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The purpose of our study was to systematically compile fatality data in Canada involving minors in school and youth groups engaged in outdoor learning, and then compare these incidents to other available data related to risk of fatalities, fatality rates, patterns, and contributory causes. This mixed methods study involved collecting fatality data using a passive environmental scan of publicly available data from multiple sources such as Google, library databases, online databases, and relevant organizations. Data analysis involved using descriptive statistics and principles of case-based analysis to uncover patterns across and within cases. There were 37 fatal incidents involving 78 youth and 6 adult fatalities related to school and youth groups engaged in outdoor learning activities in Canada. All incidents occurred between 1926 and 2019. The fatalities were categorized as water-based, land-based, and snow-based incidents involving alpine skiing (9), flat water canoeing (7), swimming/swim testing (7), walking/hiking (4), mountain climbing (2), white water rafting (2), group camping (1), solo camping (1), sailing (1), skating (1), ski touring (1), and zip-lining (1). It was not possible to determine a fatality rate from our data, however there was adequate comparative data suggesting that the probability of fatal incidents related to outdoor learning by minors in school and youth groups is relatively low in Canada, however there was inadequate data available to make direct comparisons to other contexts. Several patterns emerged from within cases, across cases, and many were similar patterns to those from a series of case-based studies in Australia.

A mandatory outdoor experience program (MOEP), involving a three- to four-day outdoor canoe excursion, has been a compulsory university course for undergraduate students for nearly five decades at a post-secondary institution in Northern Ontario, Canada. However, the experiences and perspectives of students who participated in these excursions have not been fully investigated. The aim of this study was to harness the power of storytelling by alumni to improve our understanding of the long-term impact of MOEPs. Using an innovative methodology combining computer-assisted qualitative data analysis (Leximancer) and framing theory, the links between alumni stories became evident through three main interconnected frames: people, activity, and environment. Although there are unique components of the MOEP program described by our participants, the results contribute to the retrospective literature on the critical and memorable features that students recall years after completing an outdoor adventure experience.

Outdoor adventure education programs often feature common elements, such as backcountry settings, small group sizes, and different levels of challenges. A mandatory outdoor experience program (MOEP), offered at a Canadian university for nearly 50 years, involved a three- to four-day wilderness canoe excursion. Research related to outdoor orientation programs offered at universities has identified a number of positive outcomes related to personal growth, sense of belonging, and improved academic performance. However, little is known about longer-term impacts, and how alumni perceive the experience years later. The purpose of this study was to address this gap by providing insight into alumnis' perspectives of the importance of their participation in a MOEP. This mixed methods study comprised data collection using an online self-report questionnaire with a combination of closed- and open-ended questions to explore the importance of the MOEP as a student, and in life after graduation. Data analysis involved: (1) two thematic analyses of the reasons for importance of the MOEP; and (2) two regression analyses using visual analogue scales of MOEP importance. There were 167 respondents, and the majority provided positive reflections of the importance of their experiences that occurred from 1969 to 2016. Group bonding, learning, lifestyle, nature, challenge, memories, enjoyment, leadership, growth, confidence, and career were identified as themes in participant responses. Logistic regression analysis revealed group bonding (p = 0.003) to be significantly important during life as a student, while being francophone (p = 0.033) and lifestyle (p = 0.000) were significantly important in life after graduation.

The Outdoor Adventure Leadership Experience (OALE) is an outdoor health promotion initiative primarily designed for youth. This program was developed through community-based participatory research in a First Nations Community in northern Ontario: Wiikwemkoong Unceded Territory. It is a 9- or 10-day intensive program involving a wilderness canoe expedition homeward through the traditional territory of Wiikwemkoong. The purpose of this study was to evaluate the impact of the OALE on youth well-being, using a culturally appropriate measure of health: The Aboriginal Children's Health and Well-being Measure (ACHWM©). A pre- and post-intervention study design was used to assess the impact of the OALE on health and well-being. Twenty-eight participants completed both the ACHWM and the Global Health Rating (GHR) instruments before and after the OALE intervention. In total, 68% of participants reported higher ACHWM scores after the OALE ([Delta] = 3.9, p = 0.014). There were improvements in the Medicine Wheel quadrants score of the ACHWM (spiritual, emotional, physical, and mental). Although 25% of participants had higher scores on the GHR, this did not reach statistical significance (p = 0.55). However, this study highlights the value of evaluating local programming in a culturally-relevant way. Using the ACHWM, it was demonstrated that there was a significant change in the well-being of the OALE youth participants; this was something that the GHR was unable to capture. Thus, the ACHWM appears to be sensitive to short-term changes in health. More research is needed to confirm the specificity and sensitivity of the ACHWM in different populations and contexts.

Objective To assess the individual and community health effects of task shifting for emergency care in low-resource settings and underserved populations worldwide. Methods We systematically searched 13 databases and additional grey literature for studies published between 1984 and 2019. Eligible studies involved emergency care training for laypeople in underserved or low- resource populations, and any quantitative assessment of effects on the health of individuals or communities. We conducted duplicate assessments of study eligibility, data abstraction and quality. We synthesized findings in narrative and tabular format. Findings Of 19 308 papers retrieved, 34 studies met the inclusion criteria from low- and middle-income countries (21 studies) and underserved populations in high-income countries (13 studies). Targeted emergency conditions included trauma, burns, cardiac arrest, opioid poisoning, malaria, paediatric communicable diseases and malnutrition. Trainees included the general public, non-health-care professionals, volunteers and close contacts of at-risk populations, all trained through in-class, peer and multimodal education and public awareness campaigns. Important clinical and policy outcomes included improvements in community capacity to manage emergencies (14 studies), patient outcomes (13 studies) and community health (seven studies). While substantial effects were observed for programmes to address paediatric malaria, trauma and opioid poisoning, most studies reported modest effect sizes and two reported null results. Most studies were of weak (24 studies) or moderate quality (nine studies). Conclusion First aid education and task shifting to laypeople for emergency care may reduce patient morbidity and mortality and build community capacity to manage health emergencies for a variety of emergency conditions in underserved and low-resource settings. Objectif Evaluer l'impact, sur la sante individuelle et collective, du transfert des interventions de premiers secours dans les endroits disposant de ressources limitees et au sein des populations defavorisees a travers le monde. Methodes Nous avons analyse systematiquement 13 bases de donnees ainsi que toute litterature grise complementaire pour y trouver des etudes publiees entre 1984 et 2019. Les etudes retenues devaient faire mention d'une formation aux premiers secours pour les nonprofessionnels au sein des populations defavorisees ou dotees de peu de ressources, mais aussi d'une evaluation quantitative de l'impact sur la sante individuelle et collective. Nous avons duplique les appreciations d'admissibilite de l'etude, de qualite et d'abstraction des donnees. Enfin, nous avons synthetise les resultats sous forme de textes et de tableaux. Resultats Sur 19 308 articles recuperes, 34 etudes correspondaient aux criteres d'inclusion propres aux pays a faibles et moyens revenus (21 etudes) et aux populations defavorisees dans les pays a hauts revenus (13 etudes). Plusieurs situations d'urgence etaient ciblees: traumatismes, brulures, arrets cardiaques, intoxications aux opiaces, malaria, maladies infantiles contagieuses et malnutrition. Les stagiaires etaient des individus issus du grand public, des non-professionnels de la sante, des benevoles et des contacts proches de populations a risque, tous formes dans le cadre de cours multimodaux organises par des pairs et de campagnes de sensibilisation de l'opinion publique. Diverses retombees politiques et cliniques d'envergure ont ete constatees: amelioration de la capacite de gestion des urgences dans les communautes (14 etudes), consequences positives pour les patients (13 etudes) et sante collective (7 etudes). Bien que des effets non negligeables aient ete observes pour les programmes de lutte contre la malaria infantile, les traumatismes et l'intoxication aux opiaces, la plupart des etudes n'ont remarque que des effets d'ampleur modeste et deux ont rapporte un benefice nul. En outre, la majorite d'entre elles se sont revelees de pietre qualite (24 etudes) ou de qualite moyenne (9 etudes). Conclusion La formation aux premiers secours et le transfert des interventions aux non-professionnels peut contribuer a diminuer la morbidite et la mortalite des patients, mais aussi a developper les capacites communautaires de gestion des urgences sanitaires pour une serie de situations dans les milieux defavorises ou manquant de ressources. Objetivo Evaluar los efectos en la salud individual y comunitaria del cambio de tareas para la atencion de emergencia en entornos con bajos recursos y poblaciones desatendidas a nivel mundial. Metodos Se realizaron busquedas sistematicas en 13 bases de datos y en la literatura gris adicional de estudios publicados entre 1984 y 2019. Los estudios elegibles involucraron la formacion en atencion de emergencia para personas no profesionales en poblaciones subatendidas o de bajos recursos, y cualquier evaluacion cuantitativa de los efectos en la salud de los individuos o las comunidades. Se realizaron evaluaciones duplicadas de la elegibilidad de los estudios, la abstraccion de datos y la calidad. Se sintetizaron los resultados en formato narrativo y tabular. Resultados De los 19.308 documentos recuperados, 34 estudios cumplian los criterios de inclusion de paises con ingresos bajos y medios (21 estudios) y de poblaciones desatendidas de paises con ingresos altos (13 estudios). Las condiciones de emergencia a las que se dirigian incluian traumatismos, quemaduras, paros cardiacos, intoxicacion por opioides, malaria, enfermedades pediatricas transmisibles y desnutricion. Entre los alumnos se encontraban el publico en general, los profesionales no sanitarios, los voluntarios y los contactos cercanos de las poblaciones de riesgo, todos ellos formados a traves de campanas de educacion y concienciacion publica presenciales, entre companeros y multimodales. Los resultados clinicos y politicos mas importantes fueron la mejora de la capacidad de la comunidad para gestionar emergencias (14 estudios), los resultados de los pacientes (13 estudios) y la salud de la comunidad (7 estudios). Aunque se observaron efectos sustanciales en los programas para abordar la malaria pediatrica, los traumatismos y la intoxicacion por opioides, la mayoria de los estudios informaron de tamanos de efecto modestos y dos informaron de resultados nulos. La mayoria de los estudios fueron de calidad debil (24 estudios) o moderada (9 estudios). Conclusion La formacion de personas en primeros auxilios y la transferencia de tareas a los legos para la atencion de emergencias pueden reducir la morbilidad y la mortalidad de los pacientes y fomentar la capacidad de la comunidad para gestionar las emergencias sanitarias en una variedad de condiciones de emergencia en entornos desatendidos y de bajos recursos., Introduction Conditions that could be treated with prehospital and emergency care account for an estimated 24 million lives lost each year in low- and middle-income countries. (1) Training lay providers [...]

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We report on an environmental scan (ES) of adventure therapy (AT) literature, organizations, and activities in Canada. The ES methodology involved (a) an examination of final reports related to a series of national symposiums on AT in Canada, (b) a review of academic literature related to AT in Canada, and (c) a summary of AT programs and courses offered at post-secondary institutions across Canada. Analysis of the reports from five AT symposiums revealed broad variability in terms of delegates and organizations represented and suggested that AT is practiced or endorsed by a diverse array of individuals and organizations across Canada. The literature review uncovered 113 relevant articles, book chapters, and papers with a substantial Canadian contribution. Canadian academic literature on the topic is sparse, and AT training and education opportunities at Canadian institutions are very limited. Implications for the future development of AT in Canada are shared.

Indigenous voices are largely silent in the outdoor education and adventure therapy literature. The purpose of this research collaboration was to understand how a 10-day outdoor adventure leadership experience (OALE) may promote resilience and well-being for Indigenous youth through their participation in the program. The process was examined through a community-based participatory research project that sought insight from the perspectives of one First Nations community in Canada. The OALE was implemented with six different groups for a total of 43 youth participants (ages 11.9-18.7 years) from Wikwemikong Unceded Indian Reserve in northeastern Ontario. Field data were collected from multiple sources including participant interviews, journals, focus groups, and talking circles. Using a critical ethnographic lens, we analyzed the data inductively to understand how the OALE promoted resilience and well-being. We listened to Indigenous voices, adhered to principles of Indigenous coding for thematic content and respected Indigenous ways of knowing for interpreting results. The process of connecting to the Good Life ("Anishinaabe Bimaadziwin") or waking up ("nsidwaaswok") to the Good Life emerged as the dominant theme. Connecting to the Good Life may offer a simple yet compelling way to understand the net impact of the OALE.

Wilderness therapy (WT) provides an alternative treatment modality for a number of mental health issues. It holds particular appeal for at-risk youth, a population that is often less responsive to traditional psychotherapeutic interventions. Anecdotal accounts on the effectiveness of WT often show positive outcomes. Still, some researchers have questioned the value of WT outcome studies on the basis of dubious methodology. The current study sought to address this issue through its use of well-validated observational scales drawn from the Child Behaviour Checklist (CBCL). While on a canoe expedition, three trained raters assessed the conduct of a group of at-risk youth aged 15 to 18 years. Results showed very little inter-observer agreement (Cronbach's alpha = 0.12). The findings underline the challenges of measuring WT outcomes. Even when equipped with validated and behaviourally anchored instruments, there appears to be little consistency among observers in terms of the degree to which WT influences participant change. The study demonstrates that when structured observation of WT participants is undertaken, outcomes are less definitive. This supports the criticisms offered by previous researchers who have expressed that in the absence of improvements to WT research methods, outcome findings are likely to be of questionable validity. (Contains 1 table.)

Copyright of Diversity of Research in Health Journal / Revue de la Diversité de la Recherche en Santé is the property of Diversity of Research in Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVES: The purpose of this study was to identify concepts of health and well-being important to Aboriginal children and youth. These concepts were necessary for the development of a culturally appropriate measure of health. METHODS: We completed 4 community consultation sessions, 4 advisory committee meetings, and 6 full-day focus groups within the Wikwemikong Unceded Indian Reserve. The focus groups engaged Aboriginal children and youth via relevant cultural teachings, a photography exercise combined with a community bicycling tour, and detailed discussions of health and well-being using photovoice. The process was guided by a conceptual model: the Medicine Wheel. The participants placed their photos on a wall mural and identified their most important concepts. These concepts were synthesized through expert consensus into items and reviewed by the broader community. RESULTS: The participants ranged in age from 8.2 to 17.7 years (mean age=12.3). Through innovative methods, children and youth identified 206 concepts representing the 4 quadrants of the Medicine Wheel: emotional, spiritual, physical and mental. These concepts were refocused, in collaboration with the community, to create a new 60-item measure of health and well-being that was primarily positive in focus. CONCLUSION: This study demonstrates the success of implementing a unique process of photovoice in combination with bicycling and informed by an Aboriginal framework. The results confirm the distinct conceptualization of health and well-being in this population and underscore the necessity for a culturally appropriate measure. This study also produced a first draft of the Aboriginal Children's Health and Well- being Measure (ACHWM). KEY WORDS: Child; health status; Indians, North American; quality of life; photography; questionnaires OBJECTIF: Cerner les concepts de la sante et du bien-etre qui importent aux enfants et aux jeunes autochtones. Ces concepts ont ete necessaires a l'elaboration d'un indicateur de sante culturellement approprie. METHODE: Nous avons mene 4 seances de consultation communautaire, tenu 4 reunions du comite consultatif et organise 6 groupes de discussion d'une journee dans la reserve indienne non cedee de Wikwemikong. Les groupes de discussion ont propose aux enfants et aux jeunes autochtones des enseignements culturels pertinents, un exercice de photographie combine a une excursion a velo dans la communaute et une discussion approfondie sur la sante et le bien-etre par la methode Photovoice. Le processus s'est guide sur le modele theorique de la << roue medicinale >>. Les participants ont place leurs photos sur une murale et cerne les concepts les plus importants pour eux. Ces concepts ont ete resumes par des specialistes, en consensus, et examines par la communaute elargie. RESULTATS: Les participants avaient de 8,2 a 17,7 ans (age moyen=12,3 ans). En employant des methodes novatrices, les enfants et les jeunes ont cerne 206 concepts representant les 4 secteurs de la roue medicinale: emotionnel, spirituel, physique et mental. Ces concepts ont ete peaufines, en collaboration avec la communaute, pour creer un nouvel indicateur de la sante et du bien-etre en 60 elements. La perspective adoptee etait principalement positive. CONCLUSION: L'etude montre qu'il est possible de mettre en oeuvre un processus original, combinant la methode Photovoice au velo et eclaire par une grille autochtone. Les resultats confirment la conception distincte de la sante et du bien-etre dans cette population et soulignent le besoin d'un indicateur culturellement approprie. L'etude a aussi produit une premiere version d'un << indicateur de la sante et du bien-etre des enfants autochtones >> (ACHWM). MOTS CLES: enfant; etat sanitaire; Indiens d'Amerique Nord; qualite de vie; photographie; questionnaires, Children and youth comprise 40% of the Canadian Aboriginal population and experience gross inequities in health compared to their peers. (1-4) Emerging data from health indicators (e.g., morbidity and mortality [...]

In this paper, I (S. L. Deibert) share my story of discovering the relationship between reflexivity, autoethnography, and yoga through a meaningful experience. Yoga has been an important influence on my physical and mental well-being for over a decade, but I did not consider its implications in my academic life until I was asked to write a reflexive assignment for a course. The task was exploring who I am in connection to my master's thesis project; the challenge was finding a starting point for my reflexive journey of selfdiscovery. Frustrated by the latter, I turned to yoga for refuge; instead of escaping the assignment, I found that my quest for self-exploration was intertwined with my yoga practice. The purpose of this paper is to delve further into my experience with yoga as a medium for developing reflexivity. Using autoethnography, I share my journey of developing critical thinking through a narrative related to my yoga class experience. Linking my research to my yoga practice allowed me to better understand myself as a person and researcher, become mindful of how my own views shape my experiences, and develop a deeper level of critical reflection. Overall, this work demonstrates the experience of a connection between yoga, reflexivity, and autoethnography, and adds to the sparse literature exploring the intersection of these three. [ABSTRACT FROM AUTHOR]