence at 6 weeks significantly predicted 13-week PA for the experimental group. Conclusions: This study provides a rigorous field test of SDT theory in a PA context. It demonstrates the versatility and applicability of the SDT model for health behavior change. SDT-trained PA counselors appear to provide valuable contribution to facilitating patient behavior change, by increasing patient autonomous motivation for PA. [Copyright &y& Elsevier]

Abstract: Objectives: The Physical Activity Counseling (PAC) randomized control trial examined the effects of a physical activity counseling intervention on physical activity motivation and on physical activity behavior. Results have shown that both quantity and quality motivation influenced physical activity levels at the end of the PAC intervention, however their combined influence has not been investigated and theory and past research point to a possible moderated mediation model. Thus the current study examined if self-determined motivation moderated the mediational influence of quantity of motivation on the relationship between the intervention and physical activity in the PAC trial. Method: Physically inactive primary care patients (n =120) were recruited and randomized to an intensive counseling or brief counseling group. All patients responded to a quantity of motivation scale (% of motivation for physical activity from 1 to 7 days) and a self-determined motivation scale (BREQ-2) at 6 weeks (mid intervention) and the Godin Leisure-Time Exercise Questionnaire at 13 weeks (end intervention). Moderated mediation was tested using multiple regression analysis. Results: Regression analyses showed that all criteria for mediation were met and specifically that the intervention–physical activity relationship became non-significant with the inclusion of quantity of motivation (β =.22, p <.05 to β =.13, p >.05). Furthermore, the relationship between quantity of motivation and physical activity was moderated by self-determined motivation (β =.17, p <.05). The moderation occurred at an RAI score of 22 and higher (p <.05). Conclusions: Findings confirm the importance of distinguishing quantity and quality of motivation and support Self-Determination Theory by showing significant moderation by self-determined physical activity motivation. Results demonstrate the importance of moderated mediation models to determine complex interactions between psychological constructs and physical activity. This knowledge can help increase the efficacy of physical activity interventions. [Copyright &y& Elsevier]