File - spheru

Transcription

File - spheru

Conference Program
Inside this booklet:
CPHR Training Program
3
SPHERU
4
Acknowledgements
5
Invited Speakers
7
Meeting Room Facilities
15
Conference Program
17
Poster Presentations
23
Presentation Abstracts
25
Explore Regina
57
Notes
61
PAGE 3
2008 CPHR CONFERENCE
Welcome to the New Directions in Population Health Research: Linking Theory, Ethics,
and Practice Conference!
The Community and Population Health Research Training
Program (CPHR) and the Saskatchewan Population Health
and Evaluation Research Unit (SPHERU) are pleased to host a
national conference exploring recent innovations and existing or emerging trends in population health research and
practice as they relate to reducing health disparities for particular communities or populations.
The CPHR Training Program is an innovative post-graduate training initiative with an interdisciplinary approach to population health research delivered by SPHERU. The Training
Program focuses on creating new health knowledge and applying research findings
through partnerships with community-based organizations, policy makers and government. Strategic Training Fellows, consisting of Graduate Students, Post-Doctoral Fellows
and Work-Sabbaticants, are mentored in new ways of framing research questions, applying research methodologies and disseminating research knowledge to influence
public policies. The CPHR Training Program is supported by the Canadian Institutes of
Health Research (CIHR) through its Strategic Training Initiative in Health Research (STIHR)
program, with further scholarship support from the University of Saskatchewan and the
University of Regina.
Collaboration between researchers, communities, policy makers and practitioners is vital
for the development of innovative partnerships and strategies which will address health
disparities among populations. With this in mind, I would like to extend my sincere thanks
to all the mentors, members of various committees, and the Strategic Training Fellows
themselves for their valuable contributions toward making the CPHR program a great
success.
I hope that you enjoy your conference experience and the
networking opportunities such an event provides, as well as
have some time to explore the beautiful city of
Regina.
Dr. Nazeem Muhajarine
Principal Investigator
PAGE 4
On behalf of the Saskatchewan Population Health
and Evaluation Research Unit (SPHERU) I am
pleased to welcome you to the New Directions in
Population Health Research: Linking Theory, Ethics, and Practice National Conference 2008. In
conjunction with the Community and Population
Health Research (CPHR) Training program, we are
pleased to provide a forum where exploration of
innovations and existing or emerging trends in
population health research will be investigated
and discussed.
tions that Regina has to offer. This conference is an
opportunity to bring us and our work closer together so that we can learn from each other and
discover new innovations in addressing population
health issues and challenges.
SPHERU, established jointly by the Universities of
Saskatchewan and Regina, is an interdisciplinary
research unit committed to the promotion of
health equity by understanding and addressing
population health disparities through policyrelevant research. Our researchers are committed to building new knowledge, influencing policy
change, and increasing research capacity in
three main areas of research: northern and Aboriginal health, healthy children, and rural health.
Each research project, each training opportunity,
and each linkage to a community group that is
made through our work is connected to SPHERU’s
overall mission: to understand and address health
disparities through policy-relevant research.
I hope that you will enjoy the conference sessions,
networking opportunities, and the many attrac-
WE’ RE
ON THE WEB:
SPHERU Saskatoon
Janice Michael
Research Administrator
Royal University Hospital Room 2718
University of Saskatchewan
Saskatoon, SK S7N 5E5
Phone (306) 966-2250
Fax (306) 966-7920
janice.michael@usask.ca
Dr. Bonnie Jeffery
Director, Saskatchewan Population Health and
Evaluation Research Unit
W W W . S P H E RU . C A
SPHERU Regina
Richelle Leonard
Research Administrator
CK 115
University of Regina
Regina, SK S4S 0A2
Phone (306) 585-5674
Fax (306) 585-5694
richelle.leonard@uregina.ca
SPHERU Prince Albert
Colleen Hamilton
Project Coordinator
Box 2830 - 1500 - 10th Avenue East
Prince Albert, SK S6V 7M3
Phone (306) 953-5535
Fax (306) 953-5305
colleen.hamilton@uregina.ca
PAGE 5
T
cknowledgements
A number of people have made an outstanding contribution to the success of New Directions in Population Health Research: Linking Theory, Ethics, and Practice. On behalf of The Community and Population Health Research Training Program (CPHR), the Saskatchewan Population Health and Evaluation
Research Unit (SPHERU), and the Conference Planning Committee I wish to extend thanks to those individuals and groups that aided in our success.
First, I would like to thank my fellow Planning Committee members for volunteering their time with such
dedication, skill, and experience. The committee ensured that the conference sought to bring as
many perspectives as possible together so that we could further explore the health disparities between
populations and discuss developing effective strategies to reduce them through collaboration between communities, practitioners, researchers, and policy makers. The committee members, in addition to myself, include Sylvia Abonyi (SPHERU), Shardelle Brown (CPHR), Kelly Chessie (CPHR), Randy
Johner (CPHR), Shanthi Johnson (SPHERU), Richelle Leonard (SPHERU), Janice Michael (SPHERU), and
Bonnie Zink (SPHERU).
Many people at the Universities of Regina and Saskatchewan deserve thanks as do those organizations
that provided us guidance and funding. The CPHR Training Program provided the initial funding that
allowed us to begin the planning of this event. Additional funds came from the Canadian Institutes of
Health Research (CIHR) Meetings, Planning and Dissemination Grant: End of Grant Knowledge Translation Supplement, and the Research Connections: Event Sponsorship program of the Saskatchewan
Health Research Foundation (SHRF). The University of Saskatchewan’s University Conference Fund
(Office of the Provost and Vice-President Academic) and the Offices of the Vice-President (Research
and International) and Vice-President Academic at the University of Regina not only provided financial
assistance to the conference, but the presence of senior officials from both universities speaks to their
ongoing support of CPHR, SPHERU and population health research generally.
Praise for the practical functioning of the conference belongs squarely with CNT Management Group
Inc. Claire Belanger-Parker, Conference Planner, deserves recognition for her logistical prowess and
dedication to detail. Thanks are also due to the staff and management of the Ramada Hotel for their
expertise in ensuring our participants, delegates, and invited guests enjoy their stay.
Finally, and certainly top of the bill, thanks are due to all the participants
and delegates - governmental, non-governmental, community, and
academic. Many of you travelled far to be with us and only through
your participation and support did we reach the intended goals and
success.
Enjoy the conference.
Cheers,
Tom McIntosh, Conference Planning Committee Chair
Saskatchewan Population Health and Evaluation Research Unit
PAGE 7
` ÜA TÇwÜ° c|vtÜw? g{x ZÄÉux tÇw `t|Ä
André Picard is one of Canada's top public policy writers. He is the public health reporter at The Globe and Mail, where he has been a staff
writer since 1987. He is the author of the best-selling books CRITICAL
CARE: Canadian Nurses Speak For Change and THE GIFT OF DEATH: Confronting Canada's Tainted Blood Tragedy, as well as A CALL TO ALMS: The
New Face of Charity in Canada.
André has received much acclaim for his writing, including the Michener
Award for Meritorious Public Service Journalism, the Canadian Policy Research Award, and the Atkinson Fellowship for Public Policy Research.
In 2002, he received the Centennial Prize of the Pan-American Health
Organization as the top public health reporter in the Americas. In 2005,
he was named Canada's first Public Health Hero by the Canadian Public
Health Association. In 2007, André was awarded a National Newspaper
Award for his contribution to a series about cancer care in Canada.
He has been the recipient of the Canadian Nurses' Association Award of
Excellence for Health Care Reporting, the Nursing in the Media Award of the Registered Nurses Association of
Ontario, the International Media Prize of Sigma Theta Tau (Nursing Honor Society), and the Science and Society Book Prize. His work has also been honoured by a number of consumer health groups, including the Canadian Mental Health Association and the Canadian Hearing Society.
In addition to his writing, André has participated in a number of academic endeavours, notably as a participant in the Governor-General's Canadian Leadership Conference, and as a guest lecturer at a number of
universities. He is an accomplished public speaker, and has delivered speeches in Africa, Japan, Europe and
The Philippines. He also speaks regularly to health care conferences and health professionals across Canada.
When he’s not writing and speaking André also does volunteer work with a number of professional organizations and non-profit groups. He is a former member of the advisory committees of the Canadian Institute for
Child Health, Active Healthy Kids Canada, Centraide/United Way Montréal, and the Canadian Medical Association Journal. He is also a parent representative on the Montreal School Board.
André is a long-time member of the Canadian Association of Journalists, the Association of Health Care Journalists, the Canadian Science Writers Association and Canadian Journalists for Free Expression. He lives in
Montréal with his family.
KEYNOTE
P UTTING
SOME
ADDRESS
P O P ! I N P O P U L AT I O N H E A LT H
W E D N E S DAY , N OV E M B E R 1 2 , 2 0 0 8
6:30—8:30
P. M.
PAGE 8
WÜA VtÜÉÄçÇ UxÇÇxàà? `xÅuxÜ Éy ctÜÄ|tÅxÇà
The Honourable, Dr. Carolyn Bennett, PC, MP, was appointed Minister of State (Public Health) on December 12,
2003. She was first elected to the House of Commons in the
1997 general election and was re-elected in 2000 and 2004
representing the electoral district of St. Paul’s.
Dr. Bennett served as Chair of the Standing Joint Committee on the Library of Parliament, the sub-Committee on the
Status of Persons with Disabilities (Human Resources Development Committee) and the Canada-Israel Parliamentary
Friendship Group. Dr. Bennett also served on the Standing
Committee on Government Operations and Estimates, and
the Standing Committee on Health. She was also a member of the Standing Committee on Finance and was Chair
of the Liberal Women's Caucus.
Prior to her election, Dr. Bennett was a family physician and
a founding partner of Bedford Medical Associates in downtown Toronto. She was President of the Medical Staff Association of Women's College Hospital and Assistant Professor
in the Department of Family and Community Medicine at
the University of Toronto. Dr. Bennett served on the Boards
of Havergal College, Women's College Hospital, the Ontario Medical Association, and the Medico-Legal Society of Toronto.
In 1986, Dr. Bennett received the Royal Life Saving Society Service Cross -- a Commonwealth award recognizing her more than twenty years of distinguished service. In 2002, she was the recipient of the coveted EVE
Award for contributing to the advancement of women in politics and in 2003 received the first ever CAMIMH
Mental Health Champion Award. Bennett is also author of “Kill or Cure? How Canadians Can Remake their
Health Care System,” published in October 2000.
Dr. Bennett obtained her degree in medicine from the University of Toronto in 1974, and received her certification in Family Medicine in 1976. She and her husband, Canadian film producer Peter O’Brian, have two sons.
O P E N I N G P L E N A RY A D D R E S S
T H U R S DAY , N OV E M B E R 1 3 T H , 2 0 0 8
8:30 - 9:15 A.M.
PAGE 9
W
ÜA VtÜÜ|x UÉâÜtáát? Y|Üáà atà|ÉÇá hÇ|äxÜá|àç Éy VtÇtwt
Carrie Bourassa was born and raised in Regina. Carrie pursued both her undergraduate and graduate degrees at the University of Regina. She earned her Bachelor of Arts Honours degree in Political Science in 1995,
graduated with her Master of Arts degree in 1999 and finished her Ph.D. in Social Studies in January 2008. Her
dissertation is entitled “Destruction of the Métis Nation: Health Consequences”.
Carrie has worked in several different capacities in her career including Sessional Instructor with the First Nations University of Canada (formerly the Saskatchewan Indian Federated College), Ministerial Assistant, Policy
Analyst with the Saskatchewan Provincial government and Manager of Employment Equity at the University of
Regina.
Currently, Carrie is following her dream of teaching at the postsecondary level – in August 2001, she accepted a faculty position
as Assistant Professor in the Department of Science at the First Nations University of Canada teaching Indigenous Health Studies as
well as selected Environmental Health courses including Environmental Health Communications and Administration. Carrie’s research interests include the impacts of colonization on the health of
First Nations and Métis people; creating culturally competent care
in health service delivery; Aboriginal community-based health research methodology; Aboriginal end of life care and Aboriginal
women’s health. Carrie is a member of the National First Nations
Environmental Contaminants Program Selection Committee, a
member of the International Environmental Monitoring
and Assessment Committee and is also a member of the Canadian
Institute for Health Research Standing Committee on Ethics. She is
also an accredited Aboriginal Cultural Awareness Program facilitator through the First Nations University of Canada and actively involved in volunteering at community centres including the Regina
Métis Sports and Culture Centre. In 2004, Carrie was honoured
when she was chosen as one of Saskatchewan’s ten Aboriginal
Role Models by the Aboriginal Employment Development Program’s
Provincial Aboriginal Representative Workforce Council (PARWC).
P L E N A RY P A N E L D I S C U S S I O N
F R I DAY , N OV E M B E R 1 4 T H , 2 0 0 8
8:30 - 10:15 A.M.
PAGE 10
`
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Willie J. Ermine, (M.Ed) Ethicist / Researcher with the
Indigenous Peoples Health Research Centre (IPHRC),
and Assistant Professor with the First Nations University
of Canada. Willie is Cree and is from the Sturgeon
Lake First Nation in the north central part of Saskatchewan where he lives with his family. As faculty
with the First Nations University of Canada, he lectures in subject areas of Cree Literature, and Indigenous system of Religion and Philosophy. Willie has
published numerous academic articles including a
widely read academic paper entitled “Aboriginal
Epistemology” through UBC Press, and contributed
recent reports to the Tri Council Panel on Research
Ethics and is a member of the Panel on Research
Ethics PRE TACAR (Technical Advisory Committee on
Aboriginal Research). His primary focus as an Ethicist
/ Researcher is to promote ethical practices of research involving Indigenous Peoples with particular interest is
the conceptual development of the ‘ethical space’ – a theoretical space between cultures and world views.
Ethical Space of Engagement
The Ethical Space is formed when two societies, with disparate worldviews, are poised to engage each other.
It is the thought about diverse societies and the space in between them that contributes to the development
of a framework for dialogue between human communities. The ethical space of engagement proposes a
framework as way of examining the diversity and positioning of Indigenous Peoples and Western society in the
pursuit of a relevant discussion on Indigenous legal issues and particularly to the fragile intersection of Indigenous law and Canadian legal systems. Ethical standards and the emergence of new rules of engagement
through recent Supreme Court rulings call for a new approach to Indigenous – Western dealings. The new
partnership model of the ethical space, in a cooperative spirit between Indigenous Peoples and Western institutions, will create new currents of thought that flow in different directions of legal discourse and overrun the
archaic ways of interaction.
“ E T H I C A L S PAC E : T H E S PAC E B E T W E E N E N T I T I E S
T H AT I S S O C R I T I C A L T O U N D E R S TA N D A S B E I N G
I N F LU E N T I A L I N R E L AT I O N S H I P S ”
8:30 - 10:15 A.M.
PAGE 11
W
ÜA ]tÇ|vx ZÜt{tÅ? WtÄ{Éâá|x hÇ|äxÜá|àç
Janice Graham is Canada Research Chair in Bioethics and Scientific Director of the Technoscience and Regulation Research Unit (TRRU), and the Qualitative Research Commons & Studio in the Faculty of Medicine at
Dalhousie University, Halifax, Canada.
As a medical anthropologist, Professor Graham draws upon anthropology, science studies, technology assessment and bioethics to contribute an understanding of cultural, technical and moral issues in health. Interested
in standardization and regulatory practices, diagnostic imaginaries, databases as cultural texts and aging,
Graham’s work on Alzheimer’s disease and other dementia diagnostics during the 90s led to an interest in the
moral basis of profit when disease is seen as a market opportunity. Her more recent ethnographic research
examines safety and efficacy in the regulation of emerging biotherapeutics at Health Canada. She held a
postdoctoral fellowship in geriatric medicine and neuroepidemiology (1996-8) at Dalhousie University, an endowed Research Chair in Medical Anthropology at the University of British Columbia (1998-2002), and a Canadian Institutes of Health Research New Investigator award (1999-2002). She has been a visiting senior fellow,
BIOS Centre for the Study of Bioscience, Biomedicine, Biotechnology and
Society, London School of Economics and Political Science, observer to
Scientific and Technical meetings of the World Health Organization, and
chaired the Health Canada Expert Advisory Panel on the Special Access
Program.
Along with several book chapters, and a book forthcoming, Aging and
Loss: Contesting the Dominant Paradigm, University of Toronto Press, her
articles have appeared in The Lancet, American Journal of Epidemiology,
Biosocieties, Pharmacogenetics and Genomics, Dementia and Geriatric
Cognitive Disorders, Journals of Gerontology, Journal of Aging Studies,
Ageing & Society, Philosophy, Psychology and Psychiatry, Journal of Investigative Medicine, Canadian Medical Association Journal, Lancet Neurology, New Genetics and Society, Archives of Neurology, Expert Opinion on
Pharmacotherapy, Journal of Neurology, Neurosurgery, and Psychiatry,
International Psychogeriatrics, Journal of Clinical Epidemiology, and Neuroepidemiology. Forthcoming research explores the development and
introduction of a new conjugate vaccine in sub-Saharan Africa.
“ S P E A K I N G R E S E A RC H T O P OW E R W H E N P O L I C Y
T RU M P S S C I E N C E A N D P O L I T I C S T RU M P S P O L I C Y ”
8:30 - 10:15 A. M.
PAGE 12
W
ÜA exÇ°x _çÉÇá? WtÄ{Éâá|x hÇ|äxÜá|àç
Dr. Lyons has a Tier One Canada Research Chair in Health Promotion
and a Fellow of the Canadian Academy of Health Science. She is a
Professor and Scientific Director of the Atlantic Health Promotion Research Centre (AHPRC) at Dalhousie University, Halifax, NS, Canada,
with appointments in the School of Health and Human Performance,
Department of Psychology, School of Nursing, and the Graduate Faculty, UNB. She recently returned from Green College and the John Radcliffe Hospital, University of Oxford where she was a Visiting Fellow.
She has been a faculty member at Dalhousie University since 1981. The
focus of her work has been prevention and management of chronic
disease with emphasis on knowledge translation (KT) theory and practice. She has had a special interest in research development in Atlantic
Canada and has worked to support researchers through the Atlantic
Health Promotion Research Centre and the Atlantic Networks for Prevention Research.
Over the past five years she has been principal investigator for over
$24 M in health research funding for large health promotion and
knowledge projects involving inter-sectoral, inter-disciplinary collaboration related to knowledge translation in rural health, stroke, public health, oral health of seniors, and chronic
disease prevention in midlife and youth. She has developed a KT assessment tool for researchers for two of
Canada’s Networks of Centres of Excellence (water and stroke), conducted KT interventions in low resource
environments, and developed a novel application of resource theory to foster understanding of receptor capacity in health systems.
She has assumed leadership roles within the Canadian Institutes of Health Research (Special Advisor to the
President; Awards Oversight Cte.), Health Canada (Science Advisory Board) Industry Canada (University Advisory Group), Dr. Lyons received her university education at Dalhousie University, Xavier University (Cincinnati),
the University of Oregon, and UCLA.
“A DV E N T U R E S I N M I N D I N G T H E K N OW - D O G A P — S O M E
E THICAL D ILEMMAS IN R ESOURCE- C HALLENGED
E N V I RO N M E N T S ”
8 : 3 0 - 10 : 1 5 A. M.
PAGE 13
WÜA eÉÇtÄw _tuÉÇàx? hÇ|äxÜá|àç Éy bààtãt
Ronald Labonte is Canada Research Chair in Globalization and
Health Equity at the Institute of Population Health, and Professor in
the Faculty of Medicine, University of Ottawa. Prior to his appointment in 2004 at the University of Ottawa, he was founding Director
of the Saskatchewan Population Health and Evaluation Research
Unit (SPHERU), a bi-university interdisciplinary research organization
that was committed to “engaged research” on population health
determinants at local, national and global levels.
Before working on globalization and health, Ron worked, consulted
and published extensively on health promotion, empowerment and
health, and community development. His current research interests
include globalization as a ‘determinant of determinants’ (he
chaired the Globalization Knowledge Network for the WHO Commission on Social Determinants of Health); ethics, human rights and
global health development; global migration of health workers;
revitalization of comprehensive primary health care; and globalization and the health of Canadians.
He has over 150 scientific publications and several hundred articles
in popular media. His recent books include Critical Public Health: A
Reader (co-edited with Judith Greene, Routledge. 2007); Health
Promotion: From Community Empowerment to Global Justice (coauthored with Glenn Laverack, Palgrave Macmillan. 2007); Health
for Some: Death, Disease and Disparity in a Globalizing Era (coauthored with Ted Schrecker and Amit Sen Gupta, Centre for Social
Justice, 2005); Fatal Indifference: The G8, Africa and Global Health
(co-authored with Ted Schrecker, David Sanders and Wilma Meeus, University of Cape Town Press/IDRC Books,
2004) and Dying For Trade: How Globalization Can Be Bad for Our Health (Centre for Social Justice. 2003).
C L O S I N G P L E N A RY A D D R E S S
“ N EW D IRECTIONS? O R O LD D IRECTIONS
WITH A NEW
C O M PA S S ? ”
1:00 - 2:00 P.M.
PAGE 15
Convention and Meeting Room Facilities
Ramada Hotel & Convention Centre—Regina
B
A
C
PAGE 17
Conference Program
Wednesday, November 12th
6:00 p.m.
REGISTRATION (Canadian Ballroom Lobby)
6:30 p.m.
WELCOMING RECEPTION (Canadian Ballroom)
7:15 p.m.
Conference Opening
Nazeem Muhajarine, CPHR and SPHERU
Welcome from the University of Saskatchewan
Dr. Beth Horsburgh, Associate Vice-President
Research (Health)
Welcome from University of Regina
Dr. Vianne Timmons, President &
Vice-Chancellor
KEYNOTE SPEAKER (Canadian Ballroom)
Putting some POP! In Population Health
Andre Picard, The Globe and Mail
Health Reporter
Thursday, November 13th
8:00 a.m.
BREAKFAST (Canadian Ballroom)
REGISTRATION (Canadian Ballroom Lobby)
8:30 a.m.
9:15 a.m.
OPENING PLENARY ADDRESS (Canadian Ballroom)
Introduction of Plenary Speaker
Tom McIntosh, SPHERU
The Politics of Population Health
Carolyn Bennett, Member of
SESSION 1 (Concurrent Panels)
PANEL 1A (Canadian South)
Theoretical Approaches to Population Health Research
Chair: Bonnie Jeffery, SPHERU
Essential Value(s) of Health: Implications for Population
Health Research
J. David Guerrero (University of
Calgary)
Linking Population Health Theory to the Real World of Policy
Making: Rebuilding Policy Networks and Interests.
Ron Wray (Consultant)
PANEL 1B (Batoche)
The Ethics of Doing Things Differently
Chair: Diane Martz, SPHERU
Development of a Public Health Nursing Ethics Working
Group
Kerry Hubbauer (Calgary
Health Region)
Successes of Saskatchewan Registered Nurse Activists in
Building Equity Through Practice
Sarah Liberman (University of
Saskatchewan)
PAGE 18
CPHR CONFERENCE PROGRAM
Thursday, November 13th (continued)
PANEL 1C (Conference Centre)
New Approaches to Knowledge Transfer and
Exchange
Chair: Tom McIntosh, SPHERU
Effective Strategies for Integrating ‘marginalized evidence’ into Community Health Assessment: A Case Study
from the Winnipeg Regional Health Authority
Ingrid Botting (University of
Manitoba)
A Unique Knowledge Transfer Model: The Alberta Centre
for Child, Family and Community Research
Nancy Reynolds (ACCFCR)
Aboriginal Youth Suicide and Differences in Indigenous
and Western Conceptions of Knowledge and Knowledge
Transfer
Ulrich Teucher (University of
Saskatchewan)
10:35 a.m.
BREAK (Canadian Ballroom)
10:50 a.m.
Chair: Diana Ridgeway,
Population Health Intervention Research: What works, Canadian Population health Iniin which contexts and under what circumstances?
tiative
KidsFirst Evaluation in Saskatchewan: A Report of Progress
Nazeem Muhajarine (University of
Saskatchewan) & Gail Russell
(Saskatchewan Ministry of
Education)
Annapolis Valley Health Promoting Schools Program—
Building Meaningful Research Partnerships
Ismay Bligh (Annapolis Valley
Health)
Illuminating the Black Box: Issues of Measurement and
Implementation in School Health Interventions
Marg Schwartz (University of
Alberta)
PANEL 2B (Batoche)
Programs and Perspectives on Health of Young
Canadians
Chair: Mary Hampton, SPHERU
Horse as Healer: An Examination of Equine Assisted Learning (EAL) in the Healing of First Nations Youth from Solvent
Abuse
Darlene Chalmers (University of
Regina)
“Getting My Hope Back”
Victoria Walton (Adult Community
Mental Health and Addictions,
Saskatoon Health Region)
“Well, like, If you lived in a cardboard box, you might not
be that healthy”: Youth’s Perspectives on the Determinants of Health
Jennifer Leach (University of
Manitoba)
PAGE 19
Globalization and Health: Local and International Per-
Chair: Ron Labonte, University of
Ottawa
Child Health in An Era of Globalization: A Case Study of
Saskatoon, Saskatchewan
Jennifer Cushon (University of
Saskatchewan)
Building Sustainable Capacity? Nicaraguan Experiences
with the Global Fund
Katrina Plamondon (University of
Saskatchewan)
Understanding the Role of Sport for Development Project in Ryan Wright (University of
Fostering Community Capacity Building Within a Refugee
Saskatchewan)
12:15 p.m.
LUNCH (Canadian Ballroom)
1:15 p.m.
Prairie Perspectives on Women’s Health: Prairie
Women’s Health Centre of Excellence
Chair: Diane Martz, SPHERU
Rural Saskatchewan Women and Their Communities
Joanne Havelock (PWHCE)
More Than Just Numbers: The Manitoba Women’s Health
Profile
Margaret Haworth-Brockman
(PWHCE)
The Impact of Relative Homelessness on the Mental, Physical and Emotional Health of Aboriginal Mothers
Brigette Krieg (PWHCE)
PANEL 3B (Batoche)
Chair: Sylvia Abonyi, SPHERU
Population Health Promotion and Prevention: A Model
Approach to Research and Program Development of
Angela Bowen (University of
Saskatchewan)
Choice and Regulation: A Qualitative Study of the
Janelle Hippe (University of Regina)
Importance of Social Difference to Women’s Experiences of
Does Aboriginal Identity Make a Difference? Single Mothers Randy Johner (University of Regina)
2:35 p.m.
Policy and Program Perspectives on Children’s Health
Chair: Nazeem Muhajarine,
SPHERU
Immunization Coverage Rates Among 2 Year Olds in the
Regina Qu’Appelle Health Region, 2007
Tania Diener (Regina Qu’Appelle
Health Region)
What Can Population-level Child Development Data Tell us
About Public Policy for Families with Children?
Paul Kershaw (University of British
Columbia)
PAGE 20
2:55 p.m.
4:15 p.m.
6:30 p.m.
(Re)Building Institutions for Population Health
Chair: Murray Knuttila, University of
Regina
“Bridging the Gap” - KSTE and Early Childhood Care
Hope Beanlands (National
Collaborating Centre for Determinants
of Health)
Societe santé en francais, a network of networks:
Lessons learnt in the past 5 years
Anne Leis (University of
Saskatchewan)
The Creation of the National Aboriginal Health Organization (NAHO) in Canada
Paulette Tremblay (National
Aboriginal Health Organization)
PANEL 4B (Batcohe)
Social Support as a Determinant of Health
Chair: Shanthi Johnson, SPHERU
Sport Gave Me Something to Wake Up For: Aboriginal
Adults with Disabilities Speak about Sport
Melanie Elliott (Saskatchewan Ministry
of Education
Playing for Keeps: Exploring the Sociocultural Health of
Aboriginal Youth Through Drama
Warren Linds (Concordia University)
Dragon Boat Racing as an Alternative Type of
Post-Treatment Support for Women Living with Breast
Cancer
Rhona Shaw (University of
Saskatchewan
Confronting Poverty
Chair: Nazeem Muhajarine, SPHERU
Reducing Gaps in Health: A Focus on Socio-Economic
Status in Urban Canada
Jason Disano (Canadian Population
Health Initiative)
How Healthy are Poor Working-Age Canadians?
Myriam Fortin (Human Resources and
Social Development Canada)
A Deprivation Index for Health in Canada
Robert Pampalon (Institut National de
Santé Publique du Quebec)
SESSION 5 Poster Presentations (Conference Centre)
Research Posters will be on display with the researchers available to discuss their content
and their implications. A list of poster presenters and titles is found at the end of the conference
program.
CONFERENCE DINNER (Canadian Ballroom)
PAGE 21
Friday, November 14th
8:00 a.m.
BREAKFAST (Canadian Ballroom)
PLENARY PANEL DISCUSSION: Linking Theory, Ethics, and
Practice (Canadian Ballroom)
Introductions and Chair:
Bonnie Jeffery, SPHERU
A facilitated panel discussion reflecting on the link between
ethics, theory and practice from the perspective of different
researchers
TBA
Carrie Bourassa (First Nations
University of Canada)
Ethical Space: The space between entities that is so critical
to understand as being influential in relationships
Willie Ermine (Indigenous Peoples’
Health Research Centre)
Speaking research to power when policy trumps science
and politics trumps policy
Janice Graham (Dalhousie
University)
Adventures in Minding the Know-Do Gap - Some Ethical
Dilemmas in Resource-Challenged Environments
Renée Lyons (Dalhousie University)
10:15 a.m.
10:35 a.m.
Income and Inequality: The Effect on Population Health
Chair: Nazmi Sari, SPHERU
Public Pensions and the Mortality of Seniors in Canada:
Herb Emery (University of Calgary)
Comparing Means-tested and Universal Eligibility, 1921-1970
Variable Influence of Income on Disease
Evan Morris (University of Regina)
Income Inequality and Health: A Theoretical Quagmire
Nadine Nowatzki (University of
Manitoba)
PANEL 6B (Batoche)
Chair: Tom McIntosh, SPHERU
Research, Policy and Program Innovation for Population
Health in Ontario: Two Case Studies
Don Embuldeniya (Ontario Ministry
of Health and Long-Term Care)
The Shifting Discourse of “Public Participation”: Implications
in Changing Models of Health System Regionalization
Kelly Chessie (University of
Saskatchewan)
An Activist Community is a Healthy Community? Exploring
Social and Political Determinants of Health
Gloria DeSantis (University of
Regina)
PAGE 22
Friday, November 14th (continued)
Moving In From The Margins
Chair: Wendee Kubik, University
of Regina
Migration, Health and Development: Exploring Policy
Coherence Between Canadian Immigration and
Development Policy in light of Increasing Temporary
Sophia Lowe (World Education
Services)
Imagining Peer Involvement: A Picture of Peer Involvement
in Health Research and Programs in Manitoba
Paula Migliardi (Nine Circles
Community Health Centre)
Comparing Health and Health Care Utilization Patterns
Shahin Shooshtari (Manitoba
between Persons With and Without Developmental
Centre for Health Policy)
Disabilities in Manitoba: Implications for Planning, Policy and
Service Provision
12:00 p.m.
LUNCH (Canadian Ballroom)
1:00 p.m.
Closing Plenary Address (Canadian Ballroom)
Introduction of Plenary Speaker
Nazeem Muharjarine, CPHR and
SPHERU
New Directions? Or Old Directions with a New Compass? Ron Labonte, University of
2:00 p.m.
END OF CONFERNCE
PAGE 23
Poster Presentations
APPENDIX I: Poster Presentations, Session 5
(Thursday, November 13th, 4:15 p.m., Location: Conference Centre)
Presenter
Poster Title
Beliz Acan (University of
Saskatchewan)
Does our Body Weight Indicate Weight of our Wallet too?
Connie Berry (Public Health
Agency of Canada)
Tackling Health Disparities: The Many Roles of the Voluntary Sector
Carla Bolen (Regina
Qu’Appelle Health Region)
Taking Action on the Social Determinants of Health
Jody Burnett (University of
Regina)
Understanding the Aboriginal Family Members’ Experiences of Problem Gambling
using a Population Health Perspective
Koren Fisher (University of
Saskatchewan)
Physical Inactivity and Health Services Utilization Among Older Adults in Canada
Paul Hackett (University of
Saskatchewan)
The Emergence of Type II Diabetes Mellitus Among the First Nations of Northern
Manitoba: Historical Context
Carli Haffner (Saskatchewan
Prevention Institute)
Saskatchewan Community Action Program for Children: Reaching Vulnerable
Populations
Hang Lai (University of
Saskatchewan)
A Longitudinal Analysis of Physical Activity and Overweight/Obesity in Adolescents
in Saskatoon
Dianne McCormack
(University of New Brunswick)
Program Innovations Meet Diverse Needs of Clients Living in Low Socioeconomic
Situations
Jenny Okroj (Self-employed)
Exploring Issues of Work/Life Balance in Healthcare Employees in Canada
Meric Osman (University of
Saskatchewan)
When to Drink? Effects of Alcohol Consumption on Wages
Allisson Quine (University of
Regina)
Intercultural Anxiety and Cultural Self-efficacy Among Saskatchewan Nursing
Students
Drona Rasali (Saskatchewan
Ministry of Health)
Prevalence Rates and Risk Factors of Fall Injuries in Saskatchewan Seniors
(65+ Years)
Lauren Sherar (University of
Saskatchewan)
Understanding the Decline in Physical Activity of Adolescent Girls
Kelly Wiens (SEARCH
Canada)
A Social Ecology Framework for Annual Influenza Vaccinations in Health Care
Workers
PAGE 25
Podium and Poster Abstracts
Poster Presentation
(alphabetical listing)
Podium Presentation
Does Our Body Weight Indicate Weight of Our Wallet too?
Beliz Acan
Department of Economics , University of Saskatchewan
E-mail: Acan.Beliz@gmail.com
The rapid increase of obesity rate and its adverse effects on individuals' health is a growing concern in Canada. In
addition to increased morbidity, obese people also face with poor labor market outcomes. This paper examines the
effects of obesity on wages using the Canadian Community Health Survey. The paper uses multivariate regression
analysis. Neighborhood based indicators for obesity is used as an instrument to eliminate the endogeneity bias due to
reverse causality between wages and obesity. The results from this study are similar to the findings of previous literature.
The effects of obesity on wages are not significant for men; however obesity decreases the wages for women.
Thursday, November 13th, 2008, Session 5, 4:15 p.m.
"Bridging the Gap" - KSTE & Early Childhood Care
Hope Beanlands, MN, MPA, PhD (c), RN, Scientific Director
National Collaborating Centre for Determinants of Health
E-mail: pgirvan@stfx.ca
Co-Authors and Affiliation: Layden, Faith, MA, Project Manager, NCCDH; MacLeod, Anna, PhD (c), Project Manager,
NCCDH; Poirier, Lesley, MA, Managing Director, NCCDH; Weir, Karen, Project Manager, NCCDH
Six National Collaborating Centres (NCC) for Public Health have been established in host agencies across the country:
aboriginal health (University of Northern BC, British Columbia), determinants of health (St. Francis Xavier University, Nova
Scotia), environmental health (BCCDC, British Columbia), health public policy (INSPQ, Quebec), infectious disease (ICID,
Manitoba), and methods and tools (McMaster University, Ontario).
The mandate of the National Collaborating Centre for Determinants of Health (NCCDH) is to focus on the social and
economic factors that influence the health of Canadians.
To bridge the gap between research producers and users, the NCCDH promotes Knowledge, Synthesis, Translation and
Exchange (KSTE) activities among public health practitioners, policy-makers, and researchers. The NCCDH defines knowledge translation as "the exchange, synthesis and ethically sound application of research findings within a complex system of relationships among researchers and knowledge users as part of a large process to incorporate research knowledge into policies and practice to improve the health of the population" (Kiefer, 2005).
The NCCDH views KSTE as an active process emphasizing the importance of building relationships and collaboration
among research producers and users in encouraging and supporting evidence-based public health practice.
This presentation will:
1)
Situate the social determinants of health as prime factors in population health using a health equity lens focus on
public health programs on parenting and childcare, pre & post-natal care, food insecurity, women and gender
equity, and family-friendly workplaces; and
2)
Discuss the KSTE successes and challenges in bridging the gap between public health researchers and practitioners, the lessons learned and the challenges for the future in regards to disseminating best practices in early childhood care & women's health interventions. KSTE is an emerging science, and, with the Canadian government's
recent moves towards a population health approach, evidence-based public health strategies will illuminate the
best methods to advance this approach.
Thursday, November 13th, 2008 Session 4, Panel 4A 2:50 p.m.
PAGE 26
Abstracts continued...
Tackling Health Disparities - the Many Roles of the Voluntary Sector
Connie Berry
Office of the Voluntary Sector, Public Health Agency of Canada
E-mail: connie_berry@phac-aspc.gc.ca
Co-Authors and Affiliation: Sherri Torjman, Caledon Institute of Social Policy Susan McCunn/Connie Berry, Office of the
Voluntary Sector, Public Health Agency of Canada with thanks to Kerry Robinson and the Knowledge Exchange Component of the Canadian Best Practices Initiative, Public Health Agency of Canada
In Canada, there are over 160,000 non-profit and community-based voluntary organizations working in a wide range of
areas, including health-related services. While the voluntary sector’s role in hands-on service delivery is well-recognized,
its varied roles and expertise in knowledge transfer and exchange to move research into program and policy action are
not.
The poster will examine the lesser-known roles that voluntary sector organizations play in advancing work in public
health, specifically in relation to knowledge transfer and exchange. Such roles include collecting and analyzing data,
strategically convening intersectoral stakeholder groups for developing comprehensive local interventions, and monitoring progress towards addressing public health disparities and influencing the determinants of health, such as poverty
reduction and social inclusion. Concrete examples are provided- e.g. Canadian Council on Social Development Poverty by Postal Code report, United Way convening roles, the Vibrant Communities initiative and the Vital Signs project
led by the Community Foundations of Canada.
The voluntary sector examples will be portrayed in relation to the new Knowledge Cycle Framework prepared by the
Knowledge Exchange Component of the Canadian Best Practices Initiative to demonstrate how the voluntary sector
contributes to all phases of the knowledge cycle. This approach is innovative in the way it highlights and illustrates the
connections among the researchers, policy makers, and practitioners with relevant and current examples of intersectoral knowledge transfer in action. Policy challenges arising from the analysis will identify opportunities for improvement
and further work from both knowledge and practice perspectives.
The Canadian Reference Group to the WHO Commission on the Social Determinants of Health has identified the engagement of Canadian civil society as vital to tackling health inequalities through action on the social determinants of
health. This poster will contribute to a better understanding of the depth and breadth of the voluntary sector’s contributions in that regard.
Annapolis Valley Health Promoting Schools Program - Building Meaningful Research Partnerships
Ismay Bligh
Annapolis Valley Health
E-mail: ibligh@avdha.nshealth.ca
The majority of population health research conducted to date has focused on describing population health issues. There
is less information addressing practical program implementation and evaluation that could provide relevant outcome
information to policy- and decision-makers. Informal consultations by CPHI with key informants has revealed a need for
more practical information on ‘what works and does not work’ and in which contexts and under what circumstances in
regard to program and policy intervention research at a population health level.
As part of a pilot project in intervention research, CPHI is currently funding three intervention research projects that examine evaluations of population health programs and/or policy interventions. CPHI’s overarching objectives for this pilot
program are to obtain rigorous health outcome evaluation(s) on an existing population health programs and/or policy
PAGE 27
interventions; contribute to our understanding of ‘what works and does not work’ in terms of population health program
and policy intervention(s); and, contribute to the transfer and uptake of new population health intervention knowledge
by the policy and practice community.
This multidisciplinary panel presentation will examine the current status of intervention research in Canada. Panelists will
discuss intervention research initiatives, program evaluation, and strategies to promote meaningful collaboration and
on-going partnerships. Panelists will also explore the ways in which new and existing intervention research may be translated into timely and actionable messages for policy- and decision-makers.
Thursday, November 13th, 2008 Session 2, Panel 2A 10:50 a.m.
Taking Action on the Social Determinants of Health
Carla Bolen
Population Health Promotion Coordinator, Mental Health & Addiction Services
E-mail: carla.bolen@rqhealth.ca
Co-Authors and Affiliation: Doug Ramsay (Population Health Promotion Coordinator, Mental health & Addiction Services) and Regina Regional Intersectoral Committee
Imagine living in a community that has achieved a balance of economic vitality, environmental integrity, excellent personal health, cultural vibrancy, social well-being and belonging. Picture being a part of a community that embraces
people of all ages, racial and ethnic groups, cultures, religions, genders, socioeconomic status, abilities and lifestyles.
Consider a community that works together to respond to those in need for the betterment of the community as a whole.
Communities around the globe are imagining themselves in these terms. In Regina for example, the Mayor’s Task Force
is developing a 100 Year Sustainability Plan and is looking to the Regina Regional Intersectoral Committee (RIC) for leadership in the development and implementation of the “social” quadrant of this grand plan. The kind of work that goes
into the evolution of the healthy community described above is complex and cannot be achieved by any one sector in
isolation. These kinds of results are more than just a sum total of multi-sectoral efforts. Healthy communities are the result
of fully integrated, high level efforts, cooperatively conceived and implemented, tied together by a joint accountability
that both links and transcends individual sector mandates. This is what is meant by working on the determinants of
health.
This poster presentation will highlight the framework for taking collaborative action on the social determinants of health
that was developed by the Regina Qu’Appelle Health Region for the Regina Regional Sectoral Committee (RIC). The
three pillars of action described on the poster include: Raising Consciousness; Using a Common Lens; and, Measuring
Progress. The poster articulates a shift from the traditional list of determinants to a reconfigured list of social determinants
of health (SDOH), which was the outcome of the SDOH National Conference in 2004.
Effective strategies for integrating “marginalized evidence” into Community Health Assessment: A Case Study from the
Winnipeg Regional Health Authority
Ingrid Botting, PhD (Researcher, Research and Evaluation Unit, Winnipeg Regional Health Authority and Assistant Professor, Department of Community Health Sciences, U of M) and Sarah Bowen, PhD (Director, Research and Evaluation Unit,
WRHA and Assistant Professor, Department of Community Health Sciences, U of M)
E-mail: ibotting@wrha.mb.ca
Community Health Assessment is the process of gathering evidence to identify health issues of the population served,
examining contributing factors and determining how health needs of diverse populations are or are not being
PAGE 28
addressed. The Winnipeg Regional Health Authority has revised its Community Health Assessment (CHA) process in order
to promote an emphasis on identifying and addressing health disparities, and active and appropriate use of CHA evidence by decision makers and community groups. Carrying-out this mandate is a challenge in a large and complex
health services organization.
This presentation focuses on the knowledge translation strategies developed to make this process relevant to the organization, promote partnerships, develop organizational and community capacity, and integrate evidence relevant
to underserved populations into CHA processes. A case study of how knowledge translation strategies were used to
shape the CHA redesign, build capacity, and incorporate the experiential evidence of both staff and communities will
be presented.
CHA activity areas were developed to reflect various definitions of community, allowing a focus on both geographic
and communities of identity, interest, and experience. Each of these was then developed to ensure integration of evidence into CHA to promote appropriate use of and action on this evidence. Principles of community based participatory research and knowledge translation guided the planning. Strategies include promoting stakeholder engagement
in CHA activities, partnership development, and linking to existing activities; building capacity within the organization
and communities (clarifying the purpose of CHA, promoting a more complex understanding of “community”, and increasing ability to interpret indicator data.); use of qualitative and quantitative data on issues of health disparities and
inclusion of marginalized evidence; and integration of experiential knowledge.
Knowledge translation strategies have rarely been developed to redesign CHA activities, or to promote greater awareness of issues of concern to underserved populations. This project also illustrates how CBPR principles can be demonstrated within a large and complex health services organization.
Thursday, November 13th, 2008 Session 1, Panel 1C 9:15 a.m.
Population health promotion and prevention: A model approach to research and program development for vulnerable
pregnant women.
Angela Bowen, RN PhD
Community and Population Health Research Strategic Training Fellow
College of Nursing, University of Saskatchewan
E-mail: angela.bowen@usask.ca
Co-Authors and Affiliation: Marilyn Baetz, MD Department of Psychiatry, University of Saskatchewan Nazeem Muhajarine, PhD Department of Community Health and Epidemiology, University of Saskatchewan
Depression exacts a huge emotional and physical burden on women and their growing families, with unborn and newborn children at a high vulnerability for lifelong problems as a result. Prenatal care usually follows a traditional biomedical model that focuses only on the physical well-being of the mother and fetus. However, women’s lives are more complex.
This paper discusses a model which guided a study of depression in socially high-risk pregnant women. It incorporates
two theoretical perspectives, the three levels of prevention and the population health approach, into a framework for
data collection, interpretation of findings, and program and policy development.
The model recognizes that there are determinants of health that work together at multiple levels. Some of these are at
the individual level while others are at the community, family, and societal levels. For example, a single mother of three
young children living in an inner-city neighbourhood. She may be experiencing high levels of stress, which may trigger
anxiety and depression that put her at risk for less than optimal pregnancy outcomes.
PAGE 29
The prevention perspective of the model has led to development of a maternal mental health program within a primary health care setting. The program provides primary prevention through public and professional education as well
as individual and group clinical care at the secondary and tertiary levels. The population health approach has increased awareness about the prevalence and determinants associated with antenatal depression in women in our
community.
In addition to many knowledge translation activities, the model has also informed public policy and stimulated the addition of depression screening to the provincial prenatal assessment form. The principles of prevention and population
health continue to be a guide for our research and practice activities to improve the health status of vulnerable pregnant women, their unborn children, and families.
Thursday, November 13th, 2008 Session 3, Panel 3B 1:15 p.m.
Understanding the Aboriginal family members' experiences of problem gambling using a population health perspective
Jody Burnett
Email: jjburnett@sasktel.net
Problem gambling within Aboriginal families and communities has the potential to generate significant consequences
that extend far beyond the individual problem gambler. As the incidence of gambling increases across Aboriginal
populations, it is important to gain a better understanding of the family experience as it relates to problem gambling in
the search for more effective supports and interventions. This study investigated the experiences of family members of
First Nation and Métis persons who are problem gamblers in order to gain a better understanding of what life is like being related to a problem gambler. A population health perspective was useful in exploring both macro and micro level
determinants of health as well as the interrelated conditions unique to and more readily experienced by Aboriginal
people.
Qualitative inquiry through semi-structured interviews was conducted to look at the impact of a problem gambler’s
behaviour upon Aboriginal family members. Four participants, all female and of Aboriginal ancestry, were interviewed
and 5 themes emerged: Emotional Disharmony, Disharmony of Intimacy and Feelings, Community Disharmony, Spiritual
Disharmony, and Disharmony in the ‘Healing Circle’. Economic, social, and psychological implications are discussed as
well as the quality of life experienced.
Horse as Healer: An Examination of Equine Assisted Learning (EAL) in the Healing of First Nations Youth from Solvent
Abuse
Darlene Chalmers
Faculty of Social Work, University of Regina
Email: darlene.chalmers@uregina.ca
Co-Authors and Affiliations: Darlene Chalmers (Faculty of Social Work, University of Regina), Colleen Anne Dell
(Research Chair in Substance Abuse, Department of Sociology, University of Saskatchewan), Ernie Sauve (Executive
Director, White Buffalo Youth Inhalant Treatment Centre, Sturgeon Lake First Nation)
Canada is an international leader in providing residential treatment to First nations youth who abuse solvents. The treatment centres are linked through the national Youth Solvent Addiction Committee (YSAC) network, which provides their
theoretical direction. This presentation will outline YSAC’s culture-based model of resiliency; YSAC has expanded the
Western concept of resiliency, which focuses on the individual, to include both the individual and community. YSAC’s
application of a culture-based model of resiliency is illustrated through one of its Saskatchewan treatment centres—
White Buffalo Youth Inhalant Treatment Centre—offering of Equine Assisted Learning 9EAL), an approach aimed at
PAGE 30
increasing life skills through a horse-focused curriculum. Using an exploratory, community-based method to understanding, YSAC’s resiliency model is discussed from the intersecting perspectives of White Buffalo’s program, Elders’ stories,
and the literature. We will also highlight through the EAL example how YSAC’s culture-based model of resiliency and a
Western health promotion approach are complementary. There is potentially much to be learned from YSAC’s holistic
approach to treatment and healing for both First nations and Western health promotion responses to substance abuse.
We will conclude the presentation with capacity development and research suggestions as next steps.
Thursday, November 13th, 2008 Session 2, Panel 2B 10:50 a.m.
The Shifting Discourse of “Public Participation”: Implications in Changing Models of Health System Regionalization
Kelly Chessie
University of Sasaktchewan
E-mail: kchessie@sasktel.net
In the 1980s, in response (at least in part) to the recommendations of various commissions and system reviews, many
provinces announced health system regionalization policies to support inter alia expanded roles for publics and communities in health system governance. Rooted in part in population health logics (e.g., the Ottawa Charter and the
Lalonde Report), regionalization devolved powers from provincial ministries to newly created, sub-provincial authorities,
overseen by community boards.
Within a decade, a second and smaller wave of reform swept across Canada, and while most governments remained
committed to regionalization, their regionalization policies underwent significant adjustments, including shifts in the ways
“publics” and “communities” were theorized and inserted into the governance model.
As part of larger project, I am completing a discourse analysis of key publications that document part of the logic behind regionalization and public participation in Saskatchewan. When comparing within and between documents, interesting tensions, shifts and contradictions are revealed. The documents contain overt and subtle shifts in the positioning
of “publics” and the discourse of “community engagement” and “public participation.” I argue that these shifts are
significant and carry with them social and political implications that merit attention.
Saskatchewan continues to scrutinize its health system and the role of regional health are but one focus. Surprisingly, we
have spent little time analyzing how we theorize “publics” and “communities” in this model. Attention to these shifting
discourses can help us understand how the logic of population health as an argument for regionalization and public
participation has lost ground to discourses that resonate more with the individual and the consumer.
Friday, November 14th, 2008 Session 6, Panel 6B 10:35 a.m.
Child Health in an Era of Globalization: A Case Study of Saskatoon, Saskatchewan
Jennifer Cushon
Department of Community Health and Epidemiology, University of Saskatchewan
Email: jennifer.cushon@usask.ca
My presentation will focus on my doctoral dissertation entitled, ‘Child Health in an Era of Globalization: A Case Study of
Saskatoon, Saskatchewan’. The objectives of this dissertation are:
♦
to investigate the political and economic pathways by which globalization impacts the determinants of health
and health outcomes in Saskatoon, Saskatchewan, with special reference to children; and
PAGE 31
♦
to determine the Canadian, Saskatchewan and municipal policy responses to two primary determinants of child
health, poverty and income inequality, which are often exacerbated by the processes of globalization.
The analytical framework guiding this study was developed by Labonte and Torgerson (2005), and the theoretical
framework being employed is progressive political economy. The overall design for this dissertation is a case study, emphasizing a mixed methods approach and triangulation of data sources. The qualitative and quantitative research
methods selected for this study include: a demographic profile for the City of Saskatoon; an environmental scan of federal, provincial and municipal policy documents that have direct relevance for child health; process tracing; and semistructured interviews.
At this juncture, final results have not been ascertained from the methods selected. However, at the time of the conference, results will be available and highlighted in my presentation.
While the health-related impacts of globalization have been extensively explored theoretically and conceptually, there
are only a limited number of studies that have sought to link the macro-level processes of globalization to health impacts at the local level in a specific context and/or for a particular population such as children. This research will fill a
gap in the literature, therefore, linking an empirical study of the impact of globalization on health with established theory and concepts. Moreover, this case study has the potential to inform policy.
An activist community is a healthy community? Exploring social and political determinants of health
Gloria DeSantis
Email: gdesantis@sasktel.net
There appears to be little data on the social policy advocacy role of the voluntary social service sector in Canada, yet
this sector has been engaged in advocacy work with marginalized communities for decades. Research on this topic is
timely in light of the current restructuring of the Canadian welfare state, recent citizen engagement movements, the
growing awareness that social welfare policies impact people’s health, little empirical data on the advocacy role of
the voluntary social service sector, concerns about growing health inequities and a struggle for a social justice response, and finally, the interest in creating inclusive and health cities. Voluntary agencies are vehicles to facilitate marginalized approaches. The main research question was, “How do voluntary organizations in Saskatchewan understand
and incorporate marginalized people’s participation into public policy advocacy processes and what are the perceived barriers, opportunities and impacts using a health/well-being lens?” This paper is based on qualitative data collected through telephone interviews with 39 voluntary social services agencies from 18 communities throughout Saskatchewan; a critical inquiry methodology was implemented. Results revealed a number of different types of advocacy processes, advocacy strategies, and a variety of social policy topics covered (e.g., food security, government
income assistance, re-integration of offenders, community mental health and violence against women). Results also
reveal that an “advocacy chill” does indeed exist today and this has important implications for the silencing of marginalized communities—those who generally already have worse health status than the larger population.
Friday, November 14th, 2008 Session 6, Panel 6B 10:35 a.m..
Immunization Coverage Rates Among 2 Year Olds in the Regina Qu'Appelle Health Region, 2007
Tania Diener
Regina Qu'Appelle Health Region
E-mail: tania.diener@rqhealth.ca
Co-Authors and Affiliation: Zahid Abbas, Maroag Granger
PAGE 32
Background
The objective of this study was to determine immunization coverage rates among children born in 2005 and registered
in Saskatchewan Immunization Management Program (SIMS).
Methods
We accessed web-based Saskatchewan Immunization Management System (SIMS) in January 2008 to determine coverage rates of early childhood immunizations in 2005 birth cohort. Our objective was to determine the immunization
coverage rates among children born in 2005 and registered in SIMS. Our assessment focused on immunizations children
should have by 24 months of age, specifically 4 doses of Diphtheria, Tetanus and accelluar Pertussis (DTaP) and 2 doses
of Measles, Mumps and Rubella (MMR). Antigen-specific completion rates for children 2 years of age were determined
by Regina city neighbourhood and rural communities.
Results
The results determined that the 2005 birth cohort had a 67.7% coverage rate for DTaP series and 66.9% for MMR at the
age of 24 months. There were pockets of under-immunized children in both Regina city and rural areas of the health
region. The immunization coverage rates differ considerably by city neighborhoods as well as within rural communities.
The assessment of the cohort of children born in 2005 also showed that 88.2% completed 3 DTaP, however, the 4th dose
of DTaP is keeping the immunization coverage low.
Conclusions:
Under coverage of immunization exist among children in the city of Regina. Targeted efforts are needed to increase
immunization rates and to decrease the disparity in immunization coverage in neighborhoods where rates are low. The
analysis has identified pockets of need and we are looking at different strategies to increase immunization levels in the
health region in general and in neighbourhood/communities with low immunization coverage in particular. PPHS is
working to develop web based tools to generate reminders and to provide information on childhood immunization and
health care service for children.
Thursday, November 13th, 2008 Session 3, Panel 3C 1:15 p.m.
Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada
Jason Disano
Canadian Population Health Initiative, Canadian Institute for Health Information
E-mail: jdisano@cihi.ca
Co-Authors and Affiliation: Julie Goulet - Canadian Population Health Initiative, Canadian Institute for Health Information Marc Turcotte - Canadian Population Health Initiative, Canadian Institute for Health Information
Background: Research has shown that significant gaps exist in the economic well-being and overall health of Canadians. These gaps are particularly observable in Canada’s urban population, where gaps in health as a result of unequal
socio-economic status (SES) can be analyzed at the neighbourhood or dissemination area (Statistics Canada) level.
Focus: To provide a broad overview of the links between SES and health in urban Canada by examining how health, as
measured by a variety of health indicators, varies in small geographical urban areas with different socio-economic
characteristics.
Methods: Using the Deprivation Index for health in Canada, age-standardized hospitalization rates (extracted from
CIHI’s Discharge Abstract Database and National Trauma Registry) for 12 acute and chronic conditions as well as rates
of low birth weight babies were examined. Urban dissemination areas were classified into one of three SES groups: low,
average and high SES using the Deprivation Index. Age-standardized hospitalization rates were calculated within each
of those three SES groups and analyzed for statistical differences across urban Canada.
Findings: Among all health indicators examined, there was a significant gradient across the three SES groups, with variations in the steepness of the gradient by indicator examined. Supporting previous research that has studied the links
PAGE 33
between SES and health at different levels of geography, the analyses demonstrated consistent links between SES and
health in urban Canada. In general, the analyses demonstrated that locations characterized by lower SES were more
likely to be hospitalized than locations with an average or high SES.
Innovation: SES is measured using indicators that take into account both material and social factors, and the data were
analyzed at a very detailed level of geography that will allow for comparisons across regions. These data are part of a
larger report to be released by CPHI in November 2008
Sport Gave Me Something to Wake Up For: Aboriginal Adults with Disabilities Speak about Sport
Melanie Elliot
Saskatchewan Ministry of Education
E-mail: melliott@sasked.gov.sk.ca
Co-Authors and Affiliations: Donna Goodwin, University of Alberta
This exploratory and descriptive study described the experiences of disability from the perspective of Aboriginal adults
and the meaning they give to the importance of sport in their communities. The experiences of 3 Aboriginal adults with
physical disabilities were captured using the phenomenological methods of one-on-one interviews, artifact collection,
and field notes. The co-participants were provided the opportunity for collaboration at each research stage, from clarifying the purpose to finalizing and interpreting the emerging themes, in an effort to demonstrate sensitivity and respect
for their Aboriginal culture, beliefs, and community. The thematic analysis and interpretation of the findings facilitated
by the co-participants revealed 4 themes: (a) we have to get out first, (b) not being a priority, (c) pride through accomplishments, and (d) the gift to grab others. The co-participants reflected the need to educate and build awareness of
sport opportunities for other Aboriginal people with disabilities. The co-participants also expressed the need to encourage and support people with disabilities to get out of their homes and become active, visible members of society.
Research, Policy and Program Innovation for Population Health in Ontario: Two Case Studies
Don Embuldeniya, Senior Research Advisor
Ontario Ministry of Health and Long-Term Care
E-mail: don.embuldeniya@ontario.ca
Co-Authors and Affiliations: Sarah Caldwell, Senior Research Advisor, Ontario Ministry of Health and Long-Term Care
Gaps and disparities in the health of specific (sub)populations can be, at least partially, attributed to the social determinants of health. In order to explore these gaps, health services and systems researchers funded by the Ontario Ministry
of Health and Long-Term Care are examining the potential impacts of health determinants both on their own and in
combination. This research is leading to an improved understand of how health is impacted by factors beyond those
generally considered in the development of health policy, and is also helping to identify gaps in service delivery, access, etc. as a result of highly complex interactions.
With an increased focus on using research and evidence to inform policy, the Ontario Ministry of Health and Long-Term
Care is looking to address population-based health issues by broadening the approach and definition of research in
(sub)populations. A focus on building bridges between population health researchers and policy and decision-makers
within government, and working collaboratively across disciplines is yielding promising new practices and improved
health outcomes.
Using two case studies from Ontario, this paper will:
1.
propose a ‘population health approach’ that accounts for social, economic and environmental factors in the
determination of health status;
PAGE 34
2.
3.
4.
demonstrate how Ontario is “actioning” its commitment to improving the health of (sub)population through collaborations between researchers, community-based organizations, and policy-makers;
examine how upstream investments may or may not influence the determinants of health in various (sub)
populations; and,
explore how knowledge transfer and exchange enhances policy-makers’ ability to integrate population health
research into developing effective policy solutions and strategies to address population-based health disparities.
Friday, November 14th, 2008 Session 6, Panel 6B 10:35 a.m.
Public Pensions and the Mortality of Seniors in Canada: Comparing Means-Tested and Universal Eligibility, 1921 – 1970
Herb Emery
Dept. of Economics, Dept. of Community Health Sciences, University of Calgary
E-mail: hemery@ucalgary.ca
Co-Authors and Affiliations: Jesse Matheson, Dept. of Economics, University of Calgary
We investigate the impact of three public pension programs on the mortality rates of recipient age groups in Canada.
The Old Age Pension (OAP) introduced in 1927 for Canadians over age 70, and Old Age Assistance (OAA), implemented in 1952 for Canadians aged 65-69, were means-tested programs while Old Age Security (OAS), introduced in
1952 for Canadians over age 70, was a universal plan. Our data consist of age-specific mortality rates and pension information by province, over the period 1921–1970. Our focus on mortality follows that of a number of studies that estimate
the impact of income transfer schemes on mortality to infer the impact of income on health and well-being. As the
causal relationship between income and health is difficult to identify, Canadian pension plans offer a rare “quasiexperimental” situation for identifying the health effects of income transfers. First, while the timing of OAP introduction
varied across provinces, all provinces did participate and once they participated, eligibility requirements and nominal
benefit values were common across provinces. Second, with the introduction of the universal OAS in 1952, nominal
benefit levels were unchanged from the means tested OAP so we are observing the impact of expanding the extent of
pension benefit coverage. Finally, the means tested OAA extended the same nominal benefit as the OAP under uniform
terms of eligibility across all provinces to an age group that was ineligible for pension benefits prior to 1952. We find that
only the federal universal OAS of 1952 caused a statistically significant reduction in deaths of Canadians over age 70.
Our results imply that $18.6 million (2005 purchasing power) were spent per life extended over what would have been
spent had Canada continued with the means-tested OAP in 1953
Friday, November 14th, 2008 Session 6, Panel 6A 10:35 a.m.
Physical Inactivity and Health Services Utilization among Older Adults in Canada
Koren Fisher
College of Kinesiology, University of Saskatchewan
E-mail: kori.fisher@usask.ca
Co-Authors and Affiliation: Karen Chad, Kinesiology, University of Saskatchewan Liz Harrison, Physical Therapy, University
of Saskatchewan Bruce Reeder, Community Health and Epidemiology, University of Saskatchewan Nazmi Sari, Economic, University of Saskatchewan
At a global level, physical inactivity imposes a significant economic and societal burden. It is estimated that 2 million
premature deaths each year can be attributed to physical inactivity, including 25% of CHD cases and 15% of T2DM,
breast, colon and rectal cancer cases worldwide. The prevalence of most chronic conditions increases with age, as
does impairment and disability associated with functional decline. By 2026, 20% of Canada’s population will be aged 65
years or older. Individuals who reach this age in good health have a quarter or more of their life remaining, suggesting
that increasing physical activity levels among older adults could play a significant role in reducing health services two
activity levels (active and inactive). The distribution of independent variables between groups was compared using
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utilization. However, there is a significant lack of Canadian-based research in this area. Further understanding of the relationship between physical activity and health service utilization is necessary to support resource and funding decisions
relating to physical activity programs and interventions.
Using person-level data from the Canadian Community Health Survey Cycle 3.1 (2006), this study examines the factors
influencing the level of health services utilization of active and inactive older adults in Canada. Anderson’s framework of
health services utilization (1995) was used to identify the variables included in the analysis. The sample was stratified on
the basis of age and physical activity level into three age groups (50 – 64 years, 65 – 79 years, 80 years and older) and
chi square and ANOVA. Regression analyses were conducted to assess four outcome measures: number of consultations
with family physicians, specialists and other health care professionals and overnight hospitalizations.
The findings will provide policy-relevant evidence of the burden that sedentary lifestyles place on the health care system
and in turn, provide a foundation on which population health policy and health care reforms can be built.
How healthy are poor working-age Canadians
Myriam Fortin
Human Resources and Social Development Canada, Government of Canada
E-mail: myriam.fortin@hrsdc-rhdsc.gc.ca
The objectives of this research were threefold: 1) to shed light on the health outcomes, access to, use of and satisfaction
with health care services of various sub-groups of poor working-age Canadians in 2005: working poor versus welfare
poor; poor at high risk of persistent poverty vs. non high-risk poor; and rural poor vs. urban poor; 2) to compare the health
situation of those groups to that of Canadians who do not have a low income; and 3) to explore the causal connection
between low income and poor health.
Method: Two sources of data were used to conduct analyses: the Canadian Communities Health Survey (cycle 3.1,
2005) and National Population Health Survey (cycles 1 to 6, 1994-95 to 2004-05).
Results: This research found that except in a few instances, in 2005, the working poor were generally as healthy as nonpoor working-age Canadians and a lot healthier than other poor persons. In opposition, welfare poor and high-risk poor
working-age Canadians (two groups that strongly overlap) were in the worst situation. For instance, the incidence of
various illnesses (such as cancer, heart disease and chronic mental illnesses) as well as poor self-rated health, dissatisfaction with oneself and suicidal attempts were anywhere between two to four times higher among the welfare poor than
among the non-poor. High-risk poor Canadians were much more likely than the non-poor to be anxious and depressed,
to have experienced serious traumas during their childhood, etc.
Investigating the causal connection between low income and poor health, this research indicates that the relationship
goes both ways with similar strength, although the ‘poor health leading to low income’ results are not as robust. More
importantly, it indicates that other key factors are at play. For those of working-age, unemployment, even more than low
income, leads to poor health and, for those aged 12 and over, lack of adequate health insurance coverage, more than
poor health, leads to low income.
The Essential Value(s) of Health: Implications for Population Health Research
J David Guerrero
PhD Candidate, Department of Philosophy, University of Calgary
E-mail: dave.guerrero@ucalgary.ca
PAGE 36
One cannot sensibly discuss effective strategies to reduce health disparities between populations without knowing what
health 'is'. Nor can one decide social, political and economic determinants of health without a concept of health. Simply put, surely the means for realizing the goals of “healthy people and healthy communities” are inevitably a function of
what we understand “health(y)” to be. Thus we ought to insist that the best account of health be employed to underpin
current — and future — Canadian population health research.
After discussing the account(s) of ‘health’ one currently finds in notable Canadian population health research, and the
problems facing those accounts, I suggest we should talk about the account of ‘health’ that ought to be explicitly employed. Because we require an understanding of 'what health is', I propose we first turn to a philosophical conception of
health.
There are two major positions in the literature: naturalism and normativism. Naturalists contend that ‘health’ is both an
empirically and an objectively discernible concept. The alleged upshot of the naturalist’s ‘realist’ account is that ‘health’
has a theoretical foundation in value-free science. Normativists contend that ‘health’ is an inextricably value-laden concept − a healthy population is necessarily connected with human value choice.
I consider the leading naturalist account of health and argue that it is formally unfit to underpin population health research. The implication will be that the best account of ‘health’ will be inextricably value-laden. But what values (and
whose?) ought to play a fundamental rôle in health judgements? I contend there is a pressing need to make explicit the
essential values of ‘health’: how else can one be sure that the concept of health we employ does not, in fact, perpetuate the very health disparities we seek to reduce? How and where to go− this talk will endeavor to say.
The Emergence of Type II Diabetes Mellitus among the First Nations of Northern Manitoba: Historical Context
Paul Hackett
SPHERU and Department of Geography, University of Saskatchewan
E-mail: paul.hackett@usask.ca
Between the 1940s and the 1980s Type II Diabetes Mellitus (T2DM) went from being virtually unknown among the First
Nations of northern Manitoba to an emerging epidemic. Currently, some of these communities are experiencing among
the highest T2DM rates found in Canada. The rise of this disease has been attributed to a combination of factors, including fundamental cultural change, genetic predisposition, and increased stress levels. Foremost of these has been a
combination of dietary modification and a shift to a more sedentary lifestyle, which have been implicated in an alarming increase in obesity. This research examines the historical process leading up to the current T2DM epidemic in the
north, focussing on these cultural shifts and the colonial forces that drove them during this critical period.
Saskatchewan Community Action Program for Children: Reaching Vulnerable Populations
Carli Haffner
Saskatchewan Prevention Institute
E-mail: trobertsonfrey@preventioninstitute.sk.ca
Co-Authors and Affiliation: Brenda Comaskey, Public Health Agency of Canada Donna Roy, Public Health Agency of
Canada
The Community Action Program for Children (CAPC) is a national program, funded by the Public Health Agency of Canada. CAPC provides long-term funding to community groups to deliver a variety of programs that address the health
and developmental needs of children (aged 0-6) and their families who are living in conditions of risk. An identified priority of Saskatchewan CAPC is to meet the needs of off-reserve First Nations, Métis, and northern children and their families.
PAGE 37
In order to learn more about participants from the 25 CAPC projects located throughout Saskatchewan, and to determine if the projects have been successful in reaching priority populations, Participant Information Forms (PIFs) were completed by new and returning adult participants over a one-year period. Included in the survey were questions related to
the determinants of health.
Results revealed that participants face numerous factors that place themselves and their children at risk for poor health
outcomes. While the level of risk was high among all participants, findings suggest that Aboriginal participants are even
more vulnerable. In particular, the incidence of low income, low level of education, lone parenthood, teen parenthood,
lack of social support, and food insecurity was higher among Aboriginal participants when compared to all Saskatchewan participants.
These findings confirm past research that has reported on the health disparities faced by Aboriginal populations and
demonstrates the success of Saskatchewan CAPC at reaching vulnerable populations. Understanding the complexity of
conditions faced by vulnerable populations enables community-based programs to deliver meaningful, context-specific
services.
Rural Saskatchewan Women and Their Communities
Joanne Havelock
Prairie Women's Health Centre of Excellence
E-mail: pwhce@uregina.ca
In June 2004, the Prairie Women’s Health Centre of Excellence (PWHCE) and the Centres of Excellence for Women’s
Health (CEWH) released the report Rural, Remote and Northern Women’s Health: Research and Policy Directions
(RRNWH), a comprehensive, national project. A plain language community kit was developed on the request of participating community women.
In September 2004 PWHCE began working with rural women in Saskatchewan as one step in carrying forward the
RRNWH recommendations. A Rural Women’s Health Workshop held November 17, 2004 led to the formation of the Rural
Women’s Issues Committee of Saskatchewan and a series of workshops held between 2005 and 2006 in Nipawin, Swift
Current, Carlyle, Unity, Christopher Lake and Muenster. Women at the workshops identified a wide range of factors affecting the well-being of rural women and their local communities, described the visions that would be achieved if the
issues were addressed, and actions needed to start achieving the visions.
Reports were produced for each workshop. A website was created. A small grant program has funded events related to
women’s health and community involvement. The group has provided linkages for consultation and research work. Future plans are around encouraging leadership training for rural women and opportunities to present their views.
Saskatchewan has a strong history with women and women’s organizations leading the way to many policy improvements and important social reforms. In recent years changing demographics, reductions in funding to women’s organizations and the triple workload that rural and farm women carry, have made it more difficult for rural women’s organizations to remain active and present their views. In its work RWICS hopes to link with individuals and organizations working
to improve the situation of rural women and to help to bring the recommendations of rural women forward to decisionmakers.
The presentation would discuss the process of developing national research and the success and challenges in working
with rural women to link research to local situations and to bring forward the views of rural women into the policy arena
PAGE 38
More than Just Numbers: The Manitoba Women's Health Profile
Margaret Haworth-Brockman, Executive Director
Prairie Women's Health Centre of Excellence
E-mail: m.haworth-brockman@uwinnipeg.ca
Co-Authors and Affiliation: Harpa Isfeld, Lissa Donner, Researchers, Prairie Women's Health Centre of Excellence
There is considerable discussion at many levels about the value and application of health indicators. What makes
women healthy or unhealthy is not just a combination of physical and physiological conditions, but includes many other
influences. Health is more than the absence of illness and staying healthy requires more than just receiving good health
care. Geography, stress, income, employment conditions social supports and roles and responsibilities in the community
are just some of the factors that affect women's well-being. The Manitoba Women's Health Profile, completed in 2008,
brings together current information about many facets of women's health, including a review of available data on
health and health care use and a gender-based analysis of the inter-relation of the factors and complicated influences
they have on women. The Profile describes and explains these factors, and points to policies and programs which can
lead to improvements and change. It is a comprehensive examination of the interrelatedness of gender, health and
health determinants for more than 145 indicators of women's health, and the first of its kind in Canada.
This presentation will review the methods employed including retrieval of provincial health administration and national
survey data, and the many steps involved in developing a complete gender-based analysis for every indicator. Highlights from the report, including new information about women's health generated through the Profile, will be featured in
this presentation.
Choice and Regulation: A qualitative study of the importance of social difference to women's experiences of the medicalization of pregnancy
Janelle Hippe
Queens University
E-mail: 6jdh3@queensu.ca
While the expansion of medical expertise surrounding pregnancy has been well-documented in historical studies
(Oakley 1984; Mitchinson 1999, e.g.), there is little contemporary empirical research that explores how women actually
experience the medicalization of their pregnancies. This study thus explores women’s experiences with medical expertise
during their pregnancies and focuses in particular on how differences among women, such as age, Aboriginal/nonAboriginal identity, or income can affect women’s experiences of the medicalization of their pregnancies. The theoretical framework utilized in this study incorporates Anthony Giddens’ notion that the expansion of “expert” knowledge can
enhance individuals’ agency (1990; 1999) as well as Niklas Rose and Peter Millers’ notion that the modern expansion of
“expert” knowledge increases surveillance and regulation and thus reduces individuals’ agency and autonomy (Rose
and Miller 1992; Rose 1993; Rose 1994). Empirical research included semi-structured, in-depth interviews with 10 Aboriginal and 10 non-Aboriginal women of varying income levels and ages during their pregnancies. The results of this study
address women’s experiences both with “expert” knowledge and with health “experts” during their pregnancies. In regards to “expert” knowledge, results indicated that across differences such as age, Aboriginal identity, and income,
“expert” knowledge gave most women a sense of preparedness, control and agency. However, “expert” knowledge
also appeared to underlie a process of mutual surveillance in which women monitor and judge both their own and
other women’s adherence to “expert” knowledge. In regards to health experts, results indicated that while most women
felt reassured by medical monitoring, young women and particularly young Aboriginal women could be ascribed a
“pathological” identity during their pregnancies that could result in negative treatment or intensified surveillance as they
interacted with healthcare workers. Ultimately, these findings underscore the need for further research that addresses
how social difference can affect women’s experiences of the medicalization of pregnancy.
PAGE 39
Development of a Public Health Nursing Working Group
Kerry Hubbauer
Calgary Health Region
E-mail: kerry.hubbauer@calgaryhealthregion.ca
Co-Authors and Affiliation: Kerry Hubbauer BNRN, Claire Goldburg, Mary McIntyre, Connie Mahoney, Linda Krol, Joanne
Coldham, Sherri Ferguson, Caroline Hamil, Stacy Oke
Background: Public Health Nursing (PHN) encompasses a rich and dynamic environment. Ethics have always existed
within PHN practice, within this scope of practice strengthening the application of ethical decision making is the focus of
this group. Also, the PHN is not immune to many contextual and temporal factors, resulting in a complex nature of practice requiring a flexible framework. Together, the Canadian Nurses Association Code of Ethics and the Provincial Colleges which regulate nursing registration practices and conduct, form the core ethical framework within nursing practice. Both of the latter organization’s ethical codes of conduct can to lead to tension when the PHN considers the individual, versus the society at large. Additionally, within the bioethics and medical ethical frameworks, there is an innate
dissonance amongst these principles.
Focus of Project: To increase awareness of ethics within PHN practice, Child and Youth Community Health Services within
the Calgary Health Region has supported the formation of a Public Health Working Group to focus on ethical issues, as
well as provide a forum for staff to identify ethical issues within their practice.
Methods: This group is comprised of staff from the urban Community Health Centers (CHC) within Calgary, a regional
ethics consultant, a CHC manager, and ad hoc members and guests. Areas of focus are based on the informal polling
of CHC staff, and the review of existing research. Terms of reference for this working group have been drafted.
Outcomes: The success of the Public Health Ethics Working Group will be determined by the results regarding these
goals: increasing health ethics knowledge, reviewing standards of practice and identifying transcending ideals, facilitating moral space and communication related to ethical decision making.
Does Aboriginal Identity Make a Difference? Single Mothers & Exclusion in Health
Randy Johner
E-mail: randy.johner@uregina.ca
Co-Authors and Affiliation: Dr. George Maslany ( University of Regina) Dr. Bonnie Jeffery ( University of Regina) Paul Gingrich (University of Regina)
Background: Single motherhood status, Aboriginal identity and social assistance recipiency are negatively linked to
health outcomes, and recognized as precursors to social exclusion. Comprehensive explorations of various factors that
influence single mother’s ‘exclusion in health’ are necessary to assist health and social policy-makers in determining responses to policies and programs that can influence positive health outcomes.
Methods: Data from a cross-sectional mail survey with a randomly selected sample was used to explore the link between
social exclusion, social assistance recipiency, and self-rated health in Saskatchewan Aboriginal and Non-Aboriginal single mothers (ages 18-59) who had at least 1 child (under18 years of age). Drawing from a population health perspective
and teachings from the medicine wheel, a conceptual model was developed to represent the experience of ‘exclusion
in health’. Multivariate analysis was used to analyze the relationships between the social exclusion factors of education,
social supports and networks, and a personal sense of control (confidence) with the outcome measure of self-rated
health, taking into account the following sociodemographic characteristics: social assistance recipiency, age, income,
PAGE 40
number of children 5 years and under, and disability. Qualitative (written knowledge) data provided the experience of
single mother’s ‘exclusion in health’.
Results: Overall, social exclusion was significantly and negatively linked to self-rated health. Aboriginal identity negatively
influenced single mother’s ‘exclusion in health’ at the 10 percent level. Social assistance recipiency for Non-Aboriginal
mothers was significantly and negatively associated with self-rated health, but was significantly and positively associated
with self-rated health for Aboriginal mothers.
Conclusions: Findings parallel previous studies which have demonstrated that comprehensive policies and programs
that include social supports and build self-confidence can be effective in ameliorating social exclusion and improving
health outcomes.
What can population-level child development data tell us about public policy for families with children?
Paul Kershaw
Human Early Learning Partnership, College for Interdisciplinary Studies, University of BC
Co-Authors and Affiliation: Paul Kershaw and Barry Forer Human Early Learning Partnership, College for Interdisciplinary
Studies, University of British Columbia
E-mail: paul.kershaw@ubc.ca
The authors draw on teacher evaluations about physical well-being, social and emotional maturity, and language, cognitive and communicative development for two censuses of kindergarten children in British Columbia (BC), Canada (n =
approximately 90,000). These internationally-unique, population-level data reveal that roughly 25% of BC citizens enter
the formal school system vulnerable on one or more domains of development; and that vulnerability when entering elementary school associates strongly with failure on standardized math and reading tests in grade four. Vulnerability rates
at the age of school entry vary tremendously across this population, ranging from 13% to 40% across BC’s 59 geographically contiguous school districts. Among the 480 neighborhoods that constitute the school districts, the variation in rates is
greater still, ranging from 2% to 59% (Kershaw et al., 2007).
Controlling for neighbourhood and school district socioeconomic status, the authors utilize the population-level data to
explore the influence of family policy over the geography of opportunity across intra-provincial boundaries. Questions
considered include: How do child care services influence early development patterns across neighbourhoods? Do taxdelivered expenditures for families with children mediate vulnerability rates at the neighbourhood level? Does welfare
policy mediate these rates? And, finally, do variations in the prevalence of full-time at-home caregivers within
neighbourhoods associate either negatively or positively with neighbourhood developmental patterns when children
enter school?
Preliminary results provide evidence that (i) child care service licensing standards may reduce vulnerability rates; (ii) welfare policy in BC exacerbates child vulnerability rates; (iii) the value of federal and provincial tax-delivered family expenditures in BC tend to have little association with early childhood vulnerability; and (iv) that there is little evidence that
early childhood vulnerability patterns associate with patterns regarding the division of unpaid and paid labour among
heterosexual couples within neighbourhoods.
The impact of relative homelessness on the mental, physical and emotional health of Aboriginal mothers.
Dr. Brigette Krieg
Prairie Women’s Health Centre of Excellence
University of Regina, Woodland Campus
E-mail: brigette.krieg@uregina.ca
Many indigenous peoples have reported experiences with homelessness or relative homelessness. These experiences
often include temporary living arrangements with family or friends, as well as frequent moves from one housing situation
PAGE 41
to another (Government of Canada, 2005). Indigenous women who have children living under their care often have
reported experiences of relative homelessness, as a result of having to pay out a large portion of their income to housing
costs. In many instances, these women reside in housing considered to be unsafe (NWAC, 2007). With a large portion of
their incomes being committed to their housing costs, many women and children are placed at additional risk, since the
amount of income reserved for food, clothing, medication and other basic necessities for themselves and their children
is limited (NWAC, 2007). Prolonged experience living within such conditions can have serious implication for mental,
physical and emotional health that can in turn impact the way in which Aboriginal women and families’ access and
interact with available services and resources. As such, clearly understanding how “relative homelessness” is defined
and visible within the community is essential to developing programs and policies related to housing and homelessness
of Aboriginal women and families.
This project uses a combination of visual and oral methods to examine and explore the experiences of relative homelessness from the perspective of Aboriginal women. The research is using narrative inquiry, a process used to examine and
analyze narrative materials to “represent a connected succession of happenings” (Lieblich, Tuval-Mashiach and Zilber,
1998:2). This project begins with participants taking photos of their housing circumstances and relative homelessness to
present a visual representation of the narratives later shared with the researcher. Using the photos as a spring board for
discussion 20-30 individual interviews are conducted to discuss a) how each participant defines relative homelessness b)
how experiences of relative homelessness impacts their role as mothers c) how relative homelessness impacts their mental, emotional and physical health and d) what programs and policy changes they feel are needed to meet the mental,
emotional and physical needs of Aboriginal women and their families. These stories and photos will be shared at the
conference; along with reflection on the use of visual and narrative methods with vulnerable populations.
A longitudinal analysis of physical activity and overweight/obesity in adolescents in Saskatoon.
Hang Lai
Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan
E-mail: laihang@gmail.com
Co-Authors and Affiliation: Nazeem Muhajarine and Karen Chad (UofS)
Objectives: This research was designed to address two major questions: (1) How do physical activity (PA) and overweight/obesity change over time in a cohort of adolescents in Saskatoon? Are there differences in the patterns of
change in overweight/obesity and PA between boys and girls? (2) What are the effects of family and friends and of the
physical environment on the changing patterns of PA in this sample?
Methods: We used Saskatoon’s in motion studies’ longitudinal data to address our research questions. Study participants
were 837 adolescents from12-18 years of age from seven socioeconomically diverse schools in Saskatoon. PA patterns of
adolescents were investigated over a five-month period (e.g., type, frequency, and duration). Participants were also
asked to respond to questions on demographics, social support, perceived benefits and barriers of PA, and health practices.
Results: Overweight/obesity increased with age, while PA decreased with age for both boys and girls. Boys overall were
more likely to be physically active than were girls. Adolescents who received greater direct support from family members were more likely to sustain their physical activity levels; in contrast, the more the family’s indirect support the less
sustaining were the adolescents’ physical activity. Home environments which were ‘rich’ in resources relevant to PA had
a greater influence on adolescents’ physical activity levels, and this relationship was stronger than that of the influence
of living in certain neighbourhoods.
Conclusion: This research shed some greater understanding of the impact of family’s support and physical environment
factors on adolescents’ continued PA levels. The implications of results for further research, targeted programs, and social policy will be discussed.
PAGE 42
“Well like if you lived in a Cardboard Box you might not be that Healthy”: Youth’s Perspectives on the Determinants of
Health
Jennifer Leach
Faculty of Nursing, University of Manitoba
E-mail: leach@cc.umanitoba.ca
Co-Author and Affiliation: Dr. Roberta L Woodgate, Faculty of Nursing, University of Manitoba
Background: With a changing emphasis to prevent ill-health, there is an increasing demand for health promotion programs that encourage youth to practice healthy behaviours that extend into adulthood. However, research directed at
youths’ perspectives about health and healthy living has paid minimal attention to the meanings of the people central
to these experiences. We still know remarkably little about how health-related issues and behaviors integrate within their
everyday lives.
Purpose: The purpose of this study is to extend our limited understanding of how youth frame health within the context of
their life-situations. That is, in their own words, how do youth define health, what does it mean to youth to be healthy,
what do youth think and feel about how their own life-situations impact on their ability to affect their health, and what
are the health interests of youth?
Methodology: To arrive at a detailed understanding of youth’s perspectives of health, a solid descriptive foundation
that is grounded in their experiences is needed. Accordingly, this 3-year study is being approached from the qualitative
research design of ethnography as it affords the opportunity to understand youth from their frames of reference. To
date, 70 youth from diverse socioeconomic and ethnic backgrounds and ranging in age from 12-21 years of age have
participated in the study. In addition to traditional ethnographic methods of interviewing and participant observation,
the innovative approach of photovoice is being utilized.
Findings: For the purposes of this paper, findings specific to youth’s perspectives on key health determinants within their
own life-situations will be presented. This study is innovative as it gives a voice to those youth participating in the study
and provides them the opportunity to articulate a broader vision of the determinants of health that adds to what is presently known.
Société santé en français, a network of networks: lessons learnt in the past 5 years
Ann Leis
Dept of Community Health & Epidemiology, University of Saskatchewan
E-mail: anne.leis@usask.ca
Co-Authors and Affiliations: André Lussier, Société Santé en français
Since 2000, a growing awareness of the health disparities among French-speaking people living in minority situation in
Canada led to the establishment of Société Santé en français and its 17 regional, provincial or territorial networks.
Grounded in the WHO model called unity for health renewal, these networks bring together key stakeholders
(communities, health training institutions, health professionals, health services organizations and governments) and facilitate their interactions in order to improve the access to health services in French across the country. Through a wide and
concerted mobilization, Francophone communities have become key partners in the process and are today effective
agents of change, using three strategies: influence, integration and innovation. This transformative approach has shown
powerful early results. The presentation will highlight the milestones and accomplishments of the Santé en français movement and illustrate with some examples how this approach has brought far reaching opportunities to an underserved
population, thus improving health services access and health outcomes for Francophone communities in Canada.
PAGE 43
Successes of Saskatchewan Registered Nurse Activists in Building Equity through Practice
Sarah Liberman
E-mail: sliberman@srna.org
There are a broad range of factors that affect the health of a population; the social determinant of income has been
described as the most significant. The Jakarta Declaration stated that “above all, poverty is the greatest threat to health
(World Health Organization (WHO), 1997, p. 2). Contributing to equity contributes to an increased ability to respond to
the challenges and barriers that often result in health disparities of vulnerable populations. RNs have historically used
social activism to increase awareness and advance population health. RNs live and work at the “intersection of public
policy and personal lives” this position enables them to advocate for healthy public policy as part of their practice and
promote health while alleviating suffering (Falk Rafael, 2005, p. 212). This study used appreciative inquiry (AI) to look at
the successes of RNs who are currently responding to equity issues surrounding low income clients. Highlighting the successes of Saskatchewan RNs offers an insight into what RNs are already doing to address socioeconomic issues. Translating their direct care experiences into further research, broader policy development, and education offers promise to
build future achievements rooted in past successes. AI is an innovative research method that can build social capital
within a system. Philosophically it encourages change through “creating meaningful dialogue, inspiring hope, and inviting action” (Havens, Wood & Leeman, 2006). This presentation expands on the voices of those currently making a difference in hopes of spreading their knowledge and wisdom so that we can all work towards reducing the health disparities
of vulnerable populations.
References
Falk-Rafael, A. (2005). Speaking truth to power: Nursing’s legacy and moral imperative. Advances in Nursing Science, 28
(3) 212-223.
Havens, D. S., Wood, S.O., & Leeman, J. (2006). Improving nursing practice and patient care: Building capacity with ap
preciative inquiry. Journal of Nursing Administration, 36(10): 463-470.
World Health Organization. (1997). The Jakarta Declaration on leading health promotion into the 21st century. Accessed
January 12, 2008 from http://www.who.int/hpr/NPH/docs/jakarta_declaration_en.pdf
Playing for Keeps: Exploring the Sociocultural Health of Aboriginal Youth Through Drama
Warren Linds
Concordia University
E-mail: w.linds@sasktel.net
Co-Authors and Affiliation: Karen Arnason (File Hills Qu’Appelle Tribal Council), Joanne Episkenew (First Nations University
of Canada), Linda Goulet (First Nations University of Canada)
This session describes an ongoing collaborative research project among university researchers and the health educator
for the File Hills Qu’Appelle Tribal Council in Saskatchewan. The project examines the efficacy of theatre as a method
for exploring the decision making processes that affect the health of Aboriginal youth. Drama served as both a health
education tool and a research method as youth used drama techniques to tell stories of their decision-making. In this
presentation, we will both describe and analyse the methods that we employed in our project and share our findings.
We anticipate that our project will provide researchers and health practitioners with an innovative research methodology and health education strategy.
Our research methods draw form arts-based and qualitative research. We have used themed and critical incident
analysis, including the analysis of texts from photos, videos and oral storytelling. We are using theoretical frameworks
from Aboriginal education and decolonization theory to analyze the data. Themes emerging from the data indicated
that other theoretical frames, such as play theory, may inform the findings in the future.
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As the project progressed, initial findings changed and shaped the emergent research design. Student stories revealed
that youth are embedded in peer, family and community systems profoundly affected by colonialism. The youth exhibit
historical trauma responses, including a lack of self-confidence, which result in a subsequent lack of volition and agency
in decision making. These initial findings led to ethical issues of what stories are told and how the youth and community
are represented. As such, the focus of our research shifted form the external context of decision-making to the internal
volitional reality of how, why, and when choices are made and the relationship between self-confidence and the ability
to make choices that are often contrary to peer group pressure.
MIGRATION, HEALTH AND DEVELOPMENT: Exploring Policy Coherence between Canadian Immigration and Development
Policy in Light of Increasing Temporary Migration Schemes and Global Health Care Shortages
Sophia J Lowe
World Education Services
E-mail: slowe@wes.org
This paper focuses on the differences that temporary migration schemes and permanent immigration policies play in the
recruitment of migrants and the effects this has on sending countries development -- looking specifically at the ethics of
recruiting health care workers to Canada. This paper explores the literature on migration and development and highlights an example of the skilled migration of health care professionals from Sub-Saharan Africa to Canada, pointing to
some strengths and weaknesses of migration policies and trends as they relate to international development, brain drain
and brain gain. This paper attempts to map out policy (in)coherence between Citizenship and Immigration Canada
(CIC) and Canadian International Development Agency (CIDA), looking specifically at the Canadian context, the recent immigration shifts toward more temporary migration programs and the rising reliance on foreign trained health care
professionals. Finally, policy recommendations are put forth to make Canada’s immigration policy and international development policy align with the economic and social development of sending nation states as well as the autonomy
and freedom for individuals to make choices about migration.
This topic is important as it addresses the ethics of (im)migration as a way to fill in critical health care shortages in Canada. The shortages and migration of health care workers can be detrimental to developing countries -- but it is unlikely
to slow -- and there is evidence that aspects of migration, especially the potential return of migrants, may be beneficial
to development. This paper is innovative as it explores the aspect of increasing temporary migration and different permanent migration schemes as they relate to the recruitment and settlement of health care professionals in Canada,
making recommendations for ethical migration policies that are better aligned with development policies. Understanding the complex issues surrounding migration and development is critical to addressing health care needs in Canada
and abroad.
Friday, November 14th, 2008 Session 6, Panel 6C 10:35 a.m.
Program Innovations meet Diverse Needs of Clients Living in Low Socioeconomic Situations
Dianne McCormack
Department of Nursing, University of New Brunswick
E-mail: dmccorma@unbsj.ca
Co-Authors and Affiliation: Joanne Barry (Registered Nurse / Community Planner, St. Joseph’s Community Health Centre,
Saint John, NB Verlé Harrop PhD, Senior Researcher, Applied Health Research, Atlantic Health Sciences Corporation,
Saint John, NB
Focus of the Project: To demonstrate that information literacy is an innovative strategy to promote access to health care
services while addressing socioeconomic health needs and enhancing individual capacity. St. Joseph’s Community
Health Centre (SJCHC) located in the uptown area of Saint John, New Brunswick responds to the health and well-being
needs of a population struggling with high unemployment, poverty, illiteracy, addiction, and mental health issues. The
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needs of a population struggling with high unemployment, poverty, illiteracy, addiction, and mental health issues. The
Community Adult Learning Network (CALNET) is positioned as a core SJCHC service and is designed to support a health
determinant approach to health and wellness. A new registration process ensured that clients not only gained access to
computer services but also became aware of the free services/programs offered at SJCHC to promote health. This incorporation of CALNET into the basket of core services offered by the health centre legitimizes information literacy as a
determinant of health, ensures a vehicle for on-going citizen engagement, and optimizes the health and well-being of a
challenged community. Integrating information literacy as an equal and credible health program is innovative.
Methods: Clients accessing CALNET are registered in Purkinje (Electronic Medical Record) and a short intake interview is
conducted to assess and better understand client needs. Data collected is used to quantify the type and volume of
CALNET services provided while the intake process ensures that CALNET clients have a designated ‘go-to’ person in the
SJCHC.
Findings: While citizens are connecting to the virtual world, they also become socially connected to the community and
engage in activities that promote health. The connection to health providers is established and health related concerns
are addressed. Finally, designating the CALNET as a core service of the SJCHC ensures on-going funding for this innovative approach to improving the health of the population.
Imagining Peer Involvement: a picture of peer involvement in health research and program in Manitoba
Paula Migliardi
Nine Circles Community Health Centre
E-mail: pmigliardi@ninecircles.ca
Co-Authors and Affiliation: Margaret Bryans (Manitoba Harm Reduction Network), Peer Forum (Manitoba Harm Reduction Network), Laura Thompson (University of Manitoba), John Wylie (University of Manitoba)
The Hell Yeah I’m An Expert! – An Overview of Peer Models on the Prairie project pursues to examine the strengths and
challenges in peer involvement and participation in health initiatives seeking to reduce the incidence of HIV, sexually
transmitted infections (STIs) and hepatitis C in Manitoba. In this presentation we will report on the community-based research process followed in this project, including the use of photovoice as the main method of data collection. We will
discuss the use of emerging technologies to engage peer researchers and participants and photovoice as a participatory tool for use in knowledge management. We will also present on the main findings of the project and discuss the recommendations for action geared towards the enhancement of peers’ voices and resources for involvement in health
promotion and harm reduction programming. The presentation will include at least one of the peer researcher involved
in this project.
This presentation focuses on an innovative approach to engaging community members throughout the life of a research
project. It also deals with a topic, i.e., peer participation in programming dealing with HIV/AIDS, hepatitis C, and STIs with
marginalized populations, that has been hardly systematically researched at in Manitoba.
Variable influence of income on disease
Evan Morris
E-mail: ecotech@sasktel.net
Co-author: Brennan Kahan, EcoTech Research Ltd
Canadian studies demonstrate a social gradient in life expectancy and health status. As income increases, so does positive health status. However, current knowledge of the relationship between income level and health status is incomplete
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in many areas. A knowledge of which health conditions are correlated with income will allow us to develop a better
understanding of the pathways by which income influences health, and to develop more effective population health
policies.
A common assumption is that the health gradient is present at all income levels and for most diseases. To test the validity
of this assumption, we analyzed data sets of self-reported health status, and rates of disease as measured by hospitalizations and physician services. Our research identified a correlation between some self-reported health indicators and
income. Where a link between income and health status was present, the steepest health gradient occurred within the
lowest income quintile. Within the lowest income segment of the population, a strong correlation existed for some health
conditions, and a weak or non-existent correlation for others.
These results indicate that income inequality may have little influence on some health indicators and diseases, and a
strong influence on others. The gradient appears to be strongest among individuals with lower income levels. Where income levels are correlated with health status, different mechanisms may be responsible for the variation in health status
with income for each health indicator.
Kids First Evaluation in Saskatchewan: A Report of Progress
Nazeem Muharjarine
Community Health and Epidemiology, University of Saskatchewan
E-mail: nazeem.muhajarine@usask.ca
Co-Authors and Affiliation: Gail Russell, Saskatchewan Ministry of Education
Income inequality and health: A theoretical quagmire
Nadine Nowatzki PhD (c)
Department of Sociology, University of Manitoba
E-mail: nowatzkn@mts.net
The income inequality hypothesis postulates that the degree of inequality in a society is an important determinant of
health. Coinciding with widening income gaps and increasing health inequality in developed countries has been an
explosion in research on income inequality and health. The results of recent studies suggest that the relationship
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between income inequality and health is unclear, due to contradictory findings, incomparable data and methods, as
well as methodological limitations. Clearly, it is too early to make any definitive conclusions about a causal relationship
between income distribution and population health.
Several review papers have examined the literature on income inequality and health, highlighting in particular the methodological considerations. However, comparatively less attention has been paid to the role of theory in conducting income inequality research. The purpose of my paper is to focus on the theoretical debates that have surrounded the
income inequality hypothesis. I will discuss several proposed mechanisms through which income inequality is hypothesized to affect health. The frameworks which have dominated the literature include (1) psychosocial (neo-Durkheimian),
which argue that income inequality affects health through processes of social comparisons and relative deprivation
(e.g. social cohesion, social capital), and (2) neo-material (neo-Marxist), which argue that income inequality affects
health through a systematic under-investment in resources and infrastructure. Other theoretical orientations have received much less attention in this literature, including (3) political economy (Marx), (4) cultural-structural (Bourdieu), and
(5) social exclusion frameworks.
In addition to highlighting the potential contributions of these frameworks to understanding health inequalities, I also
contrast conventional, mono-causal approaches with an intersectional analysis, and explain how an intersectional approach may lead to a better understanding of the causal linkages between social inequality and health disparities. The
paper concludes with a discussion of the research and policy implications of more theoretically grounded research.
Exploring issues of work/life balance in healthcare employees in Canada
Jenny Okroj, MSc, RD. University of Regina
Self-employed
E-mail: narok@sasktel.net
Introduction: The issue of balancing paid work and life responsibilities has become especially important recently, considering the impending labour shortage in Canada. When there is difficulty with this balance, there can be negative health
consequences for employees, and costs to the employer in decreased work performance and job dissatisfaction. Most
of the research on work/life balance (WLB) has focused on the corporate, for-profit sector. The purpose of this research is
to examine how employees in the healthcare sector workplace perceive work/life balance issues, and whether gender
has an impact on strategies and balance.
Method: This is a case study of a health region in a province in Western Canada. Through one-on-one interviews, ten
professional healthcare workers, five of each sex, provide their perspectives on WLB. They describe the strategies they
consider towards achieving balance, and how the conditions of the workplace/job affect that balance.
Results: The results indicate that in the life sphere, the participants consider their families and their financial situations
when determining strategies. In the work sphere, participants indicate that the healthcare workplace is rigid, and not
expected to assist in work/life balancing.
Conclusions: The responsibility for balancing work and life lies in both spheres. In the life sphere, each individual determines what strategies work best for them. In the work sphere, the workplace is responsible for assisting individuals in the
balancing process, especially if they hope to retain valuable employees. The employer could address inflexible hours,
unavailability of part-time work when desired, and lack of job autonomy. Although the employer has budgetary restrictions, the health of their own employees must also be a primary concern.
This year I did some preliminary work on addressing WLB in one health region. Through this experience I gained some
valuable insight on how WLB might be addressed in the healthcare setting.
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When to Drink? Effects of Alcohol Consumption on Wages
Meric Osman
Department of Economics , University of Saskatchewan
E-mail: Meric.Osman@gmail.com
This paper examines effects of alcohol consumption on wages in Canada by using Canadian Community Health Survey
Cycle 3.1. The paper uses multivariate regression models, and aims to capture non-linear relationship between alcohol
consumption and wages. It also analyzes effects of drinking on weekdays and/or weekend. Especially for a working individual, drinking on a weekday and/or weekend has different effects on health and social interaction, therefore it is also
expected that it will have different impacts on productivity and wages. The results show that there exists an inverse Ushaped relationship between alcohol consumption and wages.
A Deprivation Index for Health in Canada
Robert Pampalon
Institut national de santé publique du Québec
E-mail: robert.pampalon@inspq.qc.ca
Co-Authors and Affiliation: Denis Hamel & Philippe Gamache, Institut national de santé publique du Québec
Measuring social inequalities in health in Canada is hampered by the lack of socio-economic information in administrative databases. To compensate for this lack, researchers have used ecological proxies such as neighborhood income. In
Canada, such proxies have been developed for urban areas as a whole and for specific cities and provinces. None
covers the entire country and, as a result, the nature and the magnitude of social inequalities in health cannot be com
pared between areas and regions of Canada. This paper describes the construction and the spatial variations of a deprivation index covering the whole country and provides an example of its use through premature mortality (below 75
years). The underlying rationale for the index refers to Peter Townsend’s proposals to distinguish two forms of deprivation—the material and the social. Six socio-economic indicators (income, education, employment, marital status, living
alone and single-parent family) by dissemination area were used to depict these dimensions and combined through
principal component analysis. Different versions of the index were developed for Canada as a whole and for various
areas (Toronto, Montréal, Vancouver, other metropolitan areas, mid-size cities, small towns and rural areas) and Canadian regions. Results show that deprivation as well as socio-economic disparities in premature mortality are extremely
variable across Canada. The highest mortality rates among the most deprived groups are found in mid-size cities, small
towns and rural areas, whereas the highest mortality rate ratios and differences between the least and the most deprived groups are noted in the Prairies and British Columbia. Among major cities, Vancouver displays the highest mortality rate ratios and differences, and Toronto the lowest. Limitations and advantages of the index are discussed.
Building Sustainable Capacity? Nicaraguan experiences with the Global Fund
Katrina Plamondon
Mount Royal College
E-mail: katrina.plamondon@usask.ca
Objective: The purpose of the study was to explore and provide feedback on local stakeholders’ experiences with the
Global Fund to Fight Aids, Tuberculosis & Malaria’s (GFATM) as it related to capacity building for tuberculosis (TB) services
in Nicaragua.
Methods: An ethno-methodological approach was used to capture the experiences of three different groups: administrator, health personnel and persons affected by tuberculosis. Data collection involved secondary texts and records,
participant observation, and in-depth interviews and focus groups in both rural and urban municipalities.
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Results: Stakeholders felt that Nicaragua’s Global Fund project improved TB control, built human resources capacity
and strengthened community involvement in TB programming; however, they noted several contextual and structural
threats to sustainable capacity development. The nature of the GFATM’s performance-based evaluation deemphasized qualitative assessment and, at times, created pressure to meet numeric targets at the risk of decreasing
quality. Contextual challenges often determined or limited the potential sustainability of activities. This paper offers examples of training volunteer health workers and establishing TB clubs to highlight the structural and contextual threats to
sustainable capacity building within health systems and communities respectively.
Conclusions: Current approaches to GFATM evaluation and accountability may compromise its positive impacts on
capacity building in Nicaragua. Greater consideration needs to be given to ensuring more comprehensive evaluation
of project implementation. The use of an ethnomethodological case study approach offered a comprehensive and
innovative framework for assessing the local population health impact of a change made at a global level.
Intercultural Anxiety and Cultural Self-efficacy among Saskatchewan Nursing Students
Allisson Quine
E-mail: anquine@yahoo.com
Co-Authors and Affiliation: Dr. Heather Hadjistavropoulos, University of Regina
Background: There is a disproportionate burden of illness within Aboriginal communities in Saskatchewan. However, most
healthcare providers are of non-Aboriginal ancestry. When health care providers and patients do not share the cultural
background, researchers have found that there is an increased risk of miscommunication during interactions. Miscommunication may result in patients not receiving, understanding, or acting upon information provided that would improve
health outcomes. Furthermore, health care providers may experience anxiety and decreased confidence in working
with persons from a different culture, influencing health care services provided. Educational interventions related to culture have been associated with decreased anxiety and increased confidence for heath care providers. The purpose of
the present research was to develop, provide and evaluate an educational intervention designed to decrease intercultural anxiety and increase cultural self-efficacy for nursing students working with Aboriginal populations within Saskatchewan.
Methods: Working with key informants, an educational intervention related to Aboriginal health issues within Saskatchewan was created. Nursing students in Saskatchewan were randomly assigned to either receive the educational intervention or continue with studies as usual. Variables assessed included participant experiences with Aboriginal cultures
within Saskatchewan, intercultural anxiety, cultural self-efficacy, intercultural communication, and cultural sensitivity.
Findings: Preliminary analyses have revealed differences between those who received the educational intervention
compared to those who did not in the area of cultural self-efficacy and cultural sensitivity in health care interactions.
Significance: Health services designed to improved outcomes for persons of Aboriginal ancestry begins with implementation of education for health care providers related to the cultures being served. Improved self-efficacy and decreased anxiety among health care providers in the provision of care to Aboriginal peoples has the potential to improve
health outcomes and decrease disparities in health status between Aboriginal and non-Aboriginal persons within Saskatchewan.
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Prevalence rates and risk factors of fall injuries in Saskatchewan seniors (65+ years)
Drona Rasali
Population Health Branch, Saskatchewan Ministry of Health
E-mail: drasali@health.gov.sk.ca
Co-Authors and Affiliations: Shanthi Johnson, Faculty of Kinesiology and Health Studies & Saskatchewan Population
Health and Evaluation Research Unit, University of Regina; William Osei, Population Health Branch, Saskatchewan Ministry
of Health (Currently with Northern Health Authority, Prince George, British Columbia).
Background: Falls, the major cause of injury in older adults, form a complex health problem influenced by many factors
and their interactions. Understanding these contributing determinants is important for developing population-based
evidence for injury prevention. This study assessed the prevalence rates of fall injuries and associated risk factors among
Saskatchewan seniors (65+ years).
Methods: The study examined descriptive statistics from the Canadian Community Health Survey (CCHS), cycle 3.1
(2005) data and hospital discharge data (1995/96-2004/05) for the self-reported injuries and those injuries that required
hospitalizations, respectively, among Saskatchewan seniors. Logistic regressions were performed to assess the association
of risk factors with fall injury.
Findings: The overall proportion of seniors citing a fall injury serious enough to limit normal activities over one year was
69%. The percentage of seniors reporting falls as the cause of serious injury increased with age (50% in 65-74 years and
90% in 85+ years). Women (72%) were more likely to report a fall as the cause of serious injury than men (63%). Fractures
were the most commonly reported serious falls injury across sex and age groups. The trend in the prevalence rates for
seniors hospitalized with a fall was generally stable at around 20-22 per 1,000 population over the 10-year period. The
average length of stay (ALOS) in hospital due to falls injury declined between 1995/96 and 2004/05 from 8.9 days to 7.0
days. ALOS in hospital due to falls injury was shorter for women (about 7.7 days) than men (approximately 8.0 days),
while it increased with age. Stepwise logistic regression showed sex and age groups as having significant (p<0.001) association with the fall injury occurrence.
Innovation: This study used multiple databases (CCHS and hospital discharge) for cross-sectional and longitudinal surveillance of seniors’ fall injury rates and associated risk factors in the population health context.
A Unique Knowledge Transfer Model: The Alberta Centre for Child, Family and Community Research
Nancy Reynolds
Alberta Centre for Child, Family & Community Research
E-mail: nreynolds@research4children.com
Co-Authors and Affiliation: Monica Jack, Alberta Centre for Child, Family and Community Research, Calgary, AB, Canada Suzanne Tough, Alberta Centre for Child, Family and Community Research, Calgary, AB, Canada Nancy Reynolds,
Alberta Centre for Child, Family and Community Research, Edmonton, AB, Canada Aimee Caster, Alberta Centre for
Child, Family and Community Research, Edmonton, AB, Canada
The Alberta Centre for Child, Family and Community Research (The Centre) is a unique organization whose vision is to
improve the well-being of children, their families and communities in Alberta, Canada and internationally, by mobilizing
research evidence into policy and practice. Through its relationships with government ministries, research communities,
and practice communities, The Centre facilitates changes in organizational culture and evidence-informed decisionmaking processes and builds capacity in knowledge transfer. The Centre develops its own research agenda based on
input from government ministries and other stakeholder groups, and issues topic-directed requests for proposals to address information gaps. The Centre funds research that is both methodologically sound and demonstrates collaboration
among multi-disciplinary researchers and policy advisors, practitioners, and/or community organizations in the research
process, improving the likelihood of successful knowledge exchange. Recent analyses of activities indicate that The
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Centre is making contributions to shifts in culture, processes, and relationships among its partners and indicates further
opportunities to enhance knowledge exchange.
A particularly noteworthy accomplishment that will support knowledge exchange between researchers and policy advisors in Alberta is the development of the Child and Youth Data Laboratory (CYDL), which will be managed by The Centre. The CYDL will inform policies and practices affecting Alberta's children by linking and analyzing cross-government,
administrative data from nine government ministries. The products of the CYDL will enable policy makers and service
delivery organizations to make better decisions related to services to children, design of programs, allocation of resources and policy analysis and development. The commitment of government ministries to this initiative indicates a substantial movement towards using research evidence to inform decision-making. Alberta is the first jurisdiction in the world
to establish a data lab exclusively dedicated to understanding the impacts and policy needs that will optimize the wellbeing and future potential of its youngest citizens—children and youth.
Dragon Boat Racing as an Alternative Type of Post-Treatment Support for Women Living With Breast Cancer.
Rhona Shaw
E-mail: rhona.shaw@usask.ca
Background: What initially began as a research initiative to challenge unsubstantiated medical claims about women’s
physical limits post-treatment, has emerged a popular and new kind of activity and after-treatment support for women
living with breast cancer. In the form of a team sport, the activity of dragon boat racing offers women many of the same
benefits as traditional medically modelled breast cancer support groups. However, rather than sitting and talking about
one’s mostly negative illness experiences, the focus is instead on physical activity and of living life to the fullest after
treatment for breast cancer.
Focus: The focus of this presentation is on the ways in which this alternative and new type of after-care support for
women treated for breast cancer is both organised and experienced by the women who participate in this activity.
Methods& Theoretical: Interpretivist and constructivist, this research initiative looked at the experiences of a group of
women living with breast cancer in a city-centre in southwestern Ontario, and involved 26 in-depth interviews and 4.5
years of participant observation.
Findings: Participation in the physically strenuous team sport of dragon boat racing had a series of positive effects and
benefits for this group of women. It enabled many to recast a traumatic and negative life experience as one that was
mostly positive and meaningful. It offered them a safe and accepting space where they could be themselves as
women living with a life threatening and mutilating disease. It also allowed the majority of women to become stronger,
fitter and healthier, and to experience their bodies as a site and source of pride, physical vitality and pleasure rather
than simply as a locus of disease, alienation and distress.
This research initiative is innovative in that it addresses the experiences of women living with breast cancer who participate in dragon boat racing, a relatively new activity and form of social support.
Understanding the Decline in the Physical Activity of Adolescent Girls
Lauren Sherar
E-mail: lauren.sherar@usask.ca
Co-Authors and Affiliation: L. B. Sherar, N.C. Gyurcsik, M.L. Humbert, A.D.G. Baxter-Jones, University of Saskatchewan,
Saskatchewan, Canada
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Background: Regular participation in physical activity (PA) is important for health and well-being. Unfortunately, it is well
established that PA declines during adolescence with girls less active than boys at all ages. Little research has been directed towards understanding whether the decline in PA among adolescent girls is associated with their chronological
age (CA) or biological age (BA; i.e. how close the child is to reaching the mature adult state). Exploring the influence of
BA on the decline in PA is an innovative method to better inform researchers about the most effective timing of interventions.
Aim: Describe the PA levels and perceived barriers to PA of adolescent girls grouped by CA (i.e., school grade) and BA
(i.e., early or late maturing) within grades.
Methods: 221 girls (aged 8-16 years; grades 4-10) wore an Actical acceleometer for seven days and then completed a
semi-structured, open ended questionnaire on perceived barriers to PA over a 7-day period. Predicted age at peak
height velocity and recalled age at menarche were used to assess maturity among the elementary and high school
girls, respectively. BA and CA group differences in PA were assessed using a MANCOVA and independent sample t-test,
and barriers to PA using chi squared statistics.
Results: Daily minutes spent in moderate to vigorous PA decreased by 40% between grades 4 to 10. Within grade groupings, no differences in PA were found between early and late maturing girls (p>0.05). Grades 4-6 participants cited more
interpersonal (i.e., social) barriers. Grades 9-10 participants cited more institutional barriers to PA, primarily revolving
around the institution of school. No differences were found in types of barriers reported between early and late maturing
girls.
Discussion: Since PA and types of perceived barriers to PA were dependent on CA, future research should work to identify the most salient (i.e., frequent and limiting) barriers to PA by CA in youth. Once reliably identified, multi-pronged intervention strategies to help youth cope with their salient barriers must be tested for effectiveness.
Funding Support: Community and Population Health Research, Saskatchewan Health Research Foundation and North
American Society for Pediatric Exercise Medicine.
Comparing Health and Health Care Utilization Patterns between Persons with and without Developmental Disabilities in
Manitoba: Implications for Planning, Policy and Service Provision
Shahin Shooshtari, PhD, Assistant Professor
Faculty of Human Ecology, University of Manitoba
Researcher, St Amant Research Centre, Winnipeg, Manitoba, Canada
E-mail: shooshta@cc.umanitoba.ca
Co-Author and Affiliation: Patricia Martens, PhD, Associate Professor, Faculty of Medicine; Director, Manitoba Centre for
Health Policy, University of Manitoba
Despite poorer health and higher health care needs, research shows that people with developmental disability (DD) use
available health services at a lower rate compared to the general population or population without developmental
disability. Canadian-based research in this area is very limited. There has not been any study to look at the health status
and health care utilization patterns of individuals with DD in Manitoba. In this study, we linked data from several administrative data sources housed at Manitoba Center for Health Policy to describe health status and health care utilization
patterns of people of all ages living with DDs in the province of Manitoba (Canada). We used age, sex and place of
residence to match cases (i.e., those with DD) with a comparison group who did not have any of DD conditions. The
comparison of health and health care utilization patterns between the two groups (i.e., cases and controls) was made
using a number of health indicators. The indicators used included total mortality rates, average age at death, prevalence and incidence rates of chronic diseases and health conditions such as diabetes, dementia, depression, total respiratory morbidity, hypertension, ischemic heart disease, stroke and falls. Indicators used to measure health services use
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included average physician visits, hospitalizations and ambulatory consultations. Our research results confirm significant
disparities in health and access to health care between the two study groups. The implications of our research findings
for policy, planning, and service provision will be discussed.
Illuminating the Black Box: Issues of Measurement and Implementation in School Health Interventions
Marg Schwartz
University of Alberta
E-mail: marg.schwartz@ualberta.ca
Aboriginal Youth Suicide and Differences in Indigenous and Western conceptions of knowledge and knowledge transfer
Ulrich Teucher
E-mail: ulrich.teucher@usask.ca
Co-Author and Affiliation: Michael Chandler, Department of Psychology, University of British Columbia
Our ongoing research into the relationship between cultural knowledge and youth suicide in Aboriginal populations in
British Columbia shows that, while suicide rates are higher than in Non-Aboriginal populations, suicide rates are not uniformly distributed among Aboriginal communities (Chandler, Lalonde, & Teucher, 2003). Our epidemiological research
shows that those bands that have achieved a measure of self-governance and have successfully worked to preserve
cultural practices have no youth suicides, whereas those bands that lack such markers of cultural continuity typically
suffer from youth suicide rates hundreds of times that of the national average (Chandler, Lalonde, Sokol, & Hallett, 2003).
That is, bands with low or absent rates of youth suicide must already possess knowledge critical to lowering their youth
suicide rates.
In coming to better understand the nature of such Indigenous knowledge our problem is two-fold. First, we need to better understand what the characteristics of such Indigenous knowledge are as well as its similarities to and differences
from Western concepts. Second, we need to learn how such knowledge might best be shared. Departing from the traditional “cognitive imperialism” (e.g., Battiste 2002) of “top-down” transfers, this knowledge can be made to flow
“laterally” between Aboriginal communities. We explore how Indigenous knowledge is importantly similar to and differs
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from Western concepts. Second, we need to learn how such knowledge might best be shared. Departing from the traditional “cognitive imperialism” (e.g., Battiste 2002) of “top-down” transfers, this knowledge can be made to flow
“laterally” between Aboriginal communities. We explore how Indigenous knowledge is importantly similar to and differs
from Western concepts of knowledge, focusing on three aspects of scholarship: generalizability, place, and ownership.
Indigenous emphasis on “place” and traditional ownership counters claims to the generalizability of knowledge but can
complicate the possibilities of lateral knowledge transfers with regard to youth suicide prevention strategies. A way out
of this difficulty may be the acknowledgment that Aboriginal youth suicide can be seen as a common experience due
to colonialism and its aftermath. In an interdisciplinary fashion, the proposed paper employs different philosophies of
science to bear on epidemiological studies of Indigenous youth suicide.
The Creation of the National Aboriginal Health Organization (NAHO) in Canada
Paulette C. Tremblay, Ph.D.
National Aboriginal Health Organization
E-mail: ptremblay@naho.ca or clafontaine@naho.ca
Co-Authors and Affiliation: Paulette C. Tremblay Ph.D., Chief Executive Officer, National Aboriginal Health Organization
This presentation discusses the process involved in the creation of a national Aboriginal health organization in Canada
from conception to operationalization. Identified gaps in First Nations, Inuit and Métis health and well-being along with
issues of social capital and cohesion have indicated a need for capacity building for Aboriginal Peoples and the ability
to be self determining with regard to health status. Based on these gaps identified through various national policy discussions and community level consultations specific to health, the National Aboriginal Health Organization (NAHO) was created.
NAHO’s structure bridges public, government and NGO sectors to promote collaboration. Exemplified by its unique design, NAHO comprises First Nations, Inuit and Métis Centres that assist in the strengthening and synergizing of Aboriginal
civil society through its mandate. NAHO’s five overarching objectives are to: Improve and promote Aboriginal health
through knowledge-based activities; promote an understanding of the health issues affecting Aboriginal Peoples; facilitate and promote research on Aboriginal health and develop research partnerships; foster the participation of Aboriginal Peoples in delivery of health care; and, affirm and protect Aboriginal traditional healing practices. An example of an
innovative outcome of this organization is the Journal of Aboriginal Health, the only journal in Canada that is peer reviewed by both academic and community reviewers and dedicated strictly to Aboriginal health. The presentation will
conclude with current, ongoing and new health research initiatives to which NAHO is engaged.
“Getting My Hope Back”
Victoria Walton
Adult Community Mental Health and Addictions, Saskatoon Health Region
E-mail: Victoria.walton@saskatoonhealthregion.ca
The goal of this population health mental research was to seek input form citizens in a particular locate about their views
of what creates stress for them in their neighbourhood, what strengthens their ability to cope, and what mental health
needs they identify in the neighbourhood. A neighbourhood was chosen where residents were at risk for mental health
issues, according to the determinant of health, where barriers existed to accessing mental health services, but also
where citizens were engaged in strengthening their community. The conceptual framework of the project brought together the concepts of primary health, determinant of health and capacity building. Nine focus groups were held with
residents who represented a number of community groups. Fifteen further individual interviews were conducted. Approximately three-quarters of the participants were First Nations or Métis ancestry and a small number were immigrants.
The themes that emerged were: 1) blocks to individual, community and program capacity; 2) enhancers of individual,
PAGE 55
community and program capacity; and 3) identified needs at the individual, community and program levels. The research led to a pilot project and a partnership with a community based program promoting mental health with young
marginalized pregnant women.
A Social Ecology Framework for Annual Influenza Vaccinations in Health Care Workers
Kelly Wiens
SEARCH Canada
E-mail: kelly.wiens@searchca.net
Despite the prevalence and relatively severe consequences of annual influenza outbreaks, immunization rates are
suboptimal in at-risk and their associated health care worker (HCW) populations, even with years of effort to raise awareness and improve vaccine uptake. Although considerable research has been completed around barriers to immunization in the HCW population, little is understood about how HCWs make decisions to accept or decline annual vaccination. Applying an overlay of a social ecology framework enables targeting of change processes and strategies to improve HCW uptake at intrapersonal, interpersonal, organizational, community and public policy levels. An emphasis on
behavioural modification approaches (intrapersonal level) has not increased HCW immunizations to recommended
rates. Change targets vary with the levels although strategies may overlap levels. Identifying a constellation of changes
and working on the areas of potential influence has been shown to lead to better immunization rates over years of applying the multiple interventions. Strategies could include: offering vaccination to HCW family members (interpersonal
and organizational levels), developing local policies to encourage symptomatic HCWs to stay home (organizational
level), engaging local ethics boards in discussions of appropriate policies (community level), and planning for monitoring
and responding to adverse events to increase safety and public confidence (public policy level). This framework permits
identification of gaps in multi-intervention planning. Using the social ecology framework to integrate human behaviour
with the environment - moving beyond the biological and geographical to include social, cultural and public policy
levels - will aid decision making and program planning. Annual HCW influenza immunization is one example from a
broad range of applications in using a collaborative approach within a social ecology framework towards finding solutions to improve health within defined populations.
Linking Population Health Theory to the Real World of Policy Making – Re-building Policy Networks and Interests
Ron Wray
Policy Consultant (formally Ontario Ministry of Health and Long-Term Care, May 2006 - March 2008)
E-mail: wray3611@telus.net
Over the last ten years, population health has experienced a shift in perspective in many jurisdictions to a health equity
lens. Whereas population health emphasizes improvement in average health status, health equity draws focus on reducing unfair health differences due to socio-economic position. Although similar in many ways, there are theoretical and
practical cleavages in the goals and policy demands of each. While academic and conceptual advances are critical,
research attention is also required to the implications for policy-making as the mechanisms and objectives of conceptual models change.
Adopting a political science and public administration lens, it is argued that consideration of population health policy
must go beyond traditional concerns of political regime and ideology, and weak horizontality in government to consider
the impact of policy networks in a transformational process. In most jurisdictions, existing agendas of policy networks do
not cumulatively add up to a population health agenda. Buried within similar concerns are cleavages in both perspective and interests that can in fact work against a coherent population health approach in policy making. Such changes
create potential risks of fragmentation and conflict among networks traditionally viewed as policy allies. The risk nodes
include population health as health policy, health promotion and public health, poverty groups and agencies, and
neighbourhood groups and services. All told, the evolution of theory and approach appears to necessitate a policymaking process that includes re-shaping through consensus a re-alignment of policy networks and interests consistent
with the requirements of reducing health inequalities and the social gradient of health.
PAGE 56
Using a recent initiative within the Ontario government by example, the presentation considers the conceptual framework used in the strategic policy process (e.g., Hilary Graham, Finn Diderichsen), and the real world implications for the
policy-making process, including encountered risks and challenges posed by traditional policy networks and interests.
Understanding the Role of a Sport for Development Project in Fostering Community Capacity Building within a Refugee
Camp Setting
Ryan W. Wright, M.Sc.1 and Karen Chad, Ph.D.2
University of Saskatchewan, Canada
E-mail: rww914@mail.usask.ca
Background: There has been a rapid increase in the number of organizations using sport as a development tool in majority world communities. Specifically, ‘Sport for Development’ programs have been promoted as a means for promoting peace, a forum for social mobilization efforts and other health initiatives, and a tool for sustainable community development (UNIATF, 2003). Often, a fundamental goal of such programs is community capacity building. However,
despite this increase in attention, data on benefits of these programs remains anecdotal, without a strong body of reliable evidence on the impact of Sport for Development programs on community capacity building.
Purpose: To understand the effectiveness of a Sport for Development program in fostering community capacity building in a refugee camp in Tanzania.
Methods: Research was accomplished using a qualitative case study approach, with key stakeholders involved in the
program. The principle method of data collection was a participatory workshop methodology involving Laverack’s
(1999, 2001) nine domains to assess community capacity. A pre workshop held with stakeholders assessed current
status, which was followed by the development and implementation of strategic plans for action by participants based
on the workshop assessment. A second workshop was held one year later to re-assess community capacity. Additional
methods of data collection included interviews with key informants, observations, and field notes. Member checking
and triangulation were employed as the primary procedures for verifying the findings.
Results: Capacity was increased within eight of the nine domains; specifically participation, leadership, organizational
structures, problem assessment, resource mobilization, ability to ‘ask why’, role of outside agents, and program management.
Conclusions: A Sport for Development program can be effective in increasing community capacity, which can be
attributed to the specific participatory methodology used to assess capacity, organizational structure changes within
the program, and a change in approach to programming by Project Managers.
__________________________________________
1Ryan Wright is a Community and Population Health Research (CPHR) Strategic Training Fellow at the University of Saskatchewan; research
funded by the Canadian Institutes for Health Research (CIHR) and Partner Institutes.
2Karen
Chad is a Professor in the College of Kinesiology, University of Saskatchewan
PAGE 57
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Regina, the Capital City of Saskatchewan, is located in the southern portion of the province. The city is home
to the largest legislative building in Canada and hosts the world renowned Royal Canadian Mounted Police
Training Academy and RCMP Heritage Centre.
In the heart of the city you will find Wascana Centre - a 2300-acre urban park boasting a pristine view of the
Saskatchewan Legislature, marina, walking paths, bird watching venues, park area, tennis courts, picnic and
BBQ sites. The park also accommodates the Saskatchewan Science Centre and Kramer Imax Theatre, the
MacKenzie Art Gallery, and the Royal Saskatchewan Museum.
Aside from the many attractions, Regina is also rich in resources as agriculture, tourism, and oil and gas production fuel the economy. While Regina's economic base is diverse it is also recognized as one of the most
affordable places to live, work and do business in western North America.
The RCMP Heritage Centre is developed and operated by a non-profit organization, the Mounted Police
Heritage Centre.
RCMP Heritage Centre
Using state of the art exhibits, multimedia technologies and engaging programming the Centre tells the story of the Royal Canadian Mounted Police
including the Force's role in the development of Canada, the role of the
RCMP in policing over 200 communities across Canada, the challenges of
serving as Canada's Federal Police Force, and the role the RCMP plays internationally.
Website: http://www.rcmpheritagecentre.com/
Address: 5907 Dewdney Avenue
MacKenzie Art Gallery - We believe art is for everyone.
At the MacKenzie Art Gallery we are passionate believers
that art matters. Visit us today and discover the exciting
world of visual art in all its diversity and beauty. Through
our many exhibitions and programs, we invite you to get
connected and, above all, enjoy! This is YOUR Gallery!
Website: http://www.mackenzieartgallery.ca/
Address: T.C. Douglas Building, 3475 Albert Street
Royal Saskatchewan Museum
Explore Saskatchewan and your world - the past, the present, and the future - as never before.
Website: http://www.royalsaskmuseum.ca/
Address: 2445 Albert Street
PAGE 58
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Regina is a beautiful oasis on the prairies with more than 350,000 hand-planted trees. There are many attractions and
events that take place all year in Regina for residents and tourists alike.
SHOP DOWNTOWN
With nearly 200 shops in downtown Regina, it’s easy to “shop till you drop”. Located in the heart of downtown is Saskatchewan’s premier shopping centre – the Cornwall Centre – which is surrounded by trendy fashion boutiques and
one-of-a-kind local retail shops. Exclusive brand names, music, books, art, home decor and more…discover it all downtown!
Downtown Regina is Saskatchewan’s premiere destination for a cosmopolitan mix of retail shops, specialty boutiques,
culture, entertainment and fine dining.
You’ll find almost two hundred shops and personal services to explore in Downtown.
•
•
Cornwall Centre: www.cornwallcentre.ca
Regina Farmer's Market: www.reginafarmersmarket.ca
DINE DOWNTOWN
With over seventy food establishments to choose from, downtown’s diverse culinary scene is sure to please every taste.
From elegant dining and modern wine bars to hot dog vendors and Regina’s oldest traditional diner - The Novia Café we have it all. For the more adventurous taste buds, try out our wide assortment of coffee houses and multi-ethnic restaurants that specialize in serving up dishes from Greece, China, Japan, India, Ireland and more.
DINING & DRINKS
A Moment in Thyme Bistro & Catering - 2018
12th Ave
Asian Cuisine - 1946 Hamilton St
Atrium Family Restaurant - 1818 Victoria Ave
Beer Bros. Bakery & Cuisine - 1801 Scarth St
Bitten Appetizer & Dessert Bistro -1822 Broad St
botaniCa Restaurant - 1975 Broad St
Casa Latina - 1849 Broad St
Copper Kettle Restaurant - 1953 Scarth St
Cortland Dining Room - 2125 Victoria Ave
Crave Kitchen & Wine Bar - 1925 Victoria Ave
Dông Khánh - 1927 Albert St
Fibber Magee's Pub - 1818 Victoria Ave
Four Seas Restaurant - 1779 Rose St
Golf's Steak House - 1945 Victoria Ave
Good Time Charlie’s Pub - 1965 Albert St
Hanabi - 1950 Broad St
Indigo Restaurant - 1919 Saskatchewan Dr
J & A Restaurant - 2201 11th Ave
Kokeb Restaurant - 1769 Hamilton St
Lang's Café - 1745 Broad St
Last Spike (The) - 1880 Saskatchewan Drive
Mai Phuong Restaurant - 1821 Broad St
Memories Fine Dining - 1717 Victoria Ave
Michi Sushi - 1943 Scarth St
Monarch Lounge – 2125 Victoria Ave
Mulligan’s Lounge – 1818 Victoria Ave
New Town Restaurant - 2332 - 11th Ave
Ngoc Anh Restaurant - 1810 Smith St
Extreme Pita - Cornwall Centre
Gilmour's Corner - 1833 Scarth St
Great Canadian Bagel (The) - Cornwall Centre
Green Spot Café (The) - 2012 12th Ave
Harden & Huyse Chocolatiers - 1874 Scarth St
Henderson Café - 200-1900 Albert St
Manchu Wok - Cornwall Centre
MMMuffins - Cornwall Centre
Mrs. Vanelli's - Cornwall Centre
Muddy Joe's Coffee & Espresso Bar -1856
Hamilton St
New York Fries - Cornwall Centre
Novia Café - 2158 - 12th Ave
Onyx Café - 1920 Broad St
OPA Souvlaki - Cornwall Centre
LUNCH, COFFEE & SOMETHING SWEET
Orange Julius - Cornwall Centre
2-4-1 Pizza - 1925 Albert St
Pita Cravings - 1847 Scarth St
A & W Restaurant - Cornwall Centre
Pita Pit - 1821 Hamilton St
Aegean Coast Coffee & Tea - 1967 12th Ave
Restaurant (The) - Cornwall Centre (Sears)
Alfredo's Salads & Italian Foods - Cornwall
Robin's Donuts - 1806 Albert St
Centre
The Second Cup - Cornwall Centre
Atlantis Coffee Co. - 1992 Hamilton St
The Soup Nutsy - 1950 Hamilton St
Bay Expresso Café - Cornwall Centre (The Bay)
Treats - 2012 - 11th Ave
Bitten Appetizer & Dessert Bistro -1822 Broad St
Subway -Cornwall Centre
Taco Time - Cornwall Centre
Booster Juice - Cornwall Centre
Timothy's World Coffee - 1881 Scarth St
Burger King - 1808 Albert St
Urban Bean Grab n’ Go- 1919 Saskatchewan
botaniCa X-Press - 1975 Broad St
Dr
Café deVille- 2500 Victoria Ave
Victoria Tea Room - 2125 Victoria Ave
Canada Life Plaza Cafeteria - 1901 Scarth St
Webster's Coffee & Bake Shop - 1942 Hamilton
Cookies by George - Cornwall Centre
St
Dairy Queen - Cornwall Centre
Edo Japan - Cornwall Centre
O'Hanlon's Irish Pub - 1947 Scarth St
Omega Lounge – 1919 Saskatchewan Dr
Peking House - 1850 Rose St
Punjabi East Indian Buffet - 1851 Scarth St
Rooftop Restaurant– across from the Ramada
Fibber Magee's Pub - 1818 Victoria Ave
Saigon by Night - 1840 Broad St
Smitty’s Restaurant & Lounge - Cornwall Centre
Siam - 1946 Hamilton St
Sushi Bank (The) - 1965 Albert St
Vic's Steakhouse - 1975 Broad St
Wasabi Restaurant - 1907 11th Ave
PAGE 59
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PLAY DOWNTOWN
Live entertainment is our specialty. Downtown is home to Regina’s only farmer’s market and signature outdoor events
including the Regina Folk Festival, Scarth Street Summer Stage and the Downtown Ice & Fire Carnival. Experience wellknown celebrities or local talent at many of our indoor venues including the Casino Regina Show Lounge, Globe Theatre, Yuk Yuk’s Comedy at Fibber Magee’s, Applause Dinner Theatre or live musical entertainment at the pubs.
DOWNTOWN PARKING
You’ll find almost 5800 public parking stalls in the Downtown district.
Parking Meters
Monday-Friday, 8am - 6pm $1.00/hour
There are over 1,300 on-street parking stalls located in and around the Downtown.
Free Parking at meters:
Saturdays: 2 hours free
Sundays: All day
Monday-Friday: 6 pm - 8 am
Downtown Parkades & Parking Lots
There are over 5,800 public stalls available on surface parking lots and parkades. Rates range in price from $3 - $7.50
per day.
PLACES OF WORSHIP
Central Lutheran Church - 2625 12th Ave
Downtown Community Church - 2012 McIntyre St
Blessed Sacrament, Catholic - 2049 Scarth St
First Baptist Church - 2241 Victoria Ave
Knox Metropolitan, United - 2340 Victoria Ave
St. Paul 's Cathedral, Anglican - 1861 McIntyre St
THINGS TO SEE & DO
Applause Feast & Folly Theatre - 1975 Broad St
Belly Dance with Linda - 2536 - 11th Ave
Casino Regina & Showlounge - 1880 Saskatchewan Dr
CBO - Casino Regina - 1880 Saskatchewan Dr
CBO - Cornwall Centre
Century Studio - Harvard Broadcasting – 1900 Rose St
CNT Conventions N'Tours - 1975 Broad St
Dunlop Art Gallery - 2311 - 12th Ave
Flamenco Diaz - 1779 Albert St
Globe Theatre - 1801 Scarth St
Michael Milette’s Dance Class - 1828 Scarth St
Neutral Ground Gallery - 1856 Scarth St
Regina City Hall - 2476 Victoria Ave
Regina Plains Museum - 1835 Scarth St
Regina Public Library - 2311 - 12th Ave
Royal Canadian Legion - 1820 Cornwall St
RPL Film Theatre - 2311 - 12th Ave
Saskatchewan Filmpool Cooperative - # 300 - 1822 Scarth St
Saskatchewan Genealogical Society & Library - 1870 Lorne St
Saskatchewan Sports Hall of Fame & Museum - 2205 Victoria Ave
Wonderland Entertainment - 1729 Broad St
Yuk Yuk’s Comedy - Ramada Hotel - 1818 Victoria Ave
PAGE 61
Notes
PAGE 62
Notes
PAGE 63
Notes
Conference Sponsors and Supports
The Community and Population Health Research Training Program (CPHR) and the Saskatchewan Population Health and Evaluation Research Unit (SPHERU) would like to take
this opportunity express our gratitude and appreciation to the organizations and programs that provided financial support for this conference:
♦
♦
♦
♦
The Canadian Institutes of Health Research (CIHR): Meetings, Planning and Dissemination Grant: End of Grant Knowledge Translation Supplement;
The Saskatchewan Health Research Foundation (SHRF): Research Connections:
Event Sponsorship Program;
The Office of the Provost and Vice-President (Academic) at the University of Saskatchewan: Conference Fund; and,
The Offices of the Vice-President (Academic) and the Vice-President (Research
and International) at the University of Regina
Their sponsorship and support ensured that the New Directions in Population Health Research: Linking Theory, Ethics, and Practice conference achieved the success intended.

File - spheru

Transcription

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