Social determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts. Relationships, interconnectivity, and community are fundamental to these determinants. Understanding these determinants from the perspective of Indigenous youth is vital to identifying means of alleviating future inequities. In 2016, fifteen Yellowknives Dene First Nation (YKDFN) youth in the Canadian Northwest Territories participated in the 'On-the-Land Health Leadership Camp'. Using a strength- and community-based participatory approach through an Indigenous research lens, the YKDFN Wellness Division and university researchers crafted the workshop to provide opportunities for youth to practice cultural skills, and to capture the youth’s perspectives of health and health agency. Perspectives of a healthy community, health issues, and health priorities were collected from youth through sharing circles, PhotoVoice, mural art, and surveys. The overall emerging theme was that a connection to the land is an imperative determinant of YKDFN health. Youth identified the importance of a relationship to land including practicing cultural skills, Elders passing on traditional knowledge, and surviving off the land. The youth framed future health research to include roles for youth and an on-the-land component that builds YKDFN culture, community relations, and traditional knowledge transfer. Youth felt that a symbiotic relationship between land, environment, and people is fundamental to building a healthy community. Our research confirmed there is a direct and critical relationship between structural context and determinants of Indigenous Peoples’ health, and that this should be incorporated into health research and interventions.

Youth researching youth: benefits, limitations and ethical considerations within a participatory research process

Background: The COVID-19 pandemic brought the production of scientific knowledge onto the public agenda in real-time. News media and commentators analysed the successes and failures of the pandemic response in real-time, bringing the process of scientific inquiry, which is also fraught with uncertainty, onto the public agenda. We examine how Canadian newspapers framed scientific uncertainty in their initial coverage of the COVID-19 pandemic and how journalists made sense of the scientific process. Methods: We conducted a framing analysis of 1143 news stories and opinion during the first two waves of the COVID-19 pandemic. Using a qualitative analysis software, our analysis focused, first, on how scientific uncertainty was framed in hard news and opinion discourse (editorial, op-ed). Second, we compared how specialist health and science reporters discussed scientific evidence versus non-specialist reporters in hard news and columns. Results: Uncertainty emerged as a “master frame” across the sample, and four additional framing strategies were used by reporters and commentators when covering the pandemic: (1), evidence -focusing on presence or absence of it-; (2) transparency and leadership -focusing on the pandemic response-; (3) duelling experts – highlighting disagreement among experts or criticizing public health decisions for not adhering to expert recommendations-; and (4) mixed messaging -criticizing public health communication efforts. While specialist journalists understood that scientific knowledge evolves and the process is fraught with uncertainty, non-specialist reporters and commentators expressed frustration over changing public health guidelines, leading to the politicization of the pandemic response and condemnation of elected officials’ decisions. Conclusions: Managing scientific uncertainty in evolving science-policy situations requires timely and clear communication. Public health officials and political leaders need to provide clear and consistent messages and access to data regarding infection prevention guidelines. Public health officials should quickly engage in communication course corrections if original messages are missing the intended mark, and clearly explain the shift. Finally, public health communicators should be aware of and more responsive to a variety of media reporters, who will bring different interpretative frames to their reporting. More care and effort are needed in these communication engagements to minimize inconsistencies, uncertainty, and politicization.

Recent infectious disease outbreaks have resulted in renewed recognition of the importance of risk communication planning and execution to public health control strategies. Key to these efforts is public access to information that is understandable, reliable and meets their needs for informed decision-making on protective health behaviours. Learning from the trends in sources used in previous outbreaks will enable improvements in information access in future outbreaks. Two separate random-digit dialled telephone surveys were conducted in Alberta, Canada, to explore information sources used by the public, together with their perceived usefulness and credibility, during the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic (n = 1209) and 2009–2010 H1N1 pandemic (n = 1206). Traditional mass media were the most used information sources in both surveys. Although use of the Internet increased from 25% during SARS to 56% during H1N1, overall use of social media was not as high as anticipated. Friends and relatives were commonly used as an information source, but were not deemed very useful or credible. Conversely, doctors and health professionals were considered credible, but not consulted as frequently. The use of five or more information sources increased by almost 60% between the SARS and H1N1 surveys. There was a shift to older, more educated and more affluent respondents between the surveys, most likely caused by a decrease in the use of landlines amongst younger Canadians. It was concluded that people are increasingly using multiple sources of health risk information, presumably in a complementary manner. Subsequently, although using online media is important, this should be used to augment rather than replace more traditional information channels. Efforts should be made to improve knowledge transfer to health care professionals and doctors and provide them with opportunities to be more accessible as information sources. Finally, the future use of telephone surveys needs to account for the changing demographics of the respondents accessed through such surveys.

Objectives: Our study aimed to (1) identify barriers to equitable access to COVID-19 vaccines for Canadians with disabilities and (2) present recommendations made by study participants to improve immunization programs in terms of inclusivity and equitable access. Methods: We invited Manitobans living with disabilities to participate in online focus groups. Focus groups were conducted across multiple disability experiences, although one focus group was advertised explicitly as offering simultaneous American Sign Language interpretation to encourage people who are d/Deaf or hard of hearing to participate. Participants were asked about their perspectives on the management of COVID-19 public health measures and vaccination program rollout. Participants were also asked about barriers and facilitators of their vaccination experiences and if they had recommendations for improvement. Results: The participants identified three areas where they encountered routine barriers in accessing the COVID-19 vaccines: (1) vaccine information and appointment booking, (2) physical access to vaccination clinics, and (3) vaccination experience. While participants identified specific recommendations to improve vaccine accessibility for people with disabilities, the single most crucial advice consistently identified was to involve people with disabilities in developing accessible immunization programs. Conclusion: Meaningful engagement with people living with disabilities in immunization program planning would help ensure that people with disabilities, who already face significant challenges due to COVID-19, are offered the same protections as the rest of the population. These recommendations could be easily transferred to the administration of other large-scale immunization campaigns (e.g., influenza vaccines).