Objective: Group processes and identities play a crucial role in the development of positive attitudes toward violent radicalization (VR). However, we do not know much about the impact of specific group identities on support for violent radicalization and the mechanisms that can explain how such associations unfold. This study investigates the independent and cumulative associations between multiple group identities and support for violent radicalization among Canadian college and university students and the potential moderating role of in-group identification and perceived public collective self-esteem in these associations. Method: Students (N = 5,598; M_age = 22.8; SD_age = 7.5; 68.0% women) completed an online survey. Mixed-effects linear regression models and interaction analyses were implemented. Results: Identities related to political, gender, and sexual orientation groups were independently and cumulatively associated with higher support for violent radicalization (polarizing), whereas identities related to religion, profession, ethnicity, age, or leisure activities were cumulatively associated with lower support for violent radicalization (nonpolarizing). Identities related to religion and profession were independently associated with lower support for violent radicalization. The magnitude of associations between cumulative polarizing identities and support for violent radicalization was larger at low levels of perceived public collective self-esteem and high levels of in-group identification. Conclusions: Prevention efforts need to situate students’ identity development within the broader societal context, in a socioecological perspective. Supporting students’ multiple identities is a promising strategy to prevent violent radicalization, if we simultaneously work on local dynamics in order to enhance inclusion in schools and societies. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Background:Cultural adaptations of digital health innovations are a growing field. However, digital health innovations can increase health inequities. While completing exploratory work for the cultural adaptation of the Ned Clinic virtual survivorship app, we identified structural considerations that provided a space to design digitally connected and collective care.

Objective:This study used a community-based participatory research and user-centered design process to develop a cultural adaptation of the Ned Clinic app while designing to intervene in structural inequities.

Methods:The design process included primary data collection and qualitative analysis to explore and distill design principles, an iterative design phase with a multidisciplinary team, and a final evaluation phase with participants throughout the design process as a form of member checking and validation.

Results:Participants indicated that they found the final adapted prototype to be acceptable, appropriate, and feasible for their use. The changes made to adapt the prototype were not specifically culturally Chinese. Instead, we identified ways to strengthen connections between the survivor and their providers; improve accessibility to resources; and honor participants’ desires for relationality, accountability, and care.

Conclusions:We grounded the use of user-centered design to develop a prototype design that supports the acts of caring through digital technology by identifying and designing to resist structures that create health inequities in the lives of this community of survivors. By designing for collective justice, we can provide accessible, feasible, and relational care with digital health through the application of Indigenous and Black feminist ways of being and knowing.

JMIR Hum Factors 2024;11:e49353

Abstract

Background:Prostate cancer (PCa) is the most commonly diagnosed nonskin cancer for Canadian men and has one of the highest 5-year survival rates, straining systems to provide care. Virtual care can be one way to relieve this strain, but survivors’ care needs and technology use are influenced by intersecting social and cultural structures. Cultural adaptation has been posited as an effective method to tailor existing interventions to better serve racialized communities, including Chinese men. However, cultural adaptations may inadvertently draw attention away from addressing structural inequities.

Objective:This study used qualitative methods to (1) explore the perceptions and experiences of Chinese Canadian PCa survivors with follow-up and virtual care, and (2) identify implications for the cultural adaptation of a PCa follow-up care app, the Ned (no evidence of disease) Clinic.

Methods:An axiology of relational accountability and a relational paradigm underpinned our phenomenologically informed exploratory-descriptive qualitative study design. A community-based participatory approach was used, informed by cultural safety and user-centered design principles, to invite Chinese Canadian PCa survivors and their caregivers to share their stories. Data were inductively analyzed to explore their unmet needs, common experiences, and levels of digital literacy.

Results:Unmet needs and technology preferences were similar to broader trends within the wider community of PCa survivors. However, participants indicated that they felt uncomfortable, unable to, or ignored when expressing their needs. Responses spoke to a sense of isolation and reflected a reliance on culturally informed coping mechanisms, such as “eating bitterness,” and familial assistance to overcome systemic barriers and gaps in care. Moreover, virtual care was viewed as “better than nothing;” it did not change a perceived lack of focus on improving quality of life or care continuity in survivorship care. Systemic changes were identified as likely to be more effective in improving care delivery and well-being rather than the cultural adaptation of Ned for Chinese Canadians. Participants’ desires for care reflected accessibility issues that were not culturally specific to Chinese Canadians.

Conclusions:Chinese Canadian survivors are seeking to strengthen their connections in a health care system that provides privacy and accessibility, protects relationality, and promotes transparency, accountability, and responsibility. Designing “trickle-up” adaptations that address structural inequities and emphasize accessibility, relationality, and privacy may be more effective and efficient at improving care than creating cultural adaptations of interventions.

J Med Internet Res 2023;25:e49349

doi:10.2196/49349

ABSTRACT

This paper presents a discourse analysis of how social work values, knowledge, and attitudes toward immigrants are represented in 173 open-ended responses to a national survey (n = 1125) of Canadian social workers attitudes toward immigrants. Through discourse analysis of social workers’ commentary, we discuss notable tensions between social workers’ affinity for multicultural inclusion and their critiques of Canadian settler-colonialism. While respondents broadly emphasize “respect for diversity” and the need to advocate for immigrants as expressions of their Canadian and social work identity, some suggest that inequalities facing Indigenous communities should be addressed before Canada continues to increase its investment in immigration. We consider how dichotomizing concerns for Indigenous and immigrant communities reflect the limits of multicultural inclusion and the need to further decolonize social work education and practice. Paper to be submitted to Journal of Ethnic and Cultural Diversity in Social Work

Au cours des dernières années, la question des thèmes dits sensibles semble être devenue un enjeu récurrent et préoccupant pour de nombreux membres du personnel scolaire. L’école étant un lieu à la fois de scolarisation et de socialisation, il n’est effectivement pas rare que des sujets qui nous touchent, nous bouleversent, nous choquent ou nous fâchent s’y invitent inopinément. À certains moments, ce sont les élèves qui les font émerger tandis qu’à d’autres, ils constituent des contenus prescrits par le programme à enseigner. En tant que membres du personnel scolaire, nous nous interrogeons parfois à savoir s’il faut ou non aborder certains thèmes dits sensibles avec nos élèves. Lorsqu’il le faut, de quoi devons-nous parler? Quelle posture devonsnous adopter? Comment nous assurer de composer avec les différents points de vue formulés? Comment éviter les dérives, contourner les écueils? Quelles précautions faut-il prendre pour prévenir les débordements? Dans l’optique de proposer quelques éléments de réflexion à ce sujet, le Centre d’intervention pédagogique en contexte de diversité, en collaboration avec le Service des ressources éducatives et avec Sivane Hirsch, professeure à l’Université du Québec à Trois-Rivières, a rédigé un guide pédagogique à propos des sujets sensibles en 2015. Plus récemment, la même équipe a revisité ce guide afin d’en produire une nouvelle version s’harmonisant à des résultats de recherche plus récents. Ce guide pédagogique s’adresse spécialement aux enseignantes et aux enseignants, mais aussi plus largement à tous les membres de la communauté éducative du Centre de services scolaire Marguerite-Bourgeoys qui pourraient en faire usage dans différents contextes.

Abstract

Taking ethnocultural, religious and linguistic diversity into account in educational contexts is recognized today, in Quebec as elsewhere, as a facilitator of educational success for all students. We begin this paper by examining research in this field, using historical and reflexive perspectives of various milestones in the development of the field, to highlight the transformation of research foci over the years and to shed light on the current state of the field, which finds itself at the center of tense social debates on issues of racism and immigration. Secondly, we take a critical look at the field by discussing three issues: 1) the language surrounding ethnocultural, religious and linguistic diversity; 2) the recognition of systemic dynamics; and 3) the current socio-political context and the tensions inherent in it. We conclude with a more personal reflection on the importance of making our positionalities explicit, reflecting on them, and adopting a learning posture.

Violent extremism has galvanized public fear and attention. Driven by their concerns, the public has pushed for law enforcement and mental health systems to prevent attacks rather than just respond to them after they occur. The prevention process requires guidance for practitioners and policymakers on how best to identify people who may be at risk, to understand and assess the nature and function of the harm they may cause, and to manage them to mitigate or prevent harm. Violent Extremism provides such guidance.

Over 10 chapters, prepared by leading experts, this handbook illuminates the nature of violent extremism and the evolution of prevention-driven practice. Authors draw on the literature and their experience to explain which factors might increase (risk factors) or decrease (protective factors) risk, how those factors might operate, and how practitioners can prepare risk formulations and scenario plans that inform risk management strategies to prevent violent extremist harm.

Each chapter is crafted to support thoughtful, evidence-based practice that is transparent, accountable and ultimately defensible. Written for an international audience, the volume will be of interest to law enforcement and mental health professionals, criminal justice and security personnel, as well as criminologists, policymakers and researchers.

Praise for Violent Extremism
‘In Violent Extremism, Logan, Borum and Gill have assembled the most celebrated scholars and practitioners in anticipating and mitigating violence. This extraordinary accomplishment could transform the future of risk assessment.’
John Monahan, University of Virginia

‘Scholarly, scientific and so very practical, this is the book we have been waiting for. It should be read, and re-read, by every practitioner and researcher working on violent extremism.’
John Horgan, Georgia State University

‘Since the early 2000s, the field of assessing violent extremism risk has developed apace. This landmark text authoritatively takes stock of past and current theory, research and practice, and provides a coherent vision for the future.’
Christopher Dean, Cardiff Metropolitan University

Ce mémoire a pour objectif de proposer des recommandations afin de mieux soutenir les jeunes personnes racisées, im/migrantes, réfugiées et/ou s’identifiant à un groupe culturellement minoritaire face à plusieurs enjeux les concernant. Dans le contexte des projections récentes concernant la part grandissante que ces jeunes prendront dans notre société, ainsi que la détérioration du climat social accentuant les discriminations, il nous parait important que le prochain plan d’action jeunesse puisse prévoir des mesures permettant de mieux les soutenir et favoriser leur bien-être et une place active dans la société d’accueil. Ce mémoire s’articule en deux axes principaux. L’Axe 1 traite de la lutte contre la discrimination. Des rapports récents rapportent qu’une proportion importante des jeunes de cette population ressentent un sentiment de discrimination au sein des écoles secondaires, les cégeps et les universités. Le manque d’interactions entre les personnes de différentes cultures et les propos racistes de certains acteur.ice.s scolaires joueraient un rôle important à cet égard. L’Axe 2 traite de l’importance de reconnaitre l’adaptation des services comme un droit. Les perceptions négatives à l’égard des services sociaux, la représentation de la santé mentale, les contrastes de valeurs entre professionnel.le.s et les membres des communautés culturelles minoritaires, les craintes face à la confidentialité des suivis, la méconnaissance des services offerts, les longs délais d’attente ainsi que les barrières linguistiques sont tous décrits comme des obstacles dans l’accès aux services. Face à ces enjeux, nos recommandations visent l’adoption de mesures pour prévenir la discrimination et la mise en place de mesures d’interventions auprès des jeunes ayant vécu de la discrimination, ainsi que l’adaptation des services à leurs réalités et besoins spécifiques. Plus précisément, nous recommandons une meilleure sensibilisation des personnes intervenantes et professionnelles de la santé et services sociaux, une adaptation des services pour une équité d’accès, une valorisation des apports et des expériences des jeunes, une action intersectorielle plus cohérente au niveau institutionnel, mais aussi à travers la collaboration avec les organismes communautaires. Nous recommandons également de travailler à la réduction des multiples barrières structurelles à l’accès aux services.

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

Abstract

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.

Abstract

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

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.

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

doi:10.2196/36132

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.

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.

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.

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.

Abstract

Abstract

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various “virtual” services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist – AYP) to a universal phone consultation service led by the universal public health system in Quebec (811 Info-Santé), through a direct bridge. Semi-structured interviews were conducted with clinician users of the service, and stakeholders involved in this pilot project funded by the Ministry of Economy (n = 22); documents were also analyzed, and content of the question was asked through the AYP service. Adoption of the service was low, and it suggests a poor alignment between the need and the service as implemented. Further research should investigate the mechanisms for an appropriate integration of digital services for primary care universal consultation services.

Inequalities in access to psychiatric care are increasingly recognized as a serious public health issue in sub-Saharan Africa. In these countries, little information is available regarding social representations of mental disorders, although these can have a significant influence on access to care. In this article, we examine the popular nosological entities and their characteristics in urban Burkina Faso. To do so, 7 focus groups and 16 individual interviews were conducted with various actors in the city of Bobo-Dioulasso. A thematic analysis revealed two popular nosological entities. The term Kougolobana refers to an alteration of the brain associated with bewitchment by supernatural entities and is expressed sporadically; whereas the term Fatoya refers to an incurable condition caused by the commission of transgressive acts of various kinds. Our results highlight the mutual influence of traditional and bio-psycho-social registers in the construction of these nosological entities. These results allow us to reflect on the centrality of the notion of transgression in the social representations of mental health disorders in the city of Bobo-Dioulasso.

Les troubles mentaux et plus largement les souffrances psychologiques et sociales sont aujourd’hui un des problèmes majeurs de santé dans le monde. Au regard de la charge mondiale causée par ces troubles, l’Assemblée mondiale de la Santé a adopté en mai 2012 une résolution préconisant une réponse globale coordonnée au niveau des pays pour répondre aux besoins de prise en charge des troubles mentaux. Ainsi, dans la perspective d’une recherche visant à améliorer la santé mentale et parvenir à promouvoir la santé pour tous (Patel & Prince, 2010), la présente étude s’intéresse à comprendre les représentations sociales et culturelles de la santé et de la maladie mentale, à la lumière de la dépression et du suicide en contexte africain.

2La dépression est classée comme un trouble mental courant présent à travers le monde et les cultures sous différentes manifestations (Bellanger et al., 2001). La dépression est une affection fréquente dans le monde qui touche environ 322 millions de personnes soit environ 4.4 % de la population mondiale (OMS, 2015). Le nombre total de personnes vivant avec la dépression a augmenté de 18,4 % entre 2005 et 2015. Elle est souvent décrite comme se caractérisant par une tristesse, une perte d’intérêt ou de plaisir, des sentiments de culpabilité ou de dévalorisation de soi, un sommeil ou un appétit perturbé, une certaine fatigue et des problèmes de concentration. La dépression peut perdurer ou devenir récurrente, entravant ainsi de façon substantielle l’aptitude d’un individu à fonctionner au travail ou à l’école ou à faire face à sa vie quotidienne. Elle peut également dans certains cas conduire au suicide (OMS, 2020).

3La dépression affecte outre l’individu atteint, son entourage, et représente également un lourd fardeau social et économique. Dans sa publication « Dépression : parlons-en » de mars 2017, l’OMS met en avant non seulement la souffrance des personnes atteintes de maladies mentales, mais également le coût socio-économique important de ces maladies. En effet, selon ce rapport, la perte économique mondiale relative au manque de reconnaissance et d’accès aux soins en cas de dépression ou autres troubles mentaux comme l’anxiété se chiffrerait à 1 000 milliards de dollars américains par an. Ce fardeau, pesant sur les familles, les employeurs et les gouvernements. En raison de son impact sur le fonctionnement humain et de sa propension croissante actuelle, la dépression se présente comme la première cause d’incapacité dans le monde (OMS, 2020).

4Selon la forme, la dépression peut être durable ou récurrente. Elle résulte d’interactions complexes entre les facteurs sociaux, psychologiques et biologiques. La forme majeure de dépression fortement corrélée au risque de suicide est la dépression durable (Shea et al., 2008). De plus, la dépression et l’anxiété semblent être des facteurs de risque pour le suicide en association avec des facteurs individuels et contextuels (Turecki & Brent, 2016).

5Les dépressions majeures, les addictions, la schizophrénie, les troubles bipolaires et les personnes souffrant de troubles sévères de la personnalité de type état limite sont également à risque d’idées suicidaires et de suicide (Fawcett et al., 1993).

6Le comportement suicidaire associé à la dépression majeure, est souvent conceptualisé le long d’un spectre allant de pensées suicidaires à la tentative de suicide et à la mort, en passant par l’élaboration de projets suicidaires (Findlay, 2017). En 2015, on estime que 788 000 personnes sont décédées dans le monde des suites du suicide ce qui représente 1,5 % de tous les décès, plaçant le suicide au niveau des vingt principales causes de décès. Le taux de suicide varie en fonction de l’âge, du sexe et du niveau socio-économique des régions. Selon les données recueillies par l’OMS, le suicide représente aussi 50 % des morts violentes chez les hommes 71 % chez les femmes et il est la deuxième cause de mortalité chez les 15-29 ans. Dans les pays les plus riches, trois fois plus d’hommes que de femmes décèdent par suicide, contre 1,5 fois dans les pays à revenu faible et intermédiaire. Le suicide prélève ainsi un lourd tribut en vies humaines.

7Diverses études ont traité de la question de la dépression, du suicide et leurs représentations pour les communautés culturelles (Rodiguez et al, 2022). Dans notre étude, nous souhaitons spécifiquement nous intéresser aux représentations sociales associées à la souffrance psychologique, notamment la dépression, afin de soutenir des stratégies de préventions et d’interventions concernant le suicide non stigmatisantes et centrées sur les communautés (Rivera et al., 2021).

8À noter qu’en dépit des avancées scientifiques en matière de traitement des maladies mentales, dans les pays à revenus faible ou intermédiaire, entre 76 % et 85 % des personnes ne bénéficient d’aucun traitement (OMS, 2020). Le manque de ressources, la pénurie de soignants qualifiés, les erreurs de diagnostics, la stigmatisation sociale et le tabou liés aux troubles mentaux sont autant d’obstacles à l’accès et à l’administration de soins efficaces. Ces considérations subjectives pourraient être des indicateurs du comportement des individus, notamment leur choix de solliciter ou non l’aide des spécialistes ou même à commettre des actes comme le suicide.

9Plusieurs auteurs ont proposé une définition du concept des représentations sociales. Toutefois, la définition qui répond le mieux aux besoins de notre étude est celle de Jodelet (1989) qui définit les représentations sociales comme des phénomènes complexes (éléments informatifs, cognitifs, idéologiques, normatifs, croyances, valeurs, attitudes, opinions, images, etc.) organisés sous la forme d’un savoir disant quelque chose sur l’état de la réalité toujours activée et agissant dans la vie. Cette définition prend en considération différents concepts tels que l’environnement social aussi bien que l’aspect comportemental qui en découle.

10Ainsi, notre question de recherche est de savoir si les représentations sociales de la dépression et du suicide exercent une influence sur ceux-ci, le but étant de découvrir les meilleures pratiques de prévention, intervention et postvention.

Ce rapport technique documente les résultats d’une enquête menée en 2022 auprès du personnel de première ligne des organismes membres de la TCRI, la Table de concertation des organismes au service des personnes réfugiées et immigrantes. Un sondage auprès des gestionnaires fait l’objet d’un rapport distinct. Le sondage a été réalisé en collaboration avec OCASI, l’Ontario Council of Agencies Serving Immigrants, et la TCRI par le biais de Building Migrant Resilience in Cities/ Immigration et résilience en milieu urbain (BMRC-IRMU), un partenariat financé par le Conseil de recherches en sciences humaines (CRSH). Un groupe de travail sur les services d’accueil des nouveaux arrivants composé de membres de la communauté et d’universitaires du BMRC-IRMU ont aidé à orienter la recherche. L’instrument de sondage a été approuvé par le Comité d’examen des participants humains de l’Université York. Du point de vue des travailleurs de première ligne, le sondage examine les impacts de la COVID-19 sur eux, les clients et les organismes québécois au cours de la période de douze mois suivant la première vague de la pandémie. De nombreuses questions sont similaires à un sondage antérieur mené par OCASI et portant sur la première vague de la pandémie.

More than 40 years after the Alma-Ata Declaration on Primary Health Care, it is time to take stock. A look back at the evolution of pharmaceutical policies reveals the extent to which international health has transformed in the last four decades. The imperative of equitable access to healthcare, reaffirmed in Astana in 2018, has still not been achieved in many countries across the globe, whereas recent Ebola and COVID epidemics have opened up new political spaces for pharmaceutical development. In response to a gap in the literature with regard to the politics behind global pharmaceutical policymaking, we offer a critical interpretive synthesis of the literature on pharmaceutical policies, in English and French, from 1978 to 2018 inclusively. Our search strategy and inclusion criteria enabled us to select and review 134 papers and books on pharmaceutical policies. Building upon the seminal works of K.S. Rajan, we review the literature under the following assumption: pharmaceutical policies reflect or enact different conceptions of knowledge, political spaces, and value. We then critically discuss our findings in light of the contemporary debates, particularly in the wake of recurring epidemics. We thereby challenge the mainstream perspective according to which pharmaceuticals and pharmaceutical policies must be viewed as value-free, apolitical instruments.

This article presents an analysis of the lived experiences of youth mental health practitioners taking part in Transcultural Interinstitutional and Interdisciplinary Case Discussion Seminars (TIICDS), an intercultural training initiative developed in Montréal (Québec, Canada), while considering the current context of increasing social polarizations. Using insights from the community of practice (CoP) framework and drawing on the analysis of 21 seminar sessions and 26 semi-structured individual interviews, this article examines the relation between the local sociopolitical context, the participants’ verbalization about their identities, and the affect and cognition evoked by the training. Results indicate that TIICDSs present several features of a CoP and that intercultural training needs to build on both theoretical and experiential knowledge, while considering local contextual elements. These include historical and contemporary social representations and power differentials between groups, the cultural identities of trainees, and the institutions and sociopolitical structures in which clinical practices take place. These elements, we argue, are sensitive and potentially conflictual but can be addressed through supportive and reflexive group-based initiatives such as CoPs that bring together practitioners on a regular basis and provide them with a ‘culturally safe enough’ space in which they can learn to complexify their understanding of clinical situations.

Vaccination is a common painful procedure for children. Parents’ concern regarding vaccination pain is a significant driver of vaccine hesitancy. Despite the wealth of evidence-based practices available for managing vaccination pain, parents lack knowledge of, and access to, these strategies. Knowledge translation (KT) tools can communicate evidence-based information to parents, however little is known about what factors influence parents’ use of these tools. A two-page, electronic KT tool on psychological, physical, and pharmacological vaccination pain management strategies for children, was shared with parents as part of a larger mixed methods study, using explanatory sequential design, exploring factors related to uptake of this KT tool. The aim of this qualitative study was to understand what influenced parents’ perceptions of the relevance of the KT tool, as well as their decision as to whether to use the tool.

C’est avec une petite larme au coin de l’oeil que METISS (Migration et Ethnicité dans les Interventions en Santé et en Services sociaux) vous fait ses adieux. Eh oui! Après 28 ans de recherche et de partenariat, l’équipe ferme boutique.

Pour clore cette époque en beauté, nous vous présentons avec beaucoup de fierté une toute dernière publication, les toutes dernières « Entre-vues », qui retracent trois décennies de recherche, d’innovation et de collaboration autour de la thématique de la diversité dans les services sociaux et de santé. Des fondements sur lesquels on peut s’appuyer pour nous propulser vers l’avenir, mais un document à consulter avec un brin de nostalgie tout de même.