Distortions in the digital looking glass: Information and communication technologies and bodily self-conceptions in men seeking men

Internet-enabled information and communication technology (ICT) use has become so diffuse as to be considered a hallmark of modern life. Between 2000 and 2019, the proportion of US adults who reported using some kind of Internet-enabled device skyrocketed from 52% to 90%. Sexual and gender minorities, particularly gay, bisexual and other men who have sex with men (GBMSM), are especially keen adopters of certain types of ICT like social media (e.g., Facebook, Twitter, Instagram) and location-based real-time dating apps (LBRTDAs) (e.g., Grindr, Tinder, Bumble) due to the possibilities they afford for circumventing various cultural, geographical, and legal barriers to forging interpersonal connections. However, use of such technologies is associated with adverse bodily self-awareness, including body dissatisfaction, body shame, and appearance preoccupation, as well as maladaptive body behaviours. To date, insufficient effort has been made to derive a mechanistic explanation for the relationship between ICT use and bodily self-conceptions in GBMSM. The overarching purpose of this dissertation research is to investigate how use of certain popular Internet-enabled ICTs, including social media and LBRTDAs, influences bodily self- conceptions in GBMSM – a group who are not only particularly keen adopters of such technologies, but are disproportionately burdened by issues of body consciousness. The effort is spread across four studies, each of which address more specific questions and/or particular facets of this broad phenomenon. Generally, the works included in this dissertation adopt a symbolic interactionist, qualitative methodological approach based on in-depth, semi-structured interviews conducted with a purposive and theoretical sample of ICT-using GBMSM. When taken together, the findings illustrate a jointly-constructed standard among contemporary North American GBMSM that elevates the body as something to be perfected for aesthetic and sexual consumption, and frames as ideal the White, fair-skinned, trimmed or hairless, muscular-mesomorphic, cisgender, able body. In terms of their influence on individuals’ bodily self-conceptions, ICTs like social media and LBRTDAs function as another medium for sociocultural influence, which is to say, a platform through which individuals can be exposed to social behaviours that reflect and (re)constitute the prevailing standards. Where ICTs differ from in-person interaction as to have a demonstrable, largely deleterious effect on users’ body attitudes is with respect to how frequently and intensively the subject is confronted with the standard. Receipt of appearance-related feedback, comparison against particular others, and switching of conscious attention to the embodied self are phenomena that similarly induce comparison against the standard and which occur more often and/or to greater effect online. This is partly a consequence of changes to human behavioural routines stemming from perception of technological affordance, many of which relate to self-presentation, or the deliberate attempting to influence others’ perceptions of oneself. These include, inter alia, feelings of disinhibition to behave in otherwise face-threatening ways, which embolden critical appearance-focused commentary, as well as the potential for enhancement of the self-image beyond what is possible offline, which prompts reflection on one’s own imperfections and makes onlookers feel even more inadequate by comparison. However, these effects inevitably also come into tension with the human agency of the user, hence why the psychological outcomes of ICT use are neither total nor uniform. Users can resist to compare themselves to the standard as reflected by others’ behaviour, critique the prevailing standard, and/or internalize all manner of alternative standards according to their goals and values. The included works make numerous substantive, theoretical, and methodological contributions to the literature. Study 1 is the first to provide any kind of theoretical framework that explains how use of social media and LBRTDAs influences bodily self-conceptions in GBMSM; studies 2 and 4 to empirically investigate the mechanisms underlying the relationship between LBRTDA use and bodily self-conceptions in GBMSM; study 3 to examine GBMSM’s self-presentation behaviour on ICTs by exploring interactions between determinants of impression construction; and study 4 to empirically investigate how self-presentation behaviour as such influences bodily self-conceptions of ICT users in general, let alone LBRTDA-using GBMSM. The implications of the included works for public discourse, policy, industry, and health promotion practice are legion

Constructing Masculinity in Women’s Retailers: An Analysis of the Effect of Gendered Market Segmentation on Consumer Behavior

While gender-based differences in consumer behavior have been previously investigated within the context of gender-neutral or unisex retailers, men’s behavior in women’s retailers remains largely unexplored. Furthermore, most studies frame the retail environment as a passive platform through which essential gender differences yield setting-specific bifurcated behavior, and do not address the role the commercial establishment and men’s shopping habits play in gender identity formation and maintenance. To address this gap, we analyzed men’s behavior in women’s retailers using interactionist and social constructionist theories of sex/gender. Data were collected through non-participatory observation at a series of large, enclosed shopping malls in South-Western Ontario, Canada and analyzed thematically. We found that men tend to actively avoid women’s retailers or commercial spaces that connote femininity, while those who enter said spaces display passivity, aloofness, or reticence. We suggest the dominant cultural milieu that constitute hegemonic masculinity— disaffiliation with femininity, an accentuation of heterosexuality, and a prioritization of homosocial engagement—nform the dialectical relationship between individual and institutional gender practice that manifests through consumption

Development and validation of the trust in multidimensional healthcare systems scale (TIMHSS)

Context: The COVID-19 pandemic has reignited a commitment from the health policy and health services research communities to rebuilding trust in healthcare and created a renewed appetite for measures of trust for system monitoring and evaluation. The aim of the present paper was to develop a multidimensional measure of trust in healthcare that: (1) Is responsive to the conceptual and methodological limitations of existing measures; (2) Can be used to identify systemic explanations for lower levels of trust in equity-deserving populations; (3) Can be used to design and evaluate interventions aiming to (re)build trust. Methods: We conducted a 2021 review of existing measures of trust in healthcare, 72 qualitative interviews (Aug-Dec 2021; oversampling for equity-deserving populations), an expert review consensus process (Oct 2021), and factor analyses and validation testing based on two waves of survey data (Nov 2021, n = 694; Jan-Feb 2022, n = 740 respectively). Findings: We present the Trust in Multidimensional Healthcare Systems Scale (TIMHSS); a 38-item correlated three-factor measure of trust in doctors, policies, and the system. Measurement of invariance tests suggest that the TIMHSS can also be reliably administered to diverse populations. Conclusions: This global measure of trust in healthcare can be used to measure trust over time at a population level, or used within specific subpopulations, to inform interventions to (re)build trust. It can also be used within a clinical setting to provide a stronger evidence base for associations between trust and therapeutic outcomes

Canadians’ trust in government in a time of crisis: Does it matter?

The ability of governments and nations to handle crises and protect the lives of citizens is heavily dependent on the public’s trust in their governments and related social institutions. The aim of the present research was to understand public trust in government during a time of crisis, drawing on interview data (N = 56) collected during the COVID-19 pandemic (2021). In addition to the general public (n = 11), participants were sampled to obtain diversity as it relates to identifying as First Nations, Métis, and Inuit (n = 7), LGBT2SQ+ (n = 5), low-income (n = 8), Black Canadians (n = 7), young adult (n = 8), and newcomers to Canada (n = 10). Data were coded in consideration of social theories of trust, and specifically the nature of trust between individuals and institutions working with government in pandemic management. Canadians’ trust in government was shaped by perceptions of pandemic communication, as well as decision-making and implementation of countermeasures. Data suggest that although participants did not trust government, they were accepting of measures and messages as presented through government channels, pointing to the importance of (re)building trust in government. Perhaps more importantly however, data indicate that resources should be invested in monitoring and evaluating public perception of individuals and institutions generating the evidence-base used to guide government communication and decision-making to ensure trust is maintained. Theoretically, our work adds to our understanding of the nature of trust as it relates to the association between interpersonal and institutional trust, and also the nature of trust across institutions

Vaccination discourses among chiropractors, naturopaths and homeopaths: A qualitative content analysis of academic literature and Canadian organizational webpages.

Vaccine hesitancy-the reluctance to receive recommended vaccination because of concerns and doubts about vaccines-is recognized as a significant threat to the success of vaccination programs and has been associated with recent major outbreaks of vaccine-preventable diseases. Moreover, the association between complementary and alternative medicine (CAM) use and vaccine hesitancy and/or refusal has been frequently reported in the literature. To date, significant gaps persist in our understanding of contemporary Canadian CAM providers' beliefs regarding vaccination and how socio-professional influences may shape their vaccine-related attitudes and behaviours. To address the latter gap, the current study aims to explore the content of professional guidelines, recommendations and other discourses among CAM providers as they concern vaccination by analyzing both academic, peer-reviewed literature and Canadian organizational webpages prepared by and/or for practicing chiropractors, naturopaths and homeopaths. In the academic literature, we identified a number of complex and diverging views on vaccination that spanned topics of effectiveness; safety; theoretical, empirical, and ethical soundness; political justifiability; and compatibility with CAM philosophy and professional boundaries. However, in its current state the CAM literature cannot be described in broad strokes as being either pro- or anti-vaccination without considering finer areas of disagreement. Compared to the academic literature, which focuses more on the conceptual and evidentiary basis of vaccination, a greater proportion of vaccine-related content on Canadian CAM organizations' webpages seems to be dedicated to offering specific directives and prescriptions to providers. Guidelines and standards of practice address a number of issues, including vaccine administration, counsel, education and marketing. As CAM organizations further evolve in Canada and elsewhere as part of a broader "professionalization" initiative, greater attention will need to be directed at their role in shaping providers' beliefs and practices that both support and undermine vaccine promotion efforts

“If I'm a naturopath, It's because I trust nature above everything else”: Canadian naturopaths' construction of vaccination as a risk object

Canadians and Quebecers increasingly consult complementary and alternative medicine (CAM) practitioners in parallel with biomedical providers. The close relationship between vaccine hesitancy and CAM use remains under explored in Western countries. We present the results of a qualitative study conducted among one of Quebec's most used CAM approaches: naturopathy. Using Boholm and Corvellec's relational theory of risk to illustrate naturopaths' construction of vaccination as an “object of risk”, we describe how the health representations of 30 Quebec naturopath interviewees are associated with the ways they perceived the risks of infectious diseases and vaccination. Our findings illustrate how Quebec naturopaths' view the body as “at risk” from the possible harmful effects of vaccines. For these naturopaths, the body is a site, a “terrain”, where homeostasis must continually be preserved, and needs to be protected from risks such as vaccines—which were seen as far riskier than infectious diseases—through natural means. Such views are often perceived as unscientific or even irrational by public health researchers. Our study highlights that naturopaths' attitudes towards vaccination are perfectly aligned with the epistemological tenets of their risk representations and conceptions of health