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McCarty G, Wyeth EH, Sullivan T, Crengle S, Nelson V, Derrett S. Health-related quality of life measures used with Indigenous children/youth in the Pacific Rim: a scoping review. BMJ Open 2023; 13:e070156. [PMID: 36997253 PMCID: PMC10069609 DOI: 10.1136/bmjopen-2022-070156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To identify and describe (1) which health-related quality of life (HRQoL) measures have been used with Indigenous children/youth (aged 8-17 years) within the Pacific Rim; and (2) studies that refer to Indigenous health concepts in the use of child/youth HRQoL measures. DESIGN A scoping review. DATA SOURCES Ovid (Medline), PubMed, Scopus, Web of Science and CINAHL were searched up until 25 June 2020. ELIGIBILITY CRITERIA Eligible papers were identified by two independent reviewers. Eligible papers were written in English, published between January 1990 and June 2020 and included an HRQoL measure used in research with Indigenous child/youth populations (aged between 8 and 17 years) in the Pacific Rim region. DATA EXTRACTION AND SYNTHESIS Data extracted included study characteristics (year, country, Indigenous population, Indigenous sample size, age group), HRQoL measure characteristics (generic or condition-specific measure, child or adult measure, who completed the measure(s), dimensions, items and response scale of measure) and consideration of Indigenous concepts (created for Indigenous population, modified for Indigenous population, validated for Indigenous population, reliability in Indigenous populations, Indigenous involvement, reference to Indigenous theories/models/frameworks). RESULTS After removing duplicates, 1393 paper titles and abstracts were screened, and 543 had full-text review for eligibility. Of these, 40 full-text papers were eligible, reporting on 32 unique studies. Twenty-nine HRQoL measures were used across eight countries. Thirty-three papers did not acknowledge Indigenous concepts of health, and only two measures were specifically created for use with Indigenous populations. CONCLUSIONS There is a paucity of research investigating HRQoL measures used with Indigenous children/youth and a lack of involvement of Indigenous peoples in the development and use of HRQoL measures. We strongly recommend explicit consideration of Indigenous concepts when developing, validating, assessing and using HRQoL measures with Indigenous populations.
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Affiliation(s)
- Georgia McCarty
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Trudy Sullivan
- Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Vicky Nelson
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Lund JI, Toombs E, Mushquash CJ, Pitura V, Toneguzzi K, Bobinski T, Leon S, Vitopoulos N, Frederick T, Kidd SA. Cultural adaptation considerations of a comprehensive housing outreach program for indigenous youth exiting homelessness. Transcult Psychiatry 2022:13634615221135438. [PMID: 36567597 DOI: 10.1177/13634615221135438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Generalist health interventions that aim to reduce chronic health disparities between Indigenous and non-Indigenous populations can be culturally adapted to better meet the needs of Indigenous people in Canada; however, little is known regarding best practices in implementing these adaptations. The present study first provides a review of the research process used to adapt a previous evidence-based housing initiative for Indigenous youth in Northwestern Ontario. Second, it includes an overview of the adaptations that were made and the associated rationale for such adaptations. Third, it examines the experiences of participants and staff involved in the cultural adaptation of the Housing Outreach Program Collaborative (HOP-C), a health intervention re-designed to improve physical and mental health outcomes, wellbeing, and social support for formerly homeless Indigenous youth as they secure housing. Qualitative feedback from interviews with 15 participants and eight program staff, in addition to one focus group with an additional six frontline workers, described perceived outcomes of the program's cultural adaptations. Modifications to the overall program structure, specific roles within the program (including counseling services, peer mentorship, cultural services, and case management), and adaptations to general implementation within the health organization providing the intervention were described by participants and staff as effective and helpful adaptations. The focus of Indigenous values at an organizational level led to consistent adaptations in counseling and case management to best meet the unique needs of the youth involved. Based upon participant interviews, recommendations to future adaptations are provided.
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Affiliation(s)
- Jessie I Lund
- Department of Psychology, 7890Lakehead University, Canada
| | - Elaine Toombs
- Department of Psychology, 7890Lakehead University, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | - Christopher J Mushquash
- Department of Psychology, 7890Lakehead University, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
- Northern Ontario School of Medicine (NOSM), 7890Lakehead University, Canada
- Thunder Bay Regional Health Research Institute, Canada
| | | | | | - Tina Bobinski
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | | | | | - Tyler Frederick
- Department of Criminology and Justice, 85458Ontario Tech University, Canada
| | - Sean A Kidd
- Department of Psychiatry, University of Toronto, Canada
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Maretzki M, Geiger R, Buxton JA. How COVID-19 has impacted access to healthcare and social resources among individuals experiencing homelessness in Canada: a scoping review. BMJ Open 2022; 12:e058233. [PMID: 35914918 PMCID: PMC9344594 DOI: 10.1136/bmjopen-2021-058233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES In Canada, individuals experiencing homelessness (IEH) rely on public health and social services for healthcare, food and basic necessities. The COVID-19 pandemic has disproportionately affected marginalised populations, in part by impacting their access to such services. We performed a scoping review to identify from the published literature how access to services has changed for Canadian IEH during the pandemic. DATA SOURCES OVID Medline, Web of Science, Sociological Abstracts, CINAHL and OVID EmCare databases, and websites for the Salvation Army, Homeless Hub, Canadian Alliance to End Homelessness, Canadian Network for the Health and Housing of People Experiencing Homelessness and BC Centre for Disease Control. STUDY DESIGN We used the scoping review methodology developed by the Joanna Briggs Institute framework and defined access to healthcare and social services using the 10-component Levesque framework. Academic databases and grey literature searches were used, with the final searches for each taking place 24 May and 1 June 2021, respectively. Data were compiled into an Excel spreadsheet. Title and abstract screening and full-text review were completed by two independent reviewers (RG and MM). Data extraction was completed by MM and cross checked by RG. RESULTS In total, 17 academic and grey literature articles were included. Positive and negative changes in service access were reported in the literature. During the COVID-19 pandemic, access to social and healthcare resources was generally reduced for Canadian IEH. A new component of access, digital connectivity, was identified. Unexpectedly, coordination and collaboration of services improved, as did the number of outreach services. CONCLUSIONS Positive changes to service access such as improved coordination of services should be scaled up. Further work should be done to improve access to digital technologies for IEH.
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Affiliation(s)
- Maxine Maretzki
- Faculty of Health Sciences, Department of Global Health, McMaster University, Hamilton, Ontario, Canada
- Harm Reduction Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Rachael Geiger
- Harm Reduction Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, UBC, Vancouver, British Columbia, Canada
| | - Jane A Buxton
- Harm Reduction Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, UBC, Vancouver, British Columbia, Canada
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McQuaid RJ, Schwartz FD, Blackstock C, Matheson K, Anisman H, Bombay A. Parent-Child Separations and Mental Health among First Nations and Métis Peoples in Canada: Links to Intergenerational Residential School Attendance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116877. [PMID: 35682462 PMCID: PMC9180563 DOI: 10.3390/ijerph19116877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 01/25/2023]
Abstract
First Nations children are over 17 times more likely to be removed from their families and placed in the child welfare system (CWS) than non-Indigenous children in Canada. The high rates of parent-child separation have been linked to discriminatory public services and the Indian Residential School (IRS) system, which instigated a multi-generational cycle of family disruption. However, limited empirical evidence exists linking the IRS to subsequent parent-child separations, the CWS, and mental health outcomes among First Nations, Inuit, and Métis populations in Canada. The current studies examine these relationships using a nationally representative sample of First Nations youth (ages 12–17 years) living in communities across Canada (Study 1), and among First Nations and Métis adults (ages 18+ years) in Canada (Study 2). Study 1 revealed that First Nations youth with a parent who attended IRS had increased odds of not living with either of their biological parents, and both IRS and not living with biological parents independently predicted greater psychological distress. Similarly, Study 2 revealed that First Nations and Métis adults with familial IRS history displayed greater odds of spending time in the CWS, and both IRS and CWS predicted elevated depressive symptoms. The increased distress and depressive symptoms associated with parent-child separations calls for First Nations-led interventions to address the inequities in the practices of removing Indigenous children and youth from their families.
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Affiliation(s)
- Robyn J. McQuaid
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (K.M.); (H.A.)
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON K1Z 7K4, Canada
- Correspondence:
| | - Flint D. Schwartz
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Cindy Blackstock
- First Nations Child and Family Caring Society, Ottawa, ON K1R 7S8, Canada;
- School of Social Work, McGill University, Montreal, QC H3A 1B9, Canada
| | - Kim Matheson
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (K.M.); (H.A.)
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON K1Z 7K4, Canada
| | - Hymie Anisman
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (K.M.); (H.A.)
| | - Amy Bombay
- Department of Psychiatry and School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada;
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Ansloos JP, Wager AC, Dunn NS. Preventing Indigenous youth homelessness in Canada: A qualitative study on structural challenges and upstream prevention in education. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1918-1934. [PMID: 34427328 DOI: 10.1002/jcop.22691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
Drawing on a partnership with a group of Indigenous youth experiencing homelessness in Vancouver, Canada, this study identifies four structural challenges that have impacted them and four actionable upstream strategies to further prevent youth housing precarity. As a secondary analysis of a community-engaged study with youth experiencing homelessness, we conducted a thematic analysis with qualitative data, which included qualitative interviews with five young people and researcher observations. The results reflect the racial, colonial, and economic concerns that impact Indigenous youth experiencing homelessness. The four actionable upstream solutions highlight human rights-based approaches to homelessness, ranging from advancing and strengthening public services, transitional justice processes, and cultural and socioeconomic safety. This study provides strategies to promote Indigenous youth wellbeing and decrease risk of housing precarity, while centering and drawing from youth knowledge production. Strengths and limitations of the study are also discussed.
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Affiliation(s)
- Jeffrey Paul Ansloos
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Amanda Claudia Wager
- Faculty of Education, Vancouver Island University, Nanaimo, British Columbia, Canada
| | - Nicole Santos Dunn
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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Mathias S, Tee K, Helfrich W, Gerty K, Chan G, Barbic SP. Foundry: Early learnings from the implementation of an integrated youth service network. Early Interv Psychiatry 2022; 16:410-418. [PMID: 34008340 PMCID: PMC9292689 DOI: 10.1111/eip.13181] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/16/2022]
Abstract
AIMS To provide the first profile of the demographic and service characteristics of young people (aged 12-24 years) who access Foundry, a provincial network of integrated youth health and social service centres in British Columbia, Canada and to share early learnings about implementation and service innovation. METHODS Using a retrospective chart review, we conducted a census of all young people accessing a Foundry centre in a 'proof of concept' phase. Six centres were assessed between October 2015 and March 2018. Data included demographics, mental health service access history, service type the youth was seeking, and information about how they found out about the centre. RESULTS A total of 4783 young people presented during this proof of concept period, for a total number of 35 791 visits. The most frequently accessed category of service was mental health/substance use (57%) followed by physical health (25%). Young people were most likely to be female, aged 15-19, and White. Youth demographic characteristics showed an over-representation of Indigenous and LGBTQ2 youth and under-representation of males and youth aged 20-24. Youth were most likely to learn about Foundry from a friend (44%) or family member (22%). Most youth (58%) reported that they would have gone 'nowhere' if not for Foundry. CONCLUSIONS Foundry is a model of integrated health and social services delivery, focused on early intervention, prevention and accessibility, driven by the needs and priorities of young people and their families. Leveraging international integrated youth health service evidence, the model addresses urgent priorities in Canadian health service delivery.
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Affiliation(s)
- Steve Mathias
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, Providence Health Care, St. Paul's Hospital, Vancouver, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.,Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Karen Tee
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada
| | - Warren Helfrich
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada
| | - Krista Gerty
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada
| | - Godwin Chan
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada
| | - Skye Pamela Barbic
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.,Providence Health Care Research Institute, Vancouver, British Columbia, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Kidd SA, Gaetz S, O'Grady B, Schwan K, Zhao H, Lopes K, Wang W. The Second National Canadian Homeless Youth Survey: Mental Health and Addiction Findings: La Deuxième Enquête Nationale Auprès des Jeunes Sans Abri : Résultats en Matière De Santé Mentale et de Toxicomanie. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:897-905. [PMID: 33525910 PMCID: PMC8573707 DOI: 10.1177/0706743721990310] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Youth experiencing homelessness represent a major social problem in Canada and, as demonstrated in the first national survey of this population conducted in 2015, are experiencing significant mental health challenges. The present study examines the findings of a second national survey completed in 2019. These findings afford the opportunity to examine the reliability of the findings of the first study with another large, representative sample and to attempt to articulate the unique characteristics of youth experiencing the greatest distress among this at-risk population. METHODS This study analyzed the mental-health-related data from the 2019 Without a Home-National Youth Homelessness Survey that was administered through convenience sampling at 98 agencies serving homeless youth in 49 communities across Canada. The survey was cross-sectional and self-administered, assessing a range of demographic information, pre- and post-homelessness variables, and mental health indicators. Multinomial logistic regression and linear regression were implemented to evaluate associations with distress level. RESULTS Survey data were obtained from 1,375 youth accessing Canadian homeless services in 9 provinces. Thirty-five percent reported at least 1 suicide attempt, and 33.1% reported a drug overdose requiring hospitalization. The findings of this survey replicated most of the key findings from the 2015 survey. The current findings emphasized, for this high-risk population, the heightened adversity faced by young women, Lesbian, Gay, Bisexual, Transgender, Queer, Two-Spirit (LGBTQ2S), and Indigenous subpopulations, as well as the centrality of violence exposure in determining risk and distress. Sexual violence, in particular, emerged as a key factor in the identification of youth experiencing the greatest distress with risk buffered by contact with family. CONCLUSIONS These findings can inform prevention and intervention policies and services and reinforce the importance of attending to violence exposure and trauma as central to the mental health trajectories of youth who have experienced homelessness.
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Affiliation(s)
- Sean A Kidd
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Stephen Gaetz
- Faculty of Education, York University, Toronto, Ontario, Canada
| | - Bill O'Grady
- Department of Sociology and Anthropology, University of Guelph, Ontario, Canada
| | - Kaitlin Schwan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Ontario, Canada
| | - Haoyu Zhao
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Katrini Lopes
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Morton MH, Chávez R, Moore K. Prevalence and Correlates of Homelessness Among American Indian and Alaska Native Youth. J Prim Prev 2019; 40:643-660. [PMID: 31691062 DOI: 10.1007/s10935-019-00571-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Youth homelessness is a serious national challenge affecting millions of young people every year. However, due to their relatively small population size, together with limitations related to data and research efforts on homelessness to date, prevalence estimates and evidence of homelessness experiences among American Indian and Alaska Native (AIAN) youth have been scarce. This is particularly the case at the national level. We report findings on the prevalence, characteristics, and correlates of AIAN youth experiencing homelessness that are based on a nationally representative survey on homelessness among adolescents and young adults, age 13 to 25. The overall national survey sample included 25,492 respondents. During a 12-month period, approximately 10.2% of AIAN households with 13-17 year olds reported youth homelessness or runaway experiences that lasted at least one night. For AIAN 18-25 year olds, the 12-month population prevalence of homelessness experiences was 12.2%. AIAN young adults had three times the prevalence rate of homelessness as their White non-Hispanic peers. Furthermore, most AIAN youth experiencing homelessness, like most AIAN people overall, reside in predominantly urban counties. Controlling for other variables, lower educational attainment, and parenting (especially if unmarried) were associated with higher likelihood of homelessness. There is a clear and urgent need for tailored, culturally-responsive homelessness prevention and intervention strategies, along with focused housing and support investments, for AIAN young people and the communities in which they live. The federal government and local jurisdictions need to take policy actions to address high rates of AIAN youth homelessness in urban and suburban communities, in addition to policies centered on AIAN reservations and rural communities.
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Affiliation(s)
| | - Raúl Chávez
- University of California, Berkeley, Berkeley, CA, USA
| | - Kelly Moore
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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