Search

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to add to the research literature and begin to fill the gap in knowledge about shared parenting arrangements for women with young children and who have experienced domestic violence (DV), in three Canadian provinces; Alberta, Manitoba and Ontario. Method: This paper reports on the qualitative findings from a mixed methods study on shared parenting from women with children ages 4 and under. Twenty women participated in one-on-one individual interviews through electronic platform utilizing Zoom. Thematic analysis is used to analyze the data. Results: Despite efforts to not exclusively recruit women who had experienced domestic violence (DV) from their former partner, all participants identified as survivors of DV and ongoing survivors of DV, specifically, coercive controlling behaviours. Five themes describe the women's experiences of shared parenting with young children: 1) walking a tight-rope; 2) navigating post-separation relationships; 3) emotional realities of shared parenting; 4) shared parenting outcomes; and, 5) structural challenges. Conclusions: This paper not only adds to the significant and longstanding gap in knowledge directly from women with children ages 4 and under in shared parenting relationships, and who have experienced DV, and also helps to inform social service and legal actors. It is timely with the amendments to the Divorce Act in Canada which now includes DV as a factor in determining the best interests of the child. [ABSTRACT FROM AUTHOR]

Training staff and volunteers is an important aspect of successful program implementation. This paper follows Part A of an evaluation of the Special Olympics Canada (SOC) Coaching Young Athletes Training course. Consistent with Kirkpatrick's four-level model of training evaluation, Part A evaluated program leaders' reactions to (level 1) and immediate learning from (level 2) the training. This Part B paper covers "on the job" behavior (level 3). In-depth semi-structured interviews were conducted with youth program leaders (n = 11) from eight provinces. Overall, participants felt that more training related to working with children with autism and promoting positive athlete behavior was needed. The findings also lead us to suggest that program leaders need to develop a more fulsome understanding of how to foster skill mastery, including how to practice the same skill in many and varied ways. [ABSTRACT FROM AUTHOR]

Background: The integration of Primary Care (PC) into broader health systems has been a goal in jurisdictions around the world. Efforts to achieve integration at the meso-level have drawn particular attention, but there are few actionable recommendations for how to enact a 'pro-integration culture' amongst government and PC governance bodies. This paper describes pragmatic integration activity undertaken by meso-level participants in Alberta, Canada, and suggests ways this activity may be generalizable to other health systems. Methods: 11 semi-structured interviews with nine key informants from meso-level organizations were selected from a larger qualitative study examining healthcare policy development and implementation during the COVID-19 pandemic. Selected interviews focused on participants' experiences and efforts to 'do' integration as they responded to Alberta's first wave of the Omicron variant in September 2021. An interpretive descriptive approach was used to identify repeating cycles in the integration context, and pragmatic integration activities. Results: As Omicron arrived in Alberta, integration and relations between meso-level PC and central health system participants were tense, but efforts to improve the situation were successfully made. In this context of cycling relationships, staffing changes made in reaction to exogenous shocks and political pressures were clear influences on integration. However, participants also engaged in specific behaviours that advanced a pro-integration culture. They did so by: signaling value through staffing and resource choices; speaking and enacting personal and group commitments to collaboration; persevering; and practicing bi-directional communication through formal and informal channels. Conclusions: Achieving PC integration involves not just the reactive work of responding to exogenous factors, but also the proactive work of enacting cultural, relationship, and communication behaviors. These behaviors may support integration regardless of the shocks, staff turnover, and relational freeze-thaw cycles experienced by any health system. [ABSTRACT FROM AUTHOR]

Background: Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom‐heard voices, to ensure that a range of voices are heard and that research is meaningful to them. Objective: We explored how researchers involve and engage seldom‐heard communities around big data research. Methods: This is a qualitative study. Researchers who had experience of involving or engaging seldom‐heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio‐recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. Results: The analysis highlighted the complexity of involving and engaging seldom‐heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. Conclusion: The study offers researchers a better understanding of how to involve and engage seldom‐heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project‐specific and dependent on the public contributors, researchers' needs, resources and time available. Patient and Public Involvement: Two public contributors are authors of the paper and they were involved in the study design, analysis and writing. [ABSTRACT FROM AUTHOR]

Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

For many novice teachers, their first year on the job can be a roller coaster experience of 'ups' and 'downs' as they transition from their teacher education programs to teaching in real classrooms. While to 'ups' are always good to experience, the 'downs' can be so traumatic that novice teachers can feel so stressed that their teaching is adversely impacted and burned out to the point that they consider resigning for the profession. For the most part, however, the language teaching profession has not addressed this aspect of a novice ESL (English as a second language) teacher well-being in terms of their personal and emotional investment as they transition from trainee to novice teacher in their first year. This paper attempts to shed light on the emotional experiences of three female novice ESL teachers in a university language school in Canada as they reflected during regular group discussions and journal writing during their first semester (12 weeks) as novice ESL teachers. The results reveal that the group discussions and journal writing provided a platform for the teachers to articulate their mostly negative emotions with three most frequently expressed: frustration, anger and boredom. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Involuntary treatment orders are increasingly being used around the world to allow the treatment of individuals living with a mental illness deemed incapable of giving consent and who are actively refusing treatment.The use of involuntary treatment orders can impact the nurse–patient therapeutic relationship, which is essential to offer quality care and promote recovery. What the paper adds to existing knowledge?: Nurses and patients do not agree on the possibility to develop a therapeutic relationship, with nurses believing they can build a bond with the patients despite the challenges imposed by the involuntary treatment order, and patients rejecting this possibility.Nurses caring for patients on involuntary treatment orders feel obligated to apply the conditions of this measure, even if it damages the relationship with their patients. This difficult aspect of their work leads them to question their role in relation to the management of involuntary treatment orders. What are the implications for practice?: Nurses need to be aware of the reasons why patients on involuntary treatment orders do not believe in the possibility of building a therapeutic relationship.Nurses need to reflect on and express their concerns about the damaging effects that managing involuntary treatment orders conditions can have on the nurse–patient therapeutic relationship. Introduction: Involuntary treatment orders (ITO) can impact the nurse–patient therapeutic relationship (TR) negatively. Despite the increasing use of ITOs around the world, few studies have explored their influence on the TR from the perspectives of nurses and patients. Aim: To describe the TR in the context of ITOs as reported by nurses and individuals living with a mental illness. Method: Secondary data analysis of qualitative interviews with nurses (n = 9) and patients (n = 6) was performed using content analysis. Results: Participants described the TR as fundamentally embedded in a power imbalance amplified by the ITO, which was discussed through the conflicting roles of nurses, the legal constraints imposed on patients and nurses, the complex relation between the ITO and the TR, and the influence of mental healthcare settings' context. Discussion: Nurses and patients' views were opposed, questioning the authenticity of the relationship. Implications for Practice: Nurses should be aware of the patients' lack of faith in the TR to ensure that they are sensitive to patients' behaviours that may falsely suggest that a relationship is established. Further studies should explore ways to alleviate the burden of the management of ITOs on nurses and allow for a trusting relationship to be build. [ABSTRACT FROM AUTHOR]

This qualitative study explored how counsellors who work with women currently or formerly involved in sex work perceive these women's future. From May to July 2016, we conducted semi‐structured interviews with 21 counsellors providing psychosocial services in Canadian agencies with recognized mandates to support such women. The interview protocol was based on the Possible Selves Mapping Interview, adapted to explore the counsellors' hopes and fears for these clients. We subjected the interview transcripts to an interpretive descriptive analysis. Our findings centred on three themes: the counsellors' hopes for their clients' future, in light of their personal and social resources; the counsellors' fears about the cumulative devastating effects that their clients' work environment might have on them; and the counsellors' fears that these women would lose hope for the future. This study clearly demonstrates the importance of addressing the safety and well‐being of women involved in sex work and of recognizing the impacts of social inequalities and structural barriers on these women's life paths. The implications of these findings for policies and practices are discussed at the end of this paper. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Immigrant women in Canada are at greater risk for post‐partum depression (PPD) than native‐born women.Immigrant women are less likely to have their care needs met as they face multiple barriers to care at both individual and system levels.To date, most PPD research has focused on individual barriers to care, with limited research examining organizational and system level barriers and the uniqueness of immigrant women's post‐partum health experiences. What this paper adds to existing knowledge?: This study provides unique insights into immigrant women's perceptions of what influences their post‐partum mental health and ability to access services for PPD.Factors contributing to immigrant women's PPD included several social determinants of health, particularly a lack of social support and limited knowledge about PPD and available services.Most helpful services acknowledge women's concerns, build trust, enact cultural competence and help with system navigation.Assessment approaches and organizational wait times created barriers to accessing care. What are the implications for practice?: Relationship building by providers is foundational to effective care for immigrant women with PPD.Findings highlight the need for mental health practitioners to improve cultural competence when working with diverse ethno‐cultural communities and for more effective assistance with system navigation, service integration and timely, flexible and accessible services.Findings have implications for the development of healthy public policy to address perinatal mental health issues amongst immigrant women. Introduction: Immigrant women in Canada are at greater risk for post‐partum depression (PPD) than native‐born women yet face multiple barriers to care at individual and system levels. Aim: To explore factors that contribute to PPD and health service accessibility, and the role of health services in supporting immigrant women with PPD. Methods: A qualitative interpretive descriptive design was used. Individual interviews were conducted with 11 immigrant women who had delivered a baby within the previous year and had experienced PPD. Inductive thematic content analysis was conducted. Results: Factors contributing to immigrant women's PPD included several social health determinants. Services were most helpful and accessible when providers acknowledged women's concerns, allowed time to build trust, provided culturally competent care and helped with navigating services. Assessment approaches and organizational wait times created barriers to care. Discussion: Immigrant women with PPD see relationship building by providers as foundational to providing effective support, enhancing coping and facilitating access to services. Improved communication with diverse ethno‐cultural communities and assistance with system navigation, service integration and timely, accessible services are needed. Implications for Practice: Findings can inform health service delivery models and the development of healthy public policy to address perinatal mental health issues amongst immigrant women. [ABSTRACT FROM AUTHOR]

This paper introduces the Migrant Populations Equity Extension for Ontario's Health Equity Impact Assessment (HEIA) initiatives. It provides a mechanism to address the needs of migrant populations, within a program and policy framework. Validation of an equity extension framework using community leaders and health practitioners engaged in HEIA workshops across Ontario. Participants assessed migrants' health needs and discussed how to integrate these needs into health policy. The Migrant Populations Equity Extension's framework assists decision makers assess relevant populations, collaborate with immigrant communities, improve policy development and mitigate unintended negative impacts of policy initiatives. The tool framework aims to build stakeholder capacity and improve their ability to conduct HEIAs while including migrant populations. The workshops engaged participants in equity discussions, enhanced their knowledge of migrant policy development and promoted HEIA tools in health decision-making. Prior to these workshops, many participants were unaware of the HEIA tool. The workshops informed the validation of the equity extension and support materials for training staff in government and public health. Ongoing research on policy implementation would be valuable. Public health practitioners and migrant communities can use the equity extension's framework to support decision-making processes and address health inequities. This framework may improve policy development and reduce health inequities for Ontario's diverse migrant populations. Many countries are now using health impact assessment and health equity frameworks. This migration population equity extension is an internationally unique framework that engages migrant communities. [ABSTRACT FROM AUTHOR]

Adequate calcium intake and supply of vitamin D during childhood play important roles in ensuring adequate bone mass gain to achieve optimal peak bone mass. The Healthy Immigrant Children study employed a mixed-method cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3–13 years who had been in Canada for less than 5 years. This paper presents bone mineral content and vitamin D status data along with qualitative data that deepen the understanding of newcomer bone health status. A significantly higher percentage of refugee children (72.3%) had insufficient (<50 nmol/L) or deficient (<30 nmol/L) serum vitamin D compared with immigrants (53.2%). Vitamin D deficiency was most common among ethnic minority girls. Newcomer children with higher intakes of vitamin D, younger newcomer children, and those from western Europe or the United States had higher serum vitamin D levels. Immigrants had significantly higher mean total body bone mineral content compared with refugees. Total body fat, serum vitamin D, calcium intake, height, height by calcium intake, total body fat by calcium intake, and total body fat by height predicted total body bone mineral content levels. Vitamin D deficiency among newcomer children may be related to lack of knowledge regarding children's vitamin D requirements in the Canadian environment, dietary habits established in country of origin, low income that limits healthy dietary choices, and lifestyle habits that limit exposure to sunlight. Results suggest a need to screen newcomer children and pregnant women for vitamin D deficiency and support early intervention. [ABSTRACT FROM AUTHOR]

Recent research and theorizing has characterized contemporary mothering as medicalized, intensive and risky. The rate of diagnosis of children's mental health issues has grown rapidly, particularly since the 90s. This paper examines the construction of mothering in regard to children's behaviours and mental health through an exploratory and qualitative content analysis of the portrayal of advice to mothers in Chatelaine Magazine, the premier women's magazine published in Canada. The time periods chosen for comparison were 1945-1956 and 1990-2010. The first period was selected because it was a time of dramatic changes that occurred in family, occupational and domestic life for women immediately after World War II. The second represents the modern period. The findings of the paper suggest that mothering was intensive, medicalized and risky in both periods although the conceptualizations of problems differed. [ABSTRACT FROM AUTHOR]

Young bisexual women experience worse mental and sexual health outcomes in comparison to their heterosexual and lesbian peers. These disparities are associated with stigma and devaluation of bisexual identities. The current paper addresses a community-based focus group project in which participants discussed bisexual stigma in regard to bisexual erasure and other stereotypes. Specifically, participants detailed experiences of feeling pressured to provide evidence of their bisexual identity, modifying their relationship or sexual behavior to conform to these expectations, as well as feeling excluded from queer community. Further, participants discussed how these experiences were related to decreased mental and sexual health. Future research should further investigate the relationship between bisexual stigma, pressure to provide evidence of bisexual identity, and negative mental and sexual health outcomes. [ABSTRACT FROM PUBLISHER]

The research described herein was a three-year exploratory descriptive study to examine how meaningful involvement (MIPA) is conceptualized and experienced in rural regions of the Maritime provinces of Canada. The focus of this paper is one aspect of the research; i.e., what motivates the clients of AIDS Service Organizations (ASOs) in rural Canada to become meaningfully involved? We interviewed 34 people who were past or current clients of ASOs in Maritime Canada and who self-reported as engaging in at-risk behaviors for HIV or living with HIV. The interviews explored participants' perspectives about their motives for becoming meaningfully involved in an ASO. Three themes regarding motives for MIPA were revealed: (1) meeting personal needs; (2) making a difference to others; and (3) recognizing a fit between their skills, goals, needs and the opportunities and experiences within the ASO and with other ASO clients. Participants generally cited more than one motive. This research study contributed to the field of knowledge about the motives for MIPA in which it reveals (1) that MIPA was conceptualized by the rural ASO clients as whatever participation provided them personal meaning (i.e., by fulfilling a personal need, by making a difference, and by recognizing a fit) and (2) the important role that ASO staff and volunteers have in fostering and sustaining MIPA. The study also highlighted a trajectory of involvements that support the need for ASOs to entertain a wide range of roles that are assumed as MIPA. [ABSTRACT FROM AUTHOR]

This paper uses interview data from physicians and their spouses to describe the types of spousal support physicians receive when coping with work-related stress and to explore whether they vary by occupational similarity, gender, and parental status. The physicians described receiving different types of spousal support: emotional, informational, and instrumental. Male physicians in this study often reported receiving emotional support from their spouse, consistent with the support gap hypothesis in the literature. An unexpected finding is that from the responses of the physicians’ spouses, the husbands often reportedofferingemotional support to their physician spouse. Physicians who shared similar occupational and work experiences with their spouse (i.e. married to another physician) reported receiving informational support from their spouse, consistent with the theory of homophily. Finally, the findings also suggested that once physicians have children, their wives often reported providing instrumental support by being primarily responsible for childcare and housework. An interesting finding of this study is the discrepancy between the physicians and their spouses in their perceptions of support. [ABSTRACT FROM AUTHOR]

An interprofessional team of maternity care providers and academics developed a pilot interprofessional education (IPE) program in maternity care for undergraduate students in nursing, midwifery and medicine. There are few published studies examining IPE programs in maternity care, particularly at the undergraduate level, that examine long-term outcomes. This paper outlines findings from a case study that explored how participation in an IPE program in maternity care may enhance student knowledge, skills/attitudes, and may promote their collaborative behavior in the practice setting. The program was launched at a Canadian urban teaching hospital and consisted of six workshops and two clinical shadowing experiences. Twenty-five semi-structured, in-depth interviews were completed with nine participants at various time points up to 20 months post-program. Qualitative analysis of transcripts revealed the emergence of four themes: relationship-building, confident communication, willingness to collaborate and woman/family-centered care. Participant statements about their intentions to continue practicing interprofessional collaboration more than a year post-program lend support to its sustained effectiveness. The provision of a safe learning environment, the use of small group learning techniques with mixed teaching strategies, augmented by exposure to an interprofessional faculty, contributed to the program's perceived success. [ABSTRACT FROM AUTHOR]