Mathews Maria, Spencer Sarah, Hedden Lindsay, Marshall Emily Gard, Lukewich Julia, Meredith Leslie, Ryan Dana, Buote Richard, Liu Tiffany, Volpe Emily, Gill Paul S, Ryan Bridget, Schacter Gordon, Wickett Jamie, Freeman Thomas R, Sibbald Shannon L, Wong Eric, McKay Maddi, McCracken Rita, Brown Judith Belle
Department of Family Medicine, Schulich School of Medicine and Dentistry, London, Ontario, Canada
Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
BMJ Open. 2021 Jul 22;11(7):e048209. doi: 10.1136/bmjopen-2020-048209.
Given the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing pandemic plans in Canada, however, do not adequately incorporate family physicians' roles and perspectives. This policy and planning oversight has become increasingly evident with the emergence of the novel coronavirus disease, COVID-19, pandemic. This study is designed to inform the development of pandemic plans for primary care through evidence from four provinces in Canada: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario.
We will employ a multiple-case study of regions in four provinces. Each case consists of a mixed methods design which comprises: (1) a chronology of family physician roles in the COVID-19 pandemic response; (2) a provincial policy analysis; and (3) qualitative interviews with family physicians. Relevant policy and guidance documents will be identified through targeted, snowball and general search strategies. Additionally, these policy documents will be analysed to identify gaps and/or emphases in existing policies and policy responses. Interviews will explore family physicians' proposed, actual and potential roles during the pandemic, the facilitators and barriers they have encountered throughout and the influence of gender on their professional roles. Data will be thematically analysed using a content analysis framework, first at the regional level and then through cross-case analyses.
Approval for this study has been granted by the Research Ethics of British Columbia, the Health Research Ethics Board of Newfoundland and Labrador, the Nova Scotia Health Authority Research Ethics Board and the Western University Research Ethics Board. Findings will be disseminated via conferences and peer-reviewed publications. Evidence and lessons learnt will be used to develop tools for government ministries, public health units and family physicians for improved pandemic response plans for primary care.
鉴于基于呼吸道疾病的大流行反复出现的风险，以及家庭医生在突发公共卫生事件中发挥的重要作用，制定基层医疗的大流行计划势在必行。然而，加拿大现有的大流行计划并未充分纳入家庭医生的角色和观点。随着新型冠状病毒疾病（COVID-19）大流行的出现，这种政策和规划方面的疏忽变得越来越明显。本研究旨在通过来自加拿大四个省份（不列颠哥伦比亚省、纽芬兰和拉布拉多省、新斯科舍省和安大略省）的证据，为基层医疗的大流行计划制定提供参考。
我们将对四个省份的地区进行多案例研究。每个案例都采用混合方法设计，包括：（1）家庭医生在COVID-19大流行应对中的角色年表；（2）省级政策分析；（3）对家庭医生的定性访谈。将通过有针对性的、滚雪球式的和一般性的搜索策略识别相关政策和指导文件。此外，将对这些政策文件进行分析，以确定现有政策和政策应对措施中的差距和/或重点。访谈将探讨家庭医生在大流行期间提议的、实际的和潜在的角色，他们在整个过程中遇到的促进因素和障碍以及性别对其职业角色的影响。数据将首先在地区层面，然后通过跨案例分析，使用内容分析框架进行主题分析。
本研究已获得不列颠哥伦比亚省研究伦理委员会、纽芬兰和拉布拉多省卫生研究伦理委员会、新斯科舍省卫生管理局研究伦理委员会以及西安大略大学研究伦理委员会的批准。研究结果将通过会议和同行评审出版物进行传播。所获得的证据和经验教训将用于为政府部门、公共卫生单位和家庭医生开发工具，以改进基层医疗的大流行应对计划。
