Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has developed Live 5-2-1-0, a multi-sectoral, multi-component community-based childhood obesity prevention initiative grounded in systems thinking and participatory research principles. Building on previous work, this study continued implementation of an innovative knowledge exchange model, RE-FRAME, in two ‘new’ and two ‘existing’ Live 5-2-1-0 communities. This mixed-methods study examined follow-up data to determine the nature and extent of the model’s ability to build and sustain community capacity and facilitate the scale-up and sustainability of systems- and community-level change. Qualitative and quantitative data were collected using stakeholder interviews, and quantitative process tracking (PTT) and capacity building tools (CCBT), and were analyzed using thematic analysis and descriptive statistics, respectively. Results from three communities with baseline and follow-up CCBT data showed capacity domain scores increased (15/27; 56%) or remained constant (10/27; 37%) over the study period. PTT data showed over 50 multi-sectoral community partnerships formed in Community D (new) and 108 actions implemented. Stakeholder interviews identified having a common cause, co-ownership, champion networks and consistency of the Live 5-2-1-0 message as essential to sustainability of the initiative. RE-FRAME supports knowledge exchange and community capacity-building that is integral to initiating and sustaining a community-based childhood obesity prevention initiative.
Introduction: Sex workers still remain a largely hidden population. This study attempts to provide the a more accurate accounting for contact sex work in Canada. An analysis of a large number of Canadian online sex work advertisements from multiple websites over multiple years shows that most of the population is in fact transitory, contradicting the story promoted by much of the research and used as the basis for policy in Canada. Methods: 3.18 million advertisements were collected from websites that hosted Canadian sex work advertising between November, 2014 and December, 2016. Population was estimated based on a combination of contact information and names found in ads. In addition to population counts, other variables are examined with respect to how long advertisers stayed online: gender, language, collective vs individual advertising and service type. Results: Advertisers were online for a median 14 days (IQR 1-58, mean 73.3, SD 151.8). Monthly, an average of 27157 (SD 5148) workers were estimated to be active. Over the two year study period an estimated 209994 (95% CI 203319-222123) sex workers were active at least once. Most of the sex workers advertised collectively in some way. However, the collectives were small (median 2 names per advertiser). Working collectively was the most significant factor affecting whether an advertiser stayed online, followed by offering a specialist service (such as fetish or tantric) or being part of a traditionally marginalized group. Conclusions: The implied populations of sex workers in Canada are dynamic and change significantly depending on the time period studied. Most sex workers have only brief, intermittent involvement in the industry. Spot estimates do not provide an accurate picture of who does sex work. Indeed there are many more sex workers who are inactive than those that are active. Given that policy in Canada is based on qualitative research using small, self-selecting samples of relatively long term workers, the perspectives of these short-term workers may not be adequately represented.
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