39 results on '"Cargo, Margaret"'
Search Results
2. Additional file 2 of How does integrated knowledge translation (IKT) compare to other collaborative research approaches to generating and translating knowledge? Learning from experts in the field
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Nguyen, Tram, Graham, Ian D., Mrklas, Kelly J., Bowen, Sarah, Cargo, Margaret, Estabrooks, Carole A., Kothari, Anita, Lavis, John, Macaulay, Ann C., MacLeod, Martha, Phipps, David, Ramsden, Vivian R., Renfrew, Mary J., Salsberg, Jon, and Wallerstein, Nina
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Data_FILES ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) - Abstract
Additional file 2. Key literature.
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- 2020
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3. Promoting handwashing and sanitation behaviour change in low- and middle-income countries: a mixed-method systematic review. 3ie Systematic Review 36
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De Buck, Emmy, Van Remoortel, Hans, Hannes, Karin, Govender, Tashlin, Naidoo, S, Avau, Bert, Vande Veegaete, Axel, Musekiwa, A, Lutje, V, Cargo, Margaret, and Mosler, HJ
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WASH ,systematic review ,international development - Abstract
ispartof: pages:1-506 status: Published online
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- 2017
4. Additional file 2: of Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol
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Subash Thapa, Hannes, Karin, Cargo, Margaret, Buve, Anne, and Mathei, Catharina
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Summary of data extraction tool. (DOCX 196 kb)
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- 2015
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5. Additional file 1: of Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol
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Subash Thapa, Hannes, Karin, Cargo, Margaret, Buve, Anne, and Mathei, Catharina
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Draft keyword search strategy. Provides an overview of keyword serch strategy used in several databases in thisstudy. (DOCX 54 kb)
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- 2015
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6. Development of the Physical Activity Interactive Recall (PAIR) for Aboriginal children
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Lévesque, Lucie, Cargo, Margaret, Salsberg, Jon, Canadian Diabetes Association, and Université de Montréal. École de santé publique. Département de médecine sociale et préventive
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Canada ,lcsh:Nutritional diseases. Deficiency diseases ,Aboriginal children ,lcsh:Public aspects of medicine ,Research ,lcsh:RA1-1270 ,lcsh:RC620-627 - Abstract
BACKGROUND:Aboriginal children in Canada are at increased risk for type 2 diabetes. Given that physical inactivity is an important modifiable risk factor for type 2 diabetes, prevention efforts targeting Aboriginal children include interventions to enhance physical activity involvement. These types of interventions require adequate assessment of physical activity patterns to identify determinants, detect trends, and evaluate progress towards intervention goals. The purpose of this study was to develop a culturally appropriate interactive computer program to self-report physical activity for Kanien'kehá:ka (Mohawk) children that could be administered in a group setting. This was an ancillary study of the ongoing Kahnawake Schools Diabetes Prevention Project (KSDPP).METHODS:During Phase I, focus groups were conducted to understand how children describe and graphically depict type, intensity and duration of physical activity. Sixty-six students (40 girls, 26 boys, mean age = 8.8 years, SD = 1.8) from four elementary schools in three eastern Canadian Kanien'kehá:ka communities participated in 15 focus groups. Children were asked to discuss and draw about physical activity. Content analysis of focus groups informed the development of a school-day and non-school-day version of the physical activity interactive recall (PAIR). In Phase II, pilot-tests were conducted in two waves with 17 and 28 children respectively to assess the content validity of PAIR. Observation, videotaping, and interviews were conducted to obtain children's feedback on PAIR content and format.RESULTS:Children's representations of activity type and activity intensity were used to compile a total of 30 different physical activity and 14 non-physical activity response choices with accompanying intensity options. Findings from the pilot tests revealed that Kanien'kehá:ka children between nine and 13 years old could answer PAIR without assistance. Content validity of PAIR was judged to be adequate. PAIR was judged to be comprehensive, acceptable, and enjoyable by the children.CONCLUSIONS:Results indicate that PAIR may be acceptable to children between nine and 13 years old, with most in this age range able to complete PAIR without assistance. The flexibility of its programming makes PAIR an easily adaptable tool to accommodate diverse populations, different seasons, and changing trends in physical activity involvement., Affiliation: Margaret Cargo : Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal
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- 2003
7. Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature
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Alwin Chong, Nicola Slavin, Margaret Cargo, Natasha J. Howard, Alex Brown, Mark Daniel, Amal Chakraborty, Chakraborty, Amal, Daniel, Mark, Howard, Natasha J, Chong, Alwin, Slavin, Nicola, Brown, Alex, and Cargo, Margaret
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environmental indicators ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Health, Toxicology and Mutagenesis ,public policy ,Public policy ,lcsh:Medicine ,environmental health ,Review ,Indigenous ,03 medical and health sciences ,Gray Literature ,0302 clinical medicine ,Population Groups ,social planning ,medicine ,Northern Territory ,Health Services, Indigenous ,Humans ,030212 general & internal medicine ,indigenous ,Environmental planning ,Built environment ,Social policy ,030505 public health ,High prevalence ,community infrastructure ,Public health ,lcsh:R ,public health ,Public Health, Environmental and Occupational Health ,Grey literature ,built environment ,community capacity ,Identification (information) ,Geography ,grey literature ,Chronic Disease ,Public Health ,0305 other medical science - Abstract
The high prevalence of preventable infectious and chronic diseases in Australian Indigenous populations is a major public health concern. Existing research has rarely examined the role of built and socio-political environmental factors relating to remote Indigenous health and wellbeing. This research identified built and socio-political environmental indicators from publicly available grey literature documents locally-relevant to remote Indigenous communities in the Northern Territory (NT), Australia. Existing planning documents with evidence of community input were used to reduce the response burden on Indigenous communities. A scoping review of community-focused planning documents resulted in the identification of 1120 built and 2215 socio-political environmental indicators. Indicators were systematically classified using an Indigenous indicator classification system (IICS). Applying the IICS yielded indicators prominently featuring the “community infrastructure” domain within the built environment, and the “community capacity” domain within the socio-political environment. This research demonstrates the utility of utilizing existing planning documents and a culturally appropriate systematic classification system to consolidate environmental determinants that influence health and disease occurrence. The findings also support understanding of which features of community-level built and socio-political environments amenable to public health and social policy actions might be targeted to help reduce the prevalence of infectious and chronic diseases in Indigenous communities Refereed/Peer-reviewed
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- 2021
8. Cochrane Qualitative and Implementation Methods Group guidance series—paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews
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Andrew Booth, Janet Harris, Angela Harden, Jane Noyes, Kate Flemming, Margaret Cargo, Tomas Pantoja, Ruth Garside, Karin Hannes, James Thomas, Harden, Angela, Thomas, James, Cargo, Margaret, Harris, Janet, Pantoja, Tomas, Flemming, Kate, Booth, Andrew, Garside, Ruth, Hannes, Karin, and Noyes, Jane
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Biomedical Research ,Evidence-Based Medicine ,Epidemiology ,Process (engineering) ,Computer science ,Management science ,Multimethodology ,Guidelines as Topic ,Context (language use) ,Evidence-based medicine ,03 medical and health sciences ,0302 clinical medicine ,Systematic review ,Intervention (counseling) ,Humans ,systematic reviews ,mixed methods research ,qualitative research ,implementation research ,process evaluations ,Cochrane collaboration ,qualitative evidence synthesis ,030212 general & internal medicine ,Implementation research ,Delivery of Health Care ,Qualitative Research ,030217 neurology & neurosurgery ,Systematic Reviews as Topic ,Qualitative research - Abstract
The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Refereed/Peer-reviewed
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- 2018
9. Cochrane Qualitative and Implementation Methods Group guidance series—paper 4: methods for assessing evidence on intervention implementation
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Ruth Garside, Margaret Cargo, Karin Hannes, Janet Harris, James Thomas, Tomas Pantoja, Andrew Booth, Angela Harden, Jane Noyes, Kate Flemming, Cargo, Margaret, Harris, Janet, Pantoja, Tomas, Booth, Andrew, Harden, Angela, Hannes, Karin, Thomas, James, Flemming, Kate, Garside, Ruth, and Noyes, Jane
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Program evaluation ,Biomedical Research ,Epidemiology ,Process (engineering) ,Computer science ,Decision Making ,systematic reviews ,03 medical and health sciences ,0302 clinical medicine ,qualitative evidence synthesis ,Causal chain ,Humans ,Intervention implementation ,Review process ,030212 general & internal medicine ,implementation ,Qualitative Research ,Evidence-Based Medicine ,Management science ,030503 health policy & services ,mixed-method synthesis ,Work in process ,process evaluation ,Data Accuracy ,Cochrane ,Systematic review ,Process evaluation ,0305 other medical science ,Systematic Reviews as Topic - Abstract
Objectives: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. Study Design and Setting: Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). Results: Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. Conclusion: Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches. Refereed/Peer-reviewed
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- 2018
10. Improving the content validity of the Mixed Methods Appraisal Tool: a modified e-Delphi study
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Hong, Quan Nha, Pluye, Pierre, Fàbregues Feijóo, Sergi, Bartlett, Gillian, Boardman, Felicity, Cargo, Margaret, Dagenais, Pierre, Gagnon, Marie-Pierre, Griffiths, Frances, Nicolau, Belinda, O'Cathain, Alicia, Rousseau, Marie-Claude, and Vedel, Isabelle
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Investigación cualitativa ,Delphi technique ,Qualitative research ,Quality appraisal ,Systematic review ,Mixed methods research ,Surveys ,Survey ,Enquestes ,Investigació qualitativa ,Encuestas - Abstract
Objective: The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies. Study Design and Setting: First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale. Results: A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria. Conclusion: Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018).
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- 2019
11. Disparities in cancer stage at diagnosis and survival of Aboriginal and non-Aboriginal South Australians
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Marion Eckert, David Roder, Gelareh Farshid, Alex Brown, Dorothy M. K. Keefe, David Banham, Margaret Cargo, Banham, David, Roder, David, Keefe, Dorothy, Farshid, Gelareh, Eckert, Marion, Cargo, Margaret, and Brown, Alex
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Male ,Cancer Research ,Native Hawaiian or Other Pacific Islander ,Epidemiology ,0302 clinical medicine ,cancer stage ,Neoplasms ,030212 general & internal medicine ,Stage (cooking) ,indigenous ,Child ,Aboriginal ,Cancer ,Aged, 80 and over ,disadvantage ,Middle Aged ,medicine.anatomical_structure ,Oncology ,disparity ,030220 oncology & carcinogenesis ,Child, Preschool ,Female ,geographic remoteness ,Adult ,Risk ,medicine.medical_specialty ,Adolescent ,survival ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Healthcare Disparities ,Cervix ,Cancer staging ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Australia ,Infant, Newborn ,Infant ,Odds ratio ,medicine.disease ,Survival Analysis ,Cancer registry ,Residence ,business ,Demography - Abstract
Background/Aim: This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. Methods: This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977–2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990–2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. Results: Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p < 0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. Conclusion: Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas. Refereed/Peer-reviewed
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- 2016
12. Policy, Research and Residents' Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach
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Mark Daniel, Ivana Stankov, Natasha J. Howard, Margaret Cargo, Stankov, Ivana, Howard, Natasha J, Daniel, Mark, and Cargo, Margaret
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Male ,Health, Toxicology and Mutagenesis ,Concept Formation ,lcsh:Medicine ,0302 clinical medicine ,cardiometabolic risk ,11. Sustainability ,South Australia ,researcher perspectives ,030212 general & internal medicine ,Sociology ,Built environment ,Health Policy ,Environmental resource management ,Stakeholder ,Public relations ,Middle Aged ,3. Good health ,Cardiovascular Diseases ,Female ,community participation ,0305 other medical science ,Attitude to Health ,policy ,Adult ,medicine.medical_specialty ,Community-Based Participatory Research ,Community-based participatory research ,concept mapping ,Article ,03 medical and health sciences ,Metabolic Diseases ,Concept learning ,built environment ,medicine ,Humans ,Cities ,Health policy ,Aged ,Government ,030505 public health ,business.industry ,Public health ,lcsh:R ,Public Health, Environmental and Occupational Health ,Urban Health ,Citizen journalism ,Environment Design ,business - Abstract
An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR). Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups’ perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention. Refereed/Peer-reviewed
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- 2016
13. Improving the content validity of the mixed methods appraisal tool: a modified e-Delphi study
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Isabelle Vedel, Felicity K. Boardman, Sergi Fàbregues, Frances Griffiths, Pierre Pluye, Quan Nha Hong, Alicia O’Cathain, Gillian Bartlett, Pierre Dagenais, Marie-Pierre Gagnon, Belinda Nicolau, Marie-Claude Rousseau, Margaret Cargo, McGill University = Université McGill [Montréal, Canada], Universitat Oberta de Catalunya [Barcelona] (UOC), University of Warwick [Coventry], University of Canberra, Université de Sherbrooke (UdeS), Université Laval [Québec] (ULaval), University of Sheffield [Sheffield], Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), The authors gratefully acknowledge the sponsorship from the Method Development platform of the Québec SPOR SUPPORT Unit (#BRDV-CIHR-201-2014-05), the CIHR Doctoral Fellowship Award (#301011), and the FRSQ Senior Investigator Award (#29308)., The research team would like to acknowledge and sincerely thank all the e-Delphi panel experts for their contributions., Hong, Quan Nha, Pluye, Pierre, Fàbregues Feijóo, Sergi, Bartlett, Gillian, Boardman, Felicity, Cargo, Margaret, Dagenais, Pierre, Gagnon, Marie-Pierre, Griffiths, Frances, Nicolau, Belinda, O'Cathain, Alicia, Rousseau, Marie-Claude, and Vedel, Isabelle
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Delphi Technique ,Epidemiology ,Computer science ,[SDV]Life Sciences [q-bio] ,Applied psychology ,Delphi method ,Mixed methods research ,Surveys ,Enquestes ,Investigació qualitativa ,Likert scale ,03 medical and health sciences ,0302 clinical medicine ,Delphi technique ,Qualitative research ,Content validity ,Relevance (information retrieval) ,030212 general & internal medicine ,Survey ,Investigación cualitativa ,Multimethodology ,Clinical study design ,Reproducibility of Results ,Encuestas ,Critical appraisal ,Research Design ,Systematic review ,Quality appraisal ,030217 neurology & neurosurgery - Abstract
International audience; Objective : The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies.Study Design and Setting : First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale.Results : A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria.Conclusion : Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018).
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- 2019
14. A Role for Communities in Primary Prevention of Chronic Illness? Case Studies in Regional Australia
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Margaret Cargo, Robyn Preston, Sarah Larkins, Annette J Braunack-Mayer, Judy Taylor, Taylor, Judy, Braunack-Mayer, Annette, Cargo, Margaret, Larkins, Sarah, and Preston, Robyn
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Typology ,community and public health ,health promotion ,Local society ,Health Promotion ,Fitness Centers ,Affect (psychology) ,Public-Private Sector Partnerships ,case studies ,Capital Financing ,Nursing ,Primary prevention ,Health Planning Support ,Humans ,participation ,Community psychology ,Community Health Services ,Sociology ,health care economics and organizations ,business.industry ,Australia ,Public Health, Environmental and Occupational Health ,social ,Health Care Coalitions ,Public relations ,Community-Institutional Relations ,Additional research ,Primary Prevention ,Leadership ,Health promotion ,Chronic Disease ,Organizational Case Studies ,Community interaction ,business ,community-based programs - Abstract
In regional Australia "communities of place," defined as bounded geographic locations with a local society, undertake community-wide primary prevention programs. In helping to prevent chronic illness, communities provide valuable resources to the health system. To understand the role of community-health sector partnerships for primary prevention and the community contextual factors that affect them, we studied eight partnerships. We used an embedded multiple case study design and collected data through interviews, nonparticipant observation, and document analysis. These data were analyzed using a typology of community-health sector partnerships and community interaction theory to frame the key community contextual factors that affected partnerships. The dominant factor affecting all partnerships was the presence of a collective commitment that communities brought to making the community a better place through developing health. We call this a communitarian approach. Additional research to investigate factors influencing a communitarian approach and the role it plays in partnerships is required. Refereed/Peer-reviewed
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- 2013
15. Cochrane Qualitative and Implementation Methods Group guidance series-paper 1: introduction
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Simon Lewin, Angela Harden, Andrew Booth, Margaret Cargo, Tomas Pantoja, Jane Noyes, Kate Flemming, Ruth Garside, Janet Harris, Karin Hannes, James Thomas, Noyes, Jane, Booth, Andrew, Cargo, Margaret, Flemming, Kate, Garside, Ruth, Hannes, Karin, Harden, Angela, Harris, Janet, Lewin, Simon, Pantoja, Tomas, and Thomas, James
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Epidemiology ,education ,Decision Making ,systematic reviews ,MEDLINE ,Context (language use) ,Guidelines as Topic ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Humans ,030212 general & internal medicine ,Health policy ,Qualitative Research ,Publishing ,Medical education ,Evidence-Based Medicine ,business.industry ,Multimethodology ,Cochrane Qualitative and Implementation Methods Group ,Systematic review ,Implementation research ,business ,Psychology ,030217 neurology & neurosurgery ,Qualitative research ,Systematic Reviews as Topic - Abstract
Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognized health care resources for use in a decision-making process.1 Cochrane works collaboratively with contributors around the world to produce authoritative, relevant, and reliable reviews. Cochrane reviews are commonly used in a guideline development process to determine recommendations for practice. The Cochrane Qualitative and Implementation Methods Group provide methodological advice and guidance to Cochrane as well as leading methodological development to benefit the wider qualitative evidence synthesis community. In this introductory paper 1 we briefly outline the evolution of qualitative and mixed-method synthesis methods, the role of qualitative and mixedmethod syntheses in a decision-making process, and the contribution of qualitative and mixed-method syntheses to understanding complexity in complex intervention reviews. We then introduce a series of papers that provide Cochrane guidance on conducting qualitative and mixed-method evidence syntheses for a decision-making context. ispartof: Journal of Clinical Epidemiology vol:97 issue:97 pages:35-38 ispartof: location:United States status: published
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- 2016
16. Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses
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Margaret Cargo, Karin Hannes, Andrew Booth, Jane Noyes, Kate Flemming, Flemming, Kate, Booth, Andrew, Hannes, Karin, Cargo, Margaret, and Noyes, Jane
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Process management ,Biomedical Research ,Epidemiology ,Computer science ,Process (engineering) ,media_common.quotation_subject ,Decision Making ,systematic reviews ,Guidelines as Topic ,reporting guidelines ,methods ,03 medical and health sciences ,Presentation ,0302 clinical medicine ,qualitative evidence synthesis ,Humans ,030212 general & internal medicine ,implementation ,Qualitative Research ,media_common ,Evidence-Based Medicine ,030503 health policy & services ,Multimethodology ,Evidence-based medicine ,Transparency (behavior) ,Data Accuracy ,Systematic review ,Implementation research ,0305 other medical science ,Qualitative research ,Systematic Reviews as Topic - Abstract
Objectives: To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. Study Design and Setting: An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group.Results: Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching.Conclusion: Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses. Refereed/Peer-reviewed
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- 2016
17. Community and health sector partnerships for primary prevention in Australia: Developing a typology
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Robyn Preston, Sarah Larkins, Annette J Braunack-Mayer, Judy Taylor, Margaret Cargo, Taylor, Judy, Braunack-Mayer, Annette, Cargo, Margaret, Larkins, Sarah, and Preston, Robyn
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Typology ,Gerontology ,Sociology and Political Science ,health promotion ,business.industry ,Australia ,Public relations ,community health partnerships ,primary healthcare ,Economic sustainability ,Orientation (mental) ,Primary prevention ,Relevance (information retrieval) ,Sociology ,Health sector ,business ,chronic illness - Abstract
The Australian health system requires novel strategies to implement widespread primary prevention to reduce the burden of chronic illness. One approach is for health sectors to draw on resources available in communities of place and to form partnerships which maximize the relevance and uptake of initiatives designed to promote healthy lifestyles. This article presents a typology of conceptual approaches to community and health sector partnerships, developed through an extensive literature search and empirically tested using in-depth case studies across regional Australia. The article finds that the health sector’s orientation to primary prevention is generally instrumental involving highly targeted outcomes and pre-defined programmes. Communities of place have multifaceted priorities that include building the social and economic sustainability of their community. While these approaches might appear incompatible, careful ‘manipulation’ and ‘massaging’ of instrumental objectives to adjust to community agendas and the presence of ‘boundary crossers’ can lead to successful primary prevention outcomes. Refereed/Peer-reviewed
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- 2012
18. Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol
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Karin Hannes, Anne Buvé, Catharina Matheï, Subash Thapa, Margaret Cargo, Thapa, Subash, Hannes, Karin, Cargo, Margaret, Buve, Anne, and Mathei, Catharina
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Realist synthesis ,HIV stigma ,Stigma reduction intervention strategies ,HIV test uptake ,Low- and middle-income countries ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Social stigma ,medicine.medical_treatment ,Social Stigma ,Applied psychology ,Psychological intervention ,Medicine (miscellaneous) ,Stigma (botany) ,HIV Infections ,Support group ,Acquired immunodeficiency syndrome (AIDS) ,Intervention (counseling) ,Protocol ,Humans ,Medicine ,Psychiatry ,Developing Countries ,business.industry ,Social Discrimination ,Patient Acceptance of Health Care ,medicine.disease ,Risk perception ,Research proposal ,Research Design ,business ,Systematic Reviews as Topic - Abstract
Background Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. Methods A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. Discussion This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission. Systematic review registration PROSPERO CRD42015023687 Electronic supplementary material The online version of this article (doi:10.1186/s13643-015-0130-3) contains supplementary material, which is available to authorized users.
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- 2015
19. Community Capacity as an 'Inside Job': Evolution of Perceived Ownership within a University-Aboriginal Community Partnership
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Alex M. McComber, Lucie Lévesque, Treena Delormier, Margaret Cargo, Ann C. Macaulay, Cargo, Margaret D, Delormier, Treena, Levesque, Lucie, McComber, Alex, and Macaulay, Ann C
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Health (social science) ,Universities ,health promotion ,media_common.quotation_subject ,Statistics as Topic ,self-determination ,Community-based participatory research ,Health Promotion ,Grassroots ,Indians ,Nursing ,Political science ,Humans ,Community Health Services ,Longitudinal Studies ,Cooperative Behavior ,community-based participatory research ,media_common ,Chi-Square Distribution ,business.industry ,capacity building ,Quebec ,Public Health, Environmental and Occupational Health ,Capacity building ,Public relations ,Aboriginal community ,Self-determination ,Health promotion ,Social Perception ,prevention research ,Social Marketing ,General partnership ,Indians, North American ,business ,Administration (government) ,North American - Abstract
Purpose. To assess the evolution of perceived ownership of a university-Aboriginal community partnership across three project stages. Design. Survey administration to project partners during project formalization (1996—T1), mobilization (1999—T2), and maintenance (2004—T3). Setting. Aboriginal community of Kahnawake, outside Montreal, Quebec, Canada. Participants. Partners involved in influencing decision making in the Kahnawake Schools Diabetes Prevention Project (KSDPP). Measure and Analysis. A measure of perceived primary ownership subjected to linear trend analysis. Results. KSDPP staff were perceived as primary owner at T1 and shared ownership with Community Advisory Board (CAB) members at T2 and T3. Trend tests indicated greater perceived ownership between T1 and T3 for CAB (χ21 = 12.3, p < .0001) and declining KSDPP staff (χ21 = 10.5, p < .001) ownership over time. Academic partners were never perceived as primary owners. Conclusion. This project was community driven from the beginning. It was not dependent on an external academic change agent to activate the community and develop the community's capacity to plan and implement a solution. It still took several years for the grassroots CAB to take responsibility from KSDPP staff, thus indicating the need for sustained funding to build grassroots community capacity.
- Published
- 2011
20. Environmental Risk Conditions and Pathways to Cardiometabolic Diseases in Indigenous Populations
- Author
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Alex Brown, Margaret Cargo, Ivana Stankov, Mark Daniel, Peter Lekkas, Daniel, Mark, Lekkas, Peter, Cargo, Margaret Danna, Stankov, Ivana, and Brown, Alex
- Subjects
Cardiometabolic risk ,Public Health, Environmental and Occupational Health ,Context (language use) ,General Medicine ,Population health ,Environment ,Indigenous ,aboriginal ,cardiovascular diseases ,Geography ,Metabolic Diseases ,Population Groups ,Environmental risk ,Cardiovascular Diseases ,Risk Factors ,Environmental health ,diabetes mellitus ,composition versus context ,Humans ,population health ,Psychosocial ,Disadvantage - Abstract
This review examines environments in relation to cardiometabolic diseases in Indigenous populations in developed countries. Environmental factors are framed in terms of context (features of places) and composition (features of populations). Indigenous peoples are seen to have endured sociopolitical marginalization and material disadvantage spanning generations. Past adverse collective experiences, modified by culture, are reflected by current heterogeneity in environmental context and composition. As risk conditions, unfavorable contextual and compositional exposures influence the expression of cardiometabolic risk for individuals. Minimal research has evaluated heterogeneity in risk conditions against heterogeneity in cardiometabolic diseases between or within Indigenous populations. Thus far, the features of populations, not of places themselves, have been implicated in relation to cardiometabolic diseases. Behavioral, psychosocial, and stress-axis pathways may explain the relationships between risk conditions and cardiometabolic diseases. Implications of environmental factors and their pathways as well as important research needs are discussed in relation to ecological prevention to reduce cardiometabolic diseases. Refereed/Peer-reviewed
- Published
- 2011
21. Reliability of an instrument for direct observation of urban neighbourhoods
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Mark Daniel, Catherine Paquet, Yan Kestens, Margaret Cargo, Paquet, Catherine, Cargo, Margaret Danna, Kestens, Yan, and Daniel, Mark
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reliability and validity ,Social characteristics ,Ecology ,media_common.quotation_subject ,education ,Applied psychology ,Direct observation ,Management, Monitoring, Policy and Law ,epidemiologic measurements ,residence characteristics ,Metropolitan area ,Urban Studies ,neighbourhood observations ,Geography ,Cronbach's alpha ,Internal consistency ,Quality (business) ,Social determinants of health ,Reliability (statistics) ,Nature and Landscape Conservation ,media_common - Abstract
There is an increasing interest in evaluating physical and social characteristics of deprived and wealthy neighbourhoods to explain social health disparities. Direct observations enable obtaining a comprehensive and objective representation of such characteristics. The quality of this representation rests on the use of a reliable and valid observation tool. This study reports measurement properties of an instrument that was developed to directly observe structural and contextual environmental characteristics of urban neighbourhoods with respect to urban form (e.g., street safety elements, parking), negative attributes (e.g., rubbish, crumbling masonry, graffiti), and positive attributes (e.g., maintained dwellings, sitting benches). Two trained evaluators rated the condition of streets, public spaces, dwelling units and the presence/absence of specific characteristics of 250 street blocks within 30 socio-economically diverse census tracts of the Montreal Metropolitan Census Area in 2003. Inter- and intra-rater reliability was assessed using kappa and internal consistency was ascertained using Cronbach's alpha. Inter- and intra-rater reliability was excellent (>0.80) for items pertaining to urban form, and substantial (>0.60) for domains pertaining to positive and negative characteristics. Internal consistency was acceptable (>0.70) for urban form and negative characteristics, but not for positive characteristics. This study demonstrates the psychometric properties of an instrument designed to measure positive, negative, and urban form characteristics which has utility for examining various environmental effects on many aspects of health in a wide range of research contexts.
- Published
- 2010
22. Policy implementation: Implications for evaluation
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Amy DeGroff, Margaret Cargo, DeGroff, Amy, and Cargo, Margaret
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Government ,business.industry ,Strategy and Management ,Corporate governance ,Social change ,Public policy ,implementation processes ,program evaluation ,Context (language use) ,Management Science and Operations Research ,Public relations ,policy implementation ,Interconnectedness ,Education ,New public management ,Accountability ,Sociology ,business - Abstract
Policy implementation reflects a complex change process where government decisions are transformed into programs, procedures, regulations, or practices aimed at social betterment. Three factors affecting contemporary implementation processes are explored: networked governance, sociopolitical context and the democratic turn, and new public management. This frame of reference invites evaluators to consider challenges present when evaluating macrolevel change processes, such as the inherent complexity of health and social problems, multiple actors with variable degrees of power and influence, and a political environment that emphasizes accountability. The evaluator requires a deep and cogent understanding of the health or social issues involved; strong analysis and facilitation skills to deal with a multiplicity of values, interests, and agendas; and a comprehensive toolbox of evaluation approaches and methods, including network analysis to assess and track the interconnectedness of key champions (and saboteurs) who might affect intervention effects and sustainability. © Wiley Periodicals, Inc., and the American Evaluation Association.
- Published
- 2009
23. Strengths and limitations of a tool for monitoring and evaluating First Peoples' health promotion from an ecological perspective
- Author
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Leah Johnston, Leisa McCarthy, Mayatili Marika, Bradley Firebrace, Julie Calleja, Joyce Doyle, Kevin G. Rowley, Therese Riley, Rachel Reilly, Margaret Cargo, Petah Atkinson, Rowley, Kevin, Doyle, Joyce, Johnston, Leah, Reilly, Rachel, McCarthy, Leisa, Marika, Mayatili, Riley, Therese, Atkinson, Petah, Firebrace, Bradley, Calleja, Julie, and Cargo, Margaret
- Subjects
Program evaluation ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Human Rights ,health promotion ,Social Determinants of Health ,media_common.quotation_subject ,Ecological ,Health Promotion ,Environment ,Determinants of health ,Social Environment ,03 medical and health sciences ,0302 clinical medicine ,determinants of health ,Ecological psychology ,ecological ,Medicine ,Mainstream ,Humans ,030212 general & internal medicine ,Social determinants of health ,first peoples ,Cultural Competency ,Evaluation ,media_common ,Aboriginal and Torres Strait Islander ,030505 public health ,evaluation ,First Peoples ,Human rights ,Ecology ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Australia ,Systems ,Health promotion ,North America ,systems ,Public Health ,0305 other medical science ,business ,Cultural competence ,Program Evaluation ,Research Article - Abstract
Background: An ecological approach to health and health promotion targets individuals and the environmental determinants of their health as a means of more effectively influencing health outcomes. The approach has potential value as a means to more accurately capture the holistic nature of Australian First Peoples' health programs and the way in which they seek to influence environmental, including social, determinants of health. Methods: We report several case studies of applying an ecological approach to health program evaluation using a tool developed for application to mainstream public health programs in North America - Richard's ecological coding procedure. Results: We find the ecological approach in general, and the Richard procedure specifically, to have potential for broader use as an approach to reporting and evaluation of health promotion programs. However, our experience applying this tool in academic and community-based program evaluation contexts, conducted in collaboration with First Peoples of Australia, suggests that it would benefit from cultural adaptations that would bring the ecological coding procedure in greater alignment with the worldviews of First Peoples and better identify the aims and strategies of local health promotion programs. Conclusions: Establishing the cultural validity of the ecological coding procedure is necessary to adequately capture the underlying program activities of community-based health promotion programs designed to benefit First Peoples, and its collaborative implementation with First Peoples supports a human rights approach to health program evaluation. Refereed/Peer-reviewed
- Published
- 2015
24. Association between smoking, insulin resistance and beta-cell function in a North-western First Nation
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Margaret Cargo, Mark Daniel, Cargo, Margaret Danna, and Daniel, Mark
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Type 2 diabetes ,Disease ,Islets of Langerhans ,Endocrinology ,Insulin resistance ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Humans ,Medicine ,Aged ,British Columbia ,business.industry ,Insulin ,Smoking ,Middle Aged ,medicine.disease ,Former Smoker ,Confidence interval ,Diabetes Mellitus, Type 2 ,Multivariate Analysis ,Indians, North American ,Female ,Insulin Resistance ,business ,Body mass index ,Demography - Abstract
Aims Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised β-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and β-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. Methods A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n = 156), all adults 18 + years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate β-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. Results For normoglycaemic persons (n = 119) current smokers relative to non-smokers had high β-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low β-cell values [difference −22.8 (−20.3, −25.3)] (P
- Published
- 2004
25. Healing Traditions: Culture, Community and Mental Health Promotion with Canadian Aboriginal Peoples
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Cori Simpson, Laurence J. Kirmayer, Margaret Cargo, Cargo, Margaret Danna, Kirmayer, Laurence, and Simpson, Cori
- Subjects
youth ,Oppression ,Government ,health promotion ,media_common.quotation_subject ,Clinical Sciences ,Metis ,Psychological intervention ,Community integration ,Criminology ,Social issues ,Mental health ,culture ,Psychiatry and Mental health ,trauma ,Health promotion ,Nursing ,Inuit ,Middle Eastern Mental Health Issues & Syndromes ,Cognitive Sciences ,Sociology ,residential schools ,First Nations ,media_common - Abstract
Objective: To identify issues and concepts to guide the development of culturally appropriate mental health promotion strategies with Aboriginal populations and communities in Canada.Methods: We review recent literature examining the links between the history of colonialism and government interventions (including the residential school system, out-adoption, and centralised bureaucratic control) and the mental health of Canadian Aboriginal peoples.Results: There are high rates of social problems, demoralisation, depression, substance abuse, suicide and other mental health problems in many, though not all, Aboriginal communities. Although direct causal links are difficult to demonstrate with quantitative methods, there is clear and compelling evidence that the long history of cultural oppression and marginalisation has contributed to the high levels of mental health problems found in many communities. There is evidence that strengthening ethnocultural identity, community integration and political empowermen...
- Published
- 2003
26. Implementing participatory intervention and research in communities: lessons from the Kahnawake Schools Diabetes Prevention Project in Canada
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Ann C. Macaulay, Treena Delormier, Alex M. McComber, Louise Potvin, Margaret Cargo, Cargo, Margaret Danna, Potvin, Louise, McComber, Alex, Delormier, Treena, and Macaulay, Ann
- Subjects
Program evaluation ,medicine.medical_specialty ,Health (social science) ,media_common.quotation_subject ,Psychological intervention ,Participatory action research ,Guidelines as Topic ,Health Promotion ,Public administration ,Community Health Planning ,Participatory research ,Diabetes prevention ,Programme implementation ,Community health promotion ,Canada ,Promotion (rank) ,Sociology ,History and Philosophy of Science ,Social Justice ,medicine ,Humans ,Program Development ,Child ,School Health Services ,media_common ,business.industry ,Public health ,Community Participation ,Quebec ,Public relations ,Primary Prevention ,Intervention (law) ,Diabetes Mellitus, Type 2 ,Organizational Case Studies ,Community health ,Indians, North American ,Health education ,Patient Participation ,business ,Program Evaluation - Abstract
Community public health interventions based on citizen and community participation are increasingly discussed as promising avenues for the reduction of health inequalities and the promotion of social justice. However, very few authors have provided explicit principles and guidelines for planning and implementing such interventions, especially when they are linked with research. Traditional approaches to public health programming emphasise expert knowledge, advanced detailed planning, and the separation of research from intervention. Despite the usefulness of these approaches for evaluating targeted narrow-focused interventions, they may not be appropriate in community health promotion, especially in Aboriginal communities. Using the experience of the Kahnawake Schools Diabetes Prevention Project, in Canada, this paper elaborates four principles as basic components for an implementation model of community programmes. The principles are: (1) the integration of community people and researchers as equal partners in every phase of the project, (2) the structural and functional integration of the intervention and evaluation research components, (3) having a flexible agenda responsive to demands from the broader environment, and (4) the creation of a project that represents learning opportunities for all those involved. The emerging implementation model for community interventions, as exemplified by this project, is one that conceives a programme as a dynamic social space, the contours and vision of which are defined through an ongoing negotiation process.
- Published
- 2003
27. Participant views on participating in a pragmatic randomised controlled trial: the Aboriginal and Torres Strait Islander Women's Fitness Program
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Margaret Cargo, Karla Canuto, Robyn McDermott, Canuto, Karla Joy, McDermott, Robyn, and Cargo, Margaret
- Subjects
Research design ,Adult ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Research Subjects ,Physical fitness ,physical activity ,Vulnerable Populations ,Indigenous ,law.invention ,Interviews as Topic ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Qualitative research ,medicine ,Pragmatic RCTs ,Humans ,030212 general & internal medicine ,Health policy ,randomisation ,Randomisation ,Aboriginal and Torres Strait Islander ,business.industry ,Physical activity ,030503 health policy & services ,Public health ,Health Policy ,Research ,Health services research ,Public Health, Environmental and Occupational Health ,Australia ,Middle Aged ,pragmatic RCTs ,Physical Fitness ,Family medicine ,Women's Health ,Female ,Waist Circumference ,0305 other medical science ,business ,qualitative research - Abstract
Introduction The inequity of randomising participants to control groups in randomised controlled trials (RCTs) is often considered inappropriate, especially for research trials that include vulnerable populations such as Indigenous peoples. The Aboriginal and Torres Strait Islander Women’s Fitness Program conducted a trial that randomly assigned participants to ‘active’ and ‘waitlisted’ groups. This paper reports on participant views of the randomisation protocol. Methods A pragmatic RCT was conducted in an urban setting to assess the effectiveness of the 12-week Aboriginal and Torres Strait Islander Women’s Fitness Program on metabolic health outcomes and waist circumference. Qualitative interviews were conducted at follow-up, one of the objectives was to explore participant perspectives on the research protocol, including participant randomisation to ‘Active’ and ‘Waitlisted’ groups. Results A total of 49 interviews were conducted (26 Active and 23 Waitlisted participants). Two key factors influenced participant views on the protocol: 1) group assignment; and 2) how well they understood the research design, including the justification for randomisation. ‘Active’ participants were concerned about the inequity of the randomisation process but overall supported the study protocol. Although most Waitlisted participants were disappointed about having to wait 12-months for the program, some participants derived motivation from being waitlisted, whilst others lost motivation. Well-informed participants were more likely to express both support for the randomisation process and an understanding of the research benefits than participants not attending an information session prior to registration. Conclusions Participants were more accepting of the research protocol if it was clearly explained to them, if they understood the randomisation process and felt the randomisation was justified in terms of the potential for the results to benefit other Aboriginal and Torres Strait Islander women. Our study suggests that the time and resources required to adequately explain the research protocol in research trials should not be undervalued. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12610000224022).
- Published
- 2014
28. Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach
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Mark Daniel, Harold Stewart, Alwin Chong, Margaret Cargo, Anna Dawson, Dawson, Anna P, Cargo, Margaret, Stewart, Harold, Chong, Alwin, and Daniel, Mark
- Subjects
Male ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,health promotion ,medicine.medical_treatment ,Health Personnel ,Population ,Applied psychology ,Health Promotion ,health personnel ,oceanic ancestry group ,Education ,cultural competency ,Nursing ,Knowledge translation ,medicine ,Humans ,Cultural Competency ,education ,Qualitative Research ,education.field_of_study ,business.industry ,Public health ,Behavior change ,Tobacco control ,Public Health, Environmental and Occupational Health ,Australia ,Focus Groups ,Focus group ,smoking cessation ,Health promotion ,Smoking cessation ,Female ,Smoking Cessation ,business ,qualitative research - Abstract
Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs. Refereed/Peer-reviewed
- Published
- 2012
29. Pragmatic randomised trial of a 12-week exercise and nutrition program for Aboriginal and Torres Strait Islander women: clinical results immediate post and 3 months follow-up
- Author
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Karla Canuto, Katina D'Onise, Robyn McDermott, Adrian Esterman, Ming Li, Margaret Cargo, Canuto, Karla Joy, Cargo, Margaret Danna, Li, Ming, D'Onise, Katina, Esterman, Adrian Jeffrey, and McDermott, Robyn Anne
- Subjects
Native Hawaiian or Other Pacific Islander ,Time Factors ,Nutritional Sciences ,health promotion ,Nutrition Education ,physical activity ,Type 2 diabetes ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,030212 general & internal medicine ,Health Education ,Aboriginal ,2. Zero hunger ,Middle Aged ,Exercise Therapy ,3. Good health ,Treatment Outcome ,Cohort ,Female ,Health education ,women ,Waist Circumference ,Research Article ,Adult ,Torres Strait Islander ,medicine.medical_specialty ,Waist ,Adolescent ,030209 endocrinology & metabolism ,lifestyle program ,Lifestyle program ,Young Adult ,03 medical and health sciences ,medicine ,Humans ,Women ,Physical activity ,business.industry ,Body Weight ,Australia ,Urban Health ,Public Health, Environmental and Occupational Health ,medicine.disease ,Blood pressure ,Torres strait islander ,Physical therapy ,Health promotion ,business ,Body mass index ,Biomarkers ,Follow-Up Studies ,Program Evaluation - Abstract
Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12610000224022 Background: Aboriginal and Torres Strait Islander women experience higher rates of heart disease and type 2 diabetes than non-Indigenous Australian women. Increasing physical activity, improving diets and losing weight have been shown to reduce cardio metabolic risk. The primary aim was to evaluate the effectiveness of a 12-week structured exercise and nutrition program in a cohort of urban Indigenous Australian women on waist circumference, weight and biomedical markers of metabolic functioning from baseline (T1) to program completion (T2). The secondary aim assessed whether these outcomes were maintained at 3-month follow-up. Conclusions: This 12-week exercise program demonstrated modest reductions in weight, BMI and blood pressure at T2, which improved further at 3-month follow-up (T3). Positive intervention effects were observed despite low attendance at exercise classes. Structured exercise programs implemented in community settings require attention to understanding the barriers to participation for this high risk group. Methods: One hundred Aboriginal and/or Torres Strait Islander women aged 18-64 years living in the Adelaide metropolitan area were recruited. The program included two 60-minute group cardiovascular and resistance training classes per week, and four nutrition education workshops. Participants were randomly assigned to an 'active' group or 'waitlisted' control group. Body weight, height, waist and hip circumference, blood pressure, fasting glucose, fasting insulin, glycated haemoglobin (HbA1C), lipid profile and C-reactive protein (CRP) were assessed at baseline (T1), immediately after the program (T2) and three months post program (T3). Results: The active group showed modest reductions in weight and body mass index (BMI). Compared to the waitlisted group, the active group had a statistically significantly change in weight and BMI from baseline assessments; at T2, -1.65 kg and -0.66 kg/m2 and at T3, -2.50 kg and -1.03 kg/m2, respectively. Systolic and diastolic blood pressure also had a statistically significant difference from baseline in the active group compared to the waitlisted group at T2, -1.24 mmHg and -2.46 mmHg and at T3, -4.09 mmHg and -2.17 mmHg, respectively. The findings were independent of the baseline measure of the outcome variable, age, households with children and employment status. Changes in waist circumference and other clinical measures were not significant at T2 or T3. The primary outcome measure, waist circumference, proved problematic to assess reliably. Missing data and participants lost to follow-up were significant. Refereed/Peer-reviewed
- Published
- 2012
30. Prevalence of psychological distress and mental disorders, and use of mental health services in the epidemiological catchment area of Montreal South-West
- Author
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Anne G. Crocker, Jean Caron, Yan Kestens, Mark Daniel, Jacques Tremblay, Michel Perreault, Michel Tousignant, Marie-Josée Fleury, Margaret Cargo, Caron, Jean, Fleury, Marie Josee, Perreault, Michel, Crocker, Anne, Tremblay, Jacques, Tousignant, Michel, Kestens, Yan, Cargo, Margaret, and Daniel, Mark
- Subjects
Adult ,Male ,Mental Health Services ,Longitudinal study ,Adolescent ,lcsh:RC435-571 ,Population ,Poison control ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,Quality of life (healthcare) ,Catchment Area, Health ,psychological distress ,Residence Characteristics ,Risk Factors ,lcsh:Psychiatry ,Environmental health ,Prevalence ,Humans ,Medicine ,Longitudinal Studies ,030212 general & internal medicine ,education ,Aged ,Health Services Needs and Demand ,education.field_of_study ,business.industry ,Incidence ,Mental Disorders ,Quebec ,mental health services ,Middle Aged ,medicine.disease ,Mental health ,mental disorders ,3. Good health ,030227 psychiatry ,Substance abuse ,Psychiatry and Mental health ,depression ,Quality of Life ,Female ,business ,Self-Injurious Behavior ,Stress, Psychological ,Research Article - Abstract
Background This report presents the initial results of the first Epidemiological Catchment Area Study in mental health in Canada. Five neighbourhoods in the South-West sector of Montreal, with a population of 258,000, were under study. The objectives of the research program were: 1) to assess the prevalence and incidence of psychological distress, mental disorders, substance abuse, parasuicide, risky behaviour and quality of life; 2) to examine the links and interactions between individual determinants, neighbourhood ecology and mental health in each neighbourhood; 3) to identify the conditions facilitating the integration of individuals with mental health problems; 4) to analyse the impact of the social, economic and physical aspects of the neighbourhoods using a geographic information system. 5) to verify the adequacy of mental health services. Method A longitudinal study in the form of a community survey was used, complemented by focused qualitative sub-studies. The longitudinal study included a randomly selected sample of 2,433 individuals between the ages of 15 and 65 in the first wave of data collection, and three other waves are projected. An overview of the methods is presented. Results The prevalence of psychological distress, mental disorders and use of mental health services and their correlates are described for the first wave of data collection. Conclusion Several vulnerable groups and risk factors related to socio-demographic variables have been identified such as: gender, age, marital status, income, immigration and language. These results can be used to improve treatment services, prevention of mental disorders, and mental health promotion.
- Published
- 2012
31. Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study
- Author
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Margaret Cargo, Mark Daniel, Stella Artuso, Alex Brown, Artuso, Stella, Cargo, Margaret Danna, Brown, Alex, and Daniel, Mark
- Subjects
Gerontology ,Adult ,Male ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Heart Diseases ,Population ,Facilitators/barriers to care ,Health informatics ,Health administration ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,cardiovascular disease ,Health care ,Medicine ,Humans ,030212 general & internal medicine ,10. No inequality ,education ,health care utilisation ,Aboriginal ,Qualitative Research ,Aged ,education.field_of_study ,Health care utilisation ,business.industry ,030503 health policy & services ,Health Policy ,Public health ,Nursing research ,Australia ,15. Life on land ,facilitators/barriers to care ,Health Services ,Middle Aged ,Patient Acceptance of Health Care ,Cardiovascular disease ,Focus group ,Indigenous ,3. Good health ,Female ,0305 other medical science ,business ,Qualitative research ,Research Article - Abstract
Background Aboriginal Australians suffer from poorer overall health compared to the general Australian population, particularly in terms of cardiovascular disease and prognosis following a cardiac event. Despite such disparities, Aboriginal Australians utilise health care services at much lower rates than the general population. Improving health care utilisation (HCU) among Aboriginal cardiac patients requires a better understanding of the factors that constrain or facilitate use. The study aimed to identify ecological factors influencing health care utilisation (HCU) for Aboriginal cardiac patients, from the time of their cardiac event to 6–12 months post-event, in central Australia. Methods This qualitative descriptive study was guided by an ecological framework. A culturally-sensitive illness narrative focusing on Aboriginal cardiac patients’ “typical” journey guided focus groups and semi-structured interviews with Aboriginal cardiac patients, non-cardiac community members, health care providers and community researchers. Analysis utilised a thematic conceptual matrix and mixed coding method. Themes were categorised into Predisposing, Enabling, Need and Reinforcing factors and identified at Individual, Interpersonal, Primary Care and Hospital System levels. Results Compelling barriers to HCU identified at the Primary Care and Hospital System levels included communication, organisation and racism. Individual level factors related to HCU included language, knowledge of illness, perceived need and past experiences. Given these individual and health system barriers patients were reliant on utilising alternate family-level supports at the Interpersonal level to enable their journey. Conclusion Aboriginal cardiac patients face significant barriers to HCU, resulting in sub-optimal quality of care, placing them at risk for subsequent cardiovascular events and negative health outcomes. To facilitate HCU amongst Aboriginal people, strategies must be implemented to improve communication on all levels and reduce systemic barriers operating within the health system.
- Published
- 2012
32. 'I know it's bad for me and yet I do it': exploring the factors that perpetuate smoking in Aboriginal Health Workers--a qualitative study
- Author
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Margaret Cargo, Anna Dawson, Mark Daniel, Harold Stewart, Alwin Chong, Dawson, Anna P, Cargo, Margaret, Stewart, Harold, Chong, Alwin, and Daniel, Mark
- Subjects
Male ,medicine.medical_specialty ,Community-Based Participatory Research ,Native Hawaiian or Other Pacific Islander ,medicine.medical_treatment ,Health Behavior ,Occupational Health Services ,Community-based participatory research ,Public Policy ,Smoking Prevention ,Social Environment ,Interviews as Topic ,Social Facilitation ,Nursing ,medicine ,Prevalence ,Health Services, Indigenous ,Humans ,Interpersonal Relations ,Community Health Services ,Cultural Competency ,Qualitative Research ,Community Health Workers ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Public health ,Smoking Tobacco ,Tobacco control ,Managed Care Programs ,Smoking ,cultural relevance ,Administrative Personnel ,Australia ,Social environment ,lcsh:RA1-1270 ,Focus Groups ,Focus group ,smoking cessation ,Aboriginal health workers ,Workforce ,Smoking cessation ,Female ,Smoking Cessation ,business ,Prejudice ,Qualitative research ,Research Article - Abstract
Background Aboriginal Health Workers (AHWs) have a mandate to deliver smoking cessation support to Aboriginal people. However, a high proportion of AHWs are smokers and this undermines their delivery of smoking cessation programs. Smoking tobacco is the leading contributor to the burden of disease in Aboriginal Australians and must be prevented. Little is known about how to enable AHWs to quit smoking. An understanding of the factors that perpetuate smoking in AHWs is needed to inform the development of culturally relevant programs that enable AHWs to quit smoking. A reduction of smoking in AHWs is important to promote their health and also optimise the delivery of smoking cessation support to Aboriginal clients. Methods We conducted a fundamental qualitative description study that was nested within a larger mixed method participatory research project. The individual and contextual factors that directly or indirectly promote (i.e. perpetuate) smoking behaviours in AHWs were explored in 34 interviews and 3 focus groups. AHWs, other health service staff and tobacco control personnel shared their perspectives. Data analysis was performed using a qualitative content analysis approach with collective member checking by AHW representatives. Results AHWs were highly stressed, burdened by their responsibilities, felt powerless and undervalued, and used smoking to cope with and support a sense of social connectedness in their lives. Factors directly and indirectly associated with smoking were reported at six levels of behavioural influence: personal factors (e.g. stress, nicotine addiction), family (e.g. breakdown of family dynamics, grief and loss), interpersonal processes (e.g. socialisation and connection, domestic disputes), the health service (e.g. job insecurity and financial insecurity, demanding work), the community (e.g. racism, social disadvantage) and policy (e.g. short term and insecure funding). Conclusions An extensive array of factors perpetuated smoking in AHWs. The multitude of personal, social and environmental stressors faced by AHWs and the accepted use of communal smoking to facilitate socialisation and connection were primary drivers of smoking in AHWs in addition to nicotine dependence. Culturally sensitive multidimensional smoking cessation programs that address these factors and can be tailored to local needs are indicated.
- Published
- 2011
33. Assessing the outcomes of participatory research: protocol for identifying, selecting, appraising and synthesizing the literature for realist review
- Author
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Paula L. Bush, Pierre Pluye, Sarena D. Seifer, Trish Greenhalgh, Jon Salsberg, Geoff Wong, Jim Henderson, Carol P. Herbert, Ann C. Macaulay, Erin Sirett, Lawrence W. Green, Margaret Cargo, Robbyn Seller, Justin Jagosh, Jagosh, Justin, Pluye, Pierre, Macaulay, Ann C, Salsberg, Jon, Henderson, Jim, Sirett, Erin, Bush, Paula L, Seller, Robbyn, Wong, Geoff, Greenhalgh, Trish, Cargo, Margaret, Herbert, Carol P, Seifer, Sarena D, and Green, Lawrence W
- Subjects
Research design ,Community-Based Participatory Research ,Participatory research ,Knowledge management ,evidence based medicine ,Participatory action research ,Community-based participatory research ,Health Informatics ,Context (language use) ,Assessment ,Health informatics ,Study Protocol ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Outcome Assessment, Health Care ,Medicine and Health Sciences ,Humans ,Medicine ,030212 general & internal medicine ,Medicine(all) ,lcsh:R5-920 ,Evidence-Based Medicine ,business.industry ,030503 health policy & services ,Health Policy ,Public Health, Environmental and Occupational Health ,Health services research ,methodology ,General Medicine ,Evidence-based medicine ,Systematic review ,Research Design ,Health Services Research ,lcsh:Medicine (General) ,0305 other medical science ,business - Abstract
Background Participatory Research (PR) entails the co-governance of research by academic researchers and end-users. End-users are those who are affected by issues under study (e.g., community groups or populations affected by illness), or those positioned to act on the knowledge generated by research (e.g., clinicians, community leaders, health managers, patients, and policy makers). Systematic reviews assessing the generalizable benefits of PR must address: the diversity of research topics, methods, and intervention designs that involve a PR approach; varying degrees of end-user involvement in research co-governance, both within and between projects; and the complexity of outcomes arising from long-term partnerships. Methods We addressed the above mentioned challenges by adapting realist review methodology to PR assessment, specifically by developing inductively-driven identification, selection, appraisal, and synthesis procedures. This approach allowed us to address the non-uniformity and complexity of the PR literature. Each stage of the review involved two independent reviewers and followed a reproducible, systematic coding and retention procedure. Retained studies were completed participatory health interventions, demonstrated high levels of participation by non-academic stakeholders (i.e., excluding studies in which end-users were not involved in co-governing throughout the stages of research) and contained detailed descriptions of the participatory process and context. Retained sets are being mapped and analyzed using realist review methods. Results The librarian-guided search string yielded 7,167 citations. A total of 594 citations were retained after the identification process. Eighty-three papers remained after selection. Principle Investigators (PIs) were contacted to solicit all companion papers. Twenty-three sets of papers (23 PR studies), comprising 276 publications, passed appraisal and are being synthesized using realist review methods. Discussion The systematic and stage-based procedure addressed challenges to PR assessment and generated our robust understanding of complex and heterogeneous PR practices. To date, realist reviews have focussed on evaluations of relatively uniform interventions. In contrast our PR search yielded a wide diversity of partnerships and research topics. We therefore developed tools to achieve conceptual clarity on the PR field, as a beneficial precursor to our theoretically-driven synthesis using realist methods. Findings from the ongoing review will be provided in forthcoming publications.
- Published
- 2011
34. Environments and cardiometabolic diseases in aboriginal populations
- Author
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Margaret Cargo, Mark Daniel, Peter Lekkas, Daniel, Mark, Lekkas, Peter, and Cargo, Margaret Danna
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Pulmonary and Respiratory Medicine ,Male ,Health Knowledge, Attitudes, Practice ,Native Hawaiian or Other Pacific Islander ,Health Status ,Participatory action research ,Disease ,Environment ,Risk Assessment ,Indigenous ,physical environments ,biopsychosocial pathways ,Metabolic Diseases ,Population Groups ,Environmental health ,Outcome Assessment, Health Care ,Medicine ,Health Services, Indigenous ,Humans ,Psychology ,built ,Aboriginal ,Health Education ,Cultural Characteristics ,business.industry ,cardiovascular ,Australia ,social ,Environmental exposure ,Environmental Exposure ,metabolic disease ,Socioeconomic Factors ,Cardiovascular Diseases ,Needs assessment ,Educational Status ,Health education ,Female ,Indigenous peoples ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,Psychosocial ,Needs Assessment - Abstract
This review establishes the relevance and frames the relationship of environmental factors to cardiometabolic risk factors and disease in Aboriginal populations. Environmental factors operate at the level of communities or populations. They include contextual measures of places and compositional measures of populations which together constitute "risk conditions" affecting individual risk factors. Environmental factors have been implicated by contrasting Aboriginal and non-Aboriginal populations in cardiometabolic risk factors and outcomes, or by geographic contrasts of Aboriginal populations in remote, rural and urban regions. It is unclear whether heterogeneity in contextual or compositional factors between and within Aboriginal populations is associated with heterogeneity in cardiometabolic risk factors and outcomes. Empirical literature that links environmental factors and cardiometabolic outcomes in Aboriginal populations is critically reviewed for three postulated pathways of influence: (1) behaviour; (2) psychosocial factors; and (3) stress response axes. These pathways, represented as interdependent, can explain how and why environments are associated with cardiometabolic outcomes. The need remains, however, to develop a robust quantitative evidence base in cardiometabolic research aimed at enhancing knowledge of the specific environmental factors related to the cardiometabolic health of Aboriginal populations as well as explicating the underlying mechanisms by which environmental risk conditions ‘get under the skin'.
- Published
- 2009
35. Can the democratic ideal of participatory research be achieved? An inside look at an academic-indigenous community partnership
- Author
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Margaret Cargo, Treena Delormier, Alex M. McComber, Ann C. Macaulay, Kahente Horn-Miller, Lucie Lévesque, Cargo, Margaret Danna, Delormier, Treena, Levesque, Lucie, Horn-Miller, Kahente, McComber, Alex, and Macaulay, Ann
- Subjects
Adult ,Male ,Canada ,media_common.quotation_subject ,Participatory action research ,Indigenous ,Ideal (ethics) ,Education ,Nursing ,Political science ,Health Services, Indigenous ,Humans ,media_common ,business.industry ,Public Health, Environmental and Occupational Health ,Community Participation ,Public relations ,Middle Aged ,Democracy ,Community-Institutional Relations ,Test (assessment) ,Intervention (law) ,Health promotion ,Diabetes Mellitus, Type 2 ,General partnership ,Public Health and Health Services ,Indians, North American ,Female ,business ,Curriculum and Pedagogy - Abstract
Democratic or equal participation in decision making is an ideal that community and academic stakeholders engaged in participatory research strive to achieve. This ideal, however, may compete with indigenous peoples’ right to self-determination. Study objectives were to assess the perceived influence of multiple community (indigenous) and academic stakeholders engaged in the Kahnawake Schools Diabetes Prevention Project (KSDPP) across six domains of project decision making and to test the hypothesis that KSDPP would be directed by community stakeholders. Self-report surveys were completed by 51 stakeholders comprising the KSDPP Community Advisory Board (CAB), KSDPP staff, academic researchers and supervisory board members. KSDPP staff were perceived to share similar levels of influence with (i) CAB on maintaining partnership ethics and CAB activities and (ii) academic researchers on research and dissemination activities. KSDPP staff were perceived to carry significantly more influence than other stakeholders on decisions related to annual activities, program operations and intervention activities. CAB and staff were the perceived owners of KSDPP. The strong community leadership aligns KSDPP with a model of community-directed research and suggests that equitable participation—distinct from democratic or equal participation—is reflected by indigenous community partners exerting greater influence than academic partners in decision making.
- Published
- 2008
36. Mastery, perceived stress and health-related behaviour in northeast Arnhem Land: a cross-sectional study
- Author
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Alex Brown, J Garnggulkpuy Dhurrkay, Margaret Cargo, Mark Daniel, Kerin O'Dea, Université de Montréal. École de santé publique. Département de médecine sociale et préventive, Daniel, Mark, Brown, Alex, Dhurrkay, JG, Cargo, Margaret Danna, and O'Dea, Kerin
- Subjects
Gerontology ,education.field_of_study ,medicine.medical_specialty ,030505 public health ,business.industry ,Cross-sectional study ,Public health ,Research ,Health Policy ,lcsh:Public aspects of medicine ,Population ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Life course approach ,Stress measures ,030212 general & internal medicine ,Social determinants of health ,0305 other medical science ,education ,business ,Psychosocial ,Social status - Abstract
BACKGROUND:Indigenous peoples in Australia are disadvantaged on all markers of health and social status across the life course. Psychosocial factors are implicated in the aetiology of chronic diseases and in pathways underpinning social health disparities. Minimal research has investigated psychosocial factors and health in Indigenous peoples. This study evaluated associations between mastery, perceived stress, and health-related behaviour for a remote Indigenous population in Australia.METHODS:Complete data on mastery (the degree to which individuals feel in control of their lives), perceived stress, physical activity, and fruit and vegetable consumption were obtained for 177 participants in a community-based chronic disease risk factor survey. Psychosocial questionnaires were completed as an option during community screening (response rate = 61.9%). Extensive consultation facilitated the cross-cultural adaptation of measures.RESULTS:Mastery was inversely correlated with perceived stress measures (p < 0.009): recent stress, r = -0.47; chronic stress, r = -0.41; and youth stress, r = -0.30. Relationships between mastery and behaviour varied according to age group (, Affiliation: Mark Daniel : Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal
- Published
- 2006
37. Impact of a diabetes prevention program on body size, physical activity, and diet among Kanien'keha:ka (Mohawk) children 6 to 11 years old: 8-year results from the Kahnawake Schools Diabetes Prevention Project
- Author
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Louise Potvin, Ann C. Macaulay, Olivier Receveur, Alex M. McComber, Gilles Paradis, Lucie Lévesque, Margaret Cargo, Natalie Kishchuk, Rhonda Kirby, Cargo, Margaret Danna, Paradis, Gilles, Levesque, Lucie, Macaulay, Ann, McComber, Alex, Kirby, Rhonda, Receveur, Olivier, Kishchuk, Natalie, and Potvin, Louise
- Subjects
Gerontology ,Male ,Canada ,Cross-sectional study ,Physical fitness ,Clinical Sciences ,Community-based participatory research ,Physical exercise ,Type 2 diabetes ,Diet Surveys ,Body Mass Index ,Paediatrics and Reproductive Medicine ,Srhonda ,Surveys and Questionnaires ,medicine ,Humans ,Child ,Exercise ,Health Education ,business.industry ,oliver ,Body Weight ,medicine.disease ,Diet ,Skinfold Thickness ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Physical Fitness ,Pediatrics, Perinatology and Child Health ,Indians, North American ,Health education ,Female ,business ,Body mass index ,Demography ,Follow-Up Studies ,Program Evaluation - Abstract
Objectives. Report the 8-year impact on body size, physical activity, and diet of a community-based diabetes prevention program for elementary-school children in a Kanien'kehá:ka (Mohawk) community in Canada.Methods. Follow-up (1994–1996) of subjects in the intervention and comparison community and repeat cross-sectional measurements in the intervention community alone from 1994 to 2002. Measures included triceps and subscapular skinfold thicknesses, body mass index (BMI), weekly number of 15-minute episodes of physical activity, run/walk test times, television watching, and consumption of sugared foods, fatty foods, and fruits and vegetables.Results. The longitudinal data of 1994–1996 showed some early positive effects of the program on skinfold thickness but not on BMI, physical activity, fitness, or diet. Repeat cross-sectional measures from 1994 to 2002 showed increases in skinfold thickness and BMI. Physical activity, fitness, and television watching showed favorable trends from 1994 to 1999 that were not sustained in 2002. Key high-fat and high-sugar foods consumption decreased, as did consumption of fruits and vegetables.Conclusions. Although early results showed some successes in reducing risk factors for type 2 diabetes, these benefits were not maintained over 8 years.
- Published
- 2005
38. Legitimizing diabetes as a community health issue: a case analysis of an Aboriginal community in Canada
- Author
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Treena Delormier, Margaret Cargo, Sherri Bisset, Louise Potvin, Ann C. Macaulay, Cargo, Margaret Danna, Bisset, Sherri, Delormier, Treena, Macaulay, Ann, and Potvin, Louise
- Subjects
Male ,Canada ,Health (social science) ,Participatory action research ,Context (language use) ,Grounded theory ,Community Health Planning ,Aboriginal health ,community mobilization ,program implementation ,Nursing ,Risk Factors ,Medicine ,Health Services, Indigenous ,Humans ,Health Education ,business.industry ,Public Health, Environmental and Occupational Health ,Focus group ,Primary Prevention ,Health promotion ,Community mobilization ,Diabetes Mellitus, Type 2 ,Community health ,Public Health and Health Services ,Indians, North American ,Preventive action ,Female ,business ,Program Evaluation - Abstract
The Kahnawake Schools Diabetes Prevention Project (KSDPP) is an ongoing participatory research and intervention project aimed at the primary prevention of type 2 diabetes. Formally initiated in 1994 with strong community support, KSDPP provides a fertile opportunity to learn about how a community came to identify the need for preventive action on a health problem such as diabetes. The purpose of our study was to describe the various conditions in the community of Kahnawake, which gave rise to its mobilization for the prevention of type 2 diabetes. Qualitative data consisted of 12 individual interviews and one focus group with key community members and health professionals living and/or working in the community of Kahnawake, along with historically relevant documents. The data collection and analysis procedures of the grounded theory method were applied. Results describe a preceding phase to formal KSDPP implementation, triggered by returning research results on the community prevalence of type 2 diabetes. This phase of 'legitimizing diabetes as a community health issue' is characterized by a shift in the perceived preventability of diabetes among community members; from a problem that was to be lived with to a problem that was to be prevented. The shift in perceptions was facilitated by the context in the community, described by structural developments, cognitive and relational elements. In addition to reaffirming the critical importance of utilizing lay knowledge during the planning of a health promotion intervention, our study has uncovered some of the key conditions through which individuals in the community came to participate in the identification and planning of a diabetes prevention project.
- Published
- 2004
39. Improving the content validity of the Mixed Methods Appraisal Tool: a modified e-Delphi study
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Hong, Quan Nha, Pluye, Pierre, Fàbregues Feijóo, Sergi, Bartlett, Gillian, Boardman, Felicity, Cargo, Margaret, Dagenais, Pierre, Gagnon, Marie-Pierre, Griffiths, Frances, Nicolau, Belinda, O'Cathain, Alicia, Rousseau, Marie-Claude, and Vedel, Isabelle
- Subjects
Investigación cualitativa ,Delphi technique ,Qualitative research ,Quality appraisal ,Systematic review ,Mixed methods research ,Surveys ,Survey ,Enquestes ,Investigació qualitativa ,Encuestas - Abstract
Objective: The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies. Study Design and Setting: First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale. Results: A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria. Conclusion: Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018).
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