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Forchuk C, Gyamfi S, Hassan H, Lucyk B, Booth R. Homeowner perspectives on the implementation of the Community Homes for Opportunity (CHO) program: an ethnographic group homes study in Southwestern Ontario Canada. BMC Public Health 2023; 23:585. [PMID: 36991379 PMCID: PMC10053089 DOI: 10.1186/s12889-023-15512-2] [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: 03/09/2022] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The global extant literature acknowledge that housing serves as a key social determinant of health. Housing interventions that involve group homes have been found to support the recovery of persons with mental illness and those with addiction issues. The current study explored the views of homeowners in relation to a supportive housing program called Community Homes for Opportunity (CHO) that modernised a provincial group home program (Homes for Special Care [HSC]) and provided recommendations for improving the program implementation in other geographical areas of Ontario. METHODS We applied ethnographic qualitative techniques to purposefully recruit 36 homeowner participants from 28 group homes in Southwest Ontario, Ontario Canada. Focus group discussions were conducted at two time points, during CHO program implementation (Fall 2018, and post implementation phases (Winter 2019) respectively. RESULTS Data analysis yielded 5 major themes. These include: (1) general impressions about the modernization process, (2) perceived social, economic and health outcomes, (3) enablers of the modernization program, (4) challenges to implementation of the modernization program, and (5) suggestions for implementation of the CHO in future. CONCLUSIONS A more effective and expanded CHO program will need the effective collaboration of all stakeholders including homeowners for successful implementation.
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Affiliation(s)
- Cheryl Forchuk
- Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, Lawson Health Research Institute, Arthur Labatt School of Nursing, Western University London, Parkwood Institute Mental Health Care Building, 550 Wellington Road, Suite B3-110, P.O. Box 5777, London, STN B, N6A 4V2, Canada.
| | - Sebastian Gyamfi
- Lawson Health Research Institute, Arthur Labatt School of Nursing, Parkwood Research Institute, Western University, London, Canada
| | - Heba Hassan
- Lawson Health Research Institute, Parkwood Research Institute, London, ON, Canada
| | - Bryanna Lucyk
- Lawson Health Research Institute, Parkwood Research Institute, London, ON, Canada
| | - Richard Booth
- Lawson Health Research Institute, Arthur Labatt School of Nursing, Western University, London, Canada
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Lorking N, Wood AD, Tiamkao S, Clark AB, Kongbunkiat K, Bettencourt-Silva JH, Sawanyawisuth K, Kasemsap N, Mamas MA, Myint PK. Seasonality of stroke: Winter admissions and mortality excess: A Thailand National Stroke population database study. Clin Neurol Neurosurg 2020; 199:106261. [PMID: 33096427 DOI: 10.1016/j.clineuro.2020.106261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We examined the existence and potential burden of seasonality of stroke admissions and mortality within a tropical climate using cohort data collected between 1 st November 2003 and 31 st October 2012. PATIENTS AND METHODS In a prospective cohort of hospitalised stroke patients from the catchment of ∼75 % of the Thai population (n = 569,307; mean SD age = 64(14.5)), incident stroke admissions, in-hospital mortality, prolonged hospitalisations, and stroke related complications by season were determined. Rates of incident stroke admissions by month and season were plotted. Winter excess indexes for study outcomes expressed as a percentage were calculated. Using logistic regression we examined the association between winter admission and in-hospital mortality (non-winter admission as reference) adjusting for age, sex, stroke type, year of admission, and presence of pre-existing comorbidities. RESULTS We observed a winter excess in mortality during hospitalisation (+10.3 %) and prolonged length of stay (+7.3 %). Respective winter excess indexes for dyslipidaemias, arrhythmias, anaemia, and alcohol related disorders in patients that died during hospitalisation were +1.4 %, +6.2 %, +0.2 %, +1.5 %. In these patients, respective winter excess indexes for post-stroke complications of pneumonia and sepsis were +6.7 % and +3.2 %. In fully adjusted analyses, winter admission (compared to non-winter admission) was associated with increased odds of in-hospital mortality (OR (95 % CI) = 1.023 (1.006-1.040)). CONCLUSIONS We provide robust evidence for the existence of an excess in winter stroke admissions and subsequent in-hospital deaths within a tropical region.
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Affiliation(s)
- Nicole Lorking
- Ageing Clinical and Experimental Research Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, AB252ZD, UK
| | - Adrian D Wood
- Ageing Clinical and Experimental Research Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, AB252ZD, UK
| | - Somsak Tiamkao
- Neurology Division, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; North-eastern Stroke Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Allan B Clark
- Norwich Medical School, University of East Anglia, Norwich, NR47TJ, UK
| | - Kannikar Kongbunkiat
- North-eastern Stroke Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand; Ambulatory Medicine Division, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | | | - Kittisak Sawanyawisuth
- Ambulatory Medicine Division, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Narongrit Kasemsap
- North-eastern Stroke Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand; Ambulatory Medicine Division, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, ST55BG, UK
| | - Phyo K Myint
- Ageing Clinical and Experimental Research Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, AB252ZD, UK.
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