1 Mathews M, et al. BMJ Open 2021;11:e048209. doi:10.1136/bmjopen-2020-048209 Open access 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 Maria Mathews, 1 Sarah Spencer , 2 Lindsay Hedden, 2,3 Emily Gard Marshall , 4 Julia Lukewich, 5 Leslie Meredith, 1 Dana Ryan, 5 Richard Buote, 6 Tiffany Liu, 7 Emily Volpe, 7 Paul S Gill, 8,9 Bridget Ryan, 1,7 Gordon Schacter, 1 Jamie Wickett, 1 Thomas R Freeman, 1 Shannon L Sibbald, 1,10 Eric Wong, 1,11 Maddi McKay, 4,12 Rita McCracken , 13,14 Judith Belle Brown 1 To cite: Mathews M, Spencer S, Hedden L, et al. 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. BMJ Open 2021;11:e048209. doi:10.1136/ bmjopen-2020-048209 ► Prepublication history for this paper is available online. To view these fles, please visit the journal online (http://dx.doi. org/10.1136/bmjopen-2020- 048209). Received 18 December 2020 Accepted 05 May 2021 For numbered affliations see end of article. Correspondence to Professor Maria Mathews; maria.mathews@schulich. uwo.ca Protocol © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ABSTRACT Introduction 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. Methods and analysis 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 identifed 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 infuence of gender on their professional roles. Data will be thematically analysed using a content analysis framework, frst at the regional level and then through cross-case analyses. Ethics and dissemination 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. INTRODUCTION Family physicians have an important role to play during a pandemic, with responsibilities including sentinel surveillance, screening, testing, health education, monitoring indi- viduals and providing follow-up care, contrib- uting to hospital and emergency room surge capacity and providing vaccinations. 1–5 Strengths and limitations of this study ► Our interdisciplinary research team includes expe- rienced primary care researchers, family physicians and public health experts, allowing us to draw on their expert knowledge in the development of study tools and the interpretation and dissemination of fndings. ► The use of a multiple-case study approach will aid in making distinctions between localised issues specifc to a single case and cross-cutting themes present across health regions. ► While maximum variation sampling will facilitate the recruitment of participants along a wide variety of characteristics in the selected regions and provinc- es, the transferability of fndings may be limited by provincial variation in primary care and health policy in Canada. ► We anticipate this study will highlight gaps in current pandemic response plans and identify promising practices and key facilitators to incorporate in future pandemic response plans for family physicians. on January 26, 2022 by guest. 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