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Introduction: Responsive, integrated and sustainable health systems require that communities take an active role in service design and delivery. Much of the current literature focuses on provider‐led initiatives to gain community input, raising concerns about power imbalances inherent in invited forms of participation. This paper provides an alternate view, exploring how, in a period following reforms, community actors forge network alliances to (re)gain legitimacy and capacities to coproduce health services with system providers. Methods: A longitudinal case study traced the network‐building efforts over 3 years of a working group formed by citizens and community actors working with seniors, minorities, recent immigrants, youth and people with disabilities. The group came together over concerns about reforms that impacted access to health services and the ability of community groups to mediate access for vulnerable community residents. Data were collected from observation of the group's meetings and activities, documents circulated within and by the group, and semi‐directed interviews. The first stage of analysis used social network mapping to reveal the network development achieved by the working group; a second traced network maturation, based on actor–network theory. Results: Network mapping revealed how the working group mobilized existing links and created new links with health system actors to explore access issues. Problematization appeared as an especially important stage in network development in the context of reforms that disrupted existing collaborative relationships and introduced new structures and processes. Conclusion: Network‐building strategies enable community actors to enhance their capacity for coproduction. A key contribution lies in the creation of 'organizational infrastructure'. Patient or Public Contribution: The lead researcher was embedded over 3 years in the activities of the community groups and community residents. Several group members provided comments on an initial draft of this paper. To preserve the anonymity of the group, their names do not appear in the acknowledgements section. [ABSTRACT FROM AUTHOR]

Responding to calls to contextualize social psychological variables in history, the present research examines the relationship between collective relative deprivation and collective esteem using a historical perspective. We hypothesized that collective relative deprivation perceived to be experienced during an important low-point in a group's history serves to define the group's current collective identity, which is in turn associated with collective esteem. In Study 1, cultural narrative interviews were conducted with Francophone and Anglophone Quebecers in order to identify key historical chapters for these groups and to examine the extent to which historical low-points were identity-defining features of their narratives. In Study 2, using the information obtained from these narratives, collective relative deprivation was explored across group members' perceived histories and related to current in-group entitativity and collective esteem. The relationship between collective relative deprivation thought to be experienced by one's group during a historical low-point and collective esteem was positive for both Anglophone and Francophone Quebecers and was mediated by in-group entitativity. Collective relative deprivation perceived to be experienced during a historical low-point serves to define one's collective identity, which is in turn associated with greater collective esteem. [ABSTRACT FROM AUTHOR]

Objective To compare the prevalence of depression within the elderly Quebec population residing in rural areas, urban areas and metropolitan Montreal, and to assess differences in the associations between social relationships and depression across these urban and rural settings. Methods Data originate from the first wave of the ESA (Étude de Santé des Ainés) longitudinal study on mental health of community dwelling older persons aged over 65 (n = 2670). Depression, including major and minor depression, measured using a computer questionnaire; the ESA– Q developed by the research team and based on the DSM-IV criteria. Assessments of associations between depression and geographic area, informal social networks and community participation were estimated adjusting for demographic, socioeconomic and health characteristics. Results The prevalence of depression was higher in rural (17%) and urban areas (15.1%) than in metropolitan Montreal (10.3%). The odds ratio of rural (OR = 2.01 95% CI 1.59–2.68) and urban (OR = 1.75; 95% CI 1.25–2.45) areas compared to the metropolitan area increased slightly after adjustment by all social and health covariates. Our study indicated that social support and the lack of conflict in intimate relationships were associated with lower prevalence of depression in all areas. Conclusion Geographic differences in depression exist within the elderly population in Quebec that may generate significant impact on their health and functional abilities. Further research should be conducted to explain these differences. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]