Editorial: Adolescent sexual and reproductive health challenges in low-income settings
Alam, N., Merry, L., Browne, J., & Nahar, Q. Lisa Merry (2023, septembre)
Adolescents and young adults (10–24 years old) represent a substantial proportion of the world’s population and the majority live in low and middle-income countries (LMICs). Significant global attention has been given to improve Sexual and Reproductive Health Rights (SRHR) of adolescents and young adults, however, despite progress, the gains have been inequitable across countries largely due to harmful social norms, toxic gender stereotypes, and acute power imbalances in many LMICs, especially for females. In LMICs, poor infrastructure, poverty, and high levels of gender-based violence, have significantly impeded women and adolescent girls’ access to SRH services. Moreover, a large number of adolescents and young adults, especially those living in conflict and temporary settlement centers, are at high risk of sexual violence, genital cutting, HIV and other sexually transmitted infections (STIs), unintended pregnancies, unsafe abortions, and maternal death. In our Research Topic for Frontiers of Public Health, our objective was to contribute to the advancement of SRHR among adolescents and young adults living in LMICs. As such, we solicited articles that addressed one or more of the following topics: child marriage, contraception, unwanted pregnancy, unsafe abortion, STI/HIV/AIDS including HPV vaccine coverages, gender-based violence, sex trafficking, and exploitation, poor menstrual hygiene practices, menstrual problems, and other gynecological illnesses, SRHR of adolescents in refugee settlements, adolescent-friendly health services, adolescent SRH policies, and governance.
Within this Research Topic, a number of manuscripts were published. Two focused on adolescents in Bangladesh and analyzed data from a recent national adolescent health and wellbeing survey; the first article, entitled “Factors that provide protection against intimate partner physical violence among married adolescents in Bangladesh,” found that 16% of married adolescent girls experienced intimate partners physical violence (IPPV) (Rahman et al.). Results showed that IPPV risk was lower when living with parents-in-law or parents and when girls were married to men aged 21 or older; IPPV risk was higher among girls with a longer duration of marriage and no living children. The second article, entitled “What shapes attitudes on gender roles among adolescents in Bangladesh,” showed that among unmarried adolescents, girls were significantly more likely compared to boys to hold egalitarian views regarding gender roles (58 vs. 19%) (Streatfield et al.). Egalitarian views were significantly higher among both girls and boys if they were members of social organizations, participated in adolescent programs and had completed at least grade 10. Taken together the two papers highlight the importance of education, policy (minimum age for marriage), and the implementation of community level interventions toward advancing gender-equity and protecting young women from IPPV, and its associated adverse health outcomes, in Bangladesh.
The topic of contraception and family planning, important for the prevention of pregnancy and averting the health and social consequences that are associated with unwanted pregnancy, were addressed in two papers. The article “Social-psychological determinants of hormonal contraceptive use intentions among adolescent girls in the Bono East Region of Ghana,” highlights how positive attitudes regarding hormonal contraceptives, and self-efficacy to access and use hormonal contraceptives, are positively correlated with hormonal contraceptive use intention, thus underscoring the importance of comprehensive sex education, including enhancing adolescents’ skills and sense of competence to access and use contraceptives (Boamah-Kaali et al.). Similar conclusions were also drawn in the paper: “What are the sources of contraceptives for married and unmarried adolescents: Health services or friends? Analysis of 59 low- and middle-income countries” (Hellwig and Barros). Using national health survey data from 59 LMICs, it was shown that in almost half of the countries, the use of modern contraceptives is lower among sexually active adolescents when compared to sexually active adult women. Results also showed, that in a number of countries, adolescents are less likely to access contraceptives in the public sector, especially unmarried girls. In all regions, unmarried girls, compared to their married counterparts, were more likely to access contraceptives from friends and family. Another article, which addressed the use of reproductive more broadly, further underscored the importance of sex education, and also the necessity for services to be easily accessible; in “Reproductive health service use and associated factors among youths in Becho district, southwest Ethiopia,” the researchers found that the use of reproductive health services was relatively low (44% utilized services) among youth and that knowledge of services, discussions with parents about reproductive health, as well as close proximity of a health facility, were key predictors of reproductive health service use (Waga et al.).
Lastly, implementation and sustainability of sexual and reproductive health services, was a topic in two papers. The article: “Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries?,” provides a comprehensive overview of challenges and facilitators to HPV vaccination program implementation in LMICs (Waheed et al.). Results showed that data availability, management and reporting and supply chain difficulties are significant issues, while involvement of multi-sectoral key stakeholders, careful planning and coordination, and communication and training at all levels (district administrators, healthcare staff, teachers, and support personnel), are vital toward ensuring successful and sustained implementation of HPV programs. In their paper, entitled: “Accelerated institutionalization of an adolescent sexual and reproductive health (ASRH) intervention in Tanzania: Findings from a mixed-methods evaluation,” the authors describe the institutionalization and scale-up of a contraceptive-delivery intervention into government healthcare institutions across Tanzania; the intervention, which includes in-clinic care and a community-outreach component, aims to educate, but also to empower girls by focusing on life planning and skills acquisition (Cutherell et al.). Commitment and early, active involvement of key stakeholders, including government officials and healthcare providers, and ongoing engagement and training, were also identified in this study as important facilitating factors for successful implementation of the intervention. Integrating the intervention within existing structures, was also shown to facilitate the institutionalization process.
In sum, the research reported in this Research Topic highlights the critical role that governments in LMICs must play to ensure SRH services are available, easily accessible and responsive to the needs of adolescents and youth; these services should provide education, enhance self-efficacy and improve skills with regards to accessing and using services and care, but also equally important, is the empowerment of girls. Policies are also crucial; they should promote young people to study longer and to delay marriage until a later age. The studies also emphasize the importance of comprehensive sexuality education (CSE) within school to improve knowledge, but also to eventually shift cultural and social norms that contribute to poor SRH outcomes, especially for girls and young women. Overall, the authors conclude that more evidence and continued work by researchers, care-providers and policy makers, are still needed to improve gender equality and the SRH of adolescents and youth in LMICs. The work reported in this Research Topic offers a point of departure for those looking to contribute and advance the SRH field. We would like to express our sincere gratitude to the authors, reviewers and editors of Frontiers in Public Health, for their contributions to this Research Topic.
Prevalence and Factors Related to Post-traumatic Stress Disorder and Depression Symptoms Among Children and Adolescents Survivors and Orphans of Ebola Virus Disease in Democratic Republic of the Congo Eastern Regions During the COVID-19 Pandemic
Cénat, J. M., Farahi, S. M. M. M., Rousseau, C., Bukaka, J., Darius, W. P., Derivois, D., ... & Luyeye, N. Cécile Rousseau (2023, septembre)
Abstract
Purpose
Although previous studies have shown a high prevalence of mental health problems among adult Ebola virus disease survivors, no studies have yet been conducted on mental health problems among children and adolescents in affected regions. Consequently, the current study aimed to examine the prevalence and factors associated with depression and post-traumatic stress disorder (PTSD) among children and adolescent survivors and orphans by utilizing a cross-sectional survey following the 2018–2020 epidemic in Eastern Democratic Republic of the Congo.
Methods
A total of 146 survivors (mean age = 13.62, standard deviation [SD] = 2.50, 49.32% female), 233 orphans (mean age = 13.18, SD = 2.96, 53.32% female), and 34 orphan-survivor participants (mean age = 13.39, SD = 2.87, 44.12% female) were recruited. Participants completed measures assessing depression and PTSD symptoms, traumatic experiences, and stigma related to Ebola and COVID-19.
Results
The prevalence of depression and PTSD symptoms was 87.32% and 44.42%, respectively. Results showed significant differences in depression and PTSD symptoms between orphan-survivors (100% and 97.06%), survivors (90.21% and 75.86%), and orphans (83.48% and 16.52%; χ2(2) = 9.02; p = .011 and χ2(2) = 168.85; p < .001). Experience of traumatic events, Ebola stigmatization, and COVID-19 stigmatization positively predicted depression and PTSD symptoms. The regression models explained 61%–72% of the variance of depression and PTSD.
Discussion
The results reveal that the Ebola virus disease and its associated grief severely jeopardize the mental health of children and adolescents in affected regions. Despite the relative paucity of resources, intervention programs may be helpful to minimize associated stigma and promote psychological support.
Keywords
e–Mental Health Program to Prevent Psychological Distress Among French-Speaking International Students in a Linguistic-Cultural Minority Context (Ottawa, Alberta, and Quebec): Protocol for the Implementation and Evaluation of Psy-Web
Beogo, I., Ramdé, J., Anne, A., Gagnon, M. P., Sia, D., & Tchouaket, E. N. Drissa Sia (2023, septembre)
Abstract
Background:Based on experiences with the COVID-19 pandemic, postsecondary institutions were most affected by the restrictions. Students, especially international students, have borne the brunt associated with in-person learning restrictions imposed by public health recommendations. Canada is among the top 3 countries hosting international students (ISs), including Francophone students in provinces such as Quebec and other anglophone regions. Academic restrictions were accompanied by other measures such as quarantine, self-isolation, social distancing, and travel ban, to cite some. This has had a wide-ranging impact on these ISs. The resulting psychological distress and burden may have a much greater impact on Francophone ISs in anglophone settings, many of whom had ordinarily limited access to active offers of care in French in addition to cultural barriers and low literacy of the health care system. In order to take advantage of the effectiveness of eHealth as a pertinent and promising avenue, our project intends to build a web-based application that is cost-effective, user-friendly, anonymous, and capable to prompt interactive interventions as a first-line resource for psychological distress. In fact, internet applications have been increasingly used for the management of psychological distresses, and internet-based cognitive behavioral therapy is one of the preferred methods to prevent or control them.
Objective:The aims of this study are to (1) design, implement, and maintain Psy-Web for the psychological support of ISs and (2) analyze the results of the implementation of the Psy-Web platform, the additional resources solicited, and the results obtained.
Methods:This interventional project will use a sequential mixed design in the exploratory phase (phase 1) including the construction of the Psy-Web platform. A quantitative prospective component (phase 2) will include the intervention content of the Psy-Web platform. In total, 105 ISs participants (study group) and 52 ISs (control group), based on a ratio of 1:2, will be considered. The control group participants include those who did not use the web platform.
Results:The project is at the data collection stage (phase 1). Psy-Web will be built in accordance with the DMAIC (Define, Measure, Analyze, Improve and Control) model with the perspective of boosting its robustness. As a first-line resource to prevent psychological distress and ultimately improve their academic performance, Psy-Web is an innovative opportunity for high education managers. The project involves a multisectoral and a multidisciplinary partnership.
Conclusions:The project will develop a promising web-based solution to prevent psychological distress. Ultimately, Psy-Web will be operable in multiple languages including French.
International Registered Report Identifier (IRRID):PRR1-10.2196/47059
JMIR Res Protoc 2023;12:e47059
Relationships Between Family Connectedness and Stress-Triggering Problems Among Adolescents: Potential Mediating Role of Coping Strategies
Gervais, C., & Jose, P. E. Christine Gervais (2023, septembre)
Did the design and planning of testing and contact tracing interventions for COVID-19 consider social inequalities in health? A multiple case study from Brazil, Canada, France & Mali
Gagnon-Dufresne, M. C., Gautier, L., Beaujoin, C., Boivin, P., Coulibaly, A., Richard, Z., Cloos, P. & Zinszer, K. Lara Gautier, Patrick Cloos (2023, octobre)
Abstract
The COVID-19 pandemic has led to an unprecedented global crisis. It has exposed and exacerbated weaknesses in public health systems worldwide, particularly with regards to reaching the most vulnerable populations, disproportionately impacted by the pandemic. The objective of our study was to examine whether and how social inequalities in health (SIH) were considered in the design and planning of public health responses to COVID-19 in jurisdictions of Brazil, Canada, France, and Mali. This article reports on a qualitative multiple case study of testing and contact tracing interventions in regions with high COVID-19 incidence in each country, namely: Manaus (Brazil), Montréal (Canada), Île-de-France (France), and Bamako (Mali). We conducted interviews with 108 key informants involved in these interventions in the four jurisdictions, focusing on the first and second waves of the pandemic. We analyzed our data thematically using a theoretical bricolage framework. Our analysis suggests that the lack of a common understanding of SIH among all actors involved and the sense of urgency brought by the pandemic eclipsed the prioritization of SIH in the initial responses. The pandemic increased intersectoral collaboration, but decision-making power was often unequal between Ministries of Health and other actors in each jurisdiction. Various adaptations to COVID-19 interventions were implemented to reach certain population groups, therefore improving the accessibility, availability, and acceptability of testing and contact tracing. Our study contributes to identifying lessons learned from the current pandemic, namely that the ways in which SIH are understood shape how interventions are planned; that having clear guidelines on how to integrate SIH into public health interventions could lead to more inclusive pandemic responses; that for intersectoral collaboration to be fruitful, there needs to be sufficient resources and equitable decision-making power between partners; and that interventions must be flexible to respond to emerging needs while considering long-standing structural inequalities.
Full remission and recovery in a case of severe childhood psychosis after completion of a psychiatric day program
Mubasher, R., Heyman, M., & Kronick, R.Rachel Kronick (2023, septembre)
Abstract
Psychotic disorders with childhood onset before age 13 are rare and may have worse prognosis than their adult counterparts, although early detection and treatment may improve outcomes. This paper presents a case of a severe primary psychotic disorder in an 8-year-old child. Early initiation of antipsychotic medication combined with participation in an intensive, 6-month psychiatric day treatment program for children resulted in full remission of psychotic symptoms and a highly successful school reintegration. This case highlights the importance of early pharmacological and psychosocial interventions in improving outcomes in childhood-onset psychosis and potentially altering the course of a chronic and debilitating illness like schizophrenia.
Barriers and facilitators of access to sexual and reproductive health services among migrant, internally displaced, asylum seeking and refugee women: A scoping review
Sawadogo, P. M., Sia, D., Onadja, Y., Beogo, I., Sangli, G., Sawadogo, N., ... & Tchouaket Nguemeleu, E. Drissa Sia (2023, septembre)
Abstract
Introduction
Migrant, internally displaced, asylum seeking and refugee women experience ongoing risks of having their reproductive healthcare rights violated. This ever-increasing population also has limited access to sexual and reproductive health services. We conducted a scoping review to identify the barriers and facilitating factors when accessing sexual and reproductive health services for this specific population.
Methods
We searched the grey literature and queried eight bibliographic databases (Embase, Medline, Cinahl, Scopus, Science Direct, Web of Science, Hinari, and Cochrane Library) to extract articles published between January, 2000, and October, 2021. The extracted data were organized in a framework adapted from Peters et al. and then categorized as facilitators or barriers. We followed the Arksey and O’Malley framework and wrote the report according to the PRISMA-Scr recommendations.
Results
The search identified 4,722 records of which forty-two (42) met eligibility criteria and were retained for analysis. Ten (10) groups of factors facilitating and/or limiting access to sexual and reproductive health care emerged from the synthesis of the retained articles. The main barriers were lack of knowledge about services, cultural unacceptability of services, financial inaccessibility, and language barriers between patients and healthcare providers. Facilitators included mobile applications for translation and telehealth consultations, patients having a wide availability of information sources, the availability health promotion representatives, and healthcare providers being trained in cultural sensitivity, communication and person-centered care.
Conclusion
Ensuring the sexual and reproductive rights of migrant, internally displaced, asylum-seeking and refugee women requires that policymakers and health authorities develop intervention strategies based on barriers and facilitators identified in this scoping review. Therefore, considering their mental health in future studies would enable a better understanding of the barriers and facilitators of access to sexual and reproductive health services.
Cross-Cultural Mobility and Agency in Assessing the Appropriateness of Child Supervision in the Context of Cultural Diversity and Migration in Quebec
Ruiz-Casares, M., Sullivan, R., Gonzalez, E., Li, P., & Lacharité, C.Mónica Ruiz-Casares (2023, septembre)
Abstract
migration; child supervision; childcare; child agency; Canada; mobility
The Schooling of Forced Immigrant Afghan Youths in Iran: A Study of the Factors Leading to Exclusion
Ghasemi-Tafreshi, S., & Lafortune, G. Gina Lafortune (2023, septembre)
This article presents the results of a qualitative study which aims to better understand the educational paths of young Afghans in Iran. We conducted individual interviews with five child-parent pairs living in Tehran. The participants were invited to describe their families’ migratory experiences and the youths’ academic backgrounds. The interview data revealed that different intertwining factors led to the exclusion of the youths from school. These factors were tied to immigration policies and the youths’ social, familial, and educational environments. The results also showed that the youths were resilient; despite the many obstacles they had faced, they continued their efforts to achieve their academic and professional goals. This research highlights the challenges of welcoming and integrating young refugees in a non-Western context and contributes to the advancement of knowledge about the phenomenon of school exclusion in developing countries.Abstract
Keywords:
Youths Afghan refugees; Iran; educational pathways; formal education; exclusion
Learning From Practitioners Serving LGBTQ+ Forced Migrants and Other Diverse Groups: Implications for Culturally Informed Affirmative Practice
Alessi, E. J., Kahn, S., Ast, R. S., Cheung, S. P., Lee, E. O. J., & Kim, H.Edward Ou Jin Lee (2023, septembre)
Abstract
Objectives: This study explored the perspectives of mental health practitioners serving LGBTQ+ forced migrants, forced migrants not identifying as LGBTQ+, and nonmigrant LGBTQ+ individuals to understand the clinical frameworks guiding their practice and how they approached clients whose identities were similar to or different than their own. Method: Twenty-eight mental health practitioners from three Canadian cities participated in interviews. The sample comprised practitioners serving LGBTQ+ forced migrants (n=11�=11); forced migrants not identifying as LGBTQ+ (n=9�=9); and nonmigrant LGBTQ+ clients (n=8�=8). Data were analyzed using constructivist grounded theory. Results: Practitioners across all three groups used similar approaches whether or not they worked with clients whose sexual orientations, gender identities, racial/ethnic backgrounds, or migration status were different than their own. Practitioners described incorporating cultural competence, cultural humility, and LGBTQ+ affirmative and antioppressive practices in their work. Practitioners also noted that some clients had experienced discrimination by other providers, which sometimes made it difficult to establish a therapeutic relationship with them. Conclusions: Cultural humility, cultural competence, and affirmative practice may not be mutually exclusive. Similarities in practices across provider samples point to the salience of integrating clinical concepts and frameworks when working with LGBTQ+ forced migrants, LGBTQ+ individuals with diverse cultural backgrounds, and forced migrants who do not identity as LGBTQ+.
Vulnerability analysis of Haitian adolescent girls before pregnancy: a qualitative study
Philibert, L., Ngangue, P., Lapierre, J., Bernardino, E., Kiki, G. M., & Ntanda, G. M.Gisèle Mandiangu Ntanda (2023, septembre)
Abstract
Objectives
This article aims to analyze the vulnerabilities experienced by Haitian adolescent girls before their pregnancy.
Methods
A qualitative research design was developed from Dewey’s social survey. From October 2020 to January 2021, semi-structured interviews were conducted with 33 pregnant adolescents living in Haiti’s North and North-East departments. Thematic data analysis was performed using the qualitative data analysis software QDA miner, 6.0.5.
Results
The adolescent girls interviewed were between 14 and 19. The study showed that adolescent girls experienced economic and social hardship, gender issues, and barriers to contraceptive use before pregnancy. These girls have experienced restrictive conditions that make them vulnerable to risky sexual practices and unwanted pregnancy.
Conclusions
The results have indicated that Haitian adolescent girls’ vulnerabilities before their pregnancy result from economic, social, and cultural injustices to which they are exposed from early childhood. These adolescent girls are also highly vulnerable to sexual exploitation and rape, as well as pregnancy. It is essential to address these issues when implementing programs aimed at improving the living conditions of adolescents in Haiti, including the prevention of early and unwanted pregnancy.
Transnationalism and caring for vulnerable-status, migrant women and their families during pregnancy and early-childhood
Merry, L., Kevork, M., & Hille, J. Lisa Merry (2023, septembre)
Migrants commonly maintain transnational ties with their home country including identities, attachments, and
social, cultural, economic and service/care interactions. Significant gaps remain regarding care-providers’ perspectives on migrants’ transnational ties and whether and how these ties are addressed in the context of care. La
Maison Bleue (LMB) is a community-based social perinatal care service with four sites in Montreal, Canada,
providing health and social care to families in vulnerable contexts from pregnancy up until age five. We conducted a small, qualitative descriptive study and interviewed 7 care-providers (nursing, social work, family
medicine, psycho-education) and 3 administrators/support personnel from LMB to gather data on their experiences and perspectives on “transnationalism” in care with vulnerable-status migrant women and their families.
Transnational identity (language, culture, attachment to the home country), and ongoing connections with back
home, including communication with children and extended family, remittent sending, and the receipt of childrearing and health advice, commonly arise within care interactions. Fostering transnational relationships and
cultural identity are strategies used by LMB care-providers to strengthen migrant families’ sense of belonging and
to help them cope with losses, while addressing transnational tensions and stresses are used to promote families’
well-being and integration. This involves a combination of listening, humility, remaining open, providing information and delivering care that is respectful of culture and sensitive to families’ situations. Cultural negotiation, directly with migrant families or via local peers, is sometimes used to overcome transnational cultural
barriers related to health decisions and child-rearing. At times, care-providers also engage directly with family
back home to mediate cross-border stresses and cultural tensions and/or to draw on them as a source of information and support. Care-providers view transnational cultural ties and relationships as both positive and
negative for the well-being of families and with respect to its impact on interventions with families. Although not
always feasible, care-providers believe it’s important to know about families’ transnational contexts, in order to
provide responsive, supportive care.
Résumé à l’intention des gestionnaires. Composantes clés et conditions de succès de mise en œuvre et d’efficacité des réseaux de services intégrés pour les jeunes de 12 à 25 ans
Naïma Bentayeb, Jérémy Boisvert-Viens et Dorian MouketouNaïma Bentayeb (2023)
The Burden of Psychosis in Black Communities in Canada: More than a Feeling, a Black Family Experience. T
Cénat, J. M., Lashley, M., Jarvis, G. E., Williams, M. T., Bernheim, E., Derivois, D., & Rousseau, C.Myrna Lashley, Cécile Rousseau (2023, aout)
In the face of these pervasive problems, solutions must be implemented to create safety in mental health services to build a racially and culturally equitable system. We offer some recommendations:
Implementation of these recommendations would enhance the care for Black patients with psychosis. While this commentary is focusing on members of Black communities, we advocate at the same time for other minority groups that suffer at the hands of an inequitable and culturally unresponsive mental health care system. By reducing the many barriers to psychosis services by developing and implementing anti-racist training, policies and practices, we believe that other minority communities will benefit, with the ultimate objective of ensuring that everyone in Canada, regardless of ethno-racial background, will receive culturally appropriate and equitable care.
Supporting Reassigned Hospital Staff During the COVID-19 Pandemic in the Montreal Region: What Does it say About Leadership Styles?
Gautier, L., Gabet, M., Duhoux, A., Traverson, L., Ridde, V., Zinszer, K., & David, P. M.Lara Gautier (2023, aout)
Abstract
Supportive practices in the context of a social and vocational integration group: Impacts on the abilities of refugees within their learning pathways
Dionne, P., Joncas, J. A., & Charette, J. Josée Charette (2023, aout)
Abstract In Quebec, employment assistance centres offer social and professional integration (SPI) programs for refugees and asylum seekers, whose backgrounds are often marked by a winding path that may include traumatic experiences. This path can complicate integration into their host society and expose them to situations of social vulnerability. This article seeks to understand how a learning pathway in a group-based SPI program can open up a range of real opportunities and promote social justice from the standpoint of a capability approach. Our processual qualitative analysis of the learning pathways of these individuals addresses the resources that the program makes available in order to expand participants’ actual SPI opportunities. We also analyze barriers to the conversion of provided resources into instruments for learning. Keywords refugees, social and professional integration, capability approach, social justice, learning pathway, group
Self-representation and future perception of youth followed by a specialized intervention team in violent radicalization
Desmarais, C., Rousseau, C. Cécile Rousseau (2023, aout)
Abstract
In response to the increase in ideological and non-ideological mass killings, mental health professionals are beginning to invest in prevention and intervention in violent radicalization situations. The psychological and psychiatric literature proposes multiple psychological theories describing the individual factors at play in the process of violent radicalization: loss of meaning, responses to humiliation, dehumanization of the other as well as serious identity problems are often mentioned, but little is known about the self-representation of individuals attracted or involved in violent radicalization. This qualitative study aims at giving a sense of the complexity and texture of the experience of radicalized youth (18–30 years old), followed by a specialized clinic in Quebec (Canada). Ten patients, 18–30 years old, a significant age group for identity formation, were recruited for the study. An art-based method (self-portrait with a collage) and a projective testing method (the Thematic Apperception Test) were used to elicit the psychic representations of the patient about their identity and document their time perception. The results show that idealization and devaluation processes are central to these patients’ self-representation and are associated with adverse childhood experiences. Regarding time perception, many participants were spontaneously drawn toward a nostalgic past, manifesting significant difficulties in anchoring themselves in the present and imagining a future. These results confirm the vulnerability of this clientele and show that the projective art-based methods are perceived as more soothing than threatening. Clinical implications, tools and approaches to help evaluate and intervene with radicalized youth are discussed.
Community gardens as psychosocial interventions for refugees and migrants: a narrative review
Ramburn, T. T., Wu, Y. M., & Kronick, R.Rachel Kronick (2023, juillet)
Community gardens are increasingly used as interventions during the resettlement of refugees and other migrants. Little is known about how garden programs might support their mental health and wellbeing. Given the links between climate change and forced migration, community gardens are especially relevant, as they can also support climate change mitigation. This study aims to document psychosocial outcomes of gardening programs for refugees and migrants, and mechanisms leading to these outcomes. The authors searched major databases and the grey literature up to 2021, resulting in the inclusion of 17 peer-reviewed and 4 grey literature articles in a thematic, qualitative analysis. Four consistent themes arose from the analysis: community gardening programs promoted continuity and adaptation (81% of articles), social connectedness (81%), overall wellbeing (95%) and a sense of meaning and self-worth (67%). The results suggest that community gardens can strengthen psychosocial pillars that are key to the recovery and resettlement of refugees and migrants. The land-based and social nature of community gardening may enable connections to the land and others, nurture a sense of belonging in the host country and provide a link to the past for those from agricultural backgrounds. Further participatory action research is needed to develop guidelines for the successful implementation of community gardens by resettlement organisations. This review indicates that community gardens can be effective psychosocial interventions as part of a network of services supporting the resettlement of refugees and migrants.Abstract
Purpose
Design/methodology/approach
Findings
Research limitations/implications
Originality/value
Keywords
Are we training our students to be white saviours in global health?
Banerjee, A. T., Bandara, S., Senga, J., González-Domínguez, N., & Pai, M. Ananya Banerjee (2023, aout)
In 2012, the Nigerian-American writer and artist Teju Cole called out the culture of white saviourism in the USA and introduced the concept of the White Saviour Industrial Complex (WSIC). The make-up of global health education perpetuates and feeds into the WSIC, with universities in high-income countries (HICs) accounting for a major share of global health programmes. Global health education is in certain respects a growth industry of whiteness that promotes justice only on paper and remains rooted in harmful colonial worldviews. Cole noted that the WSIC is “not about justice”, rather “it is about a big emotional experience that validates privilege”. This reflection applies to how global health is taught, including by us as educators based in Canada, irrespective of our roots and citizenship in Sri Lanka, Rwanda, Mexico, and India. Those who work in global health in HICs benefit from an imbalance of power that maintains the white supremacist status quo, and consequently an entrenched divide in global health. As global health educators we are then compelled to ask: are we training students to be “white saviours”, irrespective of their ethnicity or country of origin, and how can global health education be reconfigured?
Children of extremist parents: Insights from a specialized clinical team
Rousseau, C., Miconi, D., Johnson-Lafleur, J., Desmarais,C., et Hassan, G.Cécile Rousseau, Janique Johnson-Lafleur, Ghayda Hassan (2023, aout)
Abstract
Background
Objective
Methods
Results
Conclusions
Community gardens as psychosocial interventions for refugees and migrants: a narrative review
Ramburn, T. T., Wu, Y. M., & Kronick, R.Rachel Kronick (2023, aout)
Community gardens are increasingly used as interventions during the resettlement of refugees and other migrants. Little is known about how garden programs might support their mental health and wellbeing. Given the links between climate change and forced migration, community gardens are especially relevant, as they can also support climate change mitigation. This study aims to document psychosocial outcomes of gardening programs for refugees and migrants, and mechanisms leading to these outcomes. The authors searched major databases and the grey literature up to 2021, resulting in the inclusion of 17 peer-reviewed and 4 grey literature articles in a thematic, qualitative analysis. Four consistent themes arose from the analysis: community gardening programs promoted continuity and adaptation (81% of articles), social connectedness (81%), overall wellbeing (95%) and a sense of meaning and self-worth (67%). The results suggest that community gardens can strengthen psychosocial pillars that are key to the recovery and resettlement of refugees and migrants. The land-based and social nature of community gardening may enable connections to the land and others, nurture a sense of belonging in the host country and provide a link to the past for those from agricultural backgrounds. Further participatory action research is needed to develop guidelines for the successful implementation of community gardens by resettlement organisations. This review indicates that community gardens can be effective psychosocial interventions as part of a network of services supporting the resettlement of refugees and migrants.Abstract
Purpose
Design/methodology/approach
Findings
Research limitations/implications
Originality/value
Keywords
What can be said about risks, vulnerabilities, and adaptation to climate change in Caribbean small island developing states (SIDS)? The case of Dominica. A qualitative study.
Cooper, S., Abraham, C., Ravaliere, T., Harris-Glenville, F., McPherson, N., & Cloos, P.Patrick Cloos (2023, aout)
Abstract
Introduction
Caribbean Small island developing states (SIDS) are generally qualified as disproportionately vulnerable to climate change, including extreme weather events like hurricanes. While many studies already documented the impacts of climate change on health in the wealthiest countries, there is little knowledge in this field in Caribbean SIDS. Our study aims to discuss health risks and vulnerabilities in a Caribbean context to inform future adaptation measures to climate change.
Methods
Our paper is based on a qualitative study that was conducted in Dominica, a Caribbean SIDS. The data come from semi-structured int… more
DOI
https://doi.org/10.31223/X52Q21
Subjects
Public Health
Keywords
climate change, health, Public health, Global Health, vulnerability, adaptation, risks, Caribbean, West Indies
Sex and gender differences in healthcare utilisation trajectories: a cohort study among Quebec workers living with chronic pain
Lacasse, A., Nguefack, H. L. N., Page, G., Choinière, M., Samb, O. M., Katz, J., Vissandjée, B. & Zerriouh, M. (2023). Bilkis Vissandjée (2023, juillet)
Abstract
Objectives Chronic pain (CP) is a poorly recognised and frequently inadequately treated condition affecting one in five adults. Reflecting on sociodemographic disparities as barriers to CP care in Canada was recently established as a federal priority. The objective of this study was to assess sex and gender differences in healthcare utilisation trajectories among workers living with CP.
Design Retrospective cohort study.
Participants This study was conducted using the TorSaDE Cohort which links the 2007–2016 Canadian Community Health Surveys and Quebec administrative databases (longitudinal claims). Among 2955 workers living with CP, the annual number of healthcare contacts was computed during the 3 years after survey completion.
Outcome Group-based trajectory modelling was used to identify subgroups of individuals with similar patterns of healthcare utilisation over time (healthcare utilisation trajectories).
Results Across the study population, three distinct 3-year healthcare utilisation trajectories were found: (1) low healthcare users (59.9%), (2) moderate healthcare users (33.6%) and (3) heavy healthcare users (6.4%). Sex and gender differences were found in the number of distinct trajectories and the stability of the number of healthcare contacts over time. Multivariable analysis revealed that independent of other sociodemographic characteristics and severity of health condition, sex—but not gender—was associated with the heavy healthcare utilisation longitudinal trajectory (with females showing a greater likelihood; OR 2.6, 95% CI 1.6 to 4.1).
Conclusions Our results underline the importance of assessing sex-based disparities in help-seeking behaviours, access to healthcare and resource utilisation among persons living with CP.
Learning from The Lived Experiences of Aging Immigrants: Extending the Reach of Photovoice Using World Café Methods
Kadowaki, L., Koehn, S. D., Brotman, S., Simard, J., Ferrer, I., Raymond, É., & Orzeck, P. Shari Brotman (2023, juillet)
Abstract
This article reports on a series of Stakeholder Outreach Forums hosted in Canadian communities from 2018 to 2019. These forums built on a previous research project, The Lived Experiences of Aging Immigrants, which sought to amplify the voices of older immigrants through Photovoice and life course narratives analyzed through an intersectional life course perspective. The forums used World Café methods to encourage cumulative discussions among a broad range of stakeholders who work with or influence the lives of immigrant older adults. Participants viewed the previously created Lived Experiences of Aging Immigrants Photovoice exhibit, which provided a springboard for these discussions. The forums’ aim was to increase the stakeholders’ awareness of the experiences of immigrants in Canada as they age and to create space for the stakeholders to reflect upon and discuss the experiences of aging immigrants. Here we illustrate how the forums complement the narrative Photovoice research methodology and highlight the potential of Photovoice and targeted outreach strategies to extend academic research findings to relevant stakeholders. Across all forums, participants identified structural and systemic barriers that shape experiences of and responses to social exclusion in the daily lives of immigrant older adults. They further identified challenges and strengths in their own work specific to the issues of social inclusion, caregiving, housing, and transportation. Intersectoral solutions are needed to address the structural and systemic roots of exclusion at the public policy and organizational levels.
Navigating bureaucratic violence in Canada’s two-step immigration system
Schmidt, C., Bergen, H., Hajjar, O., Larios, L., Nakache, D., Bhuyan, R., & Hanley, J. Jill Hanley (2023, juillet)
ABSTRACT
In recent years, Canada has moved towards a system of ‘two-step’ immigration, wherein a growing proportion of new permanent residents are selected from people who are already in the country on a temporary work permit. While the ‘two-step’ selection approach has been lauded as improving immigrants’ labour market outcomes, the process to achieve permanent residence can be complex and the stringent selection criteria prevent many migrants from attaining permanent status. In this paper, we examine the administrative burden that migrants with precarious status encounter in their interactions with state immigration bureaucracies as they try to attain permanent residence through economic programmes. The research is based on a qualitative analysis of interviews with 20 migrants with precarious status in the provinces of Ontario, Alberta and Quebec. Participants describe the stressful life consequences resulting from confusing and opaque administrative processes, unpredictable wait times, costly application fees, bureaucratic errors and a lack of accountability. We theorise how such experiences of administrative burden can compound into forms of bureaucratic violence that prolong migrant precarity, exacerbating the legal violence inherent in state immigration categories which deny full social rights to migrants without permanent residence.
Reducing the Burden of Hepatitis C and Supporting the Health of Indigenous Communities Through Culturally Congruent Nursing Practice: A Narrative Review
Patrice-Quirion, R., Dubé, V., Merry, L., & Caux, C.Lisa Merry (2023, juillet)
Abstract
Introduction: Canada’s Indigenous populations are disproportionately affected by Hepatitis C Virus (HCV). Indigenous cultures and knowledge are poorly integrated into HCV health interventions and nursing care also has deficiencies in this regard.
Objectives: The purpose of this narrative review was to analyze community-based HCV interventions in Indigenous populations in order to propose recommendations for strengthening HCV nursing practice and ensuring it responds to the needs and values of the Indigenous communities.
Methods: Rapid review methods were used. Searches were conducted in CINAHL, MEDLINE, EMBASE and Cochrane databases and using the Google search engine. The community readiness model of Stanley et al. (2014), which promotes the development of tailored interventions based on strengths, the issue and the context, guided the analysis.
Results: A total of 24 sources were used to analyze 13 intervention projects. Similarities emerged within 11/13 intervention projects applying a holistic approach (n=11) and/or a harm reduction approach (n=7), which involved a trusting, non-judgmental, and non-stigmatizing relationship. Community mobilization was inherent to all 13 intervention projects, and it is through a self-determination approach that nurses were most likely to achieve this mobilization needed for the intervention on HCV.
Discussion and conclusion: It is through the application of a holistic harm-reduction approach, that nurses can support self-determination and community mobilization to effectively reduce the burden of HCV experienced by Indigenous communities.
Keywords:
- nursing practice,
- hepatitis C virus (HCV),
- Indigenous,
- harm reduction,
- holistic
Social Media Interventions for Nutrition Education Among Adolescents: Scoping Review
Kulandaivelu, Y., Hamilton, J., Banerjee, A., Gruzd, A., Patel, B., & Stinson, J.Ananya Banerjee (2023, juillet)
Abstract
Background:Adolescence is a critical period for reinforcing healthy dietary behaviors and supporting the development of cooking skills. Social media may be an avenue for supporting these behaviors, as it is popular among adolescents and can improve access to nutrition education interventions. This study sought to understand the optimal implementation of effective social media–based nutrition education interventions to inform the implementation of future social media–based nutrition education interventions.
Objective:A scoping review of the characteristics, feasibility, effectiveness, and factors influencing social media–based nutrition education interventions for adolescents was conducted.
Methods:We searched MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO databases using a predefined search strategy. Primary research articles were independently screened and included if they involved adolescent populations (10-18 years old) and delivered nutrition education through social media. The information on intervention characteristics, feasibility, effectiveness, and factors influencing social media–based nutrition education interventions was extracted.
Results:A total of 28 publications out of 20,557 met the eligibility criteria. Twenty-five nutrition interventions were examined by 28 studies. Fourteen interventions used homegrown social media platforms, 8 used Facebook, and 2 used Instagram. Feasibility outcomes were infrequently reported, and the cost of intervention delivery was not reported. Engagement with interventions was variable; high engagement was not required to elicit significant improvements in dietary behaviors. Tailoring interventions, offering practical content, meaningful peer support, and involving families and communities facilitated successful interventions. Strategies to address engagement and technical issues were varied.
Conclusions:Emerging evidence demonstrates that social media interventions for adolescent nutrition are acceptable and improve nutrition outcomes. Future interventions should strengthen peer support components and tailor delivery to specific populations. Further research should examine engagement, adherence, and the impact of interventions on behavioral and physical outcomes. This review is the first to examine the use of social media as the primary medium for nutrition education for adolescent populations. The analysis used in this review argues the importance of peer support in social media–based nutrition interventions and the need for user-centered design of the interventions.
JMIR Pediatr Parent 2023;6:e36132
I think they should give primary health care a little more priority. The Primary Health Care in Caribbean SIDS: What can be said about adaptation to the changing climate? The case of Dominica. A qualitative study
Gervais, C., Côté, I., Pierce, T., Vallée-Ouimet, S., & de Montigny, F. Patrick Cloos (2023, juillet)
Background
Climate change (CC) adaptation is considered a priority for Caribbean Small Islands Developing States (SIDS), as these territories and communities are considered particularly vulnerable to climate-related events. The primary health care (PHC) system is an important actor in contributing to climate change adaptation. However, knowledge on how PHC is prepared for CC in Caribbean SIDS is very limited. The objective of this paper is to discuss health adaptation to climate change focusing on the PHC system.
Methods
We explored the perspectives of PHC professionals in Dominica on climate change. Focus group discussions (FGDs) were conducted in each of the seven health districts in Dominica, a Caribbean SIDS, between November 2021 and January 2022. The semi-structured interview guide was based on the Essential Public Health Functions: assessment, access to health care services, policy development and resource allocation. Data coding was organized accordingly.
Results
Findings suggest that health care providers perceive climate change as contributing to an increase in NCDs and mental health problems. Climate-related events create barriers to care and exacerbate the chronic deficiencies within the health system, especially in the absence of high-level policy support. Healthcare providers need to take a holistic view of health and act accordingly in terms of disease prevention and health promotion, epidemiological surveillance, and ensuring the widest possible access to health care, with a particular focus on the ecological and social determinants of vulnerability.
Conclusion
The Primary Health Care system should be a key actor in designing and operationalizing adaptation and transformative resilience. The Essential Public Health Functions should integrate social and climate and ecological determinants of health to guide primary care activities to protect the health of communities. This indicates a need for improved research on the linkages between climate events and health outcomes, surveillance, and development of plans that are guided by contextual knowledge in the SIDS.
Adolescents Exposed to Cumulative Natural Disasters: A Comparison Between their Realities in Rural and Urban Areas
Pouliot, E., Maltais, D., Gervais, C., Tardif-Grenier, K., Simard, A. S., Gauthier, P., ... & Hamel, A.Christine Gervais (2023, juillet)
Over the past years, the Outaouais region (Quebec, Canada) and their residents have had to endure no less than five natural disasters (floods, tornadoes). These disasters are likely to have a variety of consequences on the physical and mental health of adolescents, as well as on their personal, family, school and social lives. The experiences of teenagers are also likely to vary depending on whether they live in rural or urban areas.
Data were collected via a self-administered questionnaire in February 2022. A total of 1307 teenagers from two high schools participated in the study by completing an online survey. The questionnaire measured various aspects of the youth’s mental health using validated tests, such as manifestations of post-traumatic stress, anxiety and depression, as well as the presence of suicidal thoughts and self-harm. Other aspects of the youth’s experience were measured, including their level of social support, school engagement, alcohol and drug use, and coping strategies.
One third of young students (n=1307) were experiencing depressive symptoms and suicidal thoughts, as well as significant daily stress. More than 25% of the students had moderate or severe anxiety and thoughts of self-harm. These problems were significantly more prevalent among youths with prior exposure to a natural disaster. The study data also revealed that youths living in rural areas had a more worrying profile than those living in urban areas.
Similar to other studies (Ran et al., 2015; Stratta et al., 2014), our research data revealed that youths living in rural areas presented a more concerning profile than those residing in urban areas. It therefore seems important, in future studies and services, to focus more specifically on these teenagers to better understand their needs and to develop adapted services more likely to meet them.
Continuing professional development (CPD) system development, implementation, evaluation and sustainability for healthcare professionals in low-and lower-middle-income countries: a rapid scoping review.
Merry, L., Castiglione, S. A., Rouleau, G., Létourneau, D., Larue, C., Deschênes, M. F., ... & Ahmed, L. Lisa Merry (2023, juillet)
Embedding anti-racism in Schools of Public Health: a pathway to accountability for progress towards equity
Banerjee, A. T., Tan, A., Boston-Fisher, N., Dubois, C. A., LaFontaine, A., Cloos, P., ... & Evans, T. Ananya Banerjee, Patrick Cloos (2023, juillet)
Abstract
The importance of seeing race as a socially constructed idea continues to produce unfair differences between humans and establishes power relations that lead to injustice and exposure to death. Since the racial justice movement in early 2020, there has been a heightened awareness of, and increased interest in, addressing historic racial disparities across Schools of Public Health (SPH) in Canada. Steps have been taken to recognize systemic racism and increase diversity through structural reforms to advance equity and inclusion; however, addressing racism demands collectively uprooting racist institutional designs still inherent in learning, teaching, research, service, and community engagement. This commentary highlights the need for sustained commitment to establishing longitudinal benchmarks for greater racial equity among students, staff, and faculty; revising curricula to include historic and contemporary narratives of colonialism and slavery; and providing community-engaged learning opportunities as instrumental to dismantle systemic drivers of racial health inequities locally and globally. We also advocate for intersectoral collaboration, mutual learning, and sharing of resources across SPH and partner agencies to accomplish a continual collective agenda for racial health equity and inclusion that is intersectional in Canada, while being held accountable to Indigenous and racialized communities.
Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review
Hynie, M., Oda, A., Calaresu, M., Kuo, B. C., Ives, N., Jaimes, A., ... & McKenzie, K.Nicole Ives, Annie Jaimes (2023, juillet)
Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments. A search in CINAHL, MEDLINE, PSYCINFO, EMBASE, SOCINDEX and SCOPUS following (Arksey and O’Malley in Int J Soc Res Methodol 8:19–32, 2005) guidelines found 44 papers and 41 unique interventions/assessment tools. Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS’ accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted.
Interpellations policières et profilage racial: Contextualisation de la pratique d’interpellation à la lumière de l’identité racisée des personnes interpellées et évaluation de la nouvelle politique d’interpellation
Armony, V., Boatswain-Kyte, A., Hassaoui, M., & Mulone, M. Alicia Boatswain-Kyte (2023, juillet)
Le mandat
Le deuxième mandat de l’équipe de recherche indépendante découle directement des conclusions et des recommandations du premier mandat complété en 2019. Ce deuxième mandat a visé à « avoir une meilleure compréhension des interpellations afin de mieux définir leur usage et mieux prévenir les interpellations aléatoires »; à « comprendre les motivations des policiers dans le cadre des interpellations; à « évaluer l’impact de la politique sur les interpellations; à « déterminer si les interpellations sont réalisées conformément aux prescriptions de la politique »; à « évaluer la capacité [des nouveaux outils servant] à contextualiser l’interpellation policière ». Outre les nombreuses analyses statistiques à déployer, le Plan d’action soumis et approuvé par la direction du SPVM prévoyait un important volet qualitatif du mandat visant à « aborder les questions du contexte organisationnel qui sont à l’origine du mandat même et dont les policières et policiers qui seront sollicités seront évidemment conscients : l’observation de disparités ethnoculturelles dans les statistiques de l’interpellation ».
Cultural and Social Context of Clinical Assessment
Kirmayer, L. J., Rousseau, C., Jarvis,G. E. & Guzder, J. Cécile Rousseau (2023, mai)
Abstract
Careful assessment of the social and cultural context of psychiatric problems must form a central part of any clinical evaluation. Beyond this, culturally based attitudes and assumptions govern the perspectives that patient and clinician bring to the clinical encounter. Patients articulate their suffering and concerns through cultural models, idioms, and practices located with social networks and systems of meaning. Awareness of differences in the social and positions and cultural perspectives of patient and clinician is important for the development of a clinical alliance, the negotiation of treatment, and the delivery of effective care. This chapter introduces key concepts and approaches to culturally and structurally competent and safe clinical practice, including: notions of culture, ethnicity, and racialized identity; the intersectionality of culture with age, gender, sexual orientation; the use of the cultural formulation interview; working with interpreters and culture brokers; and issues of stigma, coping, and recovery.
Keywords
- Culture
- Ethnicity
- Cultural formulation
- Social determinants of health
- Racism
- Idioms of distress
- Explanatory models
- Cultural syndromes
- Cultural competence
- Cultural safety
Reconfiguring Health: The Importance of Recognizing Embodied Subjectivity and Social Dynamics in Health
Sturm, G., & Zoldan, Y. Yann Zoldan (2023, juin)
Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol
Gautier, L., Di Ruggiero, E., Jackson, C., Bentayeb, N., Blain, M. J., Chowdhury, F., ... & Touati, N. Lara Gautier, Naïma Bentayeb (2023, juin)
Background
Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.
Bricoleurs de rites et artistes-ritualistes au Québec : figures de proue d’un régime religieux en émergence
Kostecki, I., & Mossière, G. Géraldine Mossière (2023, juin)
Expériences de fin de vie dans un Montréal pluriel : mieux comprendre pour mieux accompagner
Symposium Depuis quelques années, une vaste recherche a été menée afin de documenter l’expérience de la fin de vie et de la mort de familles et de proches, migrants et non-migrants, qui ont perdu un être cher, à Montréal. Comment se déclinent les trajectoires de fin de vie, quels conflits et négociations engagent-elles, au sein […]
Fathering Here, Fathering There… A Phenomenological Study of the Impact of Forced Migration and Resettlement on Syrian Refugee Fathers in Canada
Al Mhamied, A., Bogossian, A., & Hanley, J.Jill Hanley (2023, juin)
Abstract
Are Healthcare Systems Failing Immigrants? Transnational Migration and Social Exclusion in the Workers’ Compensation Process in Québec
Côté, D., White, B., Dubé, J., & Gravel, S.Daniel Côté (2023, juin)
Abstract
Social and individual grievances and attraction to extremist ideologies in individuals with autism: Insights from a clinical sample
Rousseau, C., Johnson-Lafleur, J., Ngov, C., Miconi, D., Mittermaier, S., Bonnel, A., Savard, C., & Veissière, S. Cécile Rousseau, Janique Johnson-Lafleur (2023, juin)
bstract
Background
Addressing the lack of empirical data on autistic individuals referred to clinical services because of concerns about violent extremism (VE), this paper sketches a portrait of autistic patients referred to a specialized clinical team dealing with VE in Montreal (Canada).
Methods
We draw on a mixed methods concurrent triangulation design to complement a quantitative file review with qualitative data from focus groups with clinicians.
Results
Results highlight the role of isolation, stigmatization, and social grievances as risk factors. They also emphasize the role of education, law enforcement, and justice-system professionals who frequently miss or misinterpret specific features of autism, leading to problematic risk assessments and interventions with further risks of stigmatization, trauma, and disengagement from services.
Conclusion
We suggest preliminary avenues to improve intervention for autistic individuals displaying interests for VE. Addressing social isolation and promoting environments adapted to neurodiversity could decrease despair and prevent attraction to extremist discourses. Better collaboration between the different sectors involved in prevention could promote better adapted, less stigmatizing interventions.
Le projet de loi 23: une vision de la recherche et de la formation qui renforce et invisibilise les inégalités éducatives et sociales
Borri-Anadon, C., Hirsch, S., Koubeissy, R., Larochelle-Audet, J., Magnan, M. O., Maynard, C., Audet, G. & Charette, J. Geneviève Audet, Josée Charette (2023, mai)
Ce mémoire a été élaboré par des membres chercheuses de l’équipe Inclusion et diversité ethnoculturelle en éducation (IDEÉ) financée par le Fonds de recherche du Québec – Société et Culture. Cette équipe a pour principaux objectifs :
1. de comprendre comment le personnel scolaire contribue à produire ou à réduire les inégalités éducatives en contexte de diversité ethnoculturelle ;
2. d’identifier comment les institutions éducatives, du préscolaire jusqu’à l’université, et leurs agents peuvent contribuer à réduire les inégalités et favoriser la justice sociale ;
3. de contribuer à éclairer les politiques en éducation et en immigration, les initiatives communautaires, la formation initiale et continue du personnel scolaire et les pratiques des milieux éducatifs. L’équipe IDEÉ adopte une posture critique afin de comprendre comment certaines pratiques et certains processus structurels agissent sur la réussite éducative et sur l’expérience de tou.te.s les actrices et acteurs de l’école, notamment les actrices et acteurs de groupes minorisés ou racisés. L’équipe IDEÉ rassemble :
● 11 chercheuses régulières mobilisant une diversité d’approches de recherche et de disciplines dont la sociologie, la psychopédagogie, la psychologie sociale, la didactique et l’administration scolaire;
● 40 étudiantes et étudiants à la maitrise et au doctorat;
● 11 collaboratrices et collaborateurs des milieux de pratique travaillant dans les institutions éducatives et gouvernementales ainsi que dans des organismes communautaires.
Empowerment and intervention strategies to strengthen the use of sexual and reproductive health services by ensuring continuity of care for adolescent girls and internally displaced women in Burkina Faso
Sawadogo, P. M., Ngeumeleu, E. T., Onadja, Y., & Sia, D.Drissa Sia (2023, mai)
Abstract
Background: In Burkina Faso, a security crisis has displaced families within the country, fleeing high-risk areas. One of the major consequences of this displacement is the low use of sexual and reproductive health care and services, and the reduced empowerment of adolescent girls and internally displaced women (IDP). This research aims to analyze the situation and co-develop intervention strategies to strengthen the empowerment of these adolescent girls and IDP women for the use of these services by ensuring the continuity of this care.
Methods: This study is based on a mixed approach (quantitative and qualitative). The quantitative component is based on a survey of 1,474 randomly selected households in temporary IDP reception sites in the cities of Kaya and Kongoussi in Burkina Faso. Empowerment was analyzed in terms of motivational autonomy and exercise of choice in family planning. Descriptive analysis and multivariate logistic regression have allowed us to describe the empowerment of IDP women and adolescent girls and identify the determinants of the use of modern contraception among IDP adolescents and women. The qualitative component has enabled to co-construct intervention strategies to strengthen empowerment and also ensure continuity of care, using a participatory approach supported by a deliberative workshop.
Results: Out of a sample of 1,220, adolescent girls (12-19 years old) and women (20-49 years old) represented respectively 17.5% and 82.5%. The analysis showed that 42.5% of IDP adolescent girls and women were using a modern method of contraception at the time of the survey. The analysis also showed that 89.2% and 79.5% of adolescent girls and IDP women have low levels of motivational autonomy and exercise of choice in family planning, respectively. A poor perception of contraceptives side effects and possible difficulties with the partner or even the fear of having difficulties returning to fertility after contraception “”damage”” women’s motivation to use contraception methods. In addition, the ability to discuss with the partner hinders the exercise of choice in contraception. Intervention strategies based on community dialogue and communication with IDPs and community members have emerged as those promoted to facilitate the use and continuity of health services.
Recommendations: Empowerment appears as a determining factor to enhance the contraceptive demand by adolescent girls and internally displaced women. Community dialogue and communication sessions on family planning for IDPs and the population must be well implemented.
Family Functioning and the Pandemic: How Do Parental Perceived Social Support and Mental Health Contribute to Family Health?
Gervais, C., Côté, I., Pierce, T., Vallée-Ouimet, S., de Montigny, F. Christine Gervais (2023, mai)
Background
Objective
Method
Results
Conclusion
Taking Action on Racism and Structural Violence in Psychiatric Training and Clinical Practice
Jarvis G.E., Andermann L., Ayonrinde O.A., Beder, M., Cénat, J. M., Ben-Cheikh, I., Fung, K., Gajaria, A., Gómez-Carrillo,A., Guzder, J., Hanafi, S., Kassam, A., Kronick, R., Lashley, M., Lewis-Fernández, R., McMahon, A., Measham, T., Nadeau, L., Rousseau,C., Sadek,J., Schouler-Ocak, M., Wieman, C., Kirmayer, L.Rachel Kronick, Myrna Lashley, Lucie Nadeau, Cécile Rousseau (2023, mai)
Introduction
Enjeux et pratiques auprès des personnes LGBTQI+ migrantes et racisées
Colloque Dans le cadre du 90e congrès de l’ACFAS. Les réalités des personnes lesbiennes, gaies, bisexuelles, trans, queer et intersexuées (LGBTQI+) migrantes et racisées sont complexes, du fait notamment des violences qu’elles ont pu subir tout au long de leur parcours migratoire. Souvent elles ont été contraintes de quitter leur pays d’origine en raison de […]
Evaluating the feasibility and outcomes of a resident-led school-based pediatric clinic
D’Arienzo, D., Xu, S., Shahid, A., Meloche, D., Hebert, J., Dougherty, G., Li, P., & Sternszus, R.Patricia Li (2023, mai)
Abstract
A resident-led school-based clinic to serve low-income populations was established in 2019 and served as a continuity clinic for pediatric residents at a single university. Our aim was to assess the feasibility, clinic outcomes, and resident experience of a resident-led school-based clinic (RLSBC), established in an elementary school that serves an underserved population.
A retrospective chart review for the first 6 months (October 2019 to March 2020) of clinic operations was conducted. Feasibility metrics included the number of patients, visits and planned follow-ups; clinic outcomes included the number and type of presenting complaint, new diagnoses and interventions. Residents were also surveyed to assess their satisfaction and perceived learning in training at the school-based clinic.
Over the first 19 clinic days, 48 children were seen at the school-based clinic. Of the clinic users, 60% did not have a primary care physician, 46% received a new diagnosis, 46% received an intervention in the form of medication prescription, laboratory/imaging requisitions or referrals, and 96% received a treatment plan. Residents positively rated the experience of staffing the school-based clinic in all aspects, including learning environment, clinic and team environment, teaching obtained, practice management, and overall experience.
A RLSBC is feasible and our outcomes suggest that such clinics may address health care needs of low-income families and children, while being a positively rated educational experience for pediatric residents.
STOPMTL.ca: Preliminary report, 2023
Côté-Lussier, C., Bradford, B., Carmichael, J., Cloutier, M.-S., Kakimani, L., Kapo, L. T., & Lashley, M. Myrna Lashley (2023, mai)
The stopmtl.ca project uses a participatory mapping methodology to allow individuals to self-report their police stop experiences in the city of Montreal, Canada. Between July 14th 2021 and December 21st 2021, a total of 714 police stop experiences were contributed to the stopmtl.ca website. Of these contributions, approximately 28% (N = 197) were removed due to a programming error that led to the duplication of cases. Of the remaining contributions (N = 517), 21% were suspected fake data and 7% were excluded due to missing data. A total of 369 contributed police stop experiences were retained (71%). A descriptive analysis of the data suggests that most police stop experiences were reported by men (74%), individuals who identified as being White (55%), hetereosexual (70%) and being aged between 19 and 24 years (27%). A Black racioethnic identity was the second most frequent racioethnic identity (17%). In terms of spatial distribution, stop experiences were reported as occurring most frequently in the Côte-des-Neiges (13%) and Ville-Marie (12%) boroughs of Montreal. Nearly half of all reported stops were reported as having occurred in 2021 (49%), and most frequently in the summer months (May-August) (65%), peaking in July (33%). The most frequent activity individuals reported doing during their stop was being in a vehicle (42%), followed by walking (23%). Respondents could identify multiple reasons for which they believed they were stopped. The perceived reason for the stop most frequently identified was what the person was doing (39%), followed by their appearance (30%). Roughly equal proportions of police stops were seen as justified (41%) and as not justified (43%). There are several similarities between the characteristics of self-reported police stop experiences contributed to stopmtl.ca and police-recorded stops in the city of Montreal, Canada. Namely, there appears to be a comparable spatial distribution of police stops in both data sets, as well as some indication of a comparable social distribution (e.g., gender, age and racioethnic identities of those stopped). However, the self-reported police stop data is limited in several important ways. Namely, for self-reported police stops with available data on whether the respondent received a sanction following their stop (i.e., fine, arrest or charge) (N = 129), 42% were said to have led to a sanction. This limits the capacity to draw strong comparisons between self-reported data and police-recorded data (which excludes all stops leading to a sanction). Though criteria were applied to exclude suspected fake data, it is not possible to establish the veracity of self-reported stops. Nevertheless, these preliminary descriptive results provide a snapshot of who self-reported their stops and of the types of stops that led to self-reports. Furthermore, the data provide insight into citizens’ perceptions of their police stop experiences. Future directions for research, including planned validation analyses and a second wave of data collection are discussed.
Have public health responses to COVID-19 considered social inequalities in health? Insights from Brazil, Canada, France & Mali
Gagnon-Dufresne, M.-C., Gautier, L., Beaujoin, C., Richard, Z., Boivin, P., Medeiros, S. G. de, Ridde, V., & Zinszer, K. Lara Gautier (2023, mai)
Travailler en zone rouge : préposés aux bénéficiaires migrants et contexte pandémique
CATHERINE MONTGOMERY, professeure, Département de communication sociale et publique, UQAM ALEXIA PILON, doctorante, Institut santé et société, UQAM MARIE-JEANNE BLAIN, chercheure, Centre de recherche et de partage des savoirs InterActions CIUSSS du Nord-de-l’Île-de-Montréal. Professeure associée, département d’anthropologie, Université de Montréal ÉMILIE TREMBLAY, doctorante, Département de communication sociale et publique, UQAM, MARIE-EMMANUELLE LAQUERRE, professeure, Département de […]