Browsing by Author "Lashewicz, Bonnie"
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Item Open Access A Mixed Methods Approach to Identifying Barriers and Supports to Physical Activity in Adults Following Residential Relocation(2018-01-25) Salvo, Grazia; McCormack, Gavin; Lashewicz, Bonnie; Doyle-Baker, TishUsing a systematized review of qualitative studies and a quasi-longitudinal mixed methods analysis of primary data, this thesis explored the built environment’s influence on physical activity among adults. The systematized review provided insight into functional, aesthetic, destination, and safety characteristics’ that are associated with physical activity. Sociodemographic characteristics were also found to affect the built environment-physical activity relationship. In the mixed methods analysis, quantitative data suggested positive associations between self-reported changes in transportation walking and cycling and improvements in objectively measured neighbourhood walkability (Walk Score®) following residential relocation. Findings from the qualitative semi-structure interviews reinforced the quantitative findings and specifically highlighted the importance of having access to safe walking and cycling paths and nearby destinations that support active transportation. The interview data also suggested neighbourhood opportunities that allow adults to connect with community, family and the environment while being active supported enjoyable physical activity. Notably, some participants also reported using time spent on active transportation to compensate for changes in time spent in leisure physical activity. The thesis findings have the potential to inform urban planning and policy for improving physical activity and in turn health in adult populations.Item Open Access A randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol(2019-09-18) Wang, JianLi; MacQueen, Glenda; Patten, Scott; Manuel, Douglas; Lashewicz, Bonnie; Schmitz, NorbertAbstract Background Major depressive disorder is one of the most prevalent and disabling forms of mental illness in the general population. One public health strategy that may reduce the disease burden is early identification and prevention - identifying people who are at high risk and intervening to prevent symptoms from progressing into a major depressive episode (MDE). Multivariable risk predictive algorithms (MVRP) have been developed to estimate personalized risk (probability) of an MDE. The purpose of this trial is to answer the questions: (1) Does disclosure of personalized depression risk information promote high-risk individuals to take preventive actions? (2) Will disclosure of personalized depression risk information negatively affect the mental health of those at high risk? Methods We are recruiting 350 high-risk men and 350 high-risk women across the country. Individuals are eligible, if they: (1) are 18 years or older, (2) have not had a depressive episode in the past two months, (3) are at high risk of MDE based on the MVRPs (predicted risk of 6.5% + for men and of 11.2% + for women), (4) can communicate in either English or French, and (5) agree to be contacted for follow-up interviews. The MVRPs were developed and validated using longitudinal data from over 10,000 Canadians across the country. Eligible participants are randomized into (1) the control group, and (2) the group receiving personalized depression risk information. The participants are assessed at baseline, 6 and 12 months regarding accuracy of risk perception, use of self-help strategies and changes in psychological distress and functioning. Qualitative interviews are conducted in sub-samples of the intervention groups to explore how the personalized information affects risk perception, self-help behaviors and mental health. Discussion MVRPs can be used for risk stratification and planning preventive actions. The personalized risk information produced by MVRPs may also empower users to actively engage in self-management. This trial will contribute to the knowledge base about the potential health benefits and psychological harms associated with the provision of personalized depression risk information that will inform future implementation and patient-physician communication in the clinical settings. Trial registration NCT02943876 . Date of trial registration: October 21st, 2016.Item Open Access Anticipatory Governance, Anticipatory Advocacy, Knowledge Brokering, and the State of Disabled People's Rights Advocacy in Canada: Perspectives of Two Canadian Cross-Disability Rights Organizations(2017) Diep, Lucy; Wolbring, Gregor; Hendrikse, Jesse; Lashewicz, BonnieAdvancements in science, technology and innovation (STI), both conceptualized and emerging, are continuing to impact society as a whole, and disabled people in particular, in numerous ways. How STI advancements should be governed to address the impacts has been discussed for some time and several STI governance frameworks have emerged to tackle this challenge. While each framework may vary by strategy and approach, anticipatory practice (or foresight) and public engagement are two approaches utilized across these different strategies. The purpose of this study was to examine the utility and consequences of anticipatory governance practice (which entails anticipatory practice and public engagement) as an indicator of success for STI governance for disabled people. Using a multiple-case study research design, and the frameworks of Ability Studies and Sherry Arnstein’s Ladder of Citizen Participation, my thesis focuses on the views of advocates for disabled people’s rights from two national cross-disability rights organizations in Canada on the practical reality of advocacy in Canada and the capacity of disabled people to engage in and influence discourse on STI governance, especially in an anticipatory way, and what they see as approaches to increase disabled people’s influence on STI governance. I also explore the role of the knowledge broker as a facilitator for collaboration and information exchange to support cross-disability rights organizations in the practice of anticipatory advocacy. The study’s main conclusion is that the application of anticipatory practices to governance frameworks generates the need for anticipatory advocacy - the capacity and ability to advocate in an anticipatory way to be part of anticipatory governance discourses. However, anticipatory governance is, as a practical reality, a privileged discourse that is limited to those who fulfill certain abilities to participate in this practice. For disabled people and cross-disability rights organizations, anticipatory practices pose many barriers and challenges and much work remains to be done for and by disabled people in order to ensure their meaningful engagement in anticipatory governance practices for STI.Item Open Access Case study of informal online mental health communities on Reddit(2024-06-12) Boettcher, Nick; Lashewicz, Bonnie; Haines-Saah, Rebecca; Dimitropoulos, Gina; Lock, JenniferThe rise of massive informal, user-driven mental health communities on social media presents a novel context for mental health support and promotion offering both transformative opportunities and challenges. The opportunities are especially vital for some individuals given the gaps in mental health services due to provider shortages, system fragmentation, and persistent stigma surrounding serious mental illness. Informal communities endure despite varying expert opinions, even as expert evidence has gathered in support of digital mental health and peer support as viable options for promoting population mental health. The purpose of this study was to investigate the nature of informal online mental health communities through a case study of mental health communities on the discussion platform Reddit. A qualitative instrumental multicase study design was used to examine three Reddit communities organized around general mental health, depression, and anxiety. The case study methodology encompassed three methods: (1) a scoping review of 54 academic studies of depression and anxiety using data collected from Reddit, (2) a qualitative content analysis of 233 user posts containing the term “medical” posted in selected communities over a one-month period, and (3) a reflexive thematic analysis of 8 in-depth interviews with volunteer moderators of selected communities. Findings were synthesized across each analysis to examine the relationality between informal knowledge of informal online mental health communities, academic knowledge generated by researchers, and the expert knowledge associated with population health science and public health practice. Implications of the case study are discussed in terms of policy and research related to digital population and public health in Canada, as well as community-centered methodologies in mental health research that engages with perspectives of Reddit moderators and users.Item Open Access Experiences and Perceived Outcomes of Low-Income Adults During and After Participating in the British Columbia Farmers' Market Nutrition Coupon Program: A Longitudinal Qualitative Study(Elsevier, 2022-03-28) Caron-Roy, Stéphanie; Lee, Yun Yun; Sayed, Sayeeda Amber; Lashewicz, Bonnie; Milaney, Katrina; Dunn, Sharlette; O'Hara, Heather; Leblanc, Peter; Prowse, Rachel J L; Fournier, Bonnie; Raine, Kim D; Elliott, Charlene; Olstad, Dana LeeThe British Columbia Farmers' Market Nutrition Coupon Program (FMNCP) is a farmers' market food subsidy program that provides low-income households with coupons valued at $21/wk for 16 weeks to purchase healthy foods at participating BC Association of Farmers' Markets members' markets.Item Open Access Fostering an Inclusive Leadership Team: A Critical Ethnography of a Learning Support Team for Students with Severe Intellectual Disabilities(2021-09) Mooney, Laura Rae; Kowch, Eugene; Lashewicz, Bonnie; Lock, Jennifer; Scott, Shelleyann; Specht, JacquelineHigh school principals grapple with how to effectively reform the bureaucratic and social culture of their schools to be more inclusive of students with severe intellectual disabilities while also maintaining high standards of academic excellence for all students. There is a paucity of scholarship examining leadership from within an inclusive learning support team (LST) for high school students with severe intellectual disabilities. The purpose of this study was to describe how a learning support team informs inclusive leadership practice. The researcher studied learning support team members from one Alberta school and district, including a director of learning, a learning support specialist, a high school principal, a learning support teacher, two secondary teachers and two education assistants. The inquiry was guided by this research question: How does a learning support team for high school students with severe intellectual disabilities inform inclusive leadership practice? A critical ethnography approach was taken and involved both observations and interviews, with a systems analysis of the findings informing concepts like teamwork and the distribution of power among the learning support team. The resulting model for fostering an inclusive leadership team provides guidance for school leader teams in similar contexts when including students with severe intellectual disabilities. Specifically, the model emphasizes the need for a coherent relationship between the classroom, school leadership and district leadership teams so together they can: (1) make curriculum connections for students; (2) provide reflective practice opportunities for staff; (3) integrate teamwork into professional development activities; (4) innovate high school instruction to be more inclusive of this population of students; and (5) develop more inclusive policy directions. Conclusions point to a need for modified curriculum development at the high school level and collaborative professional development among principals, teachers, and education assistants.Item Open Access Group peer-mentorship in academic libraries: an approach to enhancing research engagement(American Library Association, 2022-01) Lorenzetti, Diane; Powelson, Susan; Lashewicz, Bonnie; Casebeer, Ann; Hayden, K. Alix; Oddone Paolucci, Elizabeth; Beran, TanyaItem Open Access Improving Infectious Tuberculosis Education and Counselling in Calgary for Patients who are Foreign-born and their Families(2022-07-26) Bedingfield, Nancy Joyce; King-Shier, Kathryn; Fisher, Dina; Lashewicz, BonniePatients and family members require comprehensive information and support to manage tuberculosis (TB). However, current TB education and counselling practices often fail to address family needs. This is particularly true in low TB incidence settings such as Canada, where linguistic and cultural dissonance between patients and providers is common. The objective of this research was to explore how TB health care workers (TB HCWs) and health systems leaders can focus education and counselling on the needs and preferences of patients and family members who are foreign-born experiencing advanced infectious TB in Calgary, Canada. The case study was conducted in three phases framed on the Social Ecological Model. In phase one, interviews were conducted with patients and family members to learn about their TB-related needs and experiences. In phase two, staff and physicians at the Calgary TB Clinic were interviewed to learn about their perceptions of barriers and supports to education and counselling for this group. In phase three, data from the first two phases were re-analyzed, relevant documents were reviewed, and health services and community leaders were interviewed to learn how health policy and social context influence education and counselling. Patients and family members described significant isolation associated with TB. Although patients and family members were satisfied with education and counselling, there was evidence that communication problems had occurred. TB HCWs reported numerous, multi-level barriers to providing education and counselling but found that continuity of care and clear information provided early reduced communication problems. Data from community leaders’ interviews and document review revealed that operational and public health priorities often took precedence over strengthening education and counselling. Leaders noted promising developments had recently increased attention to the needs of people who are foreign-born. Key recommendations for change include development of patient education and counselling guidelines, improved patient teaching materials, and offering a cultural patient navigator to families affected by advanced infectious TB. Adopting these changes could reduce fear and isolation in patients and family members; however, policy changes is required to realize the equity-enhancing potential of informing and supporting patients and family members affected by TB.Item Open Access Just Fun or Fundamental? Fathers’ Narratives of Leisure with Their Children with Autism Spectrum Disorder(2017) Mitchell, Jennifer; Lashewicz, Bonnie; Hughson, Anne; McIntyre, Lynn; Dewey, Deborah; McConnell, David; Badry, DorothyAnchored in the generative fathering framework and critical disability studies (CDS), I used a narrative approach to study 11 fathers’ stories of leisure with their children with autism spectrum disorder (ASD) to highlight how leisure activities are given meaning and constructed as part of active fathering. I produced four narratives - narratives of action, narratives of adjustment, narratives of tension and narratives of relationships that captured fathers’ experiences of leisure with their children with ASD. Narratives of action are the stories of what fathers are doing in their day- to- day interactions with their children. Narratives of adjustment depict how fathers have shifted and re-defined expectations of their children and themselves following their children’s diagnosis of ASD. Narratives of tension capture fathers’ strain in concurrently having to acquiesce and advocate against financial, environmental and societal constraints. Lastly, in narratives of relationships, fathers illustrate the relational outcomes of their involvement with their children, including an appreciation of their children’s individuality and the father-child connection. The findings augment a deeper understanding of fathering children with ASD and the father-child relationship. By understanding fathers’ perceived successes and challenges in leisure activities in the home and community settings, service providers can better engage and support fathers in home- and community-based leisure.Item Open Access SEED: A Mixed-Methods Study of Stroke-related Experiences and Priorities of Elderly Living with Dementia or Disability, their Family Caregivers, and Physicians.(2024-06-13) Betzner, William; Ganesh, Aravind; Smith, Eric; Demchuk, Andrew; Lashewicz, Bonnie; Dukelow, SeanAcute ischemic stroke (AIS) results from blood flow loss to part of the brain and is a leading cause of disability worldwide. Pre-stroke dementia is defined as evidence of substantial cognitive decline from a previous performance level, resulting in the person needing help with activities of daily living. This cognitive disorder is associated with higher AIS risk with around 10% of AIS patients have pre-existing dementia. A further 30% of stroke patients have pre-stroke disability. Little is known about the use of stroke therapies in PLWD, as these patients have been conventionally excluded from randomized-controlled trials. We aim to develop a broad picture of the current state of AIS management for PLWD by engaging with the key stake holders–patients, caregivers, and physicians–on the matter. This is accomplished through a systematic review and meta-analysis of reperfusion outcomes in persons with pre-existing dementia, followed by a mixed-methods approach focusing on PLWD. SEED A explores the experiences of PLWD who have a stroke and their primary caregiver. SEED B investigated physician approaches toward the acute stroke management of PLWD. The representative case style survey has been disseminated worldwide to physicians to reveal trends in the stroke management of PLWD, with data collection still ongoing. The use of reperfusion therapies in PLWD has no substantial safety concerns, although there is a need for more robust data, with tailored outcomes. Perspectives shared by patients and caregivers emphasize the importance of preserving independence, and the variety of challenges of navigating dementia and disability in the acute setting and daily life after stroke. Insights from physicians highlight the complexities and nuanced decision-making involved in managing acute stroke in PLWD. These opinions highlight an acute stroke care environment where research evidence, resources and tailored treatment strategies are limited. This thesis underscores the need for including PLWD in future clinical trials and creating tailored stroke treatment strategies. Findings will be used to develop better criteria for stroke therapies and contribute to better definitions of good outcomes after stroke for PLWD. This will inform future study designs, and is relevant to clinicians, researchers, policy makers, patients, and caregivers.Item Open Access The Lived Experience of Saudis' with Physical Disabilities when Interacting with Healthcare Providers in Saudi Arabia(2016) Albagmi, Faisal; Hughson, Elizabeth; Hansen, Nancy; Lashewicz, BonnieReflecting on the current condition of people with physical disabilities in Saudi Arabia, the literature generally features the exclusion of local knowledge from Saudis with physical disabilities, the reliance on the medical model, and the continued dependence on imported Western resources. Unlike the majority of the literature, this study addresses the lack of voices from people with physical disabilities in Saudi Arabia, which continues to be silent. Thus, the purpose of this study was to present the underrepresented dialogues and perspectives of people with physical disabilities when interacting with health care providers in Saudi Arabia. This study used a Homi Bhabha’s conception of the third space, a post-colonial perspective, as a theoretical framework. Hermeneutic phenomenology was employed to illuminate the essence of the lived experience. A purposeful sample of seven Saudi men and women with disabilities were recruited, and the audiotaped face-to-face semi-structured interviews were conducted in Arabic. It was through these conversations that a co-created interpretation of their experiences emerged. The findings of this study revealed that Saudis with physical disabilities’ perception of disability was colonized by the medical discourse that commenced at the early age and continued throughout their interaction with their healthcare professionals. Another factor was that the medical professionals have excluded people with disabilities from any relevant medical knowledge about their disability. This study also explores how the participants demonstrated their resistance to the colonizing discourse by operating in the third space. Since the role of the medical professionals is to continually provide and improve the care for their clients, examining this interaction within the third space serves to support and strengthen a new way of approaching people with disabilities within a client-centred approach. Through this interpretive investigation, the wonderment of what it may be like for a person with physical disabilities to interact with their healthcare provider continues as this study has provided an opportunity for further understanding and questioning to emerge.Item Open Access The relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study(2020-06-06) Warner, Emily; Nannarone, Molly; Smail-Crevier, Rachel; Manuel, Douglas; Lashewicz, Bonnie; Patten, Scott; Schmitz, Norbert; MacQueen, Glenda; Wang, Jian LAbstract Background Self-help may reduce the risk of depression, and risk perception of depression may influence initiating self-help. It is unknown how risk perception is associated with self-help behaviours. The objectives of this study are to (1) describe the self-help strategies used by high-risk Canadians in relation to the accuracy of perceived depression risk, by sex, and (2) identify demographic and clinical factors associated with self-help behaviours. Methods Baseline data from a randomized controlled trial including 358 men and 356 women at high-risk of developing depression were used. Following methods used in cancer research, risk perception accuracy was determined by comparing the participant’s self-perceived and objective risk of developing depression and classifying as accurate, over-estimation and under-estimation based on a ± 10% threshold. The participant’s objective depression risk was assessed using sex-specific multivariable risk predictive algorithms. Frequency of using 14 self-help strategies was assessed. One-way ANOVA testing was used to detect if differences in risk perception accuracy groups existed, stratified by sex. Linear regression was used to investigate the clinical and demographic factors associated with self-help behaviours, also stratified. Results Compared to accurate-estimators, male over-estimators were less likely to “leave the house daily,” and “participate in activities they enjoy.” Male under-estimators were also less likely to “participate in activities they enjoy.” Both male ‘inaccurate’ perception groups were more likely to ‘create lists of strategies which have worked for feelings of depression in the past and use them’. There were no significant differences between self-help behaviours and risk perception accuracy in women. Regression modeling showed negative relationships between self-rated health and self-help scores, irrespective of sex. In women, self-help score was positively associated with age and educational attainment, and negatively associated with perceived risk. In men, a positive relationship with unemployment was also seen. Conclusions Sex differences exist in the factors associated with self-help. Risk perception accuracy, work status, and self-rated health is associated with self-help behaviours in high-risk men. In women, factors related to self-help included age, education, self-rated health status, and perceived risk. More research is needed to replicate findings. Trial registration Prospectively registered at ClinicalTrials.gov (NCT02943876) as of 10/21/16.Item Open Access Understanding the lived experiences of people with myasthenia gravis: a narrative-based study(2022-04) Crooks, Rachel; Roach, Pamela; Haines-Saah, Rebecca; Lashewicz, Bonnie; Atkins, ChloëMyasthenia gravis (MG) is a neuromuscular disease that is well-studied from a clinical perspective, but research often excludes the perspectives of people with MG. This study explored the lived experience of MG with two specific aims: 1) to investigate how people with MG narrate their lived experiences, and 2) to explore how narratives of lived experience may disrupt and/or reinforce common clinical narratives of MG and their reproduction. Utilizing a critical disability studies framework, the study specifically investigated how participants internalized or resisted ableism in the telling of their stories. Informed by narrative inquiry methodology, unstructured interviews were used to co-create a narrative with four participants. Each narrative highlighted a unique experience of MG, where participants spoke of dealing with the rarity of the disorder, feelings about worthiness and value, challenges while managing social relationships, and navigating ongoing uncertainty inherent to the experience of MG. People tended to tell their stories based on dominant understandings of disability and illness; where disability is an individual problem to be overcome. These narratives describe the lived experience of people with MG beyond a symptomatic or clinical perspective, using critical disability studies to account for the social and political contexts in which these narratives are located.Item Open Access Users’ perceptions about receiving personalized depression risk information: findings from a qualitative study(2021-11-18) Eccles, Heidi; Nadouri, Doaa; Nannarone, Molly; Lashewicz, Bonnie; Schmitz, Norbert; Patten, Scott B.; Manuel, Douglas G.; Wang, JianLiAbstract Objectives To understand users’ perceptions about receiving their personalized depression risk score and to gain an understanding about how to improve the efficiency of risk communication from the user perspective. Methods A qualitative study embedded in a randomized controlled trial (RCT) on evaluating the impact of providing personalized depression risk information on psychological harms and benefits. The participants (20 males and 20 females) were randomly selected from the intervention arm of the RCT after the 12-month assessment. The qualitative interviews were conducted through telephone, audio recorded and transcribed verbatim. We conducted a content analysis to describe the content and contextual meaning of data collected from participants. Results The first theme explained the motivation for receiving a risk score. Most participants chose to receive their personalised depression risk score with the goal of improving their self-awareness. The results revealed three sub-themes surrounding perceptions and implication of receiving their risk score: positive, negative, and neutral. Most participants found that receiving their score was positive because it improved their awareness of their mental health, but some participants could see that some people would have negative feelings when getting the score causing them to be more likely to get depression. The final theme focussed on improvements including: the best delivery methods, having resources and strategies, and targeting younger people. Conclusion The most significant motivation for, and benefit of receiving one’s personalized depression risk score was improved awareness of one’s mental health. A comprehensive risk communication program may improve the uptake and maximize the impact on behavior changes and risk reduction.Item Open Access A Wages and Wellness Penalty: A Study of Women Care Workers in Canada(2021-09) Baay, Courtney; Lightman, Naomi; Wallace, Jean; Lashewicz, BonnieThis thesis establishes a nationally representative sociodemographic profile of women in lowstatus care positions in long-term care (LTC) facilities across Canada, as well as assessing whether or not they experience a wages and wellness disadvantage, compared to non-care worker women. The thesis applies Paula England’s Devaluation Framework which suggests that women in positions of care work are typically rewarded less than comparable workers due to societal and cultural biases towards feminized fields of employment. Using 2016 Canadian Census micro-data accessed at the Prairie Regional Statistics Canada Research Data Centre, low-status care work is operationalized using occupation codes for Licensed Practical Nurses or Nurse’s Aides, Orderlies and Patient Service Associates alongside the industry code for Nursing and Residential Care Facilities. Using descriptive data analysis, the author identifies that low-status care work in LTC is overwhelmingly comprised of women, racialized individuals and foreign-born people in Canada. As well, using Ordinary Least Squares (OLS) Regression and Logistic Regression methods the author finds that women in low-status care occupations experience a wage penalty in comparison to all other employed women in Canada, with women of colour experiencing a double disadvantage in terms of wages. Lastly, this thesis demonstrates that low-status women care workers also experience a disadvantage in terms of both self-rated physical and mental health in comparison to women in other occupations. Several suggestions for future research and policy implications are explored based on these research findings such as fair remuneration, employment benefits, appropriate staffing levels, and unionization for care workers in LTC.