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

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.

Résumé

Introduction : Les populations autochtones au Canada sont disproportionnellement touchées par le virus de l’hépatite C (VHC). L’intégration des cultures et savoirs autochtones aux interventions de santé est fragmentée et la pratique infirmière présente des lacunes à cet égard.

Objectifs : Cette revue narrative des écrits visait à analyser les interventions communautaires de lutte au VHC réalisées auprès de populations autochtones afin de proposer des recommandations pour renforcer la pratique infirmière en matière de VHC et la rendre plus cohérente aux besoins et valeurs des communautés autochtones.

Méthodes : Des méthodes d’examen rapide ont été adoptées. Les bases de données CINAHL, MEDLINE, EMBASE et Cochrane et le moteur de recherche Google ont été consultés. Le modèle de réceptivité communautaire de Stanley et al., (2014), qui favorise le développement d’interventions appropriées selon les forces, la problématique et le contexte, a guidé l’analyse.

Résultats : Au total, 24 sources ont servi à analyser 13 projets d’intervention. Des similarités sont ressorties dans 11/13 projets d’intervention adoptant une approche holistique (n=11) et/ou une approche de réduction des méfaits (n=7), ce qui comprend une relation de confiance, sans jugement et non stigmatisante. La mobilisation communautaire était inhérente aux 13 projets d’intervention et c’est par une approche axée sur l’autodétermination que les infirmières étaient les plus susceptibles d’inciter cette mobilisation nécessaire à l’intervention en matière de VHC.

Discussion et conclusion : Avec une approche holistique de la réduction des méfaits, l’infirmière pourrait davantage soutenir l’autodétermination et la mobilisation communautaire afin de réduire efficacement le fardeau du VHC vécu par les communautés autochtones.

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.

Résumé

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 ».

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.

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.

Abstract

bstract

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.

Introduction

Abstract

Abstract

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.

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.

Nos membres Naïma Bentayeb et Lara Gautier sont les responsables du dernier numéro de la revue Alterstice sous le thème « Expérience des réfugiés, demandeurs d’asile et migrants sans statut et offre de services de santé et sociaux pendant la pandémie au Québec ». 

Plusieurs autres membres de SHERPA ont contribué à ce numéro dont Janet Cleveland, Jill Hanley, Patrick Cloos, Mélanie M. Gagnon et  Andréanne Dufour, membre de notre équipe.

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

En nous appuyant sur une méthode mixte qui combine des sources primaires à des données empiriques collectées de façon extensive auprès d’intervenants en soins spirituels depuis 2012 au Québec, nous présentons les conditions d’émergence de cette profession dans les milieux de santé. Il apparait que cette nouvelle figure du soin offre un laboratoire fécond pour mieux saisir la mécanique de cette réalité fluctuante que constitue la spiritualité contemporaine. Nous soutenons que la vision normalisatrice du soin véhiculée actuellement dans les milieux de soins et par ricochet, dans les soins spirituels, situe le concept de spiritualité au croisement d’une conception du caring entendu sous la forme d’un humanisme qui se déploie et se réalise dans la rencontre et l’accompagnement de l’Autre d’une part, et de la réactualisation d’une représentation naturelle et universelle de la religion célébrée autour de la notion de la spiritualité d’autre part.

Résumé

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.