Public Health Commons^™

Social Support As A Determinant Of Health Related Quality Of Life In Breast Cancer Survivors In California, Faiza Rab

Electronic Thesis and Dissertation Repository

Objective:

To evaluate the relationship between perceived social support and HRQOL (physical and emotional) in low SES breast cancer survivors.

Methods:

A cross-sectional study design was used to measure perceived social support at 18 months and HRQOL at 3 years after breast cancer diagnosis using MOS SS and MOS SF-36, respectively. Multiple regression analyses were used to evaluate the relationship.

Results:

Menopause at the time of diagnosis, adjunct chemotherapy, adjunct radiation therapy, co-morbidities, treatment side effects and depression were negatively associated with PCS scores (p < 0.01). Treatment side effects, anxiety and depression were negatively associated with MCS scores (p < 0.01).

Conclusions:

Perceived social support was not associated with HRQOL in low SES breast cancer survivors …

Growing Up Our Way : The First Year Of Life In Remote Aboriginal Australia, Sue Kruske, Suzanne Belton, Molly Wardaguga, Conceptual Narjic

Aboriginal Policy Research Consortium International (APRCi)

In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and wellbeing between each infant’s birth and first birthday. We found significant differences in parenting behaviors and childrearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, …

Management Of Type 2 Diabetes, Susan Harch, David Reeve, Carole Reeve

Aboriginal Policy Research Consortium International (APRCi)

Objective: This article describes the evaluation of a new model of partnership care using an audit cycle.

Results: Statistically significant improvements in foot examination, body mass index, urine albumin creatinine ratio, total cholesterol, triglycerides and visual acuity measurements were observed. Significant increases in the proportion of patients achieving cholesterol and triglycerides therapeutic targets occurred. Most other outcome indicators demonstrated a nonsignificant improvement, which may be due to the short time interval in the audit for potential change.

Conclusion: A dedicated chronic disease team and a clinical information system to coordinate culturally appropriate, multidisciplinary chronic disease care enables effective management of …

Using First Nations Children's Perceptions Of Food And Activity To Inform An Obesity Prevention Strategy, Ashlee-Ann E. Pigford, Noreen D. Willows, Nicholas L. Holt, Amanda S. Newton, Geoff D.C. Ball

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Partnerships In Public Health: Lessons From Knowledge Translation And Program Planning, Shannon Sibbald, Anita Kothari, Debbie Rudman, Maureen Dobbins, Michael Rouse, Nancy Edwards, Dana Gore

Anita Kothari

The purpose of this study was to better understand how partnerships are initiated, maintained, and sustained in public health practice. A qualitative design was employed to conduct individual interviews and focus groups. The participants included practitioners from 6 purposively selected public health units in the Canadian province of Ontario that developed partnerships in program planning. It was found that partnerships play an essential role in program planning but that minimal information is available regarding the partnership process. Most partnerships are formed on an ad hoc basis, with little formalization. Public health professionals rely on their experiential knowledge when seeking out …

The Importance Of Self-Efficacy And Basic Psychological Needs In Children’S Physical Activity: Measurement, Prediction And Intervention, Casey E. Gray

Electronic Thesis and Dissertation Repository

The importance of physical activity in the overall health promotion and primary prevention of cardiovascular disease risk factors and metabolic diseases in children is well established. Nonetheless, interventions to increase physical activity among this population have been largely unsuccessful. The main objective of the research in this dissertation was to explore the suitability of self-efficacy and basic psychological needs for physical activity prediction and intervention in children. Item generation and psychometric evaluation of psychological questionnaires occurred in study 1 (Chapter 2). Using a prospective design, study 2 (Chapter 3) established task efficacy, barriers efficacy, competence, and autonomy as significant predictors …

Community-Based Knowledge Translation: Unexplored Opportunities, Anita Kothari, Rebecca Armstrong

Anita Kothari

BACKGROUND: Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools.

DISCUSSION: Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, …

Knowledge-To-Action Processes In Shrtn Collaborative Communities Of Practice: A Study Protocol, James Conklin, Anita Kothari, Paul Stolee, Larry Chambers, Dorothy Forbes, Ken Le Clair

Anita Kothari

BACKGROUND: The Seniors Health Research Transfer Network (SHRTN) Collaborative is a network of networks that work together to improve the health and health care of Ontario seniors. The collaborative facilitates knowledge exchange through a library service, knowledge brokers (KBs), local implementation teams, collaborative technology, and, most importantly, Communities of Practice (CoPs) whose members work together to identify innovations, translate evidence, and help implement changes.This project aims to increase our understanding of knowledge-to-action (KTA) processes mobilized through SHRTN CoPs that are working to improve the health of Ontario seniors. For this research, KTA refers to the movement of research and experience-based …

Birthweight And Natural Deaths In A Remote Australian Aboriginal Community, Wendy E. Hoy, Jennifer L. Nicol

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To describe associations between birthweight and infant, child and early adult mortality from natural causes in a remote Australian Aboriginal community against a background of rapidly changing mortality due to better health services. Design, participants and setting: Cohort study of 995 people with recorded birthweights who were born between 1956 and 1985 to an Aboriginal mother in a remote Australian Aboriginal community. Participants were followed through to the end of 2006. Main outcome measures: Rates of natural deaths of infants (aged 0 to < 1 year), children (aged 1 to < 15 years) and adults (aged 15 to < 37 years), compared by birth intervals (1956–1965, 1966–1975 and 1976–1985 for infants and children, and 1956–1962 and 1963–1969 for adults) and by birthweight. Results: Birthweights were low, but increased over time. Deaths among infants and children decreased dramatically over time, but deaths among adults did not. Lower birthweights were associated with higher mortality. Adjusted for birth interval, hazard ratios for deaths among infants, children and adults born at weights below their group birthweight medians were 2.30 (95% CI, 1.13–4.70) ), 1.78 (95% CI, 1.03–3.07) and 3.49 (95% CI, 1.50–8.09), respectively. The associations were significant individually for deaths associated with diarrhoea in infants, with cardiovascular and renal disease in adults, and marginally significant for deaths from pulmonary causes in children and adults. Conclusion: The striking improvements in infant and child survival over time must be applauded. We confirmed a predisposing effect of lower birthweights on deaths in infants and children, and showed, for the first time, an association between lower birthweights and deaths in adults. Together, these factors are probably contributing to the current epidemic of chronic disease in Aboriginal people, an effect that will persist for decades. Similar phenomena are probably operating in developing countries.

Patterns Of Mortality In Indigenous Adults In The Northern Territory, 1998–2003: Are People Living In More Remote Areas Worse Off?, Karen Andreasyan, Wendy E. Hoy

Aboriginal Policy Research Consortium International (APRCi)

Objective: ToquantifyIndigenousmortalityintheNorthernTerritorybyremotenessof residence.

Design, setting and participants: Australian Bureau of Statistics mortality data were used to compare rates of death from chronic disease in the NT Indigenous population with rates in the general Australian population over the period 1998–2003. Rates were evaluated by categories of remoteness based on the Accessibility/Remoteness Index of Australia: outer regional areas (ORAs), remote areas (RAs) and very remote areas (VRAs). Main outcome measures: Mortality from cardiovascular disease, diabetes and renal disease; standardised mortality ratios (SMRs); percentage change in annual death rates; changes in mortality between 1998–2000 and 2001–2003.

Results: In 1998–2000, SMRs for all-cause mortality …

Is Reporting On Interventions A Weak Link In Understanding How And Why They Work? A Preliminary Exploration Using Community Heart Health Exemplars, Barbara Riley, Joanne Macdonald, Omaima Mansi, Anita Kothari, Donna Kurtz, Linda Vontettenborn, Nancy Edwards

Anita Kothari

Background: The persistent gap between research and practice compromises the impact of multi-level and multi-strategy community health interventions. Part of the problem is a limited understanding of how and why interventions produce change in population health outcomes. Systematic investigation of these intervention processes across studies requires sufficient reporting about interventions. Guided by a set of best processes related to the design, implementation, and evaluation of community health interventions, this article presents preliminary findings of intervention reporting in the published literature using community heart health exemplars as case examples.

Methods: The process to assess intervention reporting involved three steps: selection of …

Lower Than Expected Morbidity And Mortality For An Australian Aboriginal Population: 10-Year Follow-Up In A Decentralised Community, Kevin G. Rowley, Kerin O'Dea, Ian Anderson, Robyn Mcdermott, Karmananda Saraswati, Ricky Tilmouth, Iris Roberts, Joseph Fitz, Zaimin Wang, Alicia Jenkins, James D. Best, Zhiqiang Wang, Alex Brown

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toexaminemortalityfromallcausesandfromcardiovasculardisease(CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Mainoutcomemeasures: MortalityfromallcausesandCVD,andhospitalisationwith CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.

Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than …

Public Health Decision Makers’ Informational Needs And Preferences For Receiving Research Evidence, Maureen Dobbins, Susan Jack, Helen Thomas, Anita Kothari

Anita Kothari

Objectives: The purpose of this study was to identify decision-makers’ preferences for the transfer and exchange of research knowledge. This article is focused on how the participants define evidence-based decision-making and their preferences for receiving research evidence to integrate into the decision-making process.

Methods: Semistructured interviews were conducted with a purposive sample of 16 Ontario public health decision-makers from six Ontario public health units in this fundamental qualitative descriptive study. The sample included nine program managers, six directors, and one Medical Officer of Health. Participants were asked to define the term evidence-based decision-making and identify preferred research dissemination strategies. The …

“Interaction” And Research Utilisation In Health Policies And Programs: Does It Work?, Anita Kothari, Stephen Birch, Cathy Charles

Anita Kothari

The objective of this study was to assess if interaction between users and producers of research is associated with a greater level of adoption of research findings in the design and delivery of health care programs. Responses to the dissemination of a research report on breast cancer prevention were compared between two groups of public health units in Ontario, Canada. Although all public health units received the report, only a subset of units was involved in the development of the report, while others were not. Research utilisation was conceptualized in terms of stages, including reading the report, information processing, and …