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Haines J, Du JT, Trevorrow AE. Cultural use of
ICT4D
to promote Indigenous knowledge continuity of Ngarrindjeri stories and communal practices. J Assoc Inf Sci Technol 2022. [DOI: 10.1002/asi.24710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Jelina Haines
- UniSA STEM University of South Australia Adelaide Australia
| | - Jia Tina Du
- UniSA STEM University of South Australia Adelaide Australia
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Buchbinder M, Juengst E, Rennie S, Blue C, Rosen DL. Advancing a Data Justice Framework for Public Health Surveillance. AJOB Empir Bioeth 2022; 13:205-213. [PMID: 35442141 PMCID: PMC10777676 DOI: 10.1080/23294515.2022.2063997] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Bioethical debates about privacy, big data, and public health surveillance have not sufficiently engaged the perspectives of those being surveilled. The data justice framework suggests that big data applications have the potential to create disproportionate harm for socially marginalized groups. Using examples from our research on HIV surveillance for individuals incarcerated in jails, we analyze ethical issues in deploying big data in public health surveillance. METHODS We conducted qualitative, semi-structured interviews with 24 people living with HIV who had been previously incarcerated in county jails about their perspectives on and experiences with HIV surveillance, as part of a larger study to characterize ethical considerations in leveraging big data techniques to enhance continuity of care for incarcerated people living with HIV. RESULTS Most participants expressed support for the state health department tracking HIV testing results and viral load data. Several viewed HIV surveillance as a violation of privacy, and several had actively avoided contact from state public health outreach workers. Participants were most likely to express reservations about surveillance when they viewed the state's motives as self-interested. Perspectives highlight the mistrust that structurally vulnerable people may have in the state's capacity to act as an agent of welfare. Findings suggest that adopting a nuanced, context-sensitive view on surveillance is essential. CONCLUSIONS Establishing trustworthiness through interpersonal interactions with public health personnel is important to reversing historical legacies of harm to racial minorities and structurally vulnerable groups. Empowering stakeholders to participate in the design and implementation of data infrastructure and governance is critical for advancing a data justice agenda, and can offset privacy concerns. The next steps in advancing the data justice framework in public health surveillance will be to innovate ways to represent the voices of structurally vulnerable groups in the design and governance of big data initiatives.
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Affiliation(s)
- Mara Buchbinder
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Eric Juengst
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Stuart Rennie
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Colleen Blue
- Institute for Global Health and Infectious Diseases, UNC—Chapel Hill
| | - David L. Rosen
- Division of Infectious Diseases, Department of Medicine, UNC—Chapel Hill
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The generative potential of mess in community-based participatory research with young people who use(d) drugs in Vancouver. Harm Reduct J 2022; 19:30. [PMID: 35337350 PMCID: PMC8956276 DOI: 10.1186/s12954-022-00615-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Community-based participatory research (CBPR) is increasingly standard practice for critical qualitative health research with young people who use(d) drugs in Vancouver, Canada. One aim of CBPR in this context is to redress the essentialization, erasure, and exploitation of people who use(d) drugs in health research. In this paper, we reflect on a partnership that began in 2018 between three university researchers and roughly ten young people (ages 17–28) who have current or past experience with drug use and homelessness in Greater Vancouver. We focus on moments when our guiding principles of shared leadership, safety, and inclusion became fraught in practice, forcing us in some cases to re-imagine these principles, and in others to accept that certain ethical dilemmas in research can never be fully resolved. We argue that this messiness can be traced to the complex and diverse positionalities of each person on our team, including young people. As such, creating space for mess was ethically necessary and empirically valuable for our CBPR project.
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Mamdani Z, McKenzie S, Cameron F, Knott M, Conway-Brown J, Scott T, Buxton JA, Pauly B. Using intervention mapping to develop 'ROSE': an intervention to support peer workers in overdose response settings. BMC Health Serv Res 2021; 21:1279. [PMID: 34838019 PMCID: PMC8626711 DOI: 10.1186/s12913-021-07241-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background Peer workers (those with lived/living experience of substance use working in overdose response settings) are at the forefront of overdose response initiatives in British Columbia (BC). Working in these settings can be stressful, with lasting social, mental and emotional impacts. Peer workers have also been disproportionately burdened by the current dual public health crises characterized by the onset of the COVID-19 pandemic and rise in illicit drug overdose deaths. It is therefore critical to develop supports tailored specifically to their realities. Methods We used the six steps outlined in the Intervention Mapping (IM) framework to identify needs of peer workers and design an intervention model to support peer workers in overdose response settings. Results Eight peer-led focus groups were conducted in community settings to identify peer workers’ needs and transcripts were analyzed using interpretive description. The strategies within the intervention model were informed by organizational development theory as well as by lived/living experience of peer workers. The support needs identified by peer workers were categorized into three key themes and these formed the basis of an intervention model titled ‘ROSE’; R stands for Recognition of peer work, O for Organizational support, S for Skill development and E for Everyone. The ROSE model aims to facilitate cultural changes within organizations, leading towards more equitable and just workplaces for peer workers. This, in turn, has the potential for positive socio-ecological impact. Conclusions Centering lived/living experience in the intervention mapping process led us to develop a framework for supporting peer workers in BC. The ROSE model can be used as a baseline for other organizations employing peer workers. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07241-2.
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Affiliation(s)
- Zahra Mamdani
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Sophie McKenzie
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Fred Cameron
- SOLID Outreach Society, 1056 N Park St, Victoria, BC, V8T 1C6, Canada
| | - Mike Knott
- SOLID Outreach Society, 1056 N Park St, Victoria, BC, V8T 1C6, Canada
| | | | - Tracy Scott
- RainCity Housing, 616 Powell St, Vancouver, BC, V6A 1H4, Canada
| | - Jane A Buxton
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Bernie Pauly
- Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, Canada.
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Mamdani Z, McKenzie S, Pauly B, Cameron F, Conway-Brown J, Edwards D, Howell A, Scott T, Seguin R, Woodrow P, Buxton JA. "Running myself ragged": stressors faced by peer workers in overdose response settings. Harm Reduct J 2021; 18:18. [PMID: 33573661 PMCID: PMC7877312 DOI: 10.1186/s12954-020-00449-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/02/2020] [Indexed: 01/10/2023] Open
Abstract
Background Peer workers or “peers” (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental health effects. Yet, little is known about the stressors peer workers face and what interventions can be implemented to support them in their roles. Methods This project used a community-based sequential mixed-methods research design. Eight peer researcher-led focus groups (n = 31) were conducted between November 2018 and March 2019 to assess needs of peer workers. The transcripts were thematically coded and analysed using interpretative description. These results informed a survey, which was conducted (n = 50) in September 2019 to acquire quantitative data on peer workers’ perception of health, quality of life, working conditions and stressors. Frequency distributions were used to describe characteristics of participants. X2 distribution values with Yates correction were conducted to check for association between variables. Results Five themes emerged from the focus groups that point to stressors felt by peer workers: (1) financial insecurity; (2) lack of respect and recognition at work; (3) housing challenges; (4) inability to access and/or refer individuals to resources; and (5) constant exposure to death and trauma. Consistent with this, the factors that survey participants picked as one of their “top three stressors” included financial situation, work situation, and housing challenges. Conclusion Peer workers are faced with a diversity of stressors in their lives which often reflect societal stigmatization of drug use. Recognition of these systemic stressors is critical in designing interventions to ease the emotional, physical and financial burden faced by peer workers.
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Affiliation(s)
- Zahra Mamdani
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Sophie McKenzie
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Bernadette Pauly
- Canadian Institute for Substance Use Research, STN CSC, University of Victoria, Box 1700, Victoria, BC, Canada
| | - Fred Cameron
- SOLID Outreach Society, 1056 N Park St, Victoria, BC, V8T 1C6, Canada
| | | | - Denice Edwards
- RainCity Housing, 616 Powell St, Vancouver, BC, V6A 1H4, Canada
| | - Amy Howell
- SOLID Outreach Society, 1056 N Park St, Victoria, BC, V8T 1C6, Canada
| | - Tracy Scott
- RainCity Housing, 616 Powell St, Vancouver, BC, V6A 1H4, Canada
| | - Ryan Seguin
- SOLID Outreach Society, 1056 N Park St, Victoria, BC, V8T 1C6, Canada
| | - Peter Woodrow
- RainCity Housing, 616 Powell St, Vancouver, BC, V6A 1H4, Canada
| | - Jane A Buxton
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada. .,School of Population and Public Health, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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“It's an emotional roller coaster… But sometimes it's fucking awesome”: Meaning and motivation of work for peers in overdose response environments in British Columbia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 88:103015. [DOI: 10.1016/j.drugpo.2020.103015] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/14/2020] [Accepted: 10/13/2020] [Indexed: 01/06/2023]
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Gagnon M, Guta A, Upshur R, Murray SJ, Bungay V. "It gets people through the door": a qualitative case study of the use of incentives in the care of people at risk or living with HIV in British Columbia, Canada. BMC Med Ethics 2020; 21:105. [PMID: 33109165 PMCID: PMC7590593 DOI: 10.1186/s12910-020-00548-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022] Open
Abstract
Background There has been growing interest in the use of incentives to increase the uptake of health-related behaviours and achieve desired health outcomes at the individual and population level. However, the use of incentives remains controversial for ethical reasons. An area in which incentives have been not only proposed but used is HIV prevention, testing, treatment and care—each one representing an interconnecting step in the "HIV Cascade." Methods The main objective of this qualitative case study was to document the experiences of health care and service providers tasked with administrating incentivized HIV testing, treatment, and care in British Columbia, Canada. A second objective was to explore the ethical and professional tensions that arise from the use of incentives as well as strategies used by providers to mitigate them. We conducted interviews with 25 providers and 6 key informants, which were analyzed using applied thematic analysis. We also collected documents and took field notes. Results Our findings suggest that incentives target populations believed to pose the most risk to public health. As such, incentives are primarily used to close the gaps in the HIV Cascade by getting the "right populations" to test, start treatment, stay on treatment, and, most importantly, achieve (and sustain) viral suppression. Participants considered that incentives work because they "bring people through the door." However, they believed the effectiveness of incentives to be superficial, short-lived and one-dimensional—thus, failing to address underlying structural barriers to care and structural determinants of health. They also raised concerns about the unintended consequences of incentives and the strains they may put on the therapeutic relationship. They had developed strategies to mitigate the ensuing ethical and professional tensions and to make their work feel relational rather than transactional. Conclusions We identify an urgent need to problematize the use of incentives as a part of the "HIV Cascade" agenda and interrogate the ethics of engaging in this practice from the perspective of health care and service providers. More broadly, we question the introduction of market logic into the realm of health care—an area of life previously not subject to monetary exchanges.
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Affiliation(s)
- Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC, V8N 5M8, Canada.
| | - Adrian Guta
- School of Social Work, University of Windsor, 167 Ferry Street, Windsor, ON, N9A 0C5, Canada
| | - Ross Upshur
- Dalla Lana Chair in Clinical Public Health, Dalla Lana School of Public Health, 678-155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Stuart J Murray
- Canada Research Chair in Rhetoric and Ethics, Department of English Language and Literature, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Vicky Bungay
- Canada Research Chair in Gender, Equity and Community Engagement, School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T2B5, Canada
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Greer A, Bungay V, Pauly B, Buxton J. 'Peer' work as precarious: A qualitative study of work conditions and experiences of people who use drugs engaged in harm reduction work. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 85:102922. [PMID: 32911320 DOI: 10.1016/j.drugpo.2020.102922] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022]
Abstract
In this study, we examine the qualitative accounts of people who use drugs engaged in 'peer' work in harm reduction settings across British Columbia, Canada. We found peer work was precarious, characterized by nonstandard or casual work arrangements, high job instability and insecurity, insufficient wages, and limited social benefits. Participants were reluctant to exercise their rights or negotiate work conditions, such as higher wages or more consistent work, out of fear of job loss. However, the flexibility of peer work was beneficial for some in that it worked within their life circumstances and provided a low-barrier entry into the labor market. If inequities in peer work are perpetuated, unrecognized and unaddressed, precarious work conditions may continue to undermine the potential benefits of harm reduction work for organizations, peer workers and the people to whom they engage with and support. This study adds people who use drugs to the many social groups that are impacted by precarious work conditions globally.
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Affiliation(s)
- A Greer
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby BC, V5A 1S6, Canada.
| | - V Bungay
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - B Pauly
- School of Nursing, University of Victoria, O Box 1700 STN CSC, Victoria BC V8W 2Y2, Canada
| | - J Buxton
- School of Population and Public Health, University of British Columbia, 2206 East Mall Vancouver, BC V6T 1Z3, Canada
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Determining if nurses are involved in political action or politics: A scoping literature review. Appl Nurs Res 2020; 54:151279. [DOI: 10.1016/j.apnr.2020.151279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/19/2020] [Accepted: 04/29/2020] [Indexed: 11/22/2022]
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Baah FO, Teitelman AM, Riegel B. Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health-An integrative review. Nurs Inq 2018; 26:e12268. [PMID: 30488635 DOI: 10.1111/nin.12268] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 08/29/2018] [Accepted: 09/15/2018] [Indexed: 11/29/2022]
Abstract
Scientific advances in health care have been disproportionately distributed across social strata. Disease burden is also disproportionately distributed, with marginalized groups having the highest risk of poor health outcomes. Social determinants are thought to influence health care delivery and the management of chronic diseases among marginalized groups, but the current conceptualization of social determinants lacks a critical focus on the experiences of people within their environment. The purpose of this article was to integrate the literature on marginalization and situate the concept in the framework of social determinants of health. We demonstrate that social position links marginalization and social determinants of health. This perspective provides a critical lens to assess the societal power dynamics that influence the construction of the socio-environmental factors affecting health. Linking marginalization with social determinants of health can improve our understanding of the inequities in health care delivery and the disparities in chronic disease burden among vulnerable groups.
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Affiliation(s)
- Foster Osei Baah
- NewCourtland Center for Transitions & Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anne M Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Greer AM, Pauly B, Scott A, Martin R, Burmeister C, Buxton J. Paying people who use illicit substances or ‘peers’ participating in community-based work: a narrative review of the literature. DRUGS-EDUCATION PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2018.1494134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Alissa Merielle Greer
- BC Centre for Disease Control, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Bernadette Pauly
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Alex Scott
- Vancouver Coastal Health, Vancouver, Canada
| | - Ruth Martin
- College of Health Disciplines, University of British Columbia, Vancouver, Canada
| | | | - Jane Buxton
- BC Centre for Disease Control, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Greer AM, Amlani A, Pauly B, Burmeister C, Buxton JA. Participant, peer and PEEP: considerations and strategies for involving people who have used illicit substances as assistants and advisors in research. BMC Public Health 2018; 18:834. [PMID: 29976169 PMCID: PMC6034321 DOI: 10.1186/s12889-018-5765-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/26/2018] [Indexed: 01/07/2023] Open
Abstract
Background The Peer Engagement and Evaluation Project (PEEP) aimed to engage, inspire, and learn from peer leaders who represented voices of people who use or have used illicit substances, through active membership on the ‘Peeps’ research team. Given the lack of critical reflection in the literature about the process of engaging people who have used illicit substances in participatory and community-based research processes, we provide a detailed description of how one project, PEEP, engaged peers in a province-wide research project. Methods By applying the Peer Engagement Process Evaluation Framework, we critically analyze the intentions, strategies employed, and outcomes of the process utilized in the PEEP project and discuss the implications for capacity building and empowerment among the peer researchers. This process included: the formation of the PEEP team; capacity building; peer-facilitated data collection; collaborative data analysis; and, strengths-based approach to outputs. Results Several lessons were learned from applying the Peer Engagement Process Evaluation Framework to the PEEP process. These lessons fall into themes of: recruiting and hiring; fair compensation; role and project expectations; communication; connection and collaboration; mentorship; and peer-facilitated research. Conclusion This project offers a unique approach to engaging people who use illicit substances and demonstrates how participation is an important endeavor that improves the relevance, capacity, and quality of research. Lessons learned in this project can be applied to future community-based research with people who use illicit substances or other marginalized groups and/or participatory settings.
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Affiliation(s)
- Alissa M Greer
- School of Population and Public Health, University of British Columbia, Vancouver, Canada. .,BC Centre for Disease Control, University of British Columbia, Vancouver, Canada.
| | - Ashraf Amlani
- BC Centre for Disease Control, University of British Columbia, Vancouver, Canada
| | - Bernadette Pauly
- School of Nursing, Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Charlene Burmeister
- BC Centre for Disease Control, University of British Columbia, Vancouver, Canada
| | - Jane A Buxton
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,BC Centre for Disease Control, University of British Columbia, Vancouver, Canada
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Cuthill F. Political representation for social justice in nursing: lessons learned from participant research with destitute asylum seekers in the UK. Nurs Inq 2016; 23:211-22. [PMID: 27562573 DOI: 10.1111/nin.12132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/28/2022]
Abstract
The concept of social justice is making a revival in nursing scholarship, in part in response to widening health inequalities and inequities in high-income countries. In particular, critical nurse scholars have sought to develop participatory research methods using peer researchers to represent the 'voice' of people who are living in marginalized spaces in society. The aim of this paper is to report on the experiences of nurse and peer researchers as part of a project to explore the experiences of people who find themselves destitute following the asylum process in the UK. In seeking to explore social injustice, three challenges are identified: lack of a robust political theory, institutional/professional constraints and an absence of skills to engage with the politics of social (in)justice. Each challenge is presented, opposing voices outlined and some possible solutions are suggested. The work of political theorist Nancy Fraser is used as a conceptual framework, in particular her focus on mis/framing and political representation for social justice. In addition, it is suggested that social justice needs to be further embedded in nursing policy and curriculum. Finally, nurses are encouraged to develop practical political skills to engage with both politics and the media in a neoliberal globalizing world.
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Affiliation(s)
- Fiona Cuthill
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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14
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Souleymanov R, Kuzmanović D, Marshall Z, Scheim AI, Mikiki M, Worthington C, Millson MP. The ethics of community-based research with people who use drugs: results of a scoping review. BMC Med Ethics 2016; 17:25. [PMID: 27129927 PMCID: PMC4850694 DOI: 10.1186/s12910-016-0108-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Drug user networks and community-based organizations advocate for greater, meaningful involvement of people with lived experience of drug use in research, programs and services, and policy initiatives. Community-based approaches to research provide an opportunity to engage people who use drugs in all stages of the research process. Conducting community-based participatory research (CBPR) with people who use drugs has its own ethical challenges that are not necessarily acknowledged or supported by institutional ethics review boards. We conducted a scoping review to identify ethical issues in CBPR with people who use drugs that were documented in peer-reviewed and grey literature. Methods The search strategy focused on three areas; community-based research, ethical issues, and drug use. Searches of five academic databases were conducted in addition to a grey literature search, hand-searching, and consultation with organizational partners and key stakeholders. Peer reviewed literature and community reports published in English between 1985 and 2013 were included, with initial screening conducted by two reviewers. Results The search strategy produced a total of 874 references. Twenty-five references met the inclusion criteria and were included in our thematic analysis. Five areas were identified as important to the ethics of CBPR with people who use drugs: 1) participant compensation, 2) drug user perspectives on CBPR, 3) peer recruitment and representation in CBPR, 4) capacity building, and 5) participation and inclusion in CBPR. Conclusions We critically discuss implications of the emerging research in this field and provide suggestions for future research and practice.
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Affiliation(s)
- Rusty Souleymanov
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M5S 1V4, Canada.
| | - Dario Kuzmanović
- Joint Centre for Bioethics, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
| | - Zack Marshall
- Division of Community Health & Humanities, Health Sciences Centre, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Ayden I Scheim
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, K201 Kresge Building, London, ON, N6A 5C1, Canada
| | - Mikiki Mikiki
- Harm Reduction Peer Street Outreach Coordinator, Queen West Central Toronto Community Health Centre, 168 Bathurst Street, Toronto, ON, M5V 2R4, Canada
| | - Catherine Worthington
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, HSD building, Victoria, BC, V8W 2Y2, Canada
| | - Margaret Peggy Millson
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
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Allen C, Murphy A, Kiselbach S, VandenBerg S, Wiebe E. Exploring the experience of chronic pain among female Survival Sex Workers: a qualitative study. BMC FAMILY PRACTICE 2015; 16:182. [PMID: 26691777 PMCID: PMC4687279 DOI: 10.1186/s12875-015-0395-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 12/09/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND The prevalence of self-identified chronic pain in Canadian adults is approximately one in five people. Marginalization and addictions have been shown to complicate chronic pain in vulnerable populations. This study aimed to understand the experience of chronic pain among female Survival Sex Workers in Vancouver's downtown eastside (DTES). METHODS This study used an exploratory qualitative analysis with in-depth, semi-structured interviews. Members of PACE Society who self-identified as a current or former Survival Sex Worker and who had a chronic pain experience known to PACE support workers were invited to participate. Interviews were conducted, audio recorded and transcribed. The investigators met to read the transcripts and discuss emerging themes. The process continued until no new themes were observed. RESULTS Participants ranged in age from 42 to 56 years old and all self- identified as females and Survival Sex Workers. Eleven of thirteen interviews were analyzed for themes. Drug use for pain management, both prescribed and illicit, was the most important theme. Poverty, the need to continue working and the lack of stable housing were barriers to adequately addressing the source of chronic pain. Participants felt judged for living in the downtown eastside, being a drug user and/or being Aboriginal and only two participants had been referred to a pain specialist. All participants were involved in support networks made up of other Sex Workers and all spoke of a sense of community and survival. CONCLUSIONS Our study emphasizes the complex nature of chronic pain and addictions among a uniquely marginalized population. The study is unique in that it contributes the perspectives of a traditionally "hard-to-reach" population and demonstrates that Sex Workers should not only participate in but should lead development and implementation of research and programs for managing chronic pain in the setting of addiction.
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Affiliation(s)
| | - Alka Murphy
- PACE Society, British Columbia, Vancouver, Canada
| | | | - Stephanie VandenBerg
- Department of Family Practice, University of British Columbia, Vancouver, Canada.
| | - Ellen Wiebe
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
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Gültekin L, Brush BL, Baiardi JM, Kirk K, VanMaldeghem K. Voices from the street: exploring the realities of family homelessness. JOURNAL OF FAMILY NURSING 2014; 20:390-414. [PMID: 25186947 PMCID: PMC4422334 DOI: 10.1177/1074840714548943] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Homelessness threatens the health and well-being of thousands of families in the United States, yet little is known about their specific needs and how current services address them. To fill this knowledge gap, we explored the experiences of homelessness families in Detroit, Michigan. We targeted homeless mothers and their caseworkers for study to see if the perceptions of needs and services were in alignment. Using focus groups and content analysis, we identified four overarching themes that illustrate homeless mothers' experience with homelessness. We then analyzed data from caseworkers to look specifically for similarities and differences in their perceptions. Key findings included reports of family histories of violence, poverty, social isolation, and a lack of informal support as contributing to homelessness. The differing perspectives of mothers and their caseworkers regarding how best to move forward highlight how current programs and services may not be meeting the needs of this growing and vulnerable cohort.
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Affiliation(s)
| | | | | | - Keri Kirk
- Howard University, Washington, DC, USA
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Mikesell L, Bromley E, Khodyakov D. Ethical community-engaged research: a literature review. Am J Public Health 2013; 103:e7-e14. [PMID: 24134352 PMCID: PMC3828990 DOI: 10.2105/ajph.2013.301605] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2013] [Indexed: 11/04/2022]
Abstract
Health research has relied on ethical principles, such as those of the Belmont Report, to protect the rights and well-being of research participants. Community-based participatory research (CBPR), however, must also consider the rights and well-being of communities. This requires additional ethical considerations that have been extensively discussed but not synthesized in the CBPR literature. We conducted a comprehensive thematic literature review and summarized empirically grounded discussions of ethics in CBPR, with a focus on the value of the Belmont principles in CBPR, additional essential components of ethical CBPR, the ethical challenges CBPR practitioners face, and strategies to ensure that CBPR meets ethical standards. Our study provides a foundation for developing a working definition and a conceptual model of ethical CBPR.
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Affiliation(s)
- Lisa Mikesell
- Lisa Mikesell is with the Communication Department, School of Communication and Information, Rutgers University, New Brunswick, NJ. Elizabeth Bromley is with the Semel Institute Center for Health Services and Society, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and the Greater Los Angeles VA Healthcare System. Dmitry Khodyakov is with the RAND Corporation, Santa Monica, CA
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18
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Bell K, Salmon A. Good intentions and dangerous assumptions: Research ethics committees and illicit drug use research. RESEARCH ETHICS REVIEW 2012. [DOI: 10.1177/1747016112461731] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Illicit drug users are frequently identified as a ‘vulnerable population’ requiring ‘special protection’ and ‘additional safeguards’ in research. However, without specific guidance on how to enact these special protections and safeguards, research ethics committee (REC) members sometimes fall back on untested assumptions about the ethics of illicit drug use research. In light of growing calls for ‘evidence-based research ethics’, this commentary examines three common assumptions amongst REC members about what constitutes ethical research with drug users, and whether such assumptions are borne out by a growing body of empirical data. The assumptions that form the focus of this commentary are as follows: (i) drug users do not have the capacity to provide informed consent to research; (ii) it is ethically problematic to provide financial incentives to drug users to participate in research; and (iii) asking drug users about their experiences ‘re-traumatizes’ and ‘re-victimizes’ them.
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Community-Based Research among Marginalized HIV Populations: Issues of Support, Resources, and Empowerment. Interdiscip Perspect Infect Dis 2012; 2012:601027. [PMID: 22997513 PMCID: PMC3444842 DOI: 10.1155/2012/601027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 07/22/2012] [Indexed: 11/17/2022] Open
Abstract
A research question was posed to us by a local HIV-resource organization interested in exploring the educational and service needs of those unreached. In order to properly address this inquiry, we developed a community-based participatory research by training peer-led volunteers to facilitate focus-group discussions within Aboriginal and refugees participants following an interview guide. We gathered Aboriginal people and refugees separated into three focus groups each, enrolling a total of 41 self-identified HIV-positive, 38 males. The discussions were tape recorded upon consent and lasted between 59 and 118 minutes. We analyzed the thematic information collected interactively through constant comparison. The qualitative data leading to categories, codes, and themes formed the basis for the spatial representation of a conceptual mapping. Both groups shared similar struggles in living with HIV and in properly accessing local nonmedical HIV resources and discussed their concerns towards the need for empowerment and support to take control of their health.
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Bell K, Salmon A. What women who use drugs have to say about ethical research: findings of an exploratory qualitative study. J Empir Res Hum Res Ethics 2012; 6:84-98. [PMID: 22228063 DOI: 10.1525/jer.2011.6.4.84] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Drug users are generally seen as a vulnerable population requiring special protection in research; however, to date there has been little empirical research into the ethics of research with illicit drug users. Moreover, the available research has tended to treat "drug users" as a homogeneous category, and has failed to consider potential gender differences in users' experiences. Drawing on focus groups with twenty-seven female drug users in Vancouver, Canada, this study examines women's experiences of research and what they see as ethical and respectful engagement. Many study participants talked about feeling dehumanized as a result of prior research participation. Women were critical of the assumption that drug users lack the capacity to take part in research, and affirmed the appropriateness of financial incentives. A variety of motivations for research participation were identified, including a desire for financial gain and altruistic concerns such as a desire to help others. These findings suggest that women drug users' views on ethical research differ from prevailing assumptions among institutional review boards about how research with such populations should proceed.
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Affiliation(s)
- Kirsten Bell
- University of British Columbia, East Hastings Street, Vancouver, BC, Canada.
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