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Kumar R, Arya N. A decolonised Commission agenda: the missing ingredients. Lancet 2023; 402:1747-1748. [PMID: 37865109 DOI: 10.1016/s0140-6736(23)02054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023]
Affiliation(s)
- Ramya Kumar
- Faculty of Medicine, University of Jaffna, Jaffna 40000, Sri Lanka; United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia.
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Balsillie School for International Affairs, Waterloo, ON, Canada
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2
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Hynie M, Oda A, Calaresu M, Kuo BCH, Ives N, Jaimes A, Bokore N, Beukeboom C, Ahmad F, Arya N, Samuel R, Farooqui S, Palmer-Dyer JL, McKenzie K. Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review. J Immigr Minor Health 2023; 25:1171-1195. [PMID: 37407884 PMCID: PMC10509103 DOI: 10.1007/s10903-023-01521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/07/2023]
Abstract
Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments. A search in CINAHL, MEDLINE, PSYCINFO, EMBASE, SOCINDEX and SCOPUS following (Arksey and O'Malley in Int J Soc Res Methodol 8:19-32, 2005) guidelines found 44 papers and 41 unique interventions/assessment tools. Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS' accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted.
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Affiliation(s)
- Michaela Hynie
- Department of Psychology, York University, Toronto, Canada.
- Centre for Refugee Studies, York University, 4700 Keele St., Toronto, ON, M3J1P3, Canada.
| | - Anna Oda
- Centre for Refugee Studies, York University, 4700 Keele St., Toronto, ON, M3J1P3, Canada
| | - Michael Calaresu
- Department of Psychology, University of Alberta, Edmonton, Canada
| | - Ben C H Kuo
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Nicole Ives
- School of Social Work, McGill University, Montreal, Canada
| | - Annie Jaimes
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada
| | - Nimo Bokore
- School of Social Work, Carleton University, Ottawa, Canada
| | | | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, Canada
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Rachel Samuel
- Counseling Psychology, Yorkville University, Fredericton, Canada
| | | | | | - Kwame McKenzie
- Wellesley Institute, Toronto, Canada
- Division of Health Equity, CAMH, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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3
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Hynie M, Oda A, Calaresu M, Kuo BCH, Ives N, Jaimes A, Bokore N, Beukeboom C, Ahmad F, Arya N, Samuel R, Farooqui S, Palmer-Dyer JL, McKenzie K. Correction: Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review. J Immigr Minor Health 2023; 25:1196. [PMID: 37522972 PMCID: PMC10509053 DOI: 10.1007/s10903-023-01525-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Affiliation(s)
- Michaela Hynie
- Department of Psychology, York University, Toronto, Canada.
- Centre for Refugee Studies, York University, 4700 Keele St, Toronto, ON, M3J1P3, Canada.
| | - Anna Oda
- Centre for Refugee Studies, York University, 4700 Keele St, Toronto, ON, M3J1P3, Canada
| | - Michael Calaresu
- Department of Psychology, University of Alberta, Edmonton, Canada
| | - Ben C H Kuo
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Nicole Ives
- School of Social Work, McGill University, Montreal, Canada
| | - Annie Jaimes
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada
| | - Nimo Bokore
- School of Social Work, Carleton University, Ottawa, Canada
| | | | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, Canada
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Rachel Samuel
- Counseling Psychology, Yorkville University, Fredericton, Canada
| | | | | | - Kwame McKenzie
- Wellesley Institute, Toronto, Canada
- Division of Health Equity, CAMH, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Lin K, Arya N, Laughlin B, Zaniletti I, Van Der Walt C, Bhandarkar A, Bydon M, Sio TTW. Characterizing Hospital Admissions after Proton Beam Therapy Using the National Inpatient Sample Database. Int J Radiat Oncol Biol Phys 2023; 117:e407-e408. [PMID: 37785352 DOI: 10.1016/j.ijrobp.2023.06.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To characterize the diagnoses, comorbidities, and length of stay in patients who received proton beam therapy during their hospital stay as part of their cancer treatment regimen. MATERIALS/METHODS The National Inpatient Sample database was queried using ICD-10 codes to identify all hospitalizations with proton beam therapy between 2016 and 2018. Weighted frequencies for categorical variables and geometric mean with standard error for continuous variables were derived. Generalized linear models for clustered data in SAS v 9.4 (Cary, NC) were used to determine the association between length of stay with patient and hospital baseline characteristics. RESULTS We studied 511 patients, representing a weighted estimate of 2,555 patients from the National Inpatient Sample from 2016 to 2018 who received proton beam therapy during hospitalization. The mean age was 40 years (StdErr = 3.0). The estimated average length of stay was 7.7 days (StdErr = 0.4). The cohort was 53.6% White, 15.3% Black, 10.4% Hispanic, 7.0% Asian or Pacific Islander, and 0.2% Native American. The most frequent diagnoses at admission were encounter for antineoplastic chemotherapy (10.0%), secondary malignant neoplasm of brain (9.2%), secondary malignant neoplasm of bone (9.0%), encounter for antineoplastic radiation therapy (6.1%), and neoplasm-related pain (3.3%). Large- and medium-sized hospitals were associated with significantly longer lengths of stay than small-sized hospitals (p<0.0001 and p = 0.0186, respectively). Compared to private investor-owned (proprietary) hospitals, nonfederal government-owned (public) hospitals are associated with prolonged length of stay (p = 0.0033). Hospital region and patient age, race, sex, comorbidity, and income quartile were not associated with a longer length of stay. CONCLUSION Our findings demonstrate that hospital-level characteristics are more important than patient-level characteristics in predicting length of stay in patients undergoing proton beam therapy while hospitalized. Patients undergoing proton beam therapy while hospitalized at large- and medium-sized hospitals had longer lengths of stay than those at small-sized hospitals. Additionally, publicly owned hospitals were associated with prolonged length of stay compared to private hospitals. The underlying reason for this difference in length of stay is unclear but may suggest different management strategies, protocols, and discharge criteria for patients receiving proton beam therapy in larger and publicly-owned hospitals compared to smaller and privately-owned hospitals. Future investigations should explore the underlying causes for these discrepancies and identify potential strategies to shorten unnecessarily prolonged hospital stays in patients undergoing proton beam therapy.
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Affiliation(s)
- K Lin
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ
| | - N Arya
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ
| | - B Laughlin
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - I Zaniletti
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ
| | - C Van Der Walt
- Department of Quantitative Health Sciences, Section of Biostatistics, Mayo Clinic, Scottsdale, AZ
| | - A Bhandarkar
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN
| | - M Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN
| | - T T W Sio
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
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Arya N, Nair NV. PEGASUS McGill courses: a model for educating on current threats to health in the Anthropocene. Med Confl Surviv 2023; 39:264-267. [PMID: 37201919 DOI: 10.1080/13623699.2023.2211698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Affiliation(s)
- Neil Arya
- Balsillie School for International Affairs, University of Waterloo and Wilfrid Laurier Universities, Waterloo, Canada
| | - Navya Vikraman Nair
- Balsillie School for International Affairs, University of Waterloo and Wilfrid Laurier Universities, Waterloo, Canada
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Arya N. How do South Asian seniors in a large Canadian city perceive long-term care? Can Fam Physician 2023; 69:e181-e188. [PMID: 37704237 PMCID: PMC10498910 DOI: 10.46747/cfp.6909e181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To understand how community-dwelling South Asian older adults understand and envision long-term care (LTC). DESIGN Descriptive qualitative study. SETTING The Region of Waterloo in Ontario. PARTICIPANTS Participants included 3 key informants (geriatrician, social worker, and medical translator, all South Asian), 1 family caregiver, and 15 community-dwelling South Asian adults aged 65 and older. METHODS In-depth interviews and focus groups were recorded, transcribed verbatim, and analyzed using a framework analysis approach. MAIN FINDINGS High-level themes included the emotional impacts of failure to provide culturally competent care, such as fear and isolation; a desire for a model of culturally competent care with an emphasis on food and language; and the need for LTC to be more integrated with the broader community and connected to families. CONCLUSION As the delivery of LTC is rethought in this country, there is the potential to deliver on the promise of culturally competent care for this growing population. These findings are among the first to communicate the LTC care needs of South Asian older adults in their own words.
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Affiliation(s)
- Neil Arya
- Assistant Clinical Professor at McMaster University in Hamilton, Ont; Fellow at the Balsillie School of International Affairs in Waterloo, Ont; and Director of the Centre for Family Medicine Refugee Health Clinic in Kitchener, Ont
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Arya N, Geurguis M, Vereecken-Smith C, Ponka D. Snapshot of family medicine around the world: Introducing the global family medicine website. Can Fam Physician 2023; 69:330-336. [PMID: 37172985 PMCID: PMC10177649 DOI: 10.46747/cfp.6905330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To develop an interactive, living map of family medicine training and practice; and to appreciate the role of family medicine within, and its effect on, health systems across the world. COMPOSITION OF THE COMMITTEE A subgroup of the College of Family Physicians of Canada's Besrour Centre for Global Family Medicine developed connections with selected international colleagues with expertise in international family medicine practice and teaching, health systems, and capacity building to map family medicine globally. In 2022, this group received support from the Foundation for Advancing Family Medicine's Trailblazers initiative to advance this work. METHODS In 2018 groups of Wilfrid Laurier University (Waterloo, Ont) students conducted broad searches of relevant articles about family medicine in different regions and countries around the world; they conducted focused interviews and then synthesized and verified information, developing a database of family medicine training and practice around the world. Outcome measures were age of family medicine training programs and duration and type of family medicine postgraduate training. REPORT To approach the question of how delivery of the family medicine model of primary care can affect health system performance, relevant data on family medicine were collated-the presence, nature, duration, and type of training and role within health care systems. The website https://www.globalfamilymedicine.org now has up-to-date country-level data on family medicine practice around the world. This publicly available information will allow such data to be correlated together with health system outputs and outcomes and will be updated as necessary through a wiki-type process. While Canada and the United States only have residency training, countries such as India have master's or fellowship programs, in part accounting for the complexity of the discipline. The maps also identify where family medicine training does not yet exist. CONCLUSION Mapping family medicine around the world will allow researchers, policy makers, and health care workers to have an accurate picture of family medicine and its impact using relevant, up-to-date information. The group's next aim is to develop data on parameters by which performance in various domains can be measured across settings and to display these in an accessible form.
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Affiliation(s)
- Neil Arya
- Family physician at and Founder and Director of the Centre for Family Medicine Refugee Health Clinic in Kitchener, Ont; Fellow at the Balsillie School for International Affairs in Waterloo, Ont; President of the PEGASUS (Peace, Global Health, Sustainability) Institute; Founding Director of the Office of Global Health at Western University in London, Ont; Scholar-in-Residence and Fellow at the International Migration Research Centre at Wilfrid Laurier University in Waterloo; and Assistant Clinical Professor in Family Medicine at McMaster University in Hamilton, Ont
| | - Michael Geurguis
- Medical student at the University of Toronto in Ontario and a master's student in the Dalla Lana School of Public Health at the University of Toronto
| | - Celine Vereecken-Smith
- Third-year medical student in the Michael G. DeGroote School of Medicine at McMaster University
| | - David Ponka
- Family doctor and Director of the Besrour Centre for Global Family Medicine at the College of Family Physicians of Canada, and Professor in the Department of Family Medicine at the University of Ottawa in Ontario
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Lin K, Arya N, Yu N, Sio T. 9-Year Analysis of Trends in the Radiation Oncology Residency Match. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tong CE, Lopez KJ, Chowdhury D, Arya N, Elliott J, Sims-Gould J, Grindrod K, Stolee P. Understanding racialised older adults' experiences of the Canadian healthcare system, and codesigning solutions: protocol for a qualitative study in nine languages. BMJ Open 2022; 12:e068013. [PMID: 36216419 PMCID: PMC9557314 DOI: 10.1136/bmjopen-2022-068013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Racialised immigrant older adults (RIOAs) in Canada have poorer self-rated health and are more likely to report chronic conditions, while they concurrently experience well-documented challenges in navigating and accessing the healthcare system. There is strong evidence that patient and caregiver engagement in their healthcare leads to improved management of chronic disease and better health outcomes. International research suggests that engagement has the potential to reduce health disparities and improve quality of care. We aim to (1) describe what role(s) RIOAs are/are not taking in their own healthcare, from the perspectives of participant groups (RIOAs, caregivers and healthcare providers (HCPs)); and (2) develop a codesign process with these participants, creating linguistically aligned and culturally aligned tools, resources or solutions to support patient engagement with RIOAs. METHODS AND ANALYSIS Using a cross-cultural participatory action research approach, our work will consist of three phases: phase 1, strengthen existing partnerships with RIOAs and appropriate agencies and cultural associations; phase 2, on receipt of informed consent, in-depth interviews with RIOAs and caregivers (n=~45) and HCPs (n=~10), professionally interpreted as needed. Phase 3, work with participants, in multiple interpreted sessions, to codesign culturally sensitive and linguistically sensitive/aligned patient engagement tools. We will conduct this research in the Waterloo-Wellington region of Ontario, in Arabic, Bangla, Cantonese, Hindi, Mandarin, Punjabi, Tamil and Urdu, plus English. Data will be transcribed, cleaned and entered into NVivo V.12, the software that will support team-based analysis. Analysis will include coding, theming and interpreting the data, and, preparing narrative descriptions that summarise each language group and each participant group (older adults, caregivers and HCPs), and illustrate themes. ETHICS AND DISSEMINATION Ethics clearance was obtained through the University of Waterloo Office of Research Ethics (ORE #43297). Findings will be disseminated through peer-reviewed publications, presentations and translated summary reports for our partners and participants.
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Affiliation(s)
- Catherine E Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Kimberly J Lopez
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Diya Chowdhury
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jacobi Elliott
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Joanie Sims-Gould
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Hynie M, Jaimes A, Oda A, Rivest-Beauregard M, Perez Gonzalez L, Ives N, Ahmad F, Kuo BCH, Arya N, Bokore N, McKenzie K. Assessing Virtual Mental Health Access for Refugees during the COVID-19 Pandemic Using the Levesque Client-Centered Framework: What Have We Learned and How Will We Plan for the Future? Int J Environ Res Public Health 2022; 19:ijerph19095001. [PMID: 35564397 PMCID: PMC9103707 DOI: 10.3390/ijerph19095001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022]
Abstract
During the COVID-19 pandemic, mental health services rapidly transitioned to virtual care. Although such services can improve access for underserved populations, they may also present unique challenges, especially for refugee newcomers. This study examined the multidimensional nature of access to virtual mental health (VMH) care for refugee newcomers during the COVID-19 pandemic, using Levesque et al.'s Client-Centered Framework for Assessing Access to Health Care. One hundred and eight structured and semi structured interviews were conducted in four Canadian provinces (8 community leaders, 37 newcomer clients, 63 mental health or service providers or managers). Deductive qualitative analysis, based on the Client-Centered Framework, identified several overarching themes: challenges due to the cost and complexity of using technology; comfort for VMH outside clinical settings; sustainability post-COVID-19; and communication and the therapeutic alliance. Mental health organizations, community organizations, and service providers can improve access to (virtual) mental health care for refugee newcomers by addressing cultural and structural barriers, tailoring services, and offering choice and flexibility to newcomers.
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Affiliation(s)
- Michaela Hynie
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
- Center for Refugee Studies, York University, Toronto, ON M3J 1P3, Canada; (A.O.); (L.P.G.)
- Correspondence:
| | - Annie Jaimes
- Department of Psychoeducation, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada;
- Sherpa University Institute, Montreal, QC H3N 1Y9, Canada;
| | - Anna Oda
- Center for Refugee Studies, York University, Toronto, ON M3J 1P3, Canada; (A.O.); (L.P.G.)
| | | | - Laura Perez Gonzalez
- Center for Refugee Studies, York University, Toronto, ON M3J 1P3, Canada; (A.O.); (L.P.G.)
| | - Nicole Ives
- Sherpa University Institute, Montreal, QC H3N 1Y9, Canada;
- School of Social Work, McGill University, Montreal, QC H3A 1B9, Canada
| | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, ON M3J 1P3, Canada;
| | - Ben C. H. Kuo
- Department of Psychology, University of Windsor, Windsor, ON N9B 3P4, Canada;
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, ON L8S 3L8, Canada;
| | - Nimo Bokore
- School of Social Work, Carleton University, Ottawa, ON K1S 5B6, Canada;
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Tabari P, Amini M, Arya N, Moghadami M, Khoshnood K, Shokripour M, Omidifar N. The role of educating health-care personnel in prevention, diagnosis, or treatment of COVID-19: A narrative mini review. J Educ Health Promot 2021; 10:476. [PMID: 35233423 PMCID: PMC8826867 DOI: 10.4103/jehp.jehp_328_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/24/2021] [Indexed: 06/14/2023]
Abstract
Front-line clinicians and health-care workers need to be educated to provide care in critical situations such as large-scale catastrophes and pandemics. This narrative review is focused on investigating educational strategies in confrontation with coronavirus disease 2019 (COVID-19) pandemic. We conducted a literature search in December 2020 through LitCovid, PubMed, ERIC, and Cochrane Library in order to retrieve relevant studies regarding the role of education in prevention, diagnosis, and treatment of COVID-19. There were 12 reviewed studies related to this specific subject. The articles selected for this study demonstrated that education and training had a positive impact on the knowledge and attitude of the participants and also the educational interventions, whether they were simulation-based or other formats of training, would be deemed crucial for enhancing participants' level of perceptions and confidence. Therefore, it is highly recommended that public health policymakers consider this important issue.
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Affiliation(s)
- Parinaz Tabari
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neil Arya
- Health Sciences, Wilfrid Laurier University, Waterloo, Canada
| | - Mohsen Moghadami
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Mansoureh Shokripour
- Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Navid Omidifar
- Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center of Quran, Hadith and Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Arya N, Redditt VJ, Talavlikar R, Holland T, Brindamour M, Wright V, Saad A, Beukeboom C, Coakley A, Rashid M, Pottie K. Caring for refugees and newcomers in the post-COVID-19 era: Evidence review and guidance for FPs and health providers. Can Fam Physician 2021; 67:575-581. [PMID: 34385202 DOI: 10.46747/cfp.6708575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To guide clinicians working in a range of primary care clinical settings on how to provide effective care and support for refugees and newcomers during and after the coronavirus disease 2019 (COVID-19) pandemic. SOURCES OF INFORMATION The described approach integrates recommendations from evidence-based clinical guidelines on refugee health and COVID-19, practical lessons learned from Canadian Refugee Health Network clinicians working in a variety of primary care settings, and contributions from persons with lived experience of forced migration. MAIN MESSAGE The COVID-19 pandemic has amplified health and social inequities for refugees, asylum seekers, undocumented migrants, transient migrant workers, and other newcomers. Refugees and newcomers face front-line exposure risks, difficulties accessing COVID-19 testing, exacerbation of mental health concerns, and challenges accessing health care, social, and settlement supports. Existing guidelines for clinical care of refugees are useful, but creative case-by-case strategies must be employed to overcome additional barriers in the context of COVID-19 and new care environments, such as the need for virtual interpretation and digital literacy skills. Clinicians can address inequities and advocate for improved services in collaboration with community partners. CONCLUSION The COVID-19 pandemic is amplifying structural inequities. Refugees and newcomers require and deserve effective health care and support during this challenging time. This article outlines practical approaches and advocacy priorities for providing care in the COVID-19 context.
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Affiliation(s)
- Neil Arya
- Assistant Clinical Professor at McMaster University in Hamilton, Ont, Fellow in the International Migration Research Centre at Wilfrid Laurier University in Waterloo, Ont, and Director of the Centre for Family Medicine Refugee Health Clinic in Kitchener, Ont.
| | - Vanessa J Redditt
- Family physician at the Crossroads Clinic at Women's College Hospital in Toronto, Ont, and Clinical Lecturer in the Department of Family and Community Medicine and the Dalla Lana School of Public Health at the University of Toronto
| | - Rachel Talavlikar
- Family physician at the Mosaic Refugee Health Clinic in Calgary, Alta, and Clinical Lecturer in the Department of Family Medicine at the University of Calgary
| | - Tim Holland
- Medical Director of the Newcomer Health Clinic in Halifax, NS, and Assistant Professor in the Faculty of Medicine at Dalhousie University in Halifax
| | - Mahli Brindamour
- Assistant Professor in the Faculty of Medicine at the University of Saskatchewan in Saskatoon
| | - Vanessa Wright
- Adjunct Lecturer in the Lawrence Bloomberg Faculty of Nursing at the University of Toronto and Women's College Hospital
| | - Ammar Saad
- Research Associate in the School of Epidemiology and Public Health at the University of Ottawa and the Bruyère Research Institute in Ottawa, Ont
| | - Carolyn Beukeboom
- Adjunct Lecturer in the Arthur Labatt Family School of Nursing at Western University in London, Ont, and a nurse practitioner at the Centre for Family Medicine Refugee Health Clinic in Kitchener
| | - Annalee Coakley
- Physician Lead at the Mosaic Refugee Health Clinic and Clinical Assistant Professor in the Department of Family Medicine at the University of Calgary
| | - Meb Rashid
- Medical Director of the Crossroads Clinic at Women's College Hospital and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto
| | - Kevin Pottie
- Scientist in the Bruyère Research Institute and the Institut du Savoir Montfort in Ottawa, and Professor in the Department of Family Medicine at the University of Ottawa
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Arya N, Redditt VJ, Talavlikar R, Holland T, Brindamour M, Wright V, Saad A, Beukeboom C, Coakley A, Rashid M, Pottie K. Soigner les réfugiés et les nouveaux arrivants à l'ère post-COVID-19: Revue des données probantes et conseils pour les MF et les professionnels de la santé. Can Fam Physician 2021; 67:e209-e216. [PMID: 34385214 DOI: 10.46747/cfp.6708e209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIF Guider les cliniciens qui travaillent dans divers milieux cliniques de soins primaires quant aux façons de prodiguer des soins et du soutien efficaces aux réfugiés et aux nouveaux arrivants, durant et après la pandémie de la maladie à coronavirus 2019 (COVID-19). SOURCES D'INFORMATION L'approche décrite intègre les recommandations tirées de guides de pratique clinique fondés sur des données probantes portant sur la santé des réfugiés et la COVID-19, de leçons concrètes apprises de cliniciens du Réseau canadien sur la santé des réfugiés (Canadian Refugee Health Network) qui travaillent dans divers milieux de soins primaires, ainsi que de contributions de personnes ayant vécu l'expérience d'une migration forcée. MESSAGE PRINCIPAL La pandémie de la COVID-19 a amplifié les iniquités sociales et de santé pour les réfugiés, les demandeurs d'asile, les migrants sans papiers, les travailleurs transitoires de l'étranger et d'autres nouveaux arrivants. Les réfugiés et les nouveaux arrivants sont confrontés à des risques d'exposition en première ligne, à des problèmes d'accès aux tests de dépistage de la COVID-19, à l'exacerbation des préoccupations liées à la santé mentale, et aux difficultés d'accéder aux soins de santé et aux services sociaux et d'établissement. Les lignes directrices existantes sur les soins cliniques aux réfugiés sont utiles, mais des stratégies créatives au cas par cas doivent être utilisées pour surmonter les obstacles additionnels dans le contexte de la COVID-19 et des nouveaux environnements de soins, comme la nécessité d'une traduction simultanée virtuelle et d'habiletés en littératie numérique. Les cliniciens peuvent lutter contre les iniquités et plaider en faveur de meilleurs services en collaboration avec des partenaires communautaires. CONCLUSION La pandémie de la COVID-19 amplifie les iniquités structurelles. Les réfugiés et les nouveaux arrivants nécessitent et méritent des soins de santé et du soutien efficaces durant ces moments éprouvants. Cet article présente des approches pratiques et les priorités en matière de défense des droits pour offrir des soins dans le contexte de la COVID-19.
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Affiliation(s)
- Neil Arya
- Professeur clinicien adjoint à l'Université McMaster à Hamilton (Ontario), boursier au International Migration Research Centre à l'Université Wilfrid-Laurier à Waterloo (Ontario) et directeur du Centre for Family Medicine Refugee Health Clinic à Kitchener (Ontario)
| | - Vanessa J Redditt
- Médecin de famille à la Clinique Crossroads de l'Hôpital Women's College à Toronto (Ontario) et chargée de cours cliniques au Département de médecine familiale et communautaire et à l'École de santé publique Dalla Lana de l'Université de Toronto
| | - Rachel Talavlikar
- Médecin de famille à la Mosaic Refugee Health Clinic à Calgary (Alberta) et chargée de cours cliniques au Département de médecine familiale de l'Université de Calgary
| | - Tim Holland
- Directeur médical de la Newcomer Health Clinic à Halifax (N.-É.) et professeur adjoint à la Faculté de médecine de l'Université Dalhousie à Halifax
| | - Mahli Brindamour
- Professeure adjointe à la Faculté de médecine de l'Université de la Saskatchewan à Saskatoon
| | - Vanessa Wright
- Chargée de cours adjointe à l'École Lawrence Bloomberg de sciences infirmières à l'Université de Toronto et à l'Hôpital Women's College
| | - Ammar Saad
- Associé de recherche à l'École d'épidémiologie et de santé publique à l'Université d'Ottawa et à l'Institut de recherche Bruyère à Ottawa (Ontario)
| | - Carolyn Beukeboom
- Chargée de cours adjointe à l'École de sciences infirmières Arthur Labatt de l'Université Western à London (Ontario) et infirmière praticienne à la Clinique de santé des réfugiés du Centre de médecine familiale à Kitchener
| | - Annalee Coakley
- Médecin en chef à la Mosaic Refugee Health Clinic et professeure clinicienne adjointe au Département de médecine familiale de l'Université de Calgary
| | - Meb Rashid
- Directeur médical de la Clinique Crossroads de l'Hôpital Women's College et professeur adjoint au Département de médecine familiale et communautaire de l'Université de Toronto
| | - Kevin Pottie
- Scientifique à l'Institut de recherche Bruyère et à l'Institut du Savoir Montfort à Ottawa, et professeur au Département de médecine familiale à l'Université d'Ottawa
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14
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Scholtes R, Muskiet M, Van Baar M, Greasley P, Karlsson C, Hammarsterdt A, Arya N, Van Raalte D, Heerspink H. Natriuretic effect of 2 weeks of dapagliflozin treatment in patients with type 2 diabetes and preserved kidney function: results of the DAPASALT trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce the risk for heart failure hospitalization, potentially by inducing sodium excretion, osmotic diuresis and plasma volume contraction, leading to more favorable systemic hemodynamic function. However, this hypothesis has never been formally investigated as no studies have assessed cumulative sodium excretion with SGLT2 inhibition during standardized sodium intake.
Methods
We conducted a mechanistic open label study in patients with type 2 diabetes mellitus (T2D) with preserved kidney function, who were receiving a standardized sodium intake (150 mmol/day) to evaluate the acute effects (average day 2–4), effects at steady state (average day 12–14) and effects during three days wash-out of dapagliflozin on sodium balance and blood pressure. Primary outcome measure was 24-hr sodium excretion during the acute phase. Secondary outcomes included 24-hr glucose excretion and 24-hr blood pressure at each time period and sodium excretion at steady state and during follow-up.
Results
Seventeen patients with T2D were enrolled (64.7% male, mean ± SD age 64.24±7.33 years, weight 99.54±17.36 kg, eGFR 94.53±10.10 mL/min/1.73m2, HbA1c 7.20±0.63%). Average sodium excretion at baseline was 147±32 mmol/24 hr, which did not significantly change during treatment (Change at day 2–4 [95% CI]: −5.21 [19.54, 9.12] mmol/24 hr; Change at Day 12–14 [95% CI]: 3.69 [−24.82, 32.20] mmol/24 hr). However, sodium excretion was reduced following washout compared to end of treatment (Change at Day 15–17 [95% CI]: −16.72 [−34.11, 0.66] mmol/24 hr). Glucose excretion was significantly increased throughout the study. Systolic blood pressure was 127.0±10.3 mmHg at baseline and significantly reduced at Day 3 [95% CI]: −5.27 [−8.55, −1.99] mmHg and Day 14 [95% CI]: −7.10 [−10.04, −4.16] mmHg compared to baseline and remained lower following washout.
Conclusions
This study shows that, during a standardized sodium intake, the SGLT-2 inhibitor dapagliflozin acutely reduces blood pressure without altering sodium excretion, indicating possible direct vascular effects independent of sodium balance.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Astra Zeneca
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Affiliation(s)
- R Scholtes
- Amsterdam UMC - Location VUmc, Amsterdam, Netherlands (The)
| | - M.H.A Muskiet
- Amsterdam UMC - Location VUmc, Amsterdam, Netherlands (The)
| | - M.J.B Van Baar
- Amsterdam UMC - Location VUmc, Amsterdam, Netherlands (The)
| | | | | | | | - N Arya
- Astra Zeneca, London, United Kingdom
| | - D.H Van Raalte
- Amsterdam UMC - Location VUmc, Amsterdam, Netherlands (The)
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Abstract
At the end of 2019, a new virus named SARS-CoV-2 emerged in China, provoking coronavirus disease 2019 or COVID-19. Self-isolation and quarantine as key strategies to overcoming the spread of the disease have had major, micro, and macroscopic consequences. This commentary, therefore, seeks to review critical factors impacting the COVID-19 pandemic through the spectrum of levels, categorising effects in the WHO's ecological framework (individual, relational, community, and societal aspects). We further describe the management of the crisis at each level to help guide health personnel, communities, governments, and international policymakers in understanding how their actions fit into a larger picture as they seek to manage the crisis.
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Affiliation(s)
- Parinaz Tabari
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Neil Arya
- Health Sciences, Wilfrid Laurier University, Waterloo, Canada
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Magwood O, Hanemaayer A, Saad A, Salvalaggio G, Bloch G, Moledina A, Pinto N, Ziha L, Geurguis M, Aliferis A, Kpade V, Arya N, Aubry T, Pottie K. Determinants of Implementation of a Clinical Practice Guideline for Homeless Health. Int J Environ Res Public Health 2020; 17:E7938. [PMID: 33138054 PMCID: PMC7663114 DOI: 10.3390/ijerph17217938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/21/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guideline. We completed a mixed-method study to identify determinants of equitable implementation of homeless health guidelines, focusing on the Grading of Recommendations Assessment, Development and Evaluation Feasibility, Acceptability, Cost, and Equity Survey (GRADE-FACE) health equity implementation outcomes. The study included a survey and framework analysis. Eighty-eight stakeholders, including practitioners and 16 persons with lived experience of homelessness, participated in the study. Most participants favourably rated the drafted recommendations' priority status, feasibility, acceptability, cost, equity impact, and intent-to-implement. Qualitative analysis uncovered stakeholder concerns and perceptions regarding "fragmented services". Practitioners were reluctant to care for persons with lived experience of homelessness, suggesting that associated social stigma serves as a barrier for this population to access healthcare. Participants called for improved "training of practitioners" to increase knowledge of patient needs and preferences. We identified several knowledge translation strategies that may improve implementation of guidelines for marginalized populations. Such strategies should be considered by other guideline development groups who aim to improve health outcomes in the context of limited and fragmented resources, stigma, and need for advocacy.
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Affiliation(s)
- Olivia Magwood
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada; (A.H.); (A.S.); (L.Z.)
| | - Amanda Hanemaayer
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada; (A.H.); (A.S.); (L.Z.)
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Ammar Saad
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada; (A.H.); (A.S.); (L.Z.)
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Ginetta Salvalaggio
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Gary Bloch
- Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada;
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Inner City Health Associates, Toronto, ON M5C 1K6, Canada
| | - Aliza Moledina
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Nicole Pinto
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Layla Ziha
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada; (A.H.); (A.S.); (L.Z.)
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Michael Geurguis
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada; (M.G.); (N.A.)
| | - Alexandra Aliferis
- Michael C. DeGroote School of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Victoire Kpade
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Neil Arya
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada; (M.G.); (N.A.)
- Department of Family Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Tim Aubry
- School of Psychology & Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Kevin Pottie
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada; (A.H.); (A.S.); (L.Z.)
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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17
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Pottie K, Kendall CE, Aubry T, Magwood O, Andermann A, Salvalaggio G, Ponka D, Bloch G, Brcic V, Agbata E, Thavorn K, Hannigan T, Bond A, Crouse S, Goel R, Shoemaker E, Wang JZJ, Mott S, Kaur H, Mathew C, Hashmi SS, Saad A, Piggott T, Arya N, Kozloff N, Beder M, Guenter D, Muckle W, Hwang S, Stergiopoulos V, Tugwell P. Lignes directrices de pratique clinique pour les personnes sans-abri, logées précairement, ou ayant connu l’itinérance. CMAJ 2020; 192:E1225-E1241. [PMID: 33051325 PMCID: PMC7588247 DOI: 10.1503/cmaj.190777-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kevin Pottie
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont.
| | - Claire E Kendall
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Tim Aubry
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Olivia Magwood
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Anne Andermann
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Ginetta Salvalaggio
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - David Ponka
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Gary Bloch
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Vanessa Brcic
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Eric Agbata
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Kednapa Thavorn
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Terry Hannigan
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Andrew Bond
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Susan Crouse
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Ritika Goel
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Esther Shoemaker
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Jean Zhuo Jing Wang
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Sebastian Mott
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Harneel Kaur
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Christine Mathew
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Syeda Shanza Hashmi
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Ammar Saad
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Thomas Piggott
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Neil Arya
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Nicole Kozloff
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Michaela Beder
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Dale Guenter
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Wendy Muckle
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Stephen Hwang
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Vicky Stergiopoulos
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
| | - Peter Tugwell
- Centre de recherche en soins de santé primaires C.T. Lamont (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Institut de recherche Bruyère; Département de médecine familiale ( Pottie, Kendall, Ponka, Shoemaker) et École d'épidémiologie et de santé publique (Pottie, Kendall), Université d'Ottawa; Institut de recherche de l'Hôpital d'Ottawa (Kendall, Shoemaker), Ottawa, Ont.; IRSS (Kendall, Shoemaker); Institut du savoir Li Ka Shing (Kendall), Hôpital St. Michael, Toronto, Ont.; École de psychologie (Aubry), Université d'Ottawa, Ottawa, Ont.; Départements de médecine familiale et d'épidémiologie, de biostatistiques et de santé du travail (Andermann), Faculté de médecine, Université McGill, Montréal, Qué.; Département de médecine familiale (Salvalaggio), Faculté de médecine et de dentisterie, Université de l'Alberta, Edmonton, Alta.; Centre de médecine Besrour pour l'avancement de la médecine de famille à l'échelle mondiale (Ponka), Collège des médecins de famille du Canada, Mississauga, Ont.; Département de médecine familiale et communautaire (Bloch), Hôpital St. Michael; Département de médecine familiale et communautaire (Bloch), Faculté de médecine, Université de Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Département de médecine familiale (Brcic), Université de la Colombie-Britannique, Vancouver, C.-B.; Départements de pédiatrie, d'obstétrique et gynécologie et de médecine préventive et santé publique (Agbata), Faculté de médecine, Université autonome de Barcelone; Institut de recherche de l'Hôpital d'Ottawa (Thavorn); École d'épidémiologie et de santé publique (Thavorn), Université d'Ottawa; Institut de recherche Bruyère (Mathew), Ottawa, Ont.; Département de médecine familiale et communautaire (Bond, Goel), Université de Toronto, Toronto, Ont.; Faculté de médecine (Crouse), Université Memorial, St. John's, T.-N.; Département de médecine familiale (Crouse), Université Dalhousie, Halifax, N.-É.; Faculté de médecine (Wang, Kaur, Hashmi), Université d'Ottawa, Ottawa, Ont.; Département de médecine familiale (Mott), Université McGill, Montréal, Qué.; Département des méthodes, des données et de l'impact de la recherche en santé (Piggott, Guenter), Université McMaster, Hamilton, Ont.; scientifique en résidence (Arya), Université Wilfrid Laurier, Waterloo, Ont.; Département de médecine familiale (Arya), Université McMaster, Hamilton, Ont.; Centre des dépendances et de santé mentale (Kozloff, Stergiopoulos); Département de psychiatrie et Institut des politiques de la gestion et de l'évaluation de la santé (Kozloff), Université de Toronto; Département de psychiatrie (Beder), Université de Toronto et Hôpital St. Michael, Toronto, Ont.; Département de médecine familiale (Guenter), Université McMaster, Hamilton, Ont.; Inner City Health (Muckle), Ottawa, Ont.; Centre MAP de solutions en santé urbaine (Hwang), Hôpital St. Michael, Toronto, Ont.; Département de médecine (Tugwell), Université d'Ottawa, Ottawa, Ont
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Affiliation(s)
- Michelle Amri
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Neil Arya
- International Migration Research Centre, Balsillie School for International Affairs, Waterloo, Ontario, Canada.,Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Steve Ferracuti
- Haliburton Highlands Health Services, Haliburton, Ontario, Canada.,Peterborough Regional Health Centre, Peterborough, Ontario, Canada.,Canadian Physicians for Aid and Relief, Toronto, Ontario, Canada
| | - Michael Clarke
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Ponka D, Agbata E, Kendall C, Stergiopoulos V, Mendonca O, Magwood O, Saad A, Larson B, Sun AH, Arya N, Hannigan T, Thavorn K, Andermann A, Tugwell P, Pottie K. The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review. PLoS One 2020; 15:e0230896. [PMID: 32271769 PMCID: PMC7313544 DOI: 10.1371/journal.pone.0230896] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/12/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Individuals who are homeless or vulnerably housed are at an increased risk for mental illness, other morbidities and premature death. Standard case management interventions as well as more intensive models with practitioner support, such as assertive community treatment, critical time interventions, and intensive case management, may improve healthcare navigation and outcomes. However, the definitions of these models as well as the fidelity and adaptations in real world interventions are highly variable. We conducted a systematic review to examine the effectiveness and cost-effectiveness of case management interventions on health and social outcomes for homeless populations. METHODS AND FINDINGS We searched Medline, Embase and 7 other electronic databases for trials on case management or care coordination, from the inception of these databases to July 2019. We sought outcomes on housing stability, mental health, quality of life, substance use, hospitalization, income and employment, and cost-effectiveness. We calculated pooled random effects estimates and assessed the certainty of the evidence using the GRADE approach. Our search identified 13,811 citations; and 56 primary studies met our full inclusion criteria. Standard case management had both limited and short-term effects on substance use and housing outcomes and showed potential to increase hostility and depression. Intensive case management substantially reduced the number of days spent homeless (SMD -0.22 95% CI -0.40 to -0.03), as well as substance and alcohol use. Critical time interventions and assertive community treatment were found to have a protective effect in terms of rehospitalizations and a promising effect on housing stability. Assertive community treatment was found to be cost-effective compared to standard case management. CONCLUSIONS Case management approaches were found to improve some if not all of the health and social outcomes that were examined in this study. The important factors were likely delivery intensity, the number and type of caseloads, hospital versus community programs and varying levels of participant needs. More research is needed to fully understand how to continue to obtain the increased benefits inherent in intensive case management, even in community settings where feasibility considerations lead to larger caseloads and less-intensive follow-up.
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Affiliation(s)
- David Ponka
- Department of Family Medicine, University of Ottawa, Ottawa, ON,
Canada
| | - Eric Agbata
- Faculty of Health Science, University of Roehampton, London, United
Kingdom
| | - Claire Kendall
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
- Department of Family Medicine and School of Epidemiology and Public
Health, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Department of Psychiatry,
University of Toronto, Toronto, ON, Canada
| | - Oreen Mendonca
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
| | - Olivia Magwood
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
| | - Ammar Saad
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa,
ON, Canada
| | - Bonnie Larson
- Department of Family Medicine, University of Calgary, Calgary, AB,
Canada
| | - Annie Huiru Sun
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
| | - Neil Arya
- Department of Health Sciences, Wilfred Laurier University, Waterloo, ON,
Canada
| | - Terry Hannigan
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa,
ON, Canada
| | - Anne Andermann
- Department of Family Medicine and Department of Epidemiology,
Biostatistics and Occupational Health, McGill University, Montreal, QC,
Canada
| | - Peter Tugwell
- Faculty of Medicine, University of Ottawa, Ottawa, ON,
Canada
| | - Kevin Pottie
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research
Institute, Ottawa, ON, Canada
- Department of Family Medicine and School of Epidemiology and Public
Health, University of Ottawa, Ottawa, ON, Canada
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Taherifard E, Molavi Vardanjani H, Arya N, Salehi A. Peace through Health and Medical Education: First Steps in Inclination of Healthcare Workers Toward Conflict-Preventive Activities. Arch Iran Med 2020; 23:S27-S32. [PMID: 32349505 DOI: 10.34172/aim.2020.s6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 10/12/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND The number of deaths and disabilities due to all types of violence has increased; violence and especially war heavily affect public and individual health and all sectors, including the health sector, are responsible for making attempts to take part in mitigation of war effects. However, "peace through health" has not been so far included globally in the curriculum of basic medical schools. The study aims to prepare data on responsibilities that could be devolved to health sector, and the importance and role of education for those health workers who are willing to participate in the peace field. METHODS A systematic search in Web of Science, PubMed, Scopus and ERIC was conducted looking for relevant documents following combination of the key terms: peace, health and education. RESULTS Health professionals consider war as a serious contagious disease that needs to be prevented like any other diseases. Prevention maneuvers at the primordial, primary, secondary and tertiary stages are important tasks that can be carried out by health professionals; there is an increasing demand for establishment of some courses; the roles and the manner of performing these tasks are not part of medical curriculum and for better execution of these roles, peace through health courses should be developed and then integrated to the current curriculum of health-related universities. CONCLUSION The work of developing peace through health courses has been started before and it will continue until it completely becomes an accepted global course.
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Affiliation(s)
- Erfan Taherifard
- MPH Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Neil Arya
- Family Medicine (part-time) McMaster University, Adjunct Professor Environment and Resource Studies University of Waterloo, Waterloo, Canada
| | - Alireza Salehi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Amini M, Shams M, Khosravi MB, Milen A, Arya N. Educating Health Science Students About Peace through Health Topic; A Panel Discussion. Arch Iran Med 2020; 23:S60-S61. [PMID: 32349512 DOI: 10.34172/aim.2020.s13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 10/12/2019] [Indexed: 11/09/2022]
Abstract
This report describes an experience of the first international health for peace conference held in November 2018 in Shiraz University of Medical Sciences. This paper discusses the panel on peace education in medical and paramedical schools and the way for the future.
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Affiliation(s)
- Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mesbah Shams
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Bagher Khosravi
- Shiraz Anesthesiology and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Neil Arya
- Fellow International Migration Research Centre and Balsillie School for International Affairs Adjunct Professor and Scholar in Residence Wilfrid Laurier University, Assistant Clinical Professor Family Medicine (part-time) McMaster University, Adjunct Professor Family Medicine Western University, Adjunct Professor Environment and Resource Studies University of Waterloo, Waterloo, Canada
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22
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Jalan D, Morakis H, Arya N, Tcholakov Y, Carpenter J, Cherniak W. Global health training in Canadian family medicine residency programmes. Fam Med Community Health 2020; 8:e000250. [PMID: 32201550 PMCID: PMC7073781 DOI: 10.1136/fmch-2019-000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Canadian family medicine (FM) residency programmes are responding to the growing demand to provide global health (GH) education to their trainees; herein, we describe the various GH activities (GHAs) offered within Canadian FM programmes. Design A bilingual online survey was sent out to all 17 Canadian FM program directors (PDs) and/or an appointed GH representative. Setting Online survey via Qualtrics Participants All 17 Canadian FM PDs and/or an appointed GH representative. Results The response rate was 100% and represented 3250 first-year and second-year FM residents across English and French Canada. All schools stated that they participate in some form of GHAs. There was variation in the level of organisation, participation and types of GHAs offered. Overall, most GHAs are optional, and there is a large amount of variation in terms of resident participation. Approximately one third of programmes receive dedicated funding for their GHAs, and two thirds wish to increase the scope/variety of GHAs. Conclusion These results suggest nationwide interest in developing a workforce trained in GH, but show great discrepancies in training, implementation and education.
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Affiliation(s)
- Divyanshi Jalan
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Helene Morakis
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neil Arya
- McMaster University, Hamilton, Ontario, Canada
| | - Yassen Tcholakov
- Department of Epidemiology, Biostatistics, Occupational Health and Public Health, McGill University, Montreal, Québec, Canada
| | - Jennifer Carpenter
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - William Cherniak
- Bridge to Health Medical and Dental, Toronto, Ontario, Canada.,Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
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23
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Pottie K, Kendall CE, Aubry T, Magwood O, Andermann A, Salvalaggio G, Ponka D, Bloch G, Brcic V, Agbata E, Thavorn K, Hannigan T, Bond A, Crouse S, Goel R, Shoemaker E, Wang JZJ, Mott S, Kaur H, Mathew C, Hashmi SS, Saad A, Piggott T, Arya N, Kozloff N, Beder M, Guenter D, Muckle W, Hwang S, Stergiopoulos V, Tugwell P. Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience. CMAJ 2020; 192:E240-E254. [PMID: 32152052 PMCID: PMC7062440 DOI: 10.1503/cmaj.190777] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kevin Pottie
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont.
| | - Claire E Kendall
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Tim Aubry
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Olivia Magwood
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Anne Andermann
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Ginetta Salvalaggio
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - David Ponka
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Gary Bloch
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Vanessa Brcic
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Eric Agbata
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Kednapa Thavorn
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Terry Hannigan
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Andrew Bond
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Susan Crouse
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Ritika Goel
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Esther Shoemaker
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Jean Zhuo Jing Wang
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Sebastian Mott
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Harneel Kaur
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Christine Mathew
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Syeda Shanza Hashmi
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Ammar Saad
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Thomas Piggott
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Neil Arya
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Nicole Kozloff
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Michaela Beder
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Dale Guenter
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Wendy Muckle
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Stephen Hwang
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Vicky Stergiopoulos
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
| | - Peter Tugwell
- C.T. Lamont Primary Health Care Research Centre (Pottie, Kendall, Magwood, Shoemaker, Saad, Hannigan, Wang, Kaur), Bruyère Research Institute; Department of Family Medicine (Pottie, Kendall, Ponka, Shoemaker), and School of Epidemiology and Public Health (Pottie, Kendall), University of Ottawa; Ottawa Hospital Research Institute (Kendall, Shoemaker), Ottawa, Ont.; ICES (Kendall, Shoemaker); Li Ka Shing Knowledge Institute (Kendall), St. Michael's Hospital, Toronto, Ont.; School of Psychology (Aubry), University of Ottawa, Ottawa, Ont.; Departments of Family Medicine, and Epidemiology, Biostatistics and Occupational Health (Andermann), Faculty of Medicine, McGill University, Montréal, Que.; Department of Family Medicine (Salvalaggio), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Besrour Centre for Global Family Medicine (Ponka), College of Family Physicians of Canada, Mississauga, Ont.; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Department of Family and Community Medicine (Bloch), Faculty of Medicine, University of Toronto; Inner City Health Associates (Bloch, Bond, Hwang, Goel), Toronto, Ont.; Department of Family Practice (Brcic), University of British Columbia, Vancouver, BC; Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine and Public Health (Agbata), Faculty of Medicine, Universitat Autònoma de Barcelona; Ottawa Hospital Research Institute (Thavorn); School of Epidemiology and Public Health (Thavorn), University of Ottawa; Bruyère Research Institute (Mathew), Ottawa, Ont.; Department of Family and Community Medicine (Bond, Goel), University of Toronto, Toronto, Ont.; Faculty of Medicine (Crouse), Memorial University, St. John's, NL; Department of Family Medicine (Crouse), Dalhousie University, Halifax, NS; Faculty of Medicine (Wang, Kaur, Hashmi), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Mott), McGill University, Montréal, Que.; Department of Health Research Methods, Evidence, and Impact (Piggott, Guenter), McMaster University, Hamilton, Ont.; scholar in residence (Arya), Wilfrid Laurier University, Waterloo, Ont.; Department of Family Medicine (Arya), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Kozloff, Stergiopoulos); Department of Psychiatry, and Institute of Health Policy, Management and Evaluation (Kozloff), University of Toronto; Department of Psychiatry (Beder), University of Toronto and St. Michael's Hospital, Toronto, Ont.; Department of Family Medicine (Guenter), McMaster University, Hamilton, Ont.; Ottawa Inner City Health (Muckle), Ottawa, Ont.; MAP Centre for Urban Health Solutions (Hwang), St. Michael's Hospital, Toronto, Ont.; Department of Medicine (Tugwell), University of Ottawa, Ottawa, Ont
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Ponka D, Arya N, Malboeuf V, Leung C, Wilson CR, Israel K, Jantsch AG, Cuba-Fuentes MS, Michaelides O, Rouleau K. The Contribution of Family Medicine and Family Medicine Leaders to Primary Health Care Development in Americas - from Alma-Ata to Astana and beyond. Cien Saude Colet 2019; 25:1215-1220. [PMID: 32267424 DOI: 10.1590/1413-81232020254.29422019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 10/23/2019] [Indexed: 11/21/2022] Open
Abstract
Since 2012, the Besrour Centre for Global Family Medicine at the College of Family Physician of Canada has brought together its partners from the Americas annually, to reflect on the evolution of Family Medicine on the continent since Alma-Ata, and to look forward to future challenges. Family doctors are but one element of a strong health system. Family Medicine provides key ingredients to respond to population health needs especially as countries move through the epidemiological transition to face larger burdens of chronic disease and multimorbidity. In this paper, we provide a high-level overview of the state of Family Medicine on the continent. We then analyze trends in the education of family physicians to face this changing landscape, including the emphasis on the leader role of future family physicians. Postgraduate programs in Family Medicine in the Americas are placing increasing emphasis on teaching collaborative care in view of creating truly interdisciplinary health teams for the benefit of patients.
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Affiliation(s)
- David Ponka
- Besrour Centre for Global Family Medicine, College of Family Physicians of Canada c/o Department of Family Medicine. 75 rue Bruyere, Ottawa, Ontario K1N 1C8, Canada.
| | - Neil Arya
- Family Medicine, McMaster University. Hamilton ON Canada
| | | | | | | | | | | | | | - Ophelia Michaelides
- Besrour Centre for Global Family Medicine, College of Family Physicians of Canada c/o Department of Family Medicine. 75 rue Bruyere, Ottawa, Ontario K1N 1C8, Canada.
| | - Katherine Rouleau
- Besrour Centre for Global Family Medicine, College of Family Physicians of Canada c/o Department of Family Medicine. 75 rue Bruyere, Ottawa, Ontario K1N 1C8, Canada.
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Affiliation(s)
- Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Neil Arya
- Health Sciences, Wilfrid Laurier University , Waterloo , ON , Canada
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Beukeboom C, Arya N. Prevalence of Nutritional Deficiencies Among Populations of Newly Arriving Government Assisted Refugee Children to Kitchener/Waterloo, Ontario, Canada. J Immigr Minor Health 2019; 20:1317-1323. [PMID: 29611017 DOI: 10.1007/s10903-018-0730-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined the variation among ethnic populations in prevalence of anemia, vitamin D and B12 deficiencies among refugee children. A retrospective chart review of 388 government assisted refugee children ≤ 16 years of age, seen at the Refugee Health Clinic in Kitchener, Canada from January 2009 to December 2014 was conducted. Vitamin D levels were only collected until December 1st 2010 (116 children). 15.7% were anemic (25% < 5 years, 8.7% 5-11 years, and 18.3% 12-16 years old) with Somali children having the lowest hemoglobin levels compared to those from Iraq, Afghanistan and Myanmar. 53.5% were vitamin D deficient (25(OH)D < 50 nmol/L), seen most commonly in Iraqis and Afghans. 11.2% had vitamin B12 levels < 150 pmol/L. Providers' knowledge of prevalence of nutritional deficiencies related to region of origin, can guide appropriate screening and treatment options to promote longer term cognitive, physical and developmental health.
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Affiliation(s)
- Carolyn Beukeboom
- School of Nursing, Western University, London, ON, Canada. .,School of Nursing, McMaster University, Hamilton, ON, Canada. .,, London, ON, Canada.
| | - Neil Arya
- Centre for Family Medicine Refugee Health Clinic, Waterloo, ON, Canada.,Family Medicine McMaster University, Hamilton, ON, Canada.,Family Medicine Western University, London, ON, Canada
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27
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Arya N. From darkness to light-Robert J Lifton's the climate swerve - understanding human nature to avert global catastrophe. Med Confl Surviv 2018; 34:144-151. [PMID: 30205720 DOI: 10.1080/13623699.2018.1518287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Neil Arya
- a Department of Environment and Resource Studies , University of Waterloo , Waterloo , Ontario , Canada
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Affiliation(s)
- Neil Arya
- a University of Waterloo , Ontario , Canada
- b University of Western Ontario , Ontario , Canada
- c McMaster University , Ontario , Canada ,
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29
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Arya N. Victor W. Sidel (7 July 1931-30 January 2018). Med Confl Surviv 2018; 34:1-2. [PMID: 29619855 DOI: 10.1080/13623699.2018.1457240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Neil Arya
- a University of Waterloo , Canada
- b University of Western Ontario , Canada
- c McMaster University , Canada
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Abstract
What is ‘mental health’ during the societal crisis and upheaval occasioned by war? Perhaps the primary psychological effect of war on victims generally is through their witnessing the destruction of a social world embodying their history, identity, values and roles of everyday life. Such suffering has largely to be resolved collectively, in this same social world, albeit one which has been intentionally weakened. Thus, as the World Health Organization and other authorities confirm, the major thrust of humanitarian interventions must be towards the depleted social fabric and its institutions, for herein lie the sources of resilience and capacity for recovery for all (Kawachi & Berkman, 2000). Beyond that, history has shown that social or political reform is the best medicine, and for victims of oppressive violence this means acknowledgement and justice (Summerfield, 2002).
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31
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Arya N, Dahlman B, Gibson C, Ponka D, Haq C, Rouleau K, Hansel S. Developing family practice to respond to global health challenges: The Besrour Papers: a series on the state of family medicine in the world. Can Fam Physician 2017; 63:602-606. [PMID: 28807953 PMCID: PMC5555325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. COMPOSITION OF THE COMMITTEE A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally. METHODS Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts. REPORT With the failure of vertical, disease-oriented models to provide sustained improvements in health outcomes, the need to develop integrated primary care involving the most appropriate health professionals for differing contexts is becoming apparent worldwide. Health system planning is required to develop policies on health professional training to achieve this. Advocating and offering appropriate incentives for, and coordination of, local opportunities within the health system also becomes paramount. The adaptability and generalist nature of family medicine allows it to respond to the unique needs of a given population. Family physicians with adequate financial and physical resources can function most effectively as members of interdisciplinary teams, thus providing valuable, comprehensive health services in any area of the world.
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Affiliation(s)
- Neil Arya
- Assistant Clinical Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont, and Adjunct Professor in the Department of Family Medicine at Western University in London, Ont
| | - Bruce Dahlman
- Head of the Department of Family Medicine and Community Care in the School of Medicine and Health Sciences at Kabarak University in Kenya at the time of the review
| | - Christine Gibson
- Clinical Assistant Professor in the Department of Family Medicine of the Cumming School of Medicine at the University of Calgary in Alberta and Executive Director of the Global Familymed Foundation
| | - David Ponka
- Associate Professor in the Department of Family Medicine at the University of Ottawa in Ontario and Lead of the Besrour Papers Working Group.
| | - Cynthia Haq
- Professor of Family Medicine and Community Health in the School of Medicine and Public Health at the University of Wisconsin in Madison
| | - Katherine Rouleau
- Associate Professor and Director of the Global Health Program in the Department of Family and Community Medicine at St Michael's Hospital and the University of Toronto in Ontario, and Director of the Besrour Centre at the College of Family Physicians of Canada
| | - Stephanie Hansel
- Senior Manager at Juzoor, a health and social development non-governmental organization in Ramallah, Palestine, at the time of the review
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Abuelaish I, Arya N. The Palestinian-Israeli conflict: a disease for which root causes must be acknowledged and treated. Med Confl Surviv 2017; 33:184-187. [PMID: 28683571 DOI: 10.1080/13623699.2017.1344378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Fourth of June 2017 marks a half century of the Six Day War, three decades post the first Intifada, seven decades post the Palestinian Nakba (catastrophe), the 70th anniversary of Israeli Independence, and one century post the Balfour Declaration. Both Palestinians and Israelis remain occupied. Five million Palestinians remain sick with hopelessness and despair rendered by years of subjugation. Israelis are stuck, occupied by their historical narrative and transcendental fears. Over two decades have passed since the Oslo accords, which both Israelis and Palestinians hoped might be a historic turning point. This was supposed to put an end to the chronic disease of protracted conflict, allowing Palestinians to enjoy freedom in an independent state side by side to Israel and Israelis to live within peaceful, secure borders with the respect of the international community. Palestinians were ready to give up 78% of their land. Free Palestine would be in the remaining 22%, with East Jerusalem as the capital and a satisfactory solution to the Right of Return. The patient's diagnosis and seeking therapy has been delayed by greed, ignorance, ideology, violence and fear. Accurate diagnosis is needed to successfully heal the wounds and cure this chronic disease.
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Affiliation(s)
- Izzeldin Abuelaish
- a Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - Neil Arya
- b Environment and Resource Studies , University of Waterloo , Waterloo , Canada
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Arya N. Renewing the call for public health advocacy against nuclear weapons. Med Confl Surviv 2017; 33:110-124. [PMID: 28851232 DOI: 10.1080/13623699.2017.1360465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Neil Arya
- a Department of Environment and Resource Studies , University of Waterloo , Waterloo , Canada
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Scheerer MF, Kosiborod M, Cavender M, Fu A, Wilding J, Norhammar A, Birkeland K, Jorgensen M, Thuresson M, Arya N, Bodegard J, Hammar N, Holl RW, Fenici P. Positive Einflüsse auf die Hospitalisierung für Herzinsuffizienz (HHI) und Gesamtmortalität bei Neueinstellung auf SGLT-2 Inhibitoren im Vergleich zu anderen Antidiabetika: Gesamtergebnisse von mehr als 300.000 Patienten aus dem klinischen Alltag – CVD-REAL Studie. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1603544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- MF Scheerer
- AstraZeneca GmbH, Medical Affairs, Wedel, Germany
| | - M Kosiborod
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, United States
| | - M Cavender
- University of North Carolina, Chapel Hill, United States
| | - A Fu
- Georgetown University Medical Center, Washington, United States
| | - J Wilding
- University of Liverpool, Liverpool, United Kingdom
| | | | | | - M Jorgensen
- Steno Diabetes Center, Copenhagen, Denmark
- National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark
| | | | - N Arya
- AstraZeneca, Gaithersburg, United States
| | | | - N Hammar
- AstraZeneca Gothenburg, Mölndal, Sweden
| | - RW Holl
- University of Ulm, Ulm, Germany
| | - P Fenici
- AstraZeneca, Cambridge, United Kingdom
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Arya N, Gibson C, Ponka D, Haq C, Hansel S, Dahlman B, Rouleau K. Family medicine around the world: overview by region: The Besrour Papers: a series on the state of family medicine in the world. Can Fam Physician 2017; 63:436-441. [PMID: 28615392 PMCID: PMC5471080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To demonstrate how family medicine has been recognized and integrated into primary health care systems in contrasting contexts around the world and to provide an overview of how family physicians are trained and certified. COMPOSITION OF THE COMMITTEE Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Papers Working Group, which was struck at the 2013 conference, was tasked with developing a series of papers to highlight the key issues, lessons learned, and outcomes emerging from the various activities of the Besrour collaboration. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. METHODS An initial search was conducted in PubMed using a family medicine hedge of MeSH terms, text words, and family medicine journals, combined with text words and terms representing low- and middle-income countries and the concept of family medicine training programs. A second search was completed using only family medicine terms in the CAB Direct and World Bank databases. Subsequent PubMed searches were conducted to identify articles about specific conditions or services based on suggestions from the authors of the articles selected from the second search. Additional articles were identified through reference lists of key articles and through Google searches. We then attempted to verify and augment the information through colleagues and partners. REPORT The scope of family medicine and the nature of family medicine training vary considerably worldwide. Challenges include limited capacity, incomplete understanding of roles, and variability of standards and recognition. Opportunities for advancement might include technology, collaboration, changes in pedagogy, flexible training methods, and system-wide support.
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Affiliation(s)
- Neil Arya
- Assistant Clinical Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont, and Adjunct Professor in the Department of Family Medicine at Western University in London, Ont
| | - Christine Gibson
- Clinical Assistant Professor in the Department of Family Medicine of the Cumming School of Medicine at the University of Calgary in Alberta and Executive Director of the Global Familymed Foundation
| | - David Ponka
- Associate Professor in the Department of Family Medicine at the University of Ottawa in Ontario and Lead of the Besrour Papers Working Group.
| | - Cynthia Haq
- Professor of Family Medicine and Community Health in the School of Medicine and Public Health at the University of Wisconsin in Madison
| | - Stephanie Hansel
- Technical Specialist at Juzoor for Health and Social Development in Ramallah, Palestine, at the time of the study
| | - Bruce Dahlman
- Head of the Department of Family Medicine and Community Care in the School of Medicine and Health Sciences at Kabarak University in Kenya
| | - Katherine Rouleau
- Associate Professor and Director of the Global Health Program in the Department of Family and Community Medicine at St Michael's Hospital and the University of Toronto in Ontario, and Director of the Besrour Centre at the College of Family Physicians of Canada
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Affiliation(s)
- Izzeldin Abuelaish
- a Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - Neil Arya
- b University of Waterloo , Waterloo , Canada
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S. Jain K, Arya N, N. Inamdar N, B. Auti P, A. Unawane S, H. Puranik H, S. Sanap M, D. Inamke A, J. Mahale V, S. Prajapati C, J. Shishoo C. The Chemistry and Bio-Medicinal Significance of Pyrimidines & Condensed Pyrimidines. Curr Top Med Chem 2016; 16:3133-3174. [DOI: 10.2174/1568026616666160609100410] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/30/2016] [Accepted: 05/30/2016] [Indexed: 11/22/2022]
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Blau E, Asrar FM, Arya N, Schabort I, Abelsohn A, Price D. [Des centres de médecine plus écologiques: Responsabilité environnementale en médecine familiale]. Can Fam Physician 2016; 62:e226-e230. [PMID: 27255631 PMCID: PMC4865348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Elaine Blau
- Professeure clinique adjointe et directrice du volet rural du programme de résidence au Département de médecine familiale de l'Université McMaster à Hamilton, en Ontario
| | - Farhan M Asrar
- Professeur adjoint au Département de médecine familiale et communautaire de l'Université de Toronto et titulaire d'une nomination conjointe avec la Division de la santé publique clinique de la Faculté Dalla Lana de santé publique de l'Université de Toronto, professeur clinique adjoint au Département de médecine familiale de l'Université McMaster et membre du Comité de la santé environnementale (CSE) du CMFC-CMFO.
| | - Neil Arya
- Professeur clinique adjoint au Département de médecine familiale de l'Université McMaster, professeur adjoint au Département de médecine familiale de l'Université Western à London, en Ontario, et ancien président du CSE
| | - Ingeborg Schabort
- Professeure agrégée, coordonnatrice des demi-journées scientifiques et coordonnatrice des diplômés internationaux en médecine au Département de médecine familiale de l'Université McMaster
| | - Alan Abelsohn
- Professeur agrégé au Département de médecine familiale et communautaire et à la Faculté Dalla Lana de santé publique de l'Université de Toronto en Ontario, de même que fondateur et premier président du CSE
| | - David Price
- Professeur et directeur du Département de médecine familiale de l'Université McMaster et directeur de la Médecine familiale aux Hamilton Health Sciences
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Blau E, Asrar FM, Arya N, Schabort I, Abelsohn A, Price D. Greener medical homes: Environmental responsibility in family medicine. Can Fam Physician 2016; 62:381-384. [PMID: 27255617 PMCID: PMC4865333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Elaine Blau
- Assistant Clinical Professor and Rural Stream Residency Program Director in the Department of Family Medicine at McMaster University in Hamilton, Ont
| | - Farhan M Asrar
- Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, cross-appointed with the Division of Clinical Public Health at the Dalla Lana School of Public Health at the University of Toronto, Assistant Clinical Professor (Adjunct) in the Department of Family Medicine at McMaster University, and a member of the CFPC-OCFP Environmental Health Committee (EHC).
| | - Neil Arya
- Assistant Clinical Professor in the Department of Family Medicine at McMaster University, Adjunct Professor in the Department of Family Medicine at Western University in London, Ont, and past Chair of the EHC
| | - Ingeborg Schabort
- Associate Professor, Academic Half Day Coordinator, and International Medical Graduate Coordinator in the Department of Family Medicine at McMaster University
| | - Alan Abelsohn
- Associate Professor in the Department of Family and Community Medicine and at the Dalla Lana School of Public Health at the University of Toronto in Ontario, and was founder and first Chair of the EHC
| | - David Price
- Professor in and Chair of the Department of Family Medicine at McMaster University, and Chief of Family Medicine at Hamilton Health Sciences
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Arya N. Responsibility to Protect at age 10--still worthy of support? Med Confl Surviv 2015; 31:144-52. [PMID: 26603111 DOI: 10.1080/13623699.2015.1113045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Neil Arya
- a Department of Environment and Resource Studies , University of Waterloo , Waterloo , Canada
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Rouleau K, Ponka D, Arya N, Couturier F, Siedlecki B, Redwood-Campbell L, Lemire F. The Besrour Conferences: Collaborating to strengthen global family medicine. Can Fam Physician 2015; 61:578-591. [PMID: 26175361 PMCID: PMC4501594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Katherine Rouleau
- Associate Professor and Director of the Global Health Program in the Department of Family and Community Medicine at St Michael's Hospital and the University of Toronto in Ontario, and Director of the Besrour Centre at the College of Family Physicians of Canada.
| | - David Ponka
- Associate Professor and International Lead of the Global Health Committee in the Department of Family Medicine at the University of Ottawa in Ontario
| | - Neil Arya
- Assistant Clinical Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont, and Adjunct Professor in the Department of Family Medicine at Western University in London, Ont
| | | | - Basia Siedlecki
- Emergency physician and Chief of Hospitalist Service at Georgian Bay General Hospital in Midland, Ont, and Global Health Coordinator for the Faculty of Medicine at the Northern Ontario School of Medicine
| | - Lynda Redwood-Campbell
- Professor and Global Health Coordinator in the Department of Family Medicine at McMaster University
| | - Francine Lemire
- Executive Director and Chief Executive Officer of the College of Family Physicians of Canada in Mississauga, Ont
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Wiist WH, Barker K, Arya N, Rohde J, Donohoe M, White S, Lubens P, Gorman G, Hagopian A. The role of public health in the prevention of war: rationale and competencies. Am J Public Health 2014; 104:e34-47. [PMID: 24825229 PMCID: PMC4062030 DOI: 10.2105/ajph.2013.301778] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/04/2022]
Abstract
In 2009 the American Public Health Association approved the policy statement, "The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War." Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health's ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes. A working group grew out of the American Public Health Association's Peace Caucus to build upon the 2009 policy by proposing competencies to understand and prevent the political, economic, social, and cultural determinants of war, particularly militarism. The working group recommends that schools of public health and public health organizations incorporate these competencies into professional preparation programs, research, and advocacy.
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Affiliation(s)
- William H Wiist
- At the time of writing, William H. Wiist was with the Interdisciplinary Health Policy Institute at Northern Arizona University, Flagstaff. Kathy Barker is with Washington Truth in Recruiting, Seattle. Neil Arya is with Office of Global Health, University of Western Ontario; Environment and Resource Studies, University of Waterloo; and Family Medicine, McMaster University, Hamilton, Ontario. Jon Rohde is retired. Martin Donohoe is with the School of Community Health, Portland State University, Portland, OR. Shelley White is with the Department of Health Sciences Worcester State University, Worcester, MA. Pauline Lubens is with the MPH Program in Public Health, University of California, Irvine. Geraldine Gorman is with the College of Nursing, University of Illinois, Chicago. Amy Hagopian is with the Department of Global Health, University of Washington School of Public Health, Seattle
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McMurray J, Breward K, Breward M, Alder R, Arya N. Integrated Primary Care Improves Access to Healthcare for Newly Arrived Refugees in Canada. J Immigr Minor Health 2013; 16:576-85. [DOI: 10.1007/s10903-013-9954-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Arya N. The Society of Obstetricians and Gynaecologists of Canada's position statement on federal budget cuts to the Interim Federal Health Program. J Obstet Gynaecol Can 2012; 34:810-811. [PMID: 22971447 DOI: 10.1016/s1701-2163(16)35376-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Neil Arya
- Global Health Office Western University, London ON; Kitchener/Waterloo Refugee Health Clinic, Kitchener ON
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Arya N, McMurray J, Rashid M. Enter at your own risk: government changes to comprehensive care for newly arrived Canadian refugees. CMAJ 2012; 184:1875-6. [PMID: 22927516 DOI: 10.1503/cmaj.120938] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Neil Arya
- Kitchener-Waterloo Refugee Health Clinic, Centre for Family Medicine, Kitchener, Ont.
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Blashki G, Abelsohn A, Woollard R, Arya N, Parkes MW, Kendal P, Bell E, Bell RW. General Practitioners' responses to global climate change - lessons from clinical experience and the clinical method. Asia Pac Fam Med 2012; 11:6. [PMID: 22873633 PMCID: PMC3469365 DOI: 10.1186/1447-056x-11-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 07/18/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND Climate change is a global public health problem that will require complex thinking if meaningful and effective solutions are to be achieved. In this conceptual paper we argue that GPs have much to bring to the issue of climate change from their wide-ranging clinical experience and from the principles underpinning their clinical methods. This experience and thinking calls forth particular contributions GPs can and should make to debate and action. DISCUSSION We contend that the privileged experience and GP way of thinking can make valuable contributions when applied to climate change solutions. These include a lifetime of experience, reflection and epistemological application to first doing no harm, managing uncertainty, the ability to make necessary decisions while possessing incomplete information, an appreciation of complex adaptive systems, maintenance of homeostasis, vigilance for unintended consequences, and an appreciation of the importance of transdisciplinarity and interprofessionalism. SUMMARY General practitioners have a long history of public health advocacy and in the case of climate change may bring a way of approaching complex human problems that could be applied to the dilemmas of climate change.
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Affiliation(s)
- Grant Blashki
- Nossal Institute for Global Health & The Melbourne Sustainable Society Institute, The University of Melbourne, 161 Barry St, Carlton, Melbourne, 3010, Australia
| | - Alan Abelsohn
- Department of Family and Community Medicine and Dalla Lana School of PublicHealth, University of Toronto, 1466 Bathurst Street, #205, Toronto, ON, M5R-3S3, Canada
| | - Robert Woollard
- Department of Family Practice, University of British Columbia, 320-5950University Blvd, Vancouver, BC, V6T 1Z3, Canada
| | - Neil Arya
- Director Global Health Office Western University AssistantClinical Professor Family Medicine McMaster University and Adjunct Professor Environment and Resource Studies University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Margot W Parkes
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, V2N 4Z9, Canada
| | - Paul Kendal
- Rural Coordination Centre of British Columbia, University of British Columbia, 300 - 5950 University Blvd, Vancouver, BC, V6T 1Z3, Canada
| | - Erica Bell
- University Department of Rural Health, University of Tasmania, Elizabeth St, Hobart, 7001, Australia
| | - R Warren Bell
- Canadian Association of Physicians for the Environment Active Staff, Shuswap Lake General Hospital Salmon Arm, Salmon Arm, BC, V1E 4S2, Canada
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Redwood-Campbell L, Pakes B, Rouleau K, MacDonald CJ, Arya N, Purkey E, Schultz K, Dhatt R, Wilson B, Hadi A, Pottie K. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches. BMC Med Educ 2011; 11:46. [PMID: 21781319 PMCID: PMC3163624 DOI: 10.1186/1472-6920-11-46] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 07/22/2011] [Indexed: 05/18/2023]
Abstract
BACKGROUND Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. METHODS A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. RESULTS The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. CONCLUSIONS The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied to other aspects of residency curriculum development.
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Affiliation(s)
- Lynda Redwood-Campbell
- Department of Family Medicine, McMaster University, 175 Longwood Road South, Hamilton, L8S 1A4 Canada
| | - Barry Pakes
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Health Science Building, 6th floor, Toronto, M5T 3M7 Canada
| | - Katherine Rouleau
- Department of Family Medicine, St. Michael's University of Toronto, 30 Bond Street, Toronto, M5B 1W8 Canada
| | - Colla J MacDonald
- Faculty of Education, University of Ottawa, Lamoureux Hall (LMX), 145 Jean-Jacques- Lussier Private, Ottawa, K1N 6N5 Canada
| | - Neil Arya
- Office of Global Health, Schulich School of Medicine & Dentistry, 1151 Richmond Street. The University of Western Ontario, London, N6A 5C1 Canada
| | - Eva Purkey
- Department of Family Medicine, Queen's University, 220 Bagot Street, Kingston, K7L 5E9 Canada
| | - Karen Schultz
- Department of Family Medicine, Queen's University, 220 Bagot Street, Kingston, K7L 5E9 Canada
| | - Reena Dhatt
- Department of Family Medicine, Northern Ontario School of Medicine, 1813 Lasalle Boulevard Sudbury, P3A 2A3 Canada
| | - Briana Wilson
- Independent member, 128 Emerald Street S, Hamilton, L8N 2a5, Canada
| | - Abdullahel Hadi
- Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, K1N 6N5 Canada
| | - Kevin Pottie
- Institute of Population Health, Department of Family Medicine, University of Ottawa, 1 Stewart Street, Ottawa, K1N 6N5 Canada
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Lexchin J, Arya N, Singh S. Gardasil® – The New HPV Vaccine: The Right Product, the Right Time? A Commentary. Healthc Policy 2010. [DOI: 10.12927/hcpol.2013.21779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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