David Northrup

Alternatives to Project-specific Consent for Access to Personal Information for Health Research: What Is the Opinion of the Canadian Public?

OBJECTIVES This study sought to determine public opinion on alternatives to project-specific consent for use of their personal information for health research. DESIGN The authors conducted a fixed-response random-digit dialed telephone survey of 1,230 adults across Canada. MEASUREMENTS We measured attitudes toward privacy and health research; trust in different institutions to keep information confidential; and consent choice for research use of ones own health information involving medical record review, automated abstraction of information from the electronic medical record, and linking education or income with health data. RESULTS Support was strong for both health research and privacy protection. Studying communicable diseases and quality of health care had greatest support (85% to 89%). Trust was highest for data institutes, university researchers, hospitals, and disease foundations (78% to 80%). Four percent of respondents thought information from their paper medical record should not be used at all for research, 32% thought permission should be obtained for each use, 29% supported broad consent, 24% supported notification and opt out, and 11% felt no need for notification or consent. Opinions were more polarized for automated abstraction of data from the electronic medical record. Respondents were more willing to link education with health data than income. CONCLUSIONS Most of the public supported alternatives to study-specific consent, but few supported use without any notification or consent. Consent choices for research use of ones health information should be documented in the medical record. The challenge remains how best to elicit those choices and ensure that they are up-to-date.

Influenza vaccination rates in Ontario children: implications for universal childhood vaccination policy.

The aims of this study were to estimate influenza vaccination coverage for children during the 2006-2007 influenza season in Ontario, Canada, where universal vaccination is available, and to compare the rate among children aged 6-23 months with corresponding rates from other Canadian provinces that specifically target this high-risk group. We conducted a telephone survey of caregivers of children aged 6 months-11 years that included 4854 children from 3029 households. Ontarios vaccination rate (complete and partial coverage combined) for children aged 2-11 years was 28.3% (95% CI 26.3-30.5%) for healthy children and 36.8% (95% CI 31.4-42.5%) for those with chronic conditions. Immunization coverage of children aged 6-23 months was 24.0% (95% CI 20.6-27.7%) in Ontario, similar to Manitobas rate of 24.1% but lower than rates in other provinces: Nova Scotia (35.5%), Quebec (41.8% for 1 year olds and 37.7% for 2 year olds during the 2005-2006 season), Saskatchewan (32.5%) and Alberta (52.2%). Universal vaccination in Ontario has achieved modest coverage in children aged 2-11 years, but has been less successful than targeted programs in vaccinating infants aged 6-23 months.

The Ontario ban on smoking on school property : Issues and challenges in enforcement

We document implementation and enforcement activities undertaken by high schools and health units with regard to the 1994 ban on smoking on school property in Ontario. Telephone interviews were conducted in the early summer of 1996 with 213 high school administrators and 38 tobacco enforcement personnel in health units. While some schools are unclear about enforcement responsibility, most are making efforts to enforce the ban, including warning and suspending students. Some school administrators (30%) suggest the reinstitution of designated smoking areas on school property. One quarter of health units had not made enforcement visits in schools in the 1995-96 school year and a minority accounted for most of the warnings and tickets issued to students. While most tobacco enforcement officers perceive that schools support the ban, they report some problems in obtaining cooperation in enforcement. However, only 11% suggest returning to designated smoking areas on school property.

Dimensions underlying legislator support for tobacco control policies

Objective: To propose and test a new classification system for characterising legislator support for various tobacco control policies. Design: Cross sectional study. Subjects: Federal and provincial legislators in Canada serving as of October 1996 who participated in the Canadian Legislator Study (n = 553; response rate 54%). Main outcome measures: A three factor model (Voters, Tobacco industry, Other interest groups) that assigns nine tobacco control policies according to legislators’ hypothesised perceptions of which group is more directly affected by these policies. Results: Based on confirmatory factor analysis, the proposed model had an acceptable fit and showed construct validity. Multivariate analysis indicated that three of the predictors (believing that the government has a role in health promotion, being a non-smoker, and knowledge that there are more tobacco than alcohol caused deaths) were associated with all three factor scales. Several variables were associated with two of the three scales. Some were unique to each scale. Conclusions: Based on our analyses, legislator support for tobacco control policies can be grouped according to our a priori factor model. The information gained from this work can help advocates understand how legislators think about different types of tobacco control policies. This could lead to the development of more effective advocacy strategies.

Canadian legislators’ knowledge of and attitudes towards tobacco and tobacco control

Rationale: Tobacco control policies are ultimately shaped by legislators, but to date, there has been very little systematic study of legislators’ knowledge about the health consequences of tobacco or their attitudes toward various tobacco control measures.

Canadian legislators’ support for tobacco control policies

Background: Because tobacco control policies are an important component of a comprehensive strategy to reduce tobacco use and its associated health consequences, and because legislators ultimately determine tobacco control policies, a study was undertaken to assess Canadian legislators*#x2019; level of support for various tobacco control measures.