Shiran Zhong’s research while affiliated with Western University and other places

Smartphones are an increasingly popular delivery mechanism for digital health interventions and observational research. Many digital health studies adopt an ecological momentary assessment (EMA) methodology, which can be extended by incorporating the collection of participant location data via embedded technology within smartphones. However, there is currently a lack of customizable, geographically appropriate software for researchers to implement geographically explicit EMA (GEMA). To address this gap, we developed the Healthy Environments and Active Living for Translational Health (HEALTH) Platform. The HEALTH Platform is a customizable smartphone application that enables researchers to deliver GEMA prompts on a smartphone in real-time based on spatially complex geofence boundaries, collect audiovisual data, and flexibly adjust system logic without the need for time-consuming updates to the application on a participant’s device. We illustrate the HEALTH Platform’s capabilities through a study of park exposure and well-being. This study demonstrates the HEALTH Platform’s improvements upon existing GEMA software platforms. We observed survey prompt adherence is associated with participant motivation and the complexity of the survey instrument itself, following past EMA research findings. Overall, we find that the HEALTH Platform is a flexible mobile phone application for implementing the GEMA methodology in digital health research and practice and can be used to meet critical quality standards in this rapidly evolving field.

Introduction: Active school travel (AST; e.g., cycling/walking to/from school) has many potential benefits, yet participation rates are low in many countries. Little is known regarding how the environmental attitudes of youth influence their beliefs and motivations regarding AST. This paper examines the relationships between pro-ecological and dominant social paradigm (DSP; e. g., belief in human exceptionalism) attitudes and the likelihood of reporting different perceived AST barriers, facilitators, and parental/guardian controls among youth, as well as how these attitudes impact different forms of motivation (i.e., external, introjected, identified, and intrinsic regulation) related to AST. Methods: Logistic and linear regression analyses of a national-level online survey (n = 1193) of Canadian 8-14 year olds were conducted. Divergences were observed with respect to each analysis of perceived barriers, facilitators, and parental controls, as well as motivations for AST. Results: Mixed findings were found regarding perceived barriers and facilitators; for example, differences were observed regarding the likelihood of perceiving road safety barriers with increases in pro-ecological perspectives being significantly more likely than increases in DSP views to report barriers such as 'drivers speeding'. Consistent divergent trends were found regarding perceived parental controls and types of motivation for AST. For instance, environment-related parental controls like 'allowed to cycle on main roads', and motivations like external regulation , were significantly associated with increases in DSP beliefs but not in response to changes in pro-ecological perspectives. Conclusions: Findings suggest that increases in pro-ecological attitudes tend to predict more perceived barriers to AST and greater intrinsic motivation to engage in AST-trends that are not mirrored in changes among DSP views. Future studies are encouraged to explore other * Corresponding author. 200 University Ave. West,

Family doctors serve as the initial contact for individuals seeking regular medical service like routine physical exam, diagnosis, and treatment of illness. Nonetheless, immigrant population who do not speak the official language usually prefers receiving healthcare in their own mother tongues. Past studies have focused on exploring accessibility to family doctors speaking Mandarin Chinese, which is not mutually intelligible with another major Chinese language called Cantonese. Despite the significant number of Cantonese-speaking population in the Greater Toronto Area (GTA) and a recent wave of immigration from Hong Kong, China (hereafter “Hong Kong”) to Canada, little knowledge has been obtained regarding the geographic accessibility to Cantonese-speaking family doctors. This study seeks to fill the knowledge gap of spatial accessibility to Cantonese-speaking family doctors in the GTA by using the two-step floating catchment area (2SFCA) method. By considering the vulnerability in terms of spatial accessibility and attractiveness to the new immigrants from Hong Kong, we have unveiled that more than 90% of neighbourhoods, with below-median accessibility scores across all five thresholds yet high likelihood of attracting new Hong Kong immigrants, are clustered within four lower-tier municipalities of Markham, Toronto, Richmond Hill, and Vaughan. This study not only sheds lights on the knowledge gap but also provides timely guidance in formulating public health policies in light of the incoming Cantonese-speaking immigrants from Hong Kong.

Background Cannabis is associated with the onset and persistence of psychotic disorders. Evidence suggests that accessibility of substances is associated with an increased risk of use-related harms. We sought to examine the effect of residing in proximity to non-medical cannabis retailers on the prevalence of health service use for psychosis. Methods We conducted a cross-sectional study using linked health administrative data, and used geospatial analyses to determine whether people in Ontario, Canada (aged 14–60 years) resided within walking (1.6 km) or driving (5.0 km) distance of non-medical cannabis retailers (open as of February-2020). We identified outpatient visits, emergency department (ED) visits, and hospitalizations for psychotic disorders between 01-April-2019 and 17-March-2020. We used zero-inflated Poisson regression models and gamma generalized linear models to estimate the association between cannabis retailer proximity and indicators of health service use. Results Non-medical cannabis retailers were differentially located in areas with high levels of marginalization and pre-existing health service use for psychosis. People residing within walking or driving distance of a cannabis retailer had a higher rate of psychosis-related outpatient visits, ED visits, and hospitalizations, compared to people living outside these areas. This effect was stronger among those with no prior service use for psychosis. Conclusions Proximity to a non-medical cannabis retailer was associated with higher health service use for psychosis, even after adjustment for prior health service use. These findings suggest that opening of non-medical cannabis retailers could worsen the burden of psychosis on mental health services in areas with high-risk populations.

Objectives The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19. Methods A sample of 239 Ontario parents of children aged 12 and younger completed two online surveys (August–December 2020; 2021) to assess parents' intentions, beliefs, and comforts concerning their child's eventual return to play, in addition to various sociodemographic and physical activity variables. Descriptive analyses were run as well as an exploratory factor analysis (EFA) was conducted to group the 14 attitude items into subscales for analysis, to ensure reliability and validity of attitude measures. Results In general, parents in communities with more urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents with lower-incomes were more hesitant to return their children to active play during the pandemic. Conclusion Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.