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Chai L. Food insecurity as a mediator and moderator in the association between residential mobility and suicidal ideation among Indigenous adults in Canada. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1073-1085. [PMID: 37907713 DOI: 10.1007/s00127-023-02562-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/28/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Despite a growing body of literature on the link between residential mobility and suicidal ideation, research into potential mediating or moderating factors, especially among socioeconomically disadvantaged populations, is sparse. This study explores the mediating and moderating roles of food insecurity in the relationship between residential mobility and suicidal ideation in Indigenous Canadian adults. METHODS Data from the 2017 Aboriginal Peoples Survey, which represent a national sample of off-reserve First Nations peoples, Métis, and Inuit in Canada (N = 16,214), were analyzed using logistic regression models. RESULTS Food insecurity partially mediated the association between residential mobility in the past 5 years and increased suicidal ideation risk among Indigenous adults. Moreover, food insecurity intensified the adverse link between residential mobility during this same timeframe and suicidal ideation. Yet, while food insecurity did mediate the adverse relationship between residential mobility in the past year and suicidal ideation, it did not function as a moderator. CONCLUSION The results emphasize that food insecurity, as a systemic challenge, acts as both a partial mediator and, in some circumstances, an amplifier of the detrimental impacts of residential mobility on suicidal ideation.
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Affiliation(s)
- Lei Chai
- University of Toronto, Toronto, Canada.
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2
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Letendre A, Khan M, Bartel R, Chiang B, James A, Shewchuk B, Kima J, Macphail M, Vaska M, Schwann M, Yang H, Kopciuk KA. Creation of a Métis-Specific Instrument for Cancer Screening: A Scoping Review of Cancer-Screening Programs and Instruments. Curr Oncol 2023; 30:9849-9859. [PMID: 37999135 PMCID: PMC10670396 DOI: 10.3390/curroncol30110715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023] Open
Abstract
Understanding the barriers to and facilitators of cancer screening programs among Indigenous populations remains limited. In the spirit of mutual respect, this co-led, collaborative project was carried out between the Métis Nation of Alberta and Screening Programs from Alberta Health Services (AHS). This scoping review assessed the cancer screening literature for available questionnaires and then identified themes and suitable questions for a Métis-specific cancer screening questionnaire. Literature searches on cervical, breast, and colorectal cancer screening programs and related concepts were conducted in electronic databases, including the Native Health Database, MEDLINE (Ovid), PsycINFO, PubMed, PubMed Central, CINAHL, MEDLINE (Ebsco), Psychology & Behavioral Sciences Collection, and Web of Science. Grey literature was collected from AHS Insite, Open Archives Initiative repository, American Society of Clinical Oncology, European Society of Medical Oncology, Google, and Google Scholar. 135 articles were screened based on the eligibility criteria with 114 articles selected, including 14 Indigenous-specific ones. Knowledge, attitude, belief, behaviour, barrier, and facilitator themes emerged from the review, but no Métis-specific cancer screening instruments were found. Thus, one was developed using existing cancer screening instruments, with additional questions created by the project team. A survey of the Métis population in Alberta will use this questionnaire and provide data to address the burden of cancer among Métis people.
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Affiliation(s)
- Angeline Letendre
- Cancer Prevention & Screening Innovation, Provincial, Population and Public Health, Alberta Health Services, Edmonton, AB T5J 3E4, Canada;
| | - Momtafin Khan
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (M.K.)
| | - Reagan Bartel
- Métis Nation of Alberta, Edmonton, AB T5G 0X5, Canada; (R.B. & A.J. & J.K.)
| | - Bonnie Chiang
- Screening Programs, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (B.C.); (M.S.); (H.Y.)
| | - Ashton James
- Métis Nation of Alberta, Edmonton, AB T5G 0X5, Canada; (R.B. & A.J. & J.K.)
| | - Brittany Shewchuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (M.K.)
| | - June Kima
- Métis Nation of Alberta, Edmonton, AB T5G 0X5, Canada; (R.B. & A.J. & J.K.)
| | - Meghan Macphail
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 4Z6, Canada;
| | - Marcus Vaska
- Knowledge Resource Service, Alberta Health Services, Calgary, AB T2N 4N2, Canada;
| | - Monica Schwann
- Screening Programs, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (B.C.); (M.S.); (H.Y.)
| | - Huiming Yang
- Screening Programs, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (B.C.); (M.S.); (H.Y.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 4Z6, Canada;
| | - Karen A. Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (M.K.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 4Z6, Canada;
- Departments of Oncology and Mathematics and Statistics, University of Calgary, Calgary, AB T2N 1N4, Canada
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Hicks LJ, Mushquash CJ, Toombs E. A national-level examination of First Nations peoples’ mental health data: Predicting mental well-being from social determinants of health using the 2017 Aboriginal Peoples Survey. Front Public Health 2023; 11:1073817. [PMID: 37064658 PMCID: PMC10102338 DOI: 10.3389/fpubh.2023.1073817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/07/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionA history of colonization and assimilation have resulted in social, economic, and political disparities for Indigenous people in Canada. Decades of discriminatory policies (e.g., the Indian Act, the Residential School System) have led to numerous health and mental health inequities, which have been intergenerationally maintained. Four main social determinants of health (i.e., income, education, employment, and housing) disproportionately influence the health of Indigenous peoples. These four social determinants have also been used within the Community Well-Being (CWB) index, which assesses the socio-economic wellbeing of a community. This study sought to extend previous research by assessing how specific indicators of CWB predict self-reported mental wellbeing within First Nations populations across Canada in a national dataset with more recent data.MethodsThis study utilized the 2017 Aboriginal Peoples Survey, which includes data on the social and economic conditions of First Nations people living off reserve aged 15 years and over.ResultsResults from a factorial ANOVA indicated that perceptions of income security, housing satisfaction, higher education, and employment are associated with increased self-reported mental health among First Nations individuals living off-reserve.DiscussionThese results support the idea that individual mental health interventions on their own are not enough; instead, broader social interventions aimed at addressing inequities in various social determinants of health (e.g., housing first initiatives) are needed to better support individual wellbeing.
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Affiliation(s)
- Lydia J. Hicks
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Thunder Bay, ON, Canada
- Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Sciences Center, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Research Institute, Lakehead University, Thunder Bay, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Thunder Bay, ON, Canada
- *Correspondence: Elaine Toombs,
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O’Campo P, Nisenbaum R, Crocker AG, Nicholls T, Eiboff F, Adair CE. Women experiencing homelessness and mental illness in a Housing First multi-site trial: Looking beyond housing to social outcomes and well-being. PLoS One 2023; 18:e0277074. [PMID: 36763583 PMCID: PMC9916643 DOI: 10.1371/journal.pone.0277074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 10/19/2022] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes over a 24 month-period. METHODS The At Home/Chez Soi multi-site randomized controlled Housing First trial recruited over 600 women between October 2009 and July 2011. This is a post-hoc subgroup exploratory analysis of self-identified women with at least one follow-up interview who were randomized to Housing First (HF) (n = 374) or treatment-as-usual (TAU) (n = 279) and had at least one follow-up interview. Linear mixed models and generalized estimating equations were used after multiple imputation was applied to address missing data. RESULTS At the end of follow-up, the mean percentage of days spent stably housed was higher for women in the intervention 74.8% (95%CI = 71.7%-77.8%) compared with women in the treatment-as-usual group, 37.9% (95%CI = 34.4%-41.3%), p<0.001. With few exceptions, social and mental health outcomes were similar for both groups at 6-, 12-, 18- and 24-months post-enrollment. Suicidality was a consistent predictor of increased mental health symptoms (beta = 2.85, 95% CI 1.59-4.11, p<0.001), decreased quality of life (beta = -3.99, 95% CI -6.49 to -1.49, p<0.001), decreased community functioning (beta = -1.16, 95% CI -2.10 to -0.22, p = 0.015) and more emergency department visits (rate ratio = 1.44, 95% CI 1.10-1.87, p<0.001) over the study period. Lower education was a predictor of lower community functioning (beta = -1.32, 95% CI -2.27 to -0.37, p = 0.006) and higher substance use problems (rate ratio = 1.27, 95% CI 1.06-1.52, p = 0.009) during the study. CONCLUSIONS Housing First interventions ensured that women experiencing homelessness are quickly and consistently stably housed. However, they did not differentially impact health and social measures compared to treatment as usual. Ensuring positive health and social outcomes may require greater supports at enrolment for subgroups such as those with low educational attainment, and additional attention to severity of baseline mental health challenges, such as suicidality. TRIAL REGISTRATION International Standard Randomized Control Trial Number Register Identifier: ISRCTN42520374.
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Affiliation(s)
- Patricia O’Campo
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- * E-mail:
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Anne G. Crocker
- Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, Canada
- Department of Psychiatry & Addictions, Université de Montréal, Montreal, Canada
- School of Criminology, Université de Montréal, Montreal, Canada
| | - Tonia Nicholls
- British Columbia Mental Health & Substance Use Services, Provincial Health Services Authority, Vancouver, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Faith Eiboff
- Interdisciplinary Studies, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Carol E. Adair
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Ford-Gilboe M, Varcoe C, Wuest J, Campbell J, Pajot M, Heslop L, Perrin N. Trajectories of Depression, Post-Traumatic Stress, and Chronic Pain Among Women Who Have Separated From an Abusive Partner: A Longitudinal Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1540-NP1568. [PMID: 35512192 PMCID: PMC9709554 DOI: 10.1177/08862605221090595] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This longitudinal study explored changes in women's health after separation from an abusive partner by characterizing the trajectories of their mental health (depression and post-traumatic stress disorder [PTSD]) and physical health (chronic pain) over a 4-year period. We examined how the severity of intimate partner violence (IPV) affected these trajectories, controlling for selected baseline factors using 5 waves of data collected from a community sample of 309 English-speaking, Canadian women. IPV severity was measured using the Index of Spouse Abuse where women were asked to consider the entire period of their partner relationship up to present at wave 1 and to rate their IPV experiences in the previous 12 months at waves 2-5. Mental health was measured using established self-report measures of depression (CESD) and PTSD (Davidson Trauma Scale), while chronic pain was measured using the Chronic Pain Grade Scale. Trajectories were estimated using MLM techniques with severity of IPV and selected co-variates (time since separation, age, financial strain) included. Our results show that women's health improved significantly over time, although significant levels of depression, PTSD symptoms and disabling chronic pain remained at the end of wave 5. Regardless of time since separation, more severe IPV was associated with higher levels of depression, PTSD, and disabling chronic pain, with IPV having a stronger effect on these health outcomes over time, suggesting cumulative effects of IPV on health. The results of this study contribute to quantifying the continuing mental and physical health burdens experienced by women after separation from an abusive partner. Increased attention to the long-term effects of violence on women's health beyond the crisis of leaving is critically needed to strengthen health and social services and better support women's recovery and healing.
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Affiliation(s)
- Marilyn Ford-Gilboe
- Arthur Labatt Family School of
Nursing, Western
University London, ON, Canada
| | - Colleen Varcoe
- School of Nursing,
University
of British Columbia, Vancouver, BC,
Canada
| | - Judith Wuest
- Faculty of Nursing,
University
of New Brunswick, Fredericton, NB,
Canada
| | | | - Michelle Pajot
- Arthur Labatt Family School of
Nursing, Western
University London, ON, Canada
| | - Lisa Heslop
- Arthur Labatt Family School of
Nursing, Western
University London, ON, Canada
| | - Nancy Perrin
- Johns Hopkins University School of
Nursing, Baltimore, MA, USA
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Box E, Flatau P, Lester L. Women sleeping rough: The health, social and economic costs of homelessness. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4175-e4190. [PMID: 35466473 PMCID: PMC10084149 DOI: 10.1111/hsc.13811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/13/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index-Service Prioritization Decision Analysis Tool (VI-SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap-around supportive housing to address poor health outcomes.
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Affiliation(s)
- Emily Box
- Centre for Social Impact UWAThe Business SchoolThe University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Paul Flatau
- Centre for Social Impact UWAThe Business SchoolThe University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Leanne Lester
- Centre for Social Impact UWAThe Business SchoolThe University of Western AustraliaCrawleyWestern AustraliaAustralia
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7
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Merghati Khoei E, Rezaei Z, Mohraz M, Brady KT, Killeen T, Korte JE, Bayat A, Yousefi H. Gender differences in post-traumatic stress disorder and depression among Iranian population with substance use disorder. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2051624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Effat Merghati Khoei
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahed Rezaei
- Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Therese Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jeffrey E. Korte
- Department of Public Health Sciences, School of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Alireza Bayat
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Yousefi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
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The Impact of Land-Based Physical Activity Interventions on Self-Reported Health and Well-Being of Indigenous Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137099. [PMID: 34281031 PMCID: PMC8296996 DOI: 10.3390/ijerph18137099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 01/03/2023]
Abstract
For many Indigenous communities, decreased participation in traditional land-based activities has led to higher rates of chronic disease and a decrease in well-being. This systematic review explores how traditional land-based activities impact self-reported health and well-being of Indigenous adults, using Indigenous and Western perspectives. A search of three electronic databases (PubMed, Scopus, and Web of Science) identified nine studies which explored the experiences and perspectives of Indigenous adults taking part in land-based subsistence and ceremonial activities. A thematic analysis of these studies identified many interconnected physical, spiritual, mental, emotional, and community benefits. Community engagement throughout all stages of the interventions was an important factor in effectively addressing challenges and barriers stemming from colonization, decreased knowledge transfer, and increased use of technology. Participants reported developing more effective stress management techniques, a greater awareness of modifiable risk factors along with increased engagement with Elders. Ultimately, land-based subsistence and ceremonial activities were identified as playing an influential role in the lives of Indigenous adults. The involvement of community members allowed for the development of more culturally relevant interventions. Future community-specific research is needed to increase engagement in traditional physical-activities, improve well-being and overall reduce the risk of chronic disease.
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Caplan R, Nelson G, Distasio J, Isaak C, Edel B, Piat M, Macnaughton E, Kirst M, Patterson M, Aubry T, Mulligan S, Goering P. Indigenous and non-Indigenous parents separated from their children and experiencing homelessness and mental illness in Canada. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2753-2772. [PMID: 33032366 DOI: 10.1002/jcop.22455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
The purpose of this study is to examine the parent-child experiences of Indigenous and non-Indigenous mothers and fathers experiencing homelessness, mental illness, and separation from their children. A qualitative thematic analysis of baseline and 18-month follow-up narrative interviews was used to compare 12 mothers (n = 8 Indigenous and n = 4 nonindigenous) with 24 fathers (n = 13 Indigenous and n = 11 non-Indigenous). First, it was found that children are more central in the lives of mothers than fathers. Second, Indigenous parents' narratives were characterized by interpersonal and systemic violence, racism and trauma, and cultural disconnection, but also more cultural healing resources. Third, an intersectional analysis showed that children were peripheral in the lives of non-Indigenous fathers, and most central to the identities of Indigenous mothers. Gender identity, Indigenous, and intersectional theories are used to interpret the findings. Implications for future theory, research, and culturally relevant intervention are discussed.
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Affiliation(s)
- Rachel Caplan
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, Canada
| | - Geoffrey Nelson
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, Canada
| | - Jino Distasio
- Department of Geography, University of Winnipeg, Winnipeg, Canada
| | | | - Betty Edel
- End Homelessness Winnipeg, Winnipeg, Canada
| | - Myra Piat
- Douglas Mental Health University Institute, Department of Psychiatry & School of Social Work, McGill University, Montreal, Canada
| | - Eric Macnaughton
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, Canada
| | - Maritt Kirst
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, Canada
| | | | - Tim Aubry
- Department of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | | | - Paula Goering
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, Canada
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
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