Indigenous Cultural Safety Training in Health, Education, and Social Service Work

Background: Indigenous Cultural Safety (ICS) training is a growing field of study; however, little consensus exists about how ICS is conceptualized and operationalized. This lack of consistency can lead to misinterpretation and misappropriation of Indigenous knowledges and histories that can further perpetuate colonial harms. Objective: The objective of this scoping review is to explore and characterize the academic literature related to the conceptualization and operationalization of ICS training within the fields of health, social services, and education. Methods: This scoping review protocol employs the Joanna Briggs Institute’s three-step search strategy to identify articles in the following databases: MEDLINE, EMBASE, CINAHL, ERIC, and ASSIA. This protocol follows the PRISMA guidelines for Scoping Reviews (Joanna Briggs Institute, 2015; Tricco et al., 2018). Discussion: This review will add new knowledge by offering insights into the historic and contemporary approaches to defining and operationalizing ICS training in the health, education and social services fields. The results produced will be of interest to scholars and health, social services, and education providers looking to apply the most current and appropriate concepts and practices of ICS

Underlying Equity Discourses of the World Health Organization

Background: Globally, increasing attention has been paid to the concept of equity in the context of health, largely stemming from the work of the World Health Organization (WHO) beginning in the late 1970s with the Declaration of Alma-Ata (WHO, 1978) and more recently following the Commission on the Social Determinants of Health (CSDH, 2008) and their final report in 2008. Despite increasing attention to this issue, there is global ambiguity on the true definition of “health inequity”, “health inequalities”, or “health disparities” (Braveman, 2006, p. 167; Braveman & Gruskin, 2003). Methods/Design: This original scoping review clarifies how the WHO conceptualizes equity. It also identifies the theoretical underpinnings guiding the WHO’s approach to equity and its broader implications. This protocol followed the PRISMA guidelines for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018), with details discussed in the full protocol. Discussion: To date, much of the research on health equity globally has been restricted to chronological discussions over time or specific research fields (Borde & Hernández, 2018, p. 3). Therefore, researching the WHO’s approach to equity in terms of alignment with theory and broader normative standpoint(s) becomes increasingly important in addressing a gap in the literature. In addition, because the definition of equity in the context of health has practical implications for its operationalization (Guerra, Borde, & Salgado De Snyder, 2016), this work seeks to clarify in the concept of equity used by the WHO in hopes of moving towards a shared understanding to bridge action [e.g. in measurement and accountability (Braveman & Gruskin, 2003)]

Probing key informants’ views of health equity within the World Health Organization’s Urban HEART initiative

To date, no studies have assessed how those involved in the World Health Organization’s (WHO) work understand the concept of health equity. To fill the gap, this research poses the question, “how do Urban Health Equity Assessment and Response Tool (Urban HEART) key informants understand the concept of health equity?”, with Urban HEART being selected given the focus on health equity. To answer this question, this study undertakes synchronous electronic interviews with key informants to assess how they understand health equity within the context of Urban HEART. Key findings demonstrate that: (i) equity is seen as a core value and inequities were understood to be avoidable, systematic, unnecessary, and unfair; (ii) there was a questionable acceptance of need to act, given that political sensitivity arose around acknowledging inequities as “unnecessary”; (iii) despite this broader understanding of the key aspects of health inequity, the concept of health equity was seen as vague; (iv) the recognized vagueness inherent in the concept of health equity may be due to various factors including country differences; (v) how the terms “health inequity” and “health inequality” were used varied drastically; and (vi) when speaking about equity, a wide range of aspects emerged. Moving forward, it would be important to establish a shared understanding across key terms and seek clarification, prior to any global health initiatives, whether explicitly focused on health equity or not.publishedVersio

Using Social Media as a Survey Recruitment Strategy for Post-Secondary Students During the COVID-19 Pandemic

The COVID-19 pandemic rapidly forced Canadian post-secondary students into remote learning methods, with potential implications on their academic success and health. In recent years, the use of social media to promote research participation and as a strategy for communicating health messages has become increasingly popular. To better understand how the pandemic has impacted this population, we used social media platforms to recruit students to participate in a national bilingual COVID-19 Health Literacy Survey. The purpose of the survey was to assess the health literacy levels and online information-seeking behaviors of post-secondary students in relation to the coronavirus. This paper outlines the social media recruitment strategies used for promoting participation in the survey among Canadian post-secondary students during the pandemic. Facebook, Twitter, and Instagram accounts were created to promote the online survey. The objective of this paper is to examine the use of Instagram, Facebook, and Twitter as survey recruitment strategies tailored to students. Data analytics from these platforms were analyzed using descriptive statistics. We found that the most commonly used platform for survey dissemination was Twitter, with 64800 total impressions recorded over 3 months. The use of social media as a survey recruitment strategy showed promise in the current context of COVID-19 where many students are participating in online learning and for a study population that actively uses these platforms to seek out information

La recherche en santé mondiale : recueil de cas

Version anglaise disponible dans la Bibliothèque numérique du CRDI : Global health research : caseboo

Taking account of context in population health intervention research: guidance for producers, users and funders of research

Population health intervention research (PHIR) seeks to develop and evaluate policies, programmes and other types of interventions that may affect population health and health equity. Such interventions are strongly influenced by context – taken to refer to any feature of the circumstances in which an intervention is conceived, developed, implemented and evaluated. Understanding how interventions relate to context is critical to understanding how they work; why they sometimes fail; whether they can be successfully adapted, scaled up or translated from one context to another; why their impacts vary; and how far effects observed in one context can be generalised to others. Concerns that context has been neglected in research to develop and evaluate population health interventions have been expressed for at least 20 years. Over this period, an increasingly comprehensive body of guidance has been developed to help with the design, conduct, reporting and appraisal of PHIR. References to context have become more frequent in recent years, as interest has grown in complex and upstream interventions, systems thinking and realist approaches to evaluation, but there remains a lack of systematic guidance for producers, users and funders of PHIR on how context should be taken into account. This document draws together recent thinking and practical experience of addressing context within PHIR. It provides a broad, working definition of context and explains why and how context is important to PHIR. It identifies the dimensions of context that are likely to shape how interventions are conceptualised, the impacts that they have and how they can be implemented, translated and scaled up. It suggests how context should be taken into account throughout the PHIR process, from priority setting and intervention development to the design and conduct of evaluations and reporting, synthesis and knowledge exchange. It concludes by summarising the key messages for producers, users and funders of PHIR and suggesting priorities for future research. The document is meant to be used alongside existing guidance for the development, evaluation and reporting of population health interventions. We expect the guidance to evolve over time, as practice changes in the light of the guidance and experience accumulates on useful approaches. The work was funded by the Canadian Institutes of Health Research (www.cihr-irsc.gc.ca) – Institute of Population and Public Health (CIHR-IPPH) and the UK National Institute for Health Research (NIHR)

The Governance of Core Competencies for Public Health: A Rapid Review of the Literature

Core competencies for public health (CCPH) define the knowledge, skills, and attitudes required of a public health workforce. Although numerous sets of CCPH have been established, few studies have systematically examined the governance of competency development, review, and monitoring, which is critical to their implementation and impact. This rapid review included 42 articles. The findings identified examples of collaboration and community engagement in governing activities (e.g., using the Delphi method to develop CCPH) and different ways of approaching CCPH review and revision (e.g., every 3 years). Insights on monitoring and resource management were scarce. Preliminary lessons emerging from the findings point towards the need for systems, structures, and processes that support ongoing reviews, revisions, and monitoring of CCPH

Physical activity practiced at a young age is associated with a less severe subsequent clinical presentation in facioscapulohumeral muscular dystrophy

Background: In facioscapulohumeral muscular dystrophy (FSHD), it is not known whether physical activity (PA) practiced at young age is associated with the clinical presentation of disease. To assess this issue, we performed a retrospective cohort study concerning the previous practice of sports and, among them, those with medium-high cardiovascular commitment in clinically categorized carriers of a D4Z4 reduced allele (DRA). Methods: People aged between 18 and 60 were recruited as being DRA carriers. Subcategory (classical phenotype, A; incomplete phenotype, B; asymptomatic carriers, C; complex phenotype, D) and FSHD score, which measures muscle functional impairment, were assessed for all participants. Information on PAs was retrieved by using an online survey dealing with the practice of sports at a young age. Results: 368 participants were included in the study, average age 36.6 years (SD = 9.4), 47.6% male. The FSHD subcategory A was observed in 157 (42.7%) participants with average (± SD) FSHD score of 5.8 ± 3.0; the incomplete phenotype (category B) in 46 (12.5%) participants (average score 2.2 ± 1.7) and the D phenotype in 61 (16.6%, average score 6.5 ± 3.8). Asymptomatic carriers were 104 (subcategory C, 28.3%, score 0.0 ± 0.2). Time from symptoms onset was higher for patients with A (15.8 ± 11.1 years) and D phenotype (13.3 ± 11.9) than for patients with B phenotype (7.3 ± 9.0). The practice of sports was associated with lower FSHD score (-17%) in participants with A phenotype (MR = 0.83, 95% CI = 0.73-0.95, p = 0.007) and by 33% in participants with D phenotype (MR = 0.67, 95% CI = 0.51-0.89, p = 0.006). Conversely, no improvement was observed in participants with incomplete phenotype with mild severity (B). Conclusions: PAs at a young age are associated with a lower clinical score in the adult A and D FSHD subcategories. These results corroborate the need to consider PAs at the young age as a fundamental indicator for the correct clinical stratification of the disease and its possible evolution