Christine Heidebrecht

Public Health Ontario · Surveillance and Epidemiology

Background Anti-fat attitudes and weight-based discrimination are prevalent in healthcare settings and among healthcare practitioners and clinical trainees, and can result in immense harm to patients. There is increasing recognition that anti-fat bias in healthcare is a critical issue that must be addressed, but there is a dearth of evidence demons...

BACKGROUND Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospital and during discharge planning. However, interprofessional communication and collaboration in the inpatient setting is often fragmented and inefficient, leading to poor patient outcomes...

Background Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospitals and during discharge planning. However, interprofessional communication and collaboration in inpatient settings are often fragmented and inefficient, leading to poor patient outcomes...

Background Since 2011, WHO has recommended that HIV-positive inpatients be routinely screened for tuberculosis with the WHO four-symptom screen (W4SS) and, if screened positive, receive a molecular WHO-recommended rapid diagnostic test (eg, Xpert MTB/RIF [Xpert] assay). To inform updated WHO tuberculosis screening guidelines, we conducted a systema...

Background and objectives: As hospital-based pediatric clinicians and researchers, we conducted engagement with representatives from public, private, and nonprofit organizations in the Peel Region of Ontario. Objectives were to build relationships and inform research, education, innovation, and programming to improve the health of local children,...

Background: Teamwork and interprofessional communication are important in addressing the comprehensive care needs of complex hospitalized patients. The objective of this study is to evaluate the impact of an electronic interprofessional communication and collaboration platform on teamwork, communication, and adverse events in the hospital setting....

Background: KwaZulu-Natal (KZN) has the highest burden of notified multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant (XDR) TB cases in South Africa. A better understanding of spatial heterogeneity in the risk of drug-resistance may help to prioritize local responses. Methods: Between July 2012 and June 2013, we conducted a...

Many hospital inpatients in South Africa have undiagnosed active and drug-resistant tuberculosis (TB). Early detection of TB is essential to inform immediate infection control actions to minimize transmission risk. We assessed the utility of Xpert® MTB/RIF (GeneXpert) as a screening tool for medical admissions at a large public hospital in South Af...

Evaluating the features and performance of health information systems can serve to strengthen the systems themselves as well as to guide other organizations in the process of designing and implementing surveillance tools. We adapted an evaluation framework in order to assess electronic immunization data collection systems, and applied it in two Ont...

Background: Immunization rates are used to assess the level of protection against influenza, but limited data exist on how such rates are measured in health care organizations. We conducted key informant interviews with campaign planners to learn about processes for collecting immunization data, including barriers and facilitating factors for meas...

Individual-level immunization data captured electronically can facilitate evidence-based decision-making and planning. Populating individual-level records through manual data entry is time-consuming. An alternative is to use scannable forms, completed at the point of vaccination and subsequently scanned and exported to a database or registry. To ex...

Background Although many studies have demonstrated the benefits of reminder/recall (RR) measures to address patient under-immunization and improve immunization coverage, they are not widely implemented by healthcare providers. We identified providers’ perceived barriers to their use from existing literature. Methods We conducted a systematic revie...

Background: The success of influenza vaccination campaigns may be suboptimal if subgroups of the population face unique barriers or have misconceptions about vaccination. We conducted a national study to estimate influenza vaccine coverage across 12 ethnic groups in Canada to assess the presence of ethnic disparities. Methods: We pooled response...

Background: Immunizing health care workers against influenza is important for preventing and reducing disease transmission in health care environments. We describe the ability of Canadian health care organizations to measure influenza immunization coverage among health care workers and identify factors associated with comprehensive influenza immun...

In response to the need for improved quality of vaccine inventory and client immunization records, barcodes containing a unique identifier and lot number will be placed on all vaccine vials in Canada. We conducted feasibility studies to examine integration of barcode scanning into inventory recording workflow for mass immunization clinics. During t...

The 2009 H1N1 pandemic vaccination campaign was an excellent opportunity to witness the many benefits of collecting individual-level immunization data at the point of vaccination. Most provinces and territories required the reporting of at least partial demographic vaccination data from their local public health agencies, so timely vaccine coverage...

During the pandemic (H1N1) 2009 influenza vaccination campaign, health regions in Canada collected client-level immunization data using fully electronic or hybrid systems, with the latter comprising both electronic and paper-based elements. The objective of our evaluation was to compare projected five-year costs associated with implementing these s...

A critical component of the 2009 H1N1 vaccination campaign was the collection of immunization data at the point of care. To meet reporting requirements and to ensure timely availability of coverage information, many jurisdictions across Canada employed new or modified approaches to vaccine data collection. The objective of this study was to observe...

Cape Town, South Africa. To evaluate the current system of tuberculosis surveillance in the Cape Metro region. This evaluation was based on the 'Updated Guidelines for Evaluating Public Health Surveillance Systems' of the Centers for Disease Control and Prevention, modified to render the framework applicable to the context of tuberculosis (TB) surv...

During the pandemic (H1N1) 2009 vaccination campaign, vaccine providers collected immunization data using hybrid (paper-based and electronic methods) and electronic data systems. We measured staff time in seconds spent on data collection tasks to compare system efficiencies. The sample consisted of 38 organizations across nine Canadian provinces/te...

Background During the 2009 H1N1 immunization campaign, electronic and hybrid (comprising both electronic and paper components) systems were employed to collect client-level vaccination data in clinics across Canada. Because different systems were used across the country, the 2009 immunization campaign offered an opportunity to study the usability o...

Immunization information systems (IISs) are electronic registries used to monitor individual vaccination status and assess vaccine coverage. IISs are currently not widely used across Canada, where health jurisdictions employ a range of approaches to capture influenza immunization information. Conducted in advance of the 2009 H1N1 vaccination campai...

Perceptions of Pandemic (H1N1) 2009 Influenza Client Data Collection Methods Questionnaire Questionnaire to elicit perceptions of data collection method employed at the respondent's clinic.

H1N1 Immunization Clinic Data Collection Methods Observation Guide Guide used to direct the passive observation component of the study.

Collected Data Elements Questionnaire Questionnaire to determine what data are collected at the respondent's clinic, as well as key functionalities of the system employed.

The collection of individual-level pandemic (H1N1) 2009 influenza immunization data was considered important to facilitate optimal vaccine delivery and accurate assessment of vaccine coverage. These data are also critical for research aimed at evaluating the new vaccine's safety and effectiveness. Systems used to collect immunization data include m...

The collection of individual-level immunization data at the point of vaccination is ideal for immunization clinic operations, rapid and precise monitoring of vaccine coverage and the evaluation of vaccine safety and effectiveness. While this practice has been adopted for routine childhood and seasonal influenza immunization in selected Canadian jur...

Every year millions of pilgrims from around the world gather under extremely crowded conditions in Mecca, Saudi Arabia to perform the Hajj. In 2009, the Hajj coincided with influenza season during the midst of an influenza A (H1N1) pandemic. After the Hajj, resource-limited countries with large numbers of traveling pilgrims could be vulnerable, giv...

M. E.Wilson, L. H.Chen, P. V.Han, J. S.Keystone, J. P.Cramer, A.Segurado, D.Hale, M.Jensenius, E.Schwartz, F.von Sonnenburg, K.Leder, A.Plier, K.Smith, G.-D.Burchard, R.Anand, S. S.Gelman, K.Kain, A.Boggild, C.Perret, F.Valdivieso, L.Loutan, F.Chappuis, P.Schlagenhauf, R.Weber, R.Steffen, E.Caumes, A.Perignon, M. D.Libman, B.Ward, J. D.Maclean, M....

Objectives: (1) To determine informal caregivers perceptions about place of care and place of death; and (2) to identify variables associated with a home death among terminally ill individuals who received in–home support services in a publicly funded home care system. Participants and design: A total of 216 informal caregivers participated in a be...