Supplement to Statistics Canada's Generic Privacy Impact Assessment related to the Survey on Health Care Workers' Experiences During the Pandemic (SHCWEP)

The impact of the COVID-19 pandemic on health care workers is not fully understood. There are few existing sources of information on this topic, in particular on the impact on health care workers' personal life, so a survey is needed to fill this data gap. The results of this survey may be used by the Public Health Agency of Canada, Health Canada, the Canadian Institute for Health Information and other government organizations to help to inform health care workforce planning, the delivery of health care services and to better understand what health care workers need in terms of equipment, training and support.

Only health care workers living in the provinces are eligible to participate. This is a targeted respondent survey and respondents will confirm that they are health care workers at the start of the survey. The demographic data and occupational group information collected will be used for analysis of subgroups of the population. The health care workers have been stratified into four groups from a list of 24 occupations: physicians, nurses, personal support workers (PSWs) and other health care workers. A goal of the survey is to be able to understand how the impacts of the pandemic are affecting different types of health care workers.

The survey data file, without direct identifiers other than postal code and date of birth, will be made available to researchers in the Research Data Centres (RDC) upon approval of requests to access the data for statistical research. Statistics Canada's directives and policies on data publication will be followed to ensure the confidentiality of any data released from the RDC. Only aggregate results, which are fully anonymized and non-confidential, without direct identifiers, which precludes the possibility of re-identifying individuals, can be released from the RDC. Statistics Canada will retain this data as long as required for statistical purposes, in order to conduct analysis of long‐term impacts.

Although there are currently no plans for record linkage, direct personal identifiers such as name will be retained on a separate file in a secure location for potential linkage opportunities in the future.

Statistics Canada's microdata linkage and related statistical activities were assessed in Statistics Canada's Generic Privacy Impact Assessment.^{Footnote 4} All data linkage activities are subject to established governance^{Footnote 5} , and are assessed against the privacy principles of necessity and proportionality.^{Footnote 6} All approved linkages are published on Statistics Canada's website.^{Footnote 7}

A questionnaire was developed by following Statistics Canada's processes and methodology to produce results that are representative of the population. The survey will be administered using a self-reported electronic questionnaire with interviewer telephone follow-up for non-response. A random sample of health care workers or individuals expected to be working as health care workers from Statistics Canada's 2016 Census 2016 will receive an invitation letter and secure access code to complete the survey on Statistics Canada's secure website. After 3 and a half weeks, interviewers will follow up with individuals that have not yet responded, to re-issue the invitation and provide respondents with the opportunity to complete the survey over the telephone with a trained Statistics Canada interviewer. The collection period will be approximately ten weeks. All Statistics Canada directives and policies for the development, collection, and dissemination of the survey will be followed, and survey responses will not be attached to respondents' addresses or phone numbers. The data will be representative of the health care worker population and may be disaggregated by province, ethnicity, gender, age groupings, and other variables; in order to ensure anonymity.

Data on mental health and its impacts, as well as data on consumption of illegal drugs are highly sensitive. Moreover, mental-health issues may be exacerbated due to COVID‐19 isolation protocols. For these reasons, experts at Statistics Canada have been consulted on the scope and methodology of the survey. Wherever possible, questions about mental health and well‐being from existing surveys have been used. Some of these questions were taken from the Survey of COVID-19 and Mental Health (SCMH) and have previously undergone qualitative testing; the SHCWEP questionnaire also underwent qualitative testing.

All the data to be collected are required to fulfill the purpose of the survey as described above. All questions and response categories were carefully considered to ensure they accurately capture the data in question to help inform activities such as health care workforce planning, the delivery of health care services and to better understand what health care workers need in terms of equipment, training, and support.

Statistics Canada directives and policies with respect to data collection and publication will be followed to ensure the confidentiality of the data. Individual responses will be grouped with those of others when reporting results. Individual responses and results for small groups (as established by minimum prevalence levels for each variable among these small groups) will not be published or shared with government departments or agencies. This approach will also reduce any potential impact on vulnerable populations or subsets of populations, as the grouping of results will protect the confidentiality of individuals within a particular subset of the population. As permitted by the Statistics Act^{Footnote 8} and with consent of individual respondents, survey responses may be shared with the Public Health Agency of Canada, Health Canada, provincial and territorial ministries of health, and for Quebec residents, the Institut de la statistique du Québec, strictly for statistical and research purposes, to aid in future policy decisions related to health care workers, in accordance with Statistics Canada's security and confidentiality requirements.

The findings will support decision-making at all levels of government and improve knowledge and understanding of the impact of the COVID-19 pandemic on health care workers, and will help inform government decision‐making in order to support health care workers in their personal and professional lives. The privacy measures taken are proportional to the potential risks to an individual's privacy.

Proportionality has also been considered based on ethics:

Prior to collection, individuals selected to participate in the survey will be clearly informed that the survey is voluntary. They will also be informed of the survey's purpose and topics, so that they can make an informed decision about whether they want to participate. This notification to all potential participants will be done in writing on the questionnaire, or verbally by the interviewer before any questions are asked. They will also be asked if their data can be shared with the Public Health Agency of Canada, Health Canada, provincial and territorial ministries of health, and for Quebec residents, the Institut de la statistique du Québec.

Since some of the survey questions are sensitive and could lead to distress, mental-health resources will be included in the help text for those questions, which can be accessed in the electronic questionnaire and during interviews.

The help text reads as follows and includes 10 resources of which 3 are listed here as examples:

In the current context of COVID-19, many people are trying to adjust to the new norms, such as returning to work or day-to-day life. During this time, many people may not feel that they are in control of things, and it is normal to feel concerned, sad, stressed, confused, scared or worried.

Should you need any support, please contact any of the following resources:

• Canada Suicide Prevention Service

  A national network of existing distress, crisis and suicide prevention line services

  Crisis Services Canada website

  Telephone: 1-833-456-4566

• APPELLE (Quebec Residents)

  Help line for those thinking about suicide or are worried about a loved one

  Telephone: 1-866-277-3553

• Centre for Addiction and Mental Health

  A wide range of clinical care services for mental illness and addictions

  Camh website

  Telephone: 1-800-463-2338

Research was conducted on existing administrative data and other surveys related to health care workers. It was determined that these types of data sources would not provide the details needed to fully understand the impact of the COVID-19 pandemic on health care workers. As a result, it was determined that a survey to collect this information was required. A previous crowdsource collection, where information is collected from volunteers, took place in November and December of 2020 which collected information primarily related to the participant's work environment and access to infection prevention and control (IPC) and personal protective equipment (PPE) at work without much information about individuals' personal lives. Additionally, because it was a crowdsource collection, it is not possible to use it to produce estimates that are representative of the Canadian population. Based on discussions between health and methodology experts within Statistics Canada and the Public Health Agency of Canada, it was determined that a survey with at least 30,000 units was necessary to produce reliable and accurate results by province and the four health occupation groups of interest (physicians, nurses, PSWs, and other health care workers). Releasing data at these aggregated levels would reduce the potential to identify impacts on vulnerable populations, subsets of populations, and groups.