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Monthly EC visit counts were modeled overall and for mental health and behavioural diagnoses (MBD). Two separate interrupted time series analyses were conducted, each with a single interruption point: the May 2016 wildfire (analytic window May 2014\u2013April 2018) and April 2020 onset of COVID-19 (analytic window April 2017\u2013March 2023). Segmented regression models (Poisson or negative binomial) estimated level and post-event slope changes stratified by age, sex, and location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The wildfire was associated with geographic displacement of care. Province-wide, EC visits showed immediate level changes (+\u200921.0% overall; +\u200943.0% MBD). Conversely, COVID-19 was associated with an immediate local decline in EC visits (\u2212\u200948.2%), slope increase, and faster post-COVID growth. MBD-related visits showed stability, with no significant immediate change and slower post-pandemic growth. Crisis impacts varied by age and sex, with youth and those assigned male at birth showing the most pronounced changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates how co-designed epidemiological methods can highlight community priorities and lived experiences through data. Repeated crises shaped EC utilization among First Nations residents in distinct ways, indicating possible disruptions in access and alterations in care-seeking patterns. Findings emphasize the importance of strengthening culturally safe, community-led, and age- and sex-responsive approaches to mental wellness, emergency preparedness, and recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.17269\/s41997-026-01238-2","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:33:13Z","timestamp":1784820793000},"page":"852-866","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patterns of emergency care utilization among First Nations residents of Wood Buffalo, Alberta, during public health crises: An interrupted time series analysis"],"prefix":"10.17269","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-9330","authenticated-orcid":false,"given":"Erynne","family":"Sjoblom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0539-8877","authenticated-orcid":false,"given":"Barbara S. 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Oversight and guidance were provided by the ATC and its member Nations, who supported the use, stewardship, and dissemination of First Nations data in alignment with OCAP\u00ae principles (Ownership, Control, Access, Possession) and Chapter 9: Research Involving the First Nations, Inuit and M\u00e9tis Peoples of Canada of the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans - TCPS 2.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Athabasca Tribal Council and the Ministry of Primary and Preventative Health Services provided consent for publication of this manuscript.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}