Development of a primary care pandemic plan informed by in-depth policy analysis and interviews with family physicians across Canada during COVID-19: a qualitative case study protocol

Abstract

IntroductionGiven 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.Methods and analysisWe 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.Ethics and disseminationApproval 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.

Medical knowledge about COVID-19 is travelling at the speed of mistrust: why this is relevant to primary care

“…The growing participation of family medicine in research at many levels will provide valuable opportunities to investigate strategies to optimize the role of primary care in pandemic preparedness, vaccination efforts, and the outpatient management of COVID-19 in high-risk groups at the community level. 35 , 36 , 37…”

The roles of family physicians during a pandemic

“…As outlined in a published protocol, 11 we conducted a multiple case study of four regions in Canada: the Vancouver Coastal Health region in British Columbia (BC), the Eastern Health region in Newfoundland and Labrador, the province of Nova Scotia, and Ontario Health West. The four regions each include urban and rural communities and cover the continuum of health services.…”

“It was horrible for that community, but not for the way we had imagined”: A qualitative study of family physicians’ experiences of caring for communities experiencing marginalisation during COVID-19

“…We sought to understand the proposed roles and actual experiences of FPs during the COVID-19 pandemic, the facilitators and barriers they encountered, and the impacts of the pandemic on both FPs and the communities they serve. The full study protocol has been documented elsewhere ( Mathews et al., 2021 ).…”