Abstract

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Abstract

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?

Abstract

Abstract

DOI

https://doi.org/10.31223/X52Q21

Subjects

Public Health

Keywords

climate change, health, Public health, Global Health, vulnerability, adaptation, risks, Caribbean, West Indies

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.

Abstract

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.

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 ».

En prenant appui sur la mission de l’école québécoise qui consiste à instruire, socialiser et qualifier, le projet PhiloJeunes, implanté au Québec depuis 2015, œuvre au renforcement des facteurs de protection face à la radicalisation violente par la voie de l’implantation d’une pratique philosophique en classe. Le présent article se fonde sur une étude qualitative menée auprès de pédagogues engagés dans ce projet éducatif, afin d’explorer leur expérience lors de la formation et de l’application dudit projet. L’analyse met en lumière les défis et les leviers rencontrés par les pédagogues, notamment en regard d’une certaine prescription/proscription normative quant à l’expression et à la circulation des émotions. L’inévitable imbrication entre la sphère rationnelle et la sphère émotionnelle amène les autrices à soutenir, dans la veine de l’héritage de John Dewey, un dépassement de cette désuète opposition, afin d’embrasser une éducation démocratique sensible qui puisse favoriser la réalisation des objectifs de prévention de la radicalisation violente par la voie de la discussion philosophique en contexte scolaire.

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.

Abstract

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Introduction

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Abstract

Abstract

Le rapport présente notre recherche sur l’expérience des parents d’enfants trans ou non-binaires dans la région du Saguenay-Lac-Saint-Jean. La méthodologie utilisée est qualitative et phénoménologique, entretiens et analyses herméneutiques contextuelles critiques. Nous avons rencontré quinze parents de la région. Les résultats ont montré que les parents ont vécu un stress parental accru lié à la transphobie, aux normes de binarité de genre et à la cisnormativité, mais aussi en raison de l’absence de services adaptés pour répondre à leurs besoins d’information, de soutien, notamment psychologiques et de soins trans affirmatifs pour leurs enfants. Les résultats décrivent plusieurs dynamiques psychologiques : un choc initial lié au coming out, vécu par les parents et pouvant affecter leur capacité de mentalisation, entraînant parfois des difficultés sur le moment à comprendre, à maintenir une relation et à réagir de manière ajustée à la situation. Les résultats ont également montré des temporalités et des rythmes dysharmoniques entre parents et enfants ainsi que la nécessité de négocier une temporalité et une expérience commune. Les facteurs concomitants majorant le stress parental présents dans cette recherche incluent les inégalités économiques, la présence de trauma dans l’histoire familiale et les troubles de santé mentale au sein de la famille. Le rapport met en évidence la richesse des expériences parentales et l’importance de respecter leur caractère unique. Le rapport propose des recommandations pour les parents, les professionnel·le·s de la santé et pour promouvoir l’inclusivité dans la société.

Note:
Funding Declaration: We would like to acknowledge the support of Manon Lapierre, Director of Operations at La Maison Bleue, towards the realisation of this project. Additionally, we recognize the support provided to C.Woronko by the Ordre des infirmières et infirmiers du Québec Bourses de fin d’études à la maîtrise – 2021-2022. A Cuerrier acknowledges the support provided by the Ingram School of Nursing, McGill University, for the Student Research Support received. L Merry, P Li and A Van Hulst acknowledge the support received through Fonds de la recherche du Québec en santé Research Salary Awards.

Abstract

Abstract

In the wake of the killing of George Floyd on May 25, 2020, there was a strong call to action, first in North America and then globally, to tackle racism and promote racial justice . Many universities created “equity, diversity, inclusion, anti-racism (EDI-AR)” task forces and other mechanisms with goals of transforming institutions entrenched in histories of colonialism and white supremacy. Concurrently, decolonizing global health movements have been gaining momentum asking all stakeholders including academic institutes to advance equity and dismantle systemic forms of oppression .

Often equity efforts initiated during watershed moments face the challenge of losing team. The crescendos and unavoidable reckoning with every individual’s relationship to structural injustices ultimately dwindle and the status quo in academia continues to instill ingrained systems of discrimination. Deliberate equity building in academia including decolonizing curricula and institutional practices are also highly relevant to addressing structural fault lines in global health governing models, implementation practices and research partnerships . Lessons from failures in Covid-19 pandemic and climate crisis highlight the urgency to better equip students and faculty to lead equity centered approaches.

In this essay, we highlight six key considerations that senior leadership and community at large within high income country (HIC) global health academic institutions need to be mindful to successfully embed equity efforts into the fabric of their foundation. While our experiences as authors stem largely from our engagement in global health academia, the following reflections cut across disciplines.

This chapter, based on results from a qualitative research project commissioned by the Canadian Department of Justice, analyzes the availability of protection services for victims of trafficking in persons in Canada from the perspective of demand and supply.1 A first objective is to identify and highlight discrepancies between the “demand” for victim protection services versus the “supply” of community-based services. A second objective is to determine the root causes of these discrepancies. The voices of the NGOs who participated in the project will illustrate these dynamics. Policy recommendations to correct the imbalances between victims’ needs for services and NGOs’ ability to provide those services will conclude the chapter. 1. Despite the convention which usually places the word supply first when referring to supply and demand, the authors choose to inverse the terms in order to emphasize the demand aspect.

An overview of the phenomenon of human trafficking will situate the Canadian experience within an international context and the evolution of awareness and debates around trafficking among Canadian academics, policymakers and practitioners will be discussed. A brief description of the research project on which this chapter is based will be offered. The authors will specify the methodology applied and the results will be presented, discussing how the theory of demand and supply can be used to understand the dynamics surrounding community-based services for trafficking victims. The voices of NGOs, expressed through interview data, will illustrate the “demand” for services in terms of the needs of victims NGOs encounter and the “supply” of such services by community-based actors. An analysis of the gaps that exist between the demand and supply of services will precede the final section where policy recommendations will be offered to diminish the gaps in the hopes of better respecting the human rights of the victims of human trafficking.

This study examines the association between gender identity, mental health, social adversity, and sympathy for violent radicalization (VR). Data were collected through an online survey in Canada. A total of 6003 eligible participants who were residents of Montreal, Toronto, Calgary, or Edmonton and aged from 18 to 35 years were included. We used Fisher exact test to assess gender differences in gender-based discrimination and we used analysis of variance tests to assess differences in scores on bullying, mental health, and sympathy for VR. We used linear regression to assess the relationship between mental health, social adversities, and sympathy for VR. Individuals who self-identified as trans and gender diverse had greater sympathy for VR than females did, experienced online victimization more frequently, and reported higher levels of psychological distress than both male and female participants. Our findings indicate that more research is needed on the association between social adversity and support for VR among this vulnerable population.

Dans un contexte où les inégalités d’accès aux soins psychiatriques sont de plus en plus reconnues comme un enjeu préoccupant de santé publique dans les pays de la région subsaharienne, et alors que les représentations sociales associées aux troubles mentaux exercent une influence notable sur cet accès aux soins, celles-ci ont suscité jusqu’à présent peu de travaux. Dans cet article, nous appréhendons les entités nosologiques populaires et leurs principales caractéristiques en milieu urbain au Burkina Faso. Pour ce faire, 7 groupes de discussion et 16 entretiens individuels ont été menés auprès de différents acteurs dans la ville de Bobo-Dioulasso. Une analyse thématique a permis d’identifier deux entités nosologiques populaires. Le terme Kougolobana renvoie à une altération du cerveau associée à l’envoûtement par des entités surnaturelles et s’exprime sporadiquement ; alors que le terme Fatoya renvoie à une condition incurable causée par la commission d’actes transgressifs de différentes natures. Nos résultats mettent en lumière l’influence mutuelle des registres traditionnels et biopsychosociaux dans la construction de ces entités nosologiques. Ces résultats permettent d’amorcer une réflexion sur la place centrale qu’occupe la notion de transgression dans les représentations sociales des troubles de santé mentale dans la ville de Bobo-Dioulasso.

The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key COVID-19 prevention and control interventions in France: testing and contact tracing. Interviews were conducted with 36 key informants involved in the design of the intervention and/or the government response to the pandemic as well as relevant documents (n = 15) were reviewed. We applied data triangulation and a hybrid deductive and inductive analysis to analyze the data. Findings revealed the divergent understandings and perspectives about SIH, as well as the challenges associated with consideration for these at the beginning stages of the pandemic. Despite a shared concern for SIH between the participants, an epidemiological frame of reference dominated the design of the intervention. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission. Although the COVID-19 health crisis highlighted the importance of SIH, it did not appear to be an opportunity to further their consideration in response efforts. This article provides original insights into consideration for SIH in the design of testing and contact-tracing interventions based upon a qualitative investigation.

When approaching the multiplicity of the spiritual experiences of healing, ethnographers are often presented with ideas of the existence of “other” worlds that may intersect with the so-called “material” or “physical” worlds. This book proposes a sensory ethnography of healing with a focus on ethnographic knowing as embedded in an embodied epistemology of healing. Epistemological embodiment signals that personal scholarly experience of the “unknown”—be it in the form of trance, or as the embodiment of an “other”—shapes the concepts of healing, body, trance, self, and matter by which ethnographers craft out analysis.