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Rana Z, Leach M, Healey Akearok GK, Ukpatiku J, Umenwofor-Nweze N. A cross-sectional study exploring community perspectives on the impacts of COVID-19 in Nunavut and recommendations for a Holistic Inuit Qaujimajatuqangit approach to emergency response. Int J Circumpolar Health 2024; 83:2336680. [PMID: 38590216 PMCID: PMC11005875 DOI: 10.1080/22423982.2024.2336680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
The goal of this study was to examine and address critical knowledge gaps and develop an understanding of both the positive and negative societal outcomes resulting from the public health measures associated with the COVID-19 pandemic in Nunavut and the interventions being undertaken to promote positive well-being. Data collection for this study included narrative, in-person interviews in Iqaluit, Rankin Inlet, Baker Lake, and Cambridge Bay between September 2022 and January 2023. A total of 70 participants were interviewed for this study. Community highlighted challenges, such as crowding and food insecurity, and concern for the collective wellbeing of the community. Strengths included financials supports, food sharing, and maintaining community connections over a distance. Recommendations included a focus on holistic health such as 1) public education and awareness about communicable disease, 2) financial supports, 3) housing, 4) access to healthcare, 5) focus on Inuit Qaujimajatuqangit, 6) mental-health and addiction supports, and 7) community spaces. Community members described both strengths and challenges they believe impacted their experiences and service delivery as well as recommendations for the future.
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Affiliation(s)
- Zoha Rana
- Qaujigiartiit Health Research Centre, Nunavut, Canada
| | - Meagan Leach
- Qaujigiartiit Health Research Centre, Nunavut, Canada
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Logie CH, Lys CL, Taylor SB, Lad A, Mackay KI, Hasham A, Gittings L, Malama K, Pooyak S, Monchalin R, Adamassu Z. Land-Based Retreats as a Method for Building Enabling Environments for HIV Prevention with Northern and Indigenous Adolescents in the Northwest Territories, Canada: Mixed-Methods Findings. AIDS Behav 2024:10.1007/s10461-024-04397-w. [PMID: 38900311 DOI: 10.1007/s10461-024-04397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
The Northwest Territories (NWT), Canada has high rates of sexually transmitted infections (STI) that elevate HIV acquisition risks. We conducted a mixed-methods study to explore the potential of land-based peer leader retreats (PLR) in building HIV prevention enabling environments among Northern and Indigenous youth in the NWT. PLRs are grounded in Indigenous principles and ways of knowing, acknowledging the land as a physical, spiritual, emotional, and intellectual being with the potential to facilitate (re)connection to culture, community, and self. We conducted one-week PLRs between 2016 and 2021 with adolescents aged 13-17 in the NWT. PLRs addressed HIV/STIs, safer sex, and gender equity. We conducted post-retreat focus groups (FGs) and pre/post-retreat surveys with youth participants (n = 353), and post-retreat FGs with PLR facilitators (n = 252). We applied thematic analysis to FGs and assessed pre/post-retreat changes in HIV/STI knowledge and safer sex efficacy (SSE) using paired sample t-tests. We assessed factors associated with post-test SSE and HIV/STI knowledge using multivariable linear regression. Youth participants (n = 353; mean age: 14.5, standard deviation [SD]: 1.3) were mostly Indigenous (71%) and women (66%). Participant narratives revealed PLRs enhanced technical communication (e.g., correct condom use). There were significant post-retreat HIV/STI knowledge increases; change score increases were lower for Indigenous participants. Qualitative narratives described how PLRs fostered transformative communication (e.g., sexual consent). There were significant post-retreat increases in SSE, and these were lower among men and sexually diverse (vs. heterosexual) participants. Land-based PLRs offer the potential to build technical and transformative communication to facilitate HIV prevention with youth in Canada's North.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada.
- United Nations University Institute for Water, Environment, and Health, Hamilton, Canada.
- Centre for Gender and Sexual Health Equity, Vancouver, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.
| | - Candice L Lys
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, NT, Canada
- Aurora Research Institute, Yellowknife, NT, Canada
| | - Shira B Taylor
- Faculty of Environmental and Urban Change, York University, Toronto, ON, Canada
- SExT: Sex Education by Theatre, Toronto, ON, Canada
| | - Anoushka Lad
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | | | - Aryssa Hasham
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Lesley Gittings
- Faculty of Health Sciences, School of Health Studies, Western University, London, ON, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Sherri Pooyak
- Communities, Alliances, and Networks (CAAN), Fort Qu'Appelle, SK, Canada
| | - Renée Monchalin
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
- Well Living House, Li Ka Shing Knowledge Institute of Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Zerihun Adamassu
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
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Healey Akearok GK, Rana Z. Community perspectives on COVID-19 outbreak and public health: Inuit positive protective pathways and lessons for Indigenous public health theory. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:395-407. [PMID: 38653866 PMCID: PMC11133288 DOI: 10.17269/s41997-024-00863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/25/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES Indigenous public health theory and the voices of Canadian Indigenous communities remain under-represented in the literature despite the Canadian Truth and Reconciliation Calls to Action, and the perspectives of Inuit are further under-represented in this literature. The goal of this paper is to explore the perspectives of Iqalungmiut (people of Iqaluit), frontline staff, and decision-makers on the management of the COVID-19 outbreak in Iqaluit in April to June 2021 and to identify lessons learned and contributions to public health policy and practice specific to Inuit populations in Canada. METHODS This study used the Piliriqatigiinniq Community Health Research Model which was developed by Nunavummiut to guide community-based health and well-being research. Interviews were conducted with 44 individuals: 22 community members and shelter users; 17 frontline workers; and 5 decision-makers representing municipal and territorial government. Participants were asked about their experiences during the outbreak, sources of information, and strengths and challenges during outbreak management. RESULTS Challenges included overcrowding, physical disconnection from family members, and mental health and trauma. Community-identified strengths included strong interagency cooperation, food hamper and COVID-19 care kit deliveries, and travel restrictions. Several Inuit positive health-protective pathways were identified including Ilaginniq; Silativut; Inuuqatigiittiarniq; Piliriqatigiinniq; Ikajurniq; and Pijitsirniq. CONCLUSION Outbreaks of infectious illness are not new to Nunavut communities and Inuit protective pathways have and continue to be critical avenues to adapt to and mitigate such challenges. This exploratory study provides clear direction for Inuit public health policy and practice in Canada, while contributing to the body of literature on Indigenous public health theory.
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Affiliation(s)
| | - Zoha Rana
- Qaujigiartiit Health Research Centre, Iqaluit, Nunavut, Canada
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Barbosa Ladino MC, Jiménez Betancourth C, Vásquez Acevedo L, Haag M, Zirkel J, Schwienhorst-Stich EM, Navarro M, Kasang C, Gágyor I, Parisi S. Body map stories from Colombia: experiences of people affected by leprosy and the influence of peers during diagnosis and treatment. Int J Equity Health 2024; 23:98. [PMID: 38741119 DOI: 10.1186/s12939-024-02152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/15/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Almost one third of people affected by leprosy in Colombia suffer from disability, which often results from delayed diagnosis and treatment. We aimed to explore the experience of people affected by leprosy during the process of diagnosis and treatment and if and how this experience was influenced by peers. METHODS A qualitative study using body map stories was conducted from October 2019 to February 2020 in Colombia. Adult people affected by leprosy were recruited through patient associations in different cities. We conducted three sessions with an average duration of 2-3 h per participant, during which the participants created a painted map of their body and chose symbols to represent their experience, while being engaged in an informal interview. The sessions were audio recorded, transcribed verbatim and analyzed thematically by an interdisciplinary team, consisting of physicians, social workers and a person affected by leprosy. RESULTS The 17 study participants (11 female) were aged 20 to 70 years. Leprosy-related manifestations ranged from no to advanced disability. Some participants were active members of associations for people affected by leprosy. Three main themes were identified during analysis: (1) A long pathway to diagnosis, (2) Therapy as a double-edged sword and (3) The influence of other people affected by leprosy. The participants described an often years-long process until being diagnosed, which was marked by insecurities, repeated misdiagnosis, and worsening mental and physical health. Delayed diagnosis was related to late health care seeking, but also to inadequate health communication, lack of leprosy-related knowledge and negligence among health care workers. A high desire to cure motivated the participants to take their medication rigorously, despite the high treatment burden. Support from peers, either within the own social environment or provided from associations, contributed to a faster diagnosis and increased therapy adherence. Peers helped to recognize the symptoms, urged patients to seek care, recommended physicians with leprosy-related knowledge and provided a realistic example of both disease severity and curability. CONCLUSION People affected by leprosy experience a significant burden during the process of diagnosis and treatment. Involving well-trained peers could foster early diagnosis, treatment compliance and prevention of disability.
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Affiliation(s)
- Martha Cecilia Barbosa Ladino
- DAHW Latin America, GLRA German Leprosy and Tuberculosis Relief Association, Bogotá, Colombia
- FELEHANSEN National federation of people affected by Hansen`s disease in Colombia, Bogotá, Colombia
| | - Camila Jiménez Betancourth
- DAHW Latin America, GLRA German Leprosy and Tuberculosis Relief Association, Bogotá, Colombia
- FELEHANSEN National federation of people affected by Hansen`s disease in Colombia, Bogotá, Colombia
| | - Lucrecia Vásquez Acevedo
- FELEHANSEN National federation of people affected by Hansen`s disease in Colombia, Bogotá, Colombia
| | - Melanie Haag
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Janina Zirkel
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
- Internal Medicine, Unit of Infectious Disease, University Hospital Würzburg, Würzburg, Germany
| | | | - Miriam Navarro
- Epidemiology Unit, Public Health Centre of Elche - FISABIO, Alicante, Spain
- Department of Public Health, Science History and Gynaecology, Universidad Miguel Hernández, Alicante, Spain
| | - Christa Kasang
- DAHW HQ, GLRA German Leprosy and Tuberculosis Relief Association, Würzburg, Germany
| | - Ildikó Gágyor
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Sandra Parisi
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
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Rivera-Romero N, Cáliz-Romero NE, Laverde EY. Social Vulnerability and Psychosocial Resilience in Adolescents and Young Adults From a Community Art Network. J Am Psychiatr Nurses Assoc 2024; 30:624-634. [PMID: 36971328 DOI: 10.1177/10783903231161614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Adolescence is a stage of transition with multiple changes and transformations. It is a critical phase to potentiate or disrupt the life course of human beings. In Latin America, adolescents and young adults from countries like Colombia have unequal access to socioeconomic resources, education, and the job market. This may generate social disadvantages and vulnerability. AIM We aimed to identify conditions of social vulnerability and psychosocial resilience in the life course of adolescents and young adults from a community art network in Bogota, Colombia. METHODS We conducted a qualitative study with a multivocal design supported by the ethnic-social life history construction. The data were collected using narrative interviews. The interviews were transcribed, coded, categorized, and triangulated according to the principles of grounded theory as an analytical method. We adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS Eight adolescents and young adults between the ages of 12 and 24 years participated in the study. Five categories emerged: social vulnerability, social environment, artistic processes, psychosocial resilience, and life course. CONCLUSIONS Social vulnerability and psychosocial resilience coexist during the life course of adolescents and young adults. Social support networks and community art processes have the potential to promote psychosocial resilience in adolescents and young adults.
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Affiliation(s)
| | | | - Eddy Yazmin Laverde
- Eddy Yazmin Laverde, AA, BFA, Colectivo Artistico y Cultural Abya Yala, Bogotá, Colombia
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Murray A, Durrani F, Winstanley A, Keiller E, Taleb PA, Islam S, Foka S, Turri MG, Lau JYF. Understanding lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London: a qualitative study protocol. BMJ Open 2024; 14:e082346. [PMID: 38604624 PMCID: PMC11015186 DOI: 10.1136/bmjopen-2023-082346] [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] [Received: 11/21/2023] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION It is important to promote resilience in preadolescence; however, there is limited research on children's understandings and experiences of resilience. Quantitative approaches may not capture dynamic and context-specific aspects of resilience. Resilience research has historically focused on white, middle-class Western adults and adolescents, creating an evidence gap regarding diverse experiences of resilience in middle childhood which could inform interventions. East London's Muslim community represents a diverse, growing population. Despite being disproportionately affected by deprivation and racial and cultural discrimination, this population is under-represented in resilience research. Using participatory and arts-based methods, this study aims to explore lived experiences and perceptions of resilience in black and South Asian Muslim children living in East London. METHODS AND ANALYSIS We propose a qualitative study, grounded in embodied inquiry, consisting of a participatory workshop with 6-12 children and their parents/carers to explore lived experiences and perceptions of resilience. Participants will be identified and recruited from community settings in East London. Eligible participants will be English-speaking Muslims who identify as being black or South Asian, have a child aged 8-12 years and live in East London. The workshop (approx. 3.5 hours) will take place at an Islamic community centre and will include body mapping with children and a focus group discussion with parents/carers to explore resilience perspectives and meanings. Participants will also complete a demographic survey. Workshop audio recordings will be transcribed verbatim and body maps and other paper-based activities will be photographed. Data will be analysed using systematic visuo-textual analysis which affords equal importance to visual and textual data. ETHICS AND DISSEMINATION The Queen Mary Ethics of Research Committee at Queen Mary University of London has approved this study (approval date: 9 October 2023; ref: QME23.0042). The researchers plan to publish the results in peer-reviewed journals and present findings at academic conferences.
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Affiliation(s)
- Aisling Murray
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Faiza Durrani
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Ali Winstanley
- Freelance Creative Health Consultant and Facilitator, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| | - Eleanor Keiller
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | | | - Shahlima Islam
- Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sevasti Foka
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Maria Grazia Turri
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jennifer Y F Lau
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Cueva K, Rink E, Lavoie JG, Stoor JPA, Healey Akearok G, Gladun E, Larsen CVL. Diving below the surface: A framework for arctic health research to support thriving communities. Scand J Public Health 2023; 51:1086-1095. [PMID: 33899601 DOI: 10.1177/14034948211007694] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Historically, health research in the Arctic has focused on documenting ill-health using a narrow set of deficit-oriented epidemiologic indicators (i.e., prevalence of disease and mortality rates). While useful, this type of research does not adequately capture the breadth and complexities of community health and well-being, and fails to highlight solutions. A community's context, strengths, and continued expressions of well-being need to guide inquiries, inform processes, and contextualize recommendations. In this paper, we present a conceptual framework developed to address the aforementioned concerns and inform community-led health and social research in the Arctic. METHODS The proposed framework is informed by our collective collaborations with circumpolar communities, and syntheses of individual and group research undertaken throughout the Circumpolar North. Our framework encourages investigation into the contextual factors that promote circumpolar communities to thrive. RESULTS Our framework centers on the visual imagery of an iceberg. There is a need to dive deeper than superficial indicators of health to examine individual, family, social, cultural, historical, linguistic, and environmental contexts that support communities in the Circumpolar North to thrive. A participatory community-based approach in conjunction with ongoing epidemiologic research is necessary in order to effectively support health and wellness. Conclusions: The iceberg framework is a way to conceptualize circumpolar health research and encourage investigators to both monitor epidemiologic indicators and also dive below the surface using participatory methodology to investigate contextual factors that support thriving communities.
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Affiliation(s)
- Katie Cueva
- Institute of Social and Economic Research, University of Alaska Anchorage, USA
| | - Elizabeth Rink
- Department of Health and Human Development, Montana State University, USA
| | - Josée G Lavoie
- Ongomiizwin Research, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Jon P A Stoor
- Department of Epidemiology and Global Health, Umea University
- Centre for Sámi Health Research, Department of Community Medicine, UiT - the Arctic University of Norway, Norway
| | | | - Elena Gladun
- Professor of Public Administration Department, Tyumen State University, Russia
| | - Christina V L Larsen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark
- Greenland Center for Health Research, University of Greenland, Greenland
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Murray A, Steffen M, Keiller E, Turri MG, Lau JYF. Body mapping for arts-based inquiry in mental health research: a scoping review. Lancet Psychiatry 2023; 10:896-908. [PMID: 37611618 DOI: 10.1016/s2215-0366(23)00224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 08/25/2023]
Abstract
Traditional research methods have not yet yielded highly effective long-term mental health treatments and might not reflect diverse lived experiences. Body mapping, which is an arts-based research method, could complement the verbal data of existing approaches through its focus on visual and symbolic processes to understand subjective, embodied experiences related to mental health. We did a scoping review on the use of body mapping in research on mental health experiences and outcomes. We searched Web of Science, PubMed, Scopus, PsycINFO, Embase, Ovid Medline, and Google Scholar to retrieve peer-reviewed articles in English. In 19 articles representing 17 studies, participant numbers for body mapping ranged from three to 48, and some studies exclusively recruited women or children and young people. Study domains included primary mental health experiences and mental health in relation to physical health or social experiences. The benefits of body mapping included its exploration of difficult-to-access emotions and experiences, its focus on strength and resilience, the therapeutic effect, its participatory and collaborative nature, its empowerment and dissemination of participants' voices, and the engagement of children and young people. Body mapping holds promise for research with marginalised groups typically excluded from mental health research.
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Affiliation(s)
- Aisling Murray
- Youth Resilience Unit, Academic Unit, Queen Mary University of London, London, UK.
| | - Mariana Steffen
- Youth Resilience Unit, Academic Unit, Queen Mary University of London, London, UK
| | - Eleanor Keiller
- Youth Resilience Unit, Academic Unit, Queen Mary University of London, London, UK
| | - Maria Grazia Turri
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jennifer Y F Lau
- Youth Resilience Unit, Academic Unit, Queen Mary University of London, London, UK
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Ostojic K, Paget S, Martin T, Dee-Price BJ, McIntyre S, Smithers Sheedy H, Mimmo L, Burnett H, Scott T, Berg A, Masi A, Scarcella M, Calderan J, Azmatullah S, Mohamed M, Woodbury M, Wilkinson A, Zwi K, Dale R, Eapen V, Lingam R, Strnadová I, Woolfenden S. Codesigning a social prescribing pathway to address the social determinant of health concerns of children with cerebral palsy and their families in Australia: a protocol for a mixed-methods formative research study. BMJ Open 2023; 13:e066346. [PMID: 37024248 PMCID: PMC10083805 DOI: 10.1136/bmjopen-2022-066346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Social determinants of health (SDH) are contributors to health inequities experienced by some children with cerebral palsy and pose barriers to families engaging with complex and fragmented healthcare systems. There is emerging evidence to support 'social prescribing' interventions that systematically identify SDH concerns and refer patients to non-medical social care support and services to address their needs. To date, social prescribing has not been trialled specifically for children with neurodevelopmental disabilities, including cerebral palsy, in Australia. This study aims to codesign a social prescribing programme to address SDH concerns of children with cerebral palsy and their families who attend one of the three tertiary paediatric rehabilitation services in New South Wales, Australia. METHODS AND ANALYSIS This is a qualitative multi-site study conducted at the three NSW paediatric hospitals' rehabilitation departments using a codesign approach. Children aged 12-18 years with cerebral palsy, parents/caregivers of children (aged 0-18 years) with cerebral palsy, and clinicians will be involved in all stages to codesign the social prescribing programme. The study will consist of three components: (1) 'what we need', (2) 'creating the pathways' and (3) 'finalising and sign off'. This project is overseen by two advisory groups: one group of young adults with cerebral palsy and one group of parents of young people with cerebral palsy. The study will be guided by the biopsychosocial ecological framework, and analysis will follow Braun and Clark's thematic approach. ETHICS AND DISSEMINATION The study protocol was approved by the human research ethics committee of the Sydney Children's Hospitals Network. This codesign study will inform a future pilot study of feasibility and acceptability, then if indicated, a pilot clinical trial of efficacy. We will collaborate with all project stakeholders to disseminate findings and undertake further research to build sustainable and scalable models of care. TRIAL REGISTRATION NUMBER ACTRN12622001459718.
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Affiliation(s)
- Katarina Ostojic
- Population Child Health Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Simon Paget
- Kids Rehab, Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Tanya Martin
- Sydney Medical School, University of Sydney Poche Centre for Indigenous Health, Camperdown, New South Wales, Australia
| | - Betty-Jean Dee-Price
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Laurel Mimmo
- Population Child Health Research Group, University of New South Wales, Sydney, New South Wales, Australia
- Nursing Research Unit, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Heather Burnett
- John Hunter Children's Hospital, Hunter Region Mail Centre, New South Wales, Australia
| | - Timothy Scott
- Rehab2Kids, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Alison Berg
- Kids Rehab, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Anne Masi
- School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Michele Scarcella
- Aboriginal Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Jack Calderan
- EPIC-CP Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Sheikh Azmatullah
- EPIC-CP Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Masyitah Mohamed
- EPIC-CP Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Mackenzie Woodbury
- EPIC-CP Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Alunya Wilkinson
- EPIC-CP Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen Zwi
- Population Child Health Research Group, University of New South Wales, Sydney, New South Wales, Australia
- Community Child Health, Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Russell Dale
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Raghu Lingam
- Population Child Health Research Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Iva Strnadová
- School of Education, University of New South Wales, Sydney, New South Wales, Australia
- Disability Innovation Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Susan Woolfenden
- Population Child Health Research Group, University of New South Wales, Sydney, New South Wales, Australia
- Community Paediatrics Research Group, Institute for Women, Children and Families, Sydney Local Health District, Camperdown, New South Wales, Australia
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Nathan S, Hodgins M, Wirth J, Ramirez J, Walker N, Cullen P. The use of arts-based methodologies and methods with young people with complex psychosocial needs: A systematic narrative review. Health Expect 2023; 26:795-805. [PMID: 36628644 PMCID: PMC10010092 DOI: 10.1111/hex.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/22/2022] [Accepted: 01/02/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Arts-based methodologies and methods (ABM) can elicit rich and meaningful data with seldom-heard groups and empower participants in research. Young people with complex psychosocial needs could be better engaged in research using arts-based approaches to overcome communication and literacy issues as well as distrust of those with power, including researchers. A critical review of the use and impact of ABM among this population is timely. The purpose of this review is to synthesize and examine the experience and use of ABM with young people with complex psychosocial needs. METHODS A systematic narrative literature review was conducted with a search of the literature from 2009 to 2021. All abstracts were reviewed independently by two authors and full papers were screened for eligibility against inclusion and exclusion criteria. Data synthesis focused on a descriptive numerical summary and a thematic analysis focused on key patterns across papers relating to the review objectives. RESULTS AND DISCUSSION A total of 25 papers were included. The most common issues of focus were mental health (n = 10) and homelessness (n = 11) and methods using Photovoice (n = 12) and Body Mapping (n = 5). Individual interview data (n = 20) were the most commonly analysed, followed by created works (n = 19). Less than half the studies involved young people in the interpretation of the data collected. Knowledge translation was not described in almost half the studies, with public exhibits (n = 7) and forums with service providers (n = 4) being the most common activities. Key themes across the studies were valued over traditional methods in eliciting data, ABM as an approach to engage these young people in research and the impact of the use of ABM on participants and on key stakeholders through knowledge translation. CONCLUSIONS The growing field of ABM presents opportunities to enhance research with young people with complex psychosocial needs by promoting meaningful exploration of experiences, engaging participants in research and strengthening knowledge translation. The involvement of young people in the interpretation of data and ensuring that knowledge translation occurs are key areas for future attention. PATIENT OR PUBLIC CONTRIBUTION The findings of this review will inform future research to improve the engagement of young people with complex psychosocial needs in research and promote power sharing between researchers and research participants.
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Affiliation(s)
- Sally Nathan
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Michael Hodgins
- School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jonathan Wirth
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jacqueline Ramirez
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Natasha Walker
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, UNSW Sydney, New South Wales Australia, Newtown, New South Wales, Australia.,Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, New South Wales, Australia
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11
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Shepherd RP, Orchard TR. “We Cause a Ruckus”: Exploring How Indigenous Youth Navigate the Challenges of Community Engagement and Leadership. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159542. [PMID: 35954896 PMCID: PMC9367837 DOI: 10.3390/ijerph19159542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
Using qualitative data from an interdisciplinary research project about mental health and community engagement with Indigenous youth in Kasabonika Lake First Nation (Ontario, Canada), this paper explores the factors that constrain and facilitate their ability to contribute to the well-being of their community. Case studies are employed to demonstrate how the youth navigate complex social and structural conditions within the context of on-going colonization through federal and provincial governance arrangements, to make a difference in the place they call home and forge unique in-roads that reflect their generational realities and aspirations. The paper contributes to ongoing discussions related to mental health, self-determination, and resilience research.
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Affiliation(s)
- Robert P. Shepherd
- School of Public Policy & Administration, Carleton University, Ottawa, ON K1S 5B6, Canada
- Correspondence:
| | - Treena R. Orchard
- School of Health Studies, Western University, London, ON N6A 3K7, Canada;
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12
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Lys C, Logie CH, Mackay KI, MacNeill N, Loppie C, Gittings L, Yasseen A. Exploring uptake of HIV/STI knowledge and safer sex-efficacy in an arts-based sexual health workshop among Northern and Indigenous adolescents in the Northwest Territories, Canada. AIDS Care 2022; 35:411-416. [PMID: 35722818 DOI: 10.1080/09540121.2022.2089617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ABSTRACTLimited research has evaluated sexual health promotion projects with adolescents living in Arctic regions. The study objective was to examine changes in STI knowledge and safer sex efficacy among youth in the Northwest Territories (NWT), Canada who participated in arts-based sexual health workshops. We used a pre/post-test design with a convenience sample of students aged 13-18 years recruited from 17 NWT communities. We conducted summary statistics and comparisons between pre and post-test scores using paired t-tests. Among participants (n = 610), we found statistically significant increases in STI knowledge overall (mean difference = 3.9; p < 0.001) and across gender and age stratifications. There were statistically significant increases in safer sex efficacy overall (mean difference = 0.9, p < 0.001), across genders, and among participants: aged <15 years, in rural communities, reporting food insecurity, reporting dating violence, and Indigenous youth. No statistically significant differences in safer sex efficacy were observed among participants who were aged ≥15, sexually active, reporting consistent condom use, and using drugs/alcohol. Findings signal the promise of youth-targeted, arts-based sexual health workshops for improving STI knowledge and safer sex efficacy among adolescents in the NWT. Further research can explore how safer sex efficacy may be shaped by age, substance use, and sexual experience to inform tailored interventions.
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Affiliation(s)
- Candice Lys
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada.,Strength, Masculinities, and Sexual Health (SMASH), 5029 57th Street, Yellowknife, NT, Canada.,Aurora College, 5004 54th Street, Yellowknife, NT, Canada
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. West, Toronto, ON, Canada.,Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, Canada.,Centre for Gender & Sexual Health Equity, 1190 Hornby St., Vancouver, V6Z 2K5 BC, Canada.,United Nations University Institute for Water, Environment and Health, 204-175 Longwood Rd S, Hamilton, L8P 0A1 ON, Canada
| | - Kayley Inuksuk Mackay
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada.,Strength, Masculinities, and Sexual Health (SMASH), 5029 57th Street, Yellowknife, NT, Canada
| | - Nancy MacNeill
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada.,Strength, Masculinities, and Sexual Health (SMASH), 5029 57th Street, Yellowknife, NT, Canada
| | - Charlotte Loppie
- School of Public Health and Social Policy, University of Victoria, 3800 Finnerty Road, Victoria, BC, Canada
| | - Lesley Gittings
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada
| | - Abdool Yasseen
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, Canada.,Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada
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13
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Ryan S, Ussher JM, Hawkey A. Mapping the abject: Women's embodied experiences of premenstrual body dissatisfaction through body-mapping. FEMINISM & PSYCHOLOGY 2022. [DOI: 10.1177/09593535211069290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Women's body shame and body dissatisfaction increase in the premenstrual phase of the cycle, associated with premenstrual distress. However, the meaning and consequences of premenstrual body dissatisfaction remain underexplored. The aim of this study was to explore how women who report premenstrual body dissatisfaction construct and experience their bodies, using qualitative arts-based methods. Four hundred and sixty women completed online open-ended survey questions and 16 women took part in body-mapping and an interview. Thematic analysis identified three major themes: construction of the premenstrual body as abject, manifested by positioning of the body and self as fat, leaking and dirty; self-policing and self-regulation through increased scrutinising and concealment of the premenstrual body; and resistance of cultural constructions of idealised femininity. These findings emphasise the need to acknowledge changes in body dissatisfaction across the menstrual cycle, and the implication for women's feelings about the self. Internalisation of negative constructions of the female body plays a role in women's experience of premenstrual change and distress. There is a need for further research to examine the role of body management behaviours in premenstrual body dissatisfaction and distress.
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Affiliation(s)
- Samantha Ryan
- Translational Health Research Institute, Western Sydney University, Australia
| | - Jane M Ussher
- Translational Health Research Institute, Western Sydney University, Australia
| | - Alexandra Hawkey
- Translational Health Research Institute, Western Sydney University, Australia
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14
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English M, Wallace L, Evans J, Diamond S, Caperchione CM. The impact of sport and physical activity programs on the mental health and social and emotional wellbeing of young Aboriginal and Torres Strait Islander Australians: A systematic review. Prev Med Rep 2022; 25:101676. [PMID: 35127355 PMCID: PMC8800038 DOI: 10.1016/j.pmedr.2021.101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/19/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022] Open
Abstract
This review aimed to identify and assess existing evidence of the impact of sport and physical activity programs on mental health and social and emotional wellbeing outcomes within young Aboriginal and Torres Strait Islander people. The review also aimed to highlight limitations of current practice within the research area. A systematic search of literature was undertaken on three peer-reviewed databases (PsycINFO, MEDLINE and SPORTSDiscus) and grey literature from January to March 2021. Studies were included if they described a sport and physical activity program for young (10-24 years) Aboriginal and Torres Strait Islander people and reported mental health or social and emotional wellbeing outcomes. Seventeen studies were selected for this review. Within these studies, the most commonly reported outcomes were related to psychosocial development (N = 12) and a sense of connectedness (N = 12). Mental illness related outcomes (N = 1) were rarely reported, as were substance use (N = 2) and social and emotional literacy (N = 1). Promising outcomes included increased connection to culture, self-esteem and confidence. Nonetheless, due to indirectness and suboptimal study design the precise impact on these outcomes could not be determined. A relevant evidence base is emerging on the impact sport and physical activity programs have on the mental health and social and emotional wellbeing of young Aboriginal and Torres Strait Islander people. However, further research that utilises robust, culturally appropriate methodologies and tools needs to be undertaken before the effects of sport and physical activity programs can reliably be discerned.
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Affiliation(s)
- Madeleine English
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
| | - Lee Wallace
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
| | - John Evans
- School of Public Health, University of Technology, Broadway, Sydney, Australia
| | - Samantha Diamond
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
| | - Cristina M. Caperchione
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
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15
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Experience of Vulnerable Women Narrated through the Body-Mapping Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413094. [PMID: 34948703 PMCID: PMC8701214 DOI: 10.3390/ijerph182413094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
Vulnerable women are considered a priority in public policies and research agendas. It is necessary to understand better the specificities of their daily lives and the meanings they attribute to their experiences, as this undoubtedly contributes to more grounded and culturally appropriate practices. Additionally, innovative techniques in qualitative research are demanded in academia. This narrative research study was carried out with fourteen women from a Brazilian socioeconomically vulnerable neighborhood. We used the body-mapping technique to investigate the experiences of women with mental health disorders or psychosocial distress. The aim was to analyze the self-perception about daily stressors and discuss the feasibility of this technique to facilitate this group’s storytelling. Data collection was performed through focus groups, guided by the body-mapping technique steps, and supplemented with individual interviews. Interpersonal conflicts and violence were the main stressors. These strongly impacted the well-being of these women and their children. Some important personal qualities and resilience were identified. Body-mapping played a fundamental role in facilitating storytelling. It amplified the linguistic possibilities for participants to express their feelings and promoted reflections about the present, past, and glimpses into the future.
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16
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Managing the premenstrual body: a body mapping study of women's negotiation of premenstrual food cravings and exercise. J Eat Disord 2021; 9:125. [PMID: 34627402 PMCID: PMC8501588 DOI: 10.1186/s40337-021-00478-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/15/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Women's eating behaviours and exercise patterns have been found to fluctuate across the menstrual cycle, manifested by premenstrual food cravings and reduced exercise. However, the meaning and consequences of premenstrual changes in eating and exercise behaviours remains underexplored. The aim of this qualitative study was to explore how women who feel negatively about their premenstrual bodies construct and experience premenstrual changes to eating and exercise practices, which disrupt their usual patterns of body management. METHODS Four hundred and sixty women aged 18-45 completed an online survey in response to a Facebook advertisement targeted at women who feel negatively about their bodies during the premenstrual phase of the cycle. Participants reported moderate premenstrual distress, high body shame and high risk of disordered eating attitudes using standardised measures. Sixteen women reporting rich accounts of premenstrual body dissatisfaction were invited to participate in body-mapping, involving visually illustrating experiences on a life-sized outline of the body, followed by a telephone interview. Thematic analysis was used to explore qualitative survey, interview, and body-mapping data. RESULTS AND DISCUSSION Results found that outside of the premenstrual phase these women engaged in restrictive eating and intensive exercise behaviours, which were disrupted by premenstrual cravings, hunger, fatigue, pain and feeling physically uncomfortable. For a minority of the women, this facilitated self-care in reducing the strict management of their bodies during the premenstrual phase. Others experienced feelings of guilt, shame, self-disgust and pushed their bodies physically through increased exercise. CONCLUSIONS These findings emphasise the need to acknowledge changes in body management across the menstrual cycle, with implications for women's mental health and feelings about the self. Internalisation of pressures placed on women to manage their bodies through restrictive eating behaviours and rigorous exercise plays a role in women's premenstrual body dissatisfaction and distress. The current study aimed to explore how women who feel negatively about their premenstrual bodies construct and experience premenstrual changes to eating and exercise practices. Outside of the premenstrual phase these women engaged in restrictive eating and intensive exercise behaviours which were disrupted by premenstrual cravings, hunger, fatigue, pain and feeling physically uncomfortable. Some women allowed themselves to take a premenstrual break from their usual strict eating and exercise behaviours, whereas others felt guilt, shame, self-disgust and physically pushed their bodies through increased exercise. These findings emphasise that changes to eating and exercise behaviours across the menstrual cycle and pressures placed on women to manage their eating and exercise behaviours have implications for women's premenstrual distress and body dissatisfaction.
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Vaughn LM, DeJonckheere M. The Opportunity of Social Ecological Resilience in the Promotion of Youth Health and Wellbeing: A Narrative Review. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:129-141. [PMID: 33795989 PMCID: PMC7995941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Youth experience adversity that increases their risk for immediate and long-term health consequences. Resilience has traditionally been conceptualized as an internal disposition or trait that supports youth to overcome that risk and avoid the negative impact on their health and wellbeing. However, this model of resilience overemphasizes the role of the individual and their capacity to control their environment, while minimizing the integral role of relational, social, structural, and cultural contexts in which they live. Instead, social ecological resilience (SER) emphasizes the influence of social and environmental factors on individual processes and outcomes and offers different pathways for preventive interventions to promote youth health and wellbeing. Within preventive medicine, it is important for researchers and practitioners to understand the processes that support or impede SER, particularly in youth when adversity can impact health throughout the lifespan. The purpose of this review was to examine the contributions and scope of the SER model in research on youth, with the goal of advancing SER-informed research and interventions within preventive medicine. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach as a guiding framework, we conducted a narrative review of the literature. The review characterizes 37 existing studies across the fields of education, psychology, and social work in terms of topic, focal population, methods, use of SER, and implications. We conclude with recommendations for future applications of SER to promote the health and wellbeing of youth.
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Affiliation(s)
- Lisa M. Vaughn
- Cincinnati Children’s Hospital Medical
Center/University of Cincinnati College of Medicine, Joint appointment,
University of Cincinnati, Educational and Community-Based Action Research,
Cincinnati, OH, USA,To whom all correspondence should be addressed:
Lisa M. Vaughn, PhD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet
Ave. ML 2008, Cincinnati, OH 45229; Tel: 513-636-9424, Fax: 513-636-7967;
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18
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Contextual factors associated with depression among Northern and Indigenous adolescents in the Northwest Territories, Canada. Glob Ment Health (Camb) 2021; 8:e22. [PMID: 34249369 PMCID: PMC8246646 DOI: 10.1017/gmh.2021.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Persons in Arctic regions disproportionately experience depression. Knowledge gaps remain regarding factors associated with depression among adolescents in the Northwest Territories (NWT), Canada, where child and adolescent mental health hospitalizations are nearly 2.5 times the national rate. This study assesses correlates of depression among adolescents in the NWT. METHODS We conducted a cross-sectional survey with adolescents aged 13-18 in 17 NWT communities. We assessed associations between socio-demographic characteristics, dating violence, food insecurity and depression, measured with the 9-item Patient Health Questionnaire. We conducted ordered logistic regressions to assess associations with no, mild, or moderate/severe depression scores. RESULTS Participants (n = 399; mean age: 14.3, s.d.: 1.3) were mostly Indigenous (79%) and 45% reported food insecurity. Nearly half (47%) reported minimal/no depression symptoms, 25% mild symptoms and 28% moderate/severe symptoms. In multivariate analyses, participants who were cisgender women compared to other genders, sexually diverse v. heterosexual, and food insecure had double the odds of more severe depression symptoms. Among those dating, dating violence was associated with double the odds of moderate/severe depression symptoms. CONCLUSIONS Findings support tailored interventions to address material (food insecurity), relational (dating violence) and symbolic (gender and sexual orientation norms) contextual factors associated with depression among adolescents in the NWT.
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Logie CH, Lys CL, Fujioka J, MacNeill N, Mackay K, Yasseen Iii AS. Sexual practices and condom use among a sample of Northern and Indigenous adolescents in Northern Canada: cross-sectional survey results. BMJ SEXUAL & REPRODUCTIVE HEALTH 2018; 45:bmjsrh-2018-200174. [PMID: 30591551 PMCID: PMC6579555 DOI: 10.1136/bmjsrh-2018-200174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/26/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sexually transmitted infections (STI) prevention in the Northwest Territories (NWT), Canada is an urgent concern as STI prevalence is seven-fold the national average. The study objective was to explore factors associated with sexual activity and condom use among adolescents in the NWT. METHODS We conducted a cross-sectional survey with youth aged 13-18-years-old in 17 NWT communities. We use Poisson regression models with a robust sandwich error variance to estimate adjusted relative risks estimates of the likelihood of experiencing the primary outcomes of sexual activity (vaginal/anal/oral sex) and consistent condom use (oral/anal sex) in the past 3 months by gender. RESULTS Participants (n=607; mean age: 14.2 years; SD: 1.5) included adolescent cisgender girls (n=302; 49.5%), cisgender boys (n=298; 48.9%) and transgender persons (n=7; 1.2%). Most identified as Indigenous (n=444; 73.1%) and 14.0% (n=85) as lesbian, gay, bisexual or queer sexuality (LGBQ+). Among sexually active individuals (n=115), less than half (n=54; 47.0%) reported past 3 month consistent condom use. In adjusted analyses among girls, sexual activity was associated with age, STI knowledge, and alcohol/drug use; LGBQ+ identity and alcohol/drug use were associated with reduced likelihood of condom use. Among boys, sexual activity was associated with age and alcohol/drug use; LGBQ+ identity was associated with increased likelihood of condom use. CONCLUSIONS Findings demonstrate sexual activity among adolescents in the NWT varies by gender, age, and alcohol/drug use. Consistent condom utilisation was low, particularly for those using alcohol/drugs. Gender-tailored STI prevention strategies with Northern adolescents should address alcohol/drug use and build protective factors.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Candice L Lys
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Jamie Fujioka
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nancy MacNeill
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Kayley Mackay
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Abdool S Yasseen Iii
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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