Papers by Federico Roncarolo
Canadian Journal of Public Health-revue Canadienne De Sante Publique, 2017
OBJECTIVES: To examine the association between the local food environment and the severity of foo... more OBJECTIVES: To examine the association between the local food environment and the severity of food insecurity among new families using community food security interventions in Montreal. METHODS: In this cross-sectional study, we analyzed baseline data from 785 adults aged 18-65 years enrolled in the evaluation of the effects of organizations delivering community food security interventions in Montreal. The dependent variable was household food insecurity, while the independent variable was the local food environment, assessed through: location of the most frequently used grocery store, distance between the participant's residence and the community organization used, mode of transportation, walking time to the most frequently used grocery store, satisfaction with the acceptability and affordability of food available at the most frequently used grocery store, and self-reported difficulties in accessing food. We used polytomous logistic regression to estimate the association between household food insecurity and the local food environment. In all the models, we coded food security status in three categories: food security, moderate food insecurity and severe food insecurity. The last group was used as a reference group. RESULTS: Our data suggest that compared to households with severe food insecurity, those with moderate food insecurity (OR = 0.43, 95% CI: 0.28-0.62) and those with food security (OR = 0.13, 95% CI: 0.06-0.26) were less likely to report difficulties in accessing food due to food affordability. Food-secure households also had lower odds of reporting difficulties in accessing food due to transportation constraints (OR = 0.18, 95% CI: 0.06-0.55) compared with severe food-insecure households. Living a distance of between 1 and 2 km from the organization used was significantly correlated with moderate food insecurity (OR = 1.80, 95% CI: 1.12-2.88). CONCLUSION: The local food environment is associated with severity of household food insecurity among new families using community food security interventions in Montreal. Future studies should study the relationship between the local food environment and food insecurity across all dimensions of food access.
Research Square (Research Square), Dec 5, 2022
Introduction: While considerable research has been conducted on household food insecurity (HFI), ... more Introduction: While considerable research has been conducted on household food insecurity (HFI), little research has examined the effects of food donation programs on users' living conditions. The Pathways study was established to investigate the long-term effects of food donation programs on food insecurity as well as other critical outcomes, such as diet, health, and social support. Herein, we describe the design of the Pathways Study and the participants' characteristics at baseline. Methods: The Pathways study is a prospective cohort study of 1,001 food-aid users in Quebec (Canada). We recruited newly registered users of food donation programs from 106 community-based food-aid organizations that partnered with the study. Baseline data were collected through face-to-face interviews from September 2018 to January 2020, with planned follow-up interviews at 12 and 24 months after enrollment. Household food insecurity, diet, food competencies, food shopping behaviors, perceived food environment, health status, social support and isolation, sociodemographic characteristics, housing conditions, negative life events, and the impacts of COVID-19 were assessed with validated questionnaires. Results: The cohort included 1,001 participants living in rural (n=181), semi-urban (n=250), and urban areas (n= 570). Overall, household food insecurity was reported as severe among 46.2% and moderate in 36.9% of participants. Severe household food insecurity was more prevalent in rural (51.4%) and urban (47.8%) areas compared to semi-urban (39%) areas. Overall, 76.1% of participants reported an annual income below C$20,000. Half (52%) had low education levels (high school or lower), 22.0% lived in singleparent households, and 52.1% lived alone. Most (62.9%) experienced at least one major nancial crisis in the preceding year. Conclusions: Results show that newly registered users of food donation programs often have low-income and severe food insecurity, with major differences across geographical locations. The Pathways study is the rst study designed to follow, over a two-year period, a cohort of newly registered users of food donation programs and to quantify their trajectories of service use. Findings from the Pathways study might help adapt the community response to the strategies used by food-insecure households to feed themselves. Longitudinal studies that follow participants from when they rst start using food donation programs are needed to describe the trajectories of the use of food donation programs (e.g., occasional resource or regular source of food acquisition) and to evaluate their effect on HFI and other related outcomes. Likewise, studies considering the geographical context of food banks and of their users, as well as the type of programs offered by community organizations in addition to food donation programs should be conducted. The Pathways study was designed to address these knowledge gaps. The rst of its kind, the Pathways study was designed to estimate the long-term impact of food donation programs on HFI and other outcomes such as diet, health, and social support among a cohort of newly registered users of food donation programs,. It also aims to identify conditions that might facilitate the transition from food donation to capacity-building programs. The speci c objectives of the Pathways study are to: (1) identify pathways for the use of food security programs and understand the drivers associated with most common pathways; (2) compare pathways of program use among new users in community organizations offering only food donation programs only (FD) and new users of food donation programs in community organizations that also offer food-related capacity-building programs (FD + CBP); and (3) quantify the relationships between pathways of donation program use and food security, diet, mental and physical health, and social integration. This paper presents the design of the Pathways study and the characteristics of participants at baseline, contrasting both the three different areas (rural semiurban and urban) and the Montreal region versus the other three regions participating in the study. Methods The Pathways study is conducted in the province of Québec, Canada. It was developed in close partnership with public health, provincial, and regional organizations (i.e., Food banks Quebec) that contributed to its design and implementation. The Pathways study is funded by the Canadian Institutes of Health Research (grant# omitted for blind review), with additional nancial support from the Quebec Ministry of Health and Social Services, the Foundation of Greater Montreal, and Mission Inclusion. We received ethical approval from the Research Ethics Board of the Université de Montréal (n. certi cate blinded for peer review).
Engaging with community organizations to recruit and retain vulnerable adults: The Pathways Study
SSM-Population Health, Jun 1, 2022
Highlights • Researchers must overcome multiple barriers in recruiting and retaining research par... more Highlights • Researchers must overcome multiple barriers in recruiting and retaining research participants living in conditions of vulnerability.• A comprehensive recruitment strategy that combines various elements tailored to vulnerable populations is required.• Most studies describing recruitment and retention of participants from vulnerable populations pertain to clinical settings.• This study describes strategies and challenges in recruiting participants through community organizations.• This paper provides recommendations on recruiting and retaining people living in conditions of extreme vulnerability.
European journal of public health, Sep 1, 2020
Canadian Family Physician, Apr 1, 2016
Canadian Family Physician, 2016
La securite alimentaire designe « le droit de chaque etre humain d’avoir acces a une nourriture s... more La securite alimentaire designe « le droit de chaque etre humain d’avoir acces a une nourriture saine et nutritive conformement au droit a une nourriture adequate et au droit fondamental de chacun d’etre a l’abri de la faim »[1][1]. En depit de l’association bien connue entre l
European Journal of Public Health, 2020
Background Few studies investigate long-term effects of food donation programs on food insecurity... more Background Few studies investigate long-term effects of food donation programs on food insecurity, diet, social integration or health. We describe household food insecurity (HFI), health, social integration and sociodemographic characteristics of 1003 new food banks users in rural, suburban and urban areas in Quebec, Canada. Methods Adults requesting food aid for the first time in the past 6 months were recruited in 117 food aid organizations (32 in rural, 35 in suburban, 50 in urban areas) using a nested sampling technique. Baseline data were collected from Sept 2018 to Jan 2020 in computer-assisted face-to-face interviews. Participants will be followed biennially. HFI was assessed with the 18-item Household Food Security Survey Module. Perceived physical and mental health scores were assessed with the SF12V2 module. Psychological distress and social integration were assessed with the Kessler scale K6+ and a modified version of MSPSS Scale. Differences across groups were tested wit...
Sustainability, 2018
Responsible Innovation in Health (RIH) represents an emerging Science, Technology and Innovation ... more Responsible Innovation in Health (RIH) represents an emerging Science, Technology and Innovation (STI) approach that could support not only the Sustainable Development Goal (SDG) “Good health and well-being” but also other SDGs. Since few studies have conceptualized the relationships between RIH and the SDGs, our goal was to inductively develop a framework to identify knowledge gaps and areas for further reflections. Our exploratory study involved: (1) performing a web-based horizon scanning to identify health innovations with responsibility features; and (2) illustrating through empirical examples how RIH addresses the SDGs. A total of 105 innovations were identified: up to 43% were developed by non-profit organizations, universities or volunteers; 46.7% originated from the United States; and 64.5% targeted countries in Africa, Central and South America and South Asia. These innovations addressed health problems such as newborn care (15.5%), reduced mobility and limb amputation (14...
Can J Public Health, 2017
OBJECTIVES: To examine the association between the local food environment and the severity of foo... more OBJECTIVES: To examine the association between the local food environment and the severity of food insecurity among new families using community food security interventions in Montreal. METHODS: In this cross-sectional study, we analyzed baseline data from 785 adults aged 18-65 years enrolled in the evaluation of the effects of organizations delivering community food security interventions in Montreal. The dependent variable was household food insecurity, while the independent variable was the local food environment, assessed through: location of the most frequently used grocery store, distance between the participant's residence and the community organization used, mode of transportation, walking time to the most frequently used grocery store, satisfaction with the acceptability and affordability of food available at the most frequently used grocery store, and self-reported difficulties in accessing food. We used polytomous logistic regression to estimate the association between household food insecurity and the local food environment. In all the models, we coded food security status in three categories: food security, moderate food insecurity and severe food insecurity. The last group was used as a reference group. RESULTS: Our data suggest that compared to households with severe food insecurity, those with moderate food insecurity (OR = 0.43, 95% CI: 0.28-0.62) and those with food security (OR = 0.13, 95% CI: 0.06-0.26) were less likely to report difficulties in accessing food due to food affordability. Food-secure households also had lower odds of reporting difficulties in accessing food due to transportation constraints (OR = 0.18, 95% CI: 0.06-0.55) compared with severe food-insecure households. Living a distance of between 1 and 2 km from the organization used was significantly correlated with moderate food insecurity (OR = 1.80, 95% CI: 1.12-2.88). CONCLUSION: The local food environment is associated with severity of household food insecurity among new families using community food security interventions in Montreal. Future studies should study the relationship between the local food environment and food insecurity across all dimensions of food access.
Medical innovation and the sustainability of health systems: A historical perspective on technological change in health
Health Services Management Research, 2016
New medical technology challenges the sustainability of healthcare systems in several countries. ... more New medical technology challenges the sustainability of healthcare systems in several countries. Drawing on secondary sources of data, the aim of this article is to generate a better understanding of the historical Research & Development dynamics that have contributed to shape today’s medical innovation ecosystem. We describe key technological achievements along three historical periods – the 1950s, the 1980s and the 2000s – and situate them within their broader political, social, cultural and economic contexts. Our analyses bring forward self-reinforcing dynamics between technology, medical specialization, individualization of disease and the concentration of resources in academic teaching centres. We argue that the way medical innovation has been financed, designed and commercialized since the 1950s has engendered path dependency, which exacerbates the sustainability challenges healthcare systems are now facing. We conclude on the need for innovation design principles that could p...
BMC Health Services Research, 2017
Background: While there is an extensive literature on Health System (HS) strengthening and on the... more Background: While there is an extensive literature on Health System (HS) strengthening and on the performance of specific HSs, there are few exhaustive syntheses of the challenges HSs are facing worldwide. This paper reports the findings of a scoping review aiming to classify the challenges of HSs investigated in the scientific literature. Specifically, it determines the kind of research conducted on HS challenges, where it was performed, in which health sectors and on which populations. It also identifies the types of challenge described the most and how they varied across countries. Methods: We searched 8 databases to identify scientific papers published in English, French and Italian between January 2000 and April 2016 that addressed HS needs and challenges. The challenges reported in the articles were classified using van Olmen et al.'s dynamic HS framework. Countries were classified using the Human Development Index (HDI). Our analyses relied on descriptive statistics and qualitative content analysis. Results: 292 articles were included in our scoping review. 33.6% of these articles were empirical studies and 60.1% were specific to countries falling within the very high HDI category, in particular the United States. The most frequently researched sectors were mental health (41%), infectious diseases (12%) and primary care (11%). The most frequently studied target populations included elderly people (23%), people living in remote or poor areas (21%), visible or ethnic minorities (15%), and children and adolescents (15%). The most frequently reported challenges related to human resources (22%), leadership and governance (21%) and health service delivery (24%). While health service delivery challenges were more often examined in countries within the very high HDI category, human resources challenges attracted more attention within the low HDI category. Conclusions: This scoping review provides a quantitative description of the available evidence on HS challenges and a qualitative exploration of the dynamic relationships that HS components entertain. While health services research is increasingly concerned about the way HSs can adopt innovations, little is known about the system-level challenges that innovations should address in the first place. Within this perspective, four key lessons are drawn as well as three knowledge gaps.
International Journal of Health Policy and Management, 2019
Food security is “the right of every individual to have access to safe and nutritious food, consi... more Food security is “the right of every individual to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger.”[1][1] Despite the well-known association between food insecurity and type 2 diabetes, hypertension
International Journal of Health Policy and Management
Background: While responsible innovation in health (RIH) suggests that health innovations could b... more Background: While responsible innovation in health (RIH) suggests that health innovations could be purposefully designed to better support health systems, little is known about the system-level challenges that it should address. The goal of this paper is thus to document what is known about health systems’ demand for innovations. Methods: We searched 8 databases to perform a scoping review of the scientific literature on health system challenges published between January 2000 and April 2016. The challenges reported in the articles were classified using the dynamic health system framework. The countries where the studies had been conducted were grouped using the human development index (HDI). Frequency distributions and qualitative content analysis were performed. Results: Up to 1391 challenges were extracted from 254 articles examining health systems in 99 countries. Across countries, the most frequently reported challenges pertained to: service delivery (25%), human resources (23%)...
The monitoring and controlling of the beam transverse emittance is essential to allow high lumino... more The monitoring and controlling of the beam transverse emittance is essential to allow high luminosity performances in a collider operation. The profile monitors in the LHC injection chain are exploited to determine their precision. A fit strategy was developed to reduce the fitting procedure error and make it negligible compared to instrumentation errors. The method proved to be robust against non-Gaussian tails and can estimate the fraction of non-Gaussian distributed beam intensity. The procedure was applied to the 2003 SPS Wire Scanner measurements with different kind of LHC type beams. The reproducibility and accuracy of the six available monitors was determined by making synchronized measurements on the same proton beam. Some instrumental errors were discovered and corrected to the three per cent level. The demanding small LHC transverse emittances were determined under different beam conditions in terms of intensity, bunch spacing and length in the PS Booster, PS and SPS.
At the LHC, four Roman Pot (RP) type detectors will be installed on both sides of the ATLAS exper... more At the LHC, four Roman Pot (RP) type detectors will be installed on both sides of the ATLAS experiment with the aim of measuring elastic scattering at very small angles and determining the absolute luminosity at the interaction point. During dedicated LHC runs, the detectors will be positioned at about 1 mm from the nominal beam orbit. Numerical simulations and laboratory measurements were carried out to characterize the RP impact on the total LHC beam coupling impedance. The measurement results assess the effectiveness of RF-absorbing ferrite plates that have been mounted in convenient locations in order to damp high Q resonances of the RP structure. In addition, we review the RP mechanics emphasizing the accuracy and reproducibility of the positioning system.
Igiene e sanita pubblica
"I don't smoke, and you?" is a project aimed at secondary school students and is pa... more "I don't smoke, and you?" is a project aimed at secondary school students and is part of a wider project called "Free from Smoke", implemented by the Lombardia Region and involving elementary and secondary school students. The project is a controlled non randomized study whose aim is to direct students toward a healthy and smoke-free way of living, by also involving parents and teachers. A total of 11,610 12 year-olds of both sexes were evaluated, 6392 of whom were enrolled in the program and 5218 of whom served as controls and only completed the questionnaire. Three years after the start of the program, a greater increase in the prevalence of smokers was found amongst the group of controls than amongst the enrolled group (108,3% vs +93.8%, p>0.001). The percentage of students who believe that smoking even a small number of cigarettes is harmful, increased in the enrolled group (+0.6%) while it diminished in controls (-2.1%). In addition, a strong associat...
Clouds of electrons in the vacuum chambers of accelerators of positively charged particle beams p... more Clouds of electrons in the vacuum chambers of accelerators of positively charged particle beams present a serious limitation for operation of these machines at high currents. Because of the size of these accelerators, it is difficult to probe the low energy electron clouds over substantial lengths of the beam pipe. We applied a novel technique to directly measure the electron cloud density via the phase shift induced in a TE wave which is independently excited and transmitted over a straight section of the accelerator. The modulation in the wave transmission which appear to increase in depth when the clearing solenoids are switched off, seem to be directly correlated to the electron cloud density in the section. Furthermore, we expect a larger phase shift of a wave transmitted through magnetic dipole field regions if the transmitted wave couples with the gyration motion of the electrons. We have used this technique to measure the average electron cloud density (ECD) specifically for...
[Evaluation of the efficacy of a school-based program to prevent tobacco smoking among adolescents in Lombardy (Italy)]
Igiene e sanità pubblica
The program "Free to choose" was a school-based program aimed at encouraging secondary ... more The program "Free to choose" was a school-based program aimed at encouraging secondary school students to lead healthy lifestyles and free from tobacco smoke. The project was part of a wider project named "Free from tobacco smoke", implemented in kindergarten, elementary and secondary schools in Lombardy (Italy). The "Free to choose" program was a controlled, non randomized study involving 2,145 subjects aged 16 years, of whom 1,063 participated in the activities laid out by the program (treatment group) and 1,082 only completed the questionnaires (control group). The program did not achieve the aim of reducing the number of subjects who start smoking. However, an increased awareness of the risks of smoking was observed among "treated" subjects as well as an increased number of non smokers who intend to refuse a cigarette if they were offered one.
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Papers by Federico Roncarolo