A Critical Look at Food Security in Social Work: Applying the Socio-ecological Lens

One in six children under the age of 18 in Canada lives in a food insecure household.  This is deeply concerning as the presence of food insecurity can disrupt developmental trajectories potentially impacting the lifespan of a child.  However, when compared to other social problems, food security takes a backseat.  Twenty-four years ago, a call to action was issued to social workers to make food security a priority within their practice. The literature demonstrates a slow but encouraging rise in the number of social workers heeding that call. This paper provides a critical analysis of twenty-one articles investigating social work and food security interventions.  The articles were published in peer-reviewed, academic journals between 1993 and 2016.  The socio-ecological model was used to guide the review of the articles to help extrapolate how social workers can address food security at the microsystem, mesosystem, exosystem, macrosystem, and chronosystem level.  Forty-three interventions were identified. Most of the interventions considered the exosystem and macrosystem level of practice, which highlighted the importance of building strong communities and implementing policies for “food justice”.  The results also indicate that front-line social workers are well suited for food security interventions, but comprehensive research on how microsystem, mesosystem and chronosystem level strategies are best executed would help bring them to fruition.  Furthermore, implementing food security into social work curriculum and becoming food conscious themselves was highly recommended

Adapting Descriptive Psychological Phenomenology to Include Dyadic Interviews: Practical Considerations for Data Analysis

Dyadic interviews are an approach to qualitative data collection designed to understand the meaning pairs of individuals make from experiences. The greatest benefit of dyadic interviews, and perhaps a reason for their gaining momentum in the literature, is that they encourage participants to interact, resulting in detailed and complex descriptions of phenomena. However, dyadic interviews pose challenges to qualitative researchers. Researchers must figure out how to account for the presence of two interviewees, any differences in perspective, and interactions. Unfortunately, no known study demonstrates how the interactions of dyadic interviews can be analyzed in accordance with a methodological approach. Rather, researchers tend to observe pre-existing methods without direct mention of modification for conducting and analyzing dyadic interviews. Thus, the degree to which participant interactions are being analyzed in current studies remains unknown. In the following paper, we use Giorgi’s (2009) descriptive psychological phenomenology as an exemplar for how dyadic interviews may be applied to qualitative investigations. The theoretical fit of dyadic interviews with Giorgi’s approach, proposed modifications, and their limitations, are discussed

Not Quite this and not Quite that: Anorexia Nervosa, Counselling Psychology, and Hermeneutic Inquiry in a Tapestry of Ambiguity

As a group of researchers exploring how to best understand the complex topic of families discovering their loved one has anorexia nervosa (AN), we found that we had to weave ambiguity into our design. Embracing ambiguity allowed us to create a tapestry that acknowledges the ambiguity of AN, counselling psychology (and other helping professions), and hermeneutic inquiry. In fact, the “not quite this and not quite that” features of these three constructs emerged as the thread that holds the inquiry together. We review the topic of AN through a lens of ambiguity.  Further, we position both the field of counselling psychology and the research method of hermeneutic inquiry as compatible frameworks in the study of AN, in both practice and research. By acknowledging, and at times even embracing, ambiguity, we respect the complexity of the situation we are studying. 

More Than Simply “Letting Go”: Stakeholder Perspectives on Parental Roles in Health Care Transition

The transfer from pediatric to adult health care for youth with special health care needs (YSHCN) is a vulnerable period. Parents play a pivotal role in the transition process, however, little is known about the specific ways they may support YSHCN in negotiating the transition to adult services. A qualitative supplementary secondary data analysis was conducted to explore stakeholders’ perceptions about parents’ roles in health care transition. Thematic analysis was used to analyze individual and focus group interviews. Four themes were identified: 1) Parents are crucial; 2) Changing roles; 3) Interdependence rather than independence; 4) One of many transitions. These themes may serve as the basis for planning future intervention studies directed at parents of YSHCN

Communities of practice: acknowledging vulnerability to improve resilience in healthcare teams.

The majority of healthcare professionals regularly witness fragility, suffering, pain and death in their professional lives. Such experiences may increase the risk of burnout and compassion fatigue, especially if they are without self-awareness and a healthy work environment. Acquiring a deeper understanding of vulnerability inherent to their professional work will be of crucial importance to face these risks. From a relational ethics perspective, the role of the team is critical in the development of professional values which can help to cope with the inherent vulnerability of healthcare professionals. The focus of this paper is the role of Communities of Practice as a source of resilience, since they can create a reflective space for recognising and sharing their experiences of vulnerability that arises as part of their work. This shared knowledge can be a source of strength while simultaneously increasing the confidence and resilience of the healthcare team

Using Administrative Health Data to Define a Cohort of Youth Affected by Chronic Health Conditions: Preparing for Cross-Sectoral Data Linkage

Introduction In Alberta, 2,400 youth with chronic needs transition to adulthood every year, and many are not prepared for this change. Transferring youth from pediatric to adult-oriented care is poorly managed. To improve this process, we need to know how youth patients use health services during this period. Objectives and Approach We used the Alberta Health Services Corporate Data Repository (CDR-9), which collects records of ambulatory visits, to define a cohort of patients with chronic disease using pediatric tertiary care; data is available from 2008 to 2016. Personal health numbers allowed for deterministic data linkage to CDR-9, registry data (e.g., death dates, moves out of province), and area deprivation indices. Eligible patients were: (a) between ages 12-15 years in 2008 (for ≥2 years observation in adulthood, after age 18), (b) involved with a Chronic Care Clinic (CCC) at Alberta Children’s Hospital, and (c) had repeated CCC visits with ≥3 months between visits. Results We identified 26 Chronic Care Clinics (CCC) at Alberta Children’s Hospital (Calgary, Alberta), with stakeholder input. Using CDR-9, a total of 10,111 patients at the hospital were identified who were 12 to 15 years old at the start of the study window (in 2008), and who visited a CCC before age 18. Less than 1% (n=418) were excluded due to moving out of province or having an invalid personal heath number. Final sample sizes were captured across 3 algorithms (A1, A2, A3), based on frequency of CCC visits within a 2-year period: (i) A1: ≥2 CCC visits (N=4123); (ii) A2: ≥3 CCC visits (N=2242); (iii) A3: ≥4 CCC visits (N=1344). Conclusion/Implications Our identified cohort of youth affected by chronic conditions is the first of its kind in Alberta, and can answer important questions about patterns of service utilization in other sectors of care. Our next step is to link the cohort to population-level datasets (e.g., physician claims, NACRS, CIHI-DAD)