Active And Safe Routes To School: Evaluating School Travel Planning To Support Children's Active Travel, Adrian Nicholas Buttazzoni

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Most Canadian children are not achieving their daily recommended physical activity (PA) levels despite the many emotional, psychological, and physical benefits of PA. Walking or wheeling to/from school, or active school travel (AST), is a viable method for improving children’s daily participation in PA. In Canada, the Active and Safe Routes to School initiative promotes AST through its comprehensive School Travel Planning (STP) program. Utilizing a mixed-methods approach, broadly, this thesis investigates the i) implementation and ii) effectiveness of a regional, two-year STP program supporting AST. This thesis includes a systematic review of AST intervention models implemented in North America, …

Risk Perceptions Of Smoking In China, Imran Syed

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Approximately one million smokers die in China every year. Risk perceptions of smoking have been theorized as being important in explaining behaviour change and have been found to be associated with initiating and quitting smoking. This study examined the extent to which smokers in China perceive risks associated with smoking (i.e., perceived likelihood of getting a smoking-related disease) and the roles of socio-demographic factors (i.e., gender, age, ethnicity, income and education) and knowledge of the consequences of smoking in explaining risk perceptions of smoking. Participants included 4861 smokers from six cities in China. The prevalence of perceived risk for smoking …

Examining Geographic Variation In Children's Perceived Barriers To Physical Activity And The Implications On Behaviour, Leah Gabrielle Taylor

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Low levels of physical activity among Canadian children has become a national public health issue. Recent research has suggested that children’s physical activity levels are associated with their perceptions of their everyday environments. A better understanding of the formation of these perceptions within different contexts is needed to explain the extent of the relationship. Using a multi-tool quantitative protocol, this thesis examines geographic variation in socio-ecological factors influencing children’s perceptions of barriers to PA, and the extent to which perceptions mediate the relationship of the environment and PA. Results indicate that perceptions form within contexts, and have an influence on …

Standing And Dynamic Sitting In The University Classroom, Siobhan Smith

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Students almost exclusively sit in class, which translates to large amounts of forced sedentary behaviour and this in turn may have negative health consequences. The effect alternative postures have on classroom performance of university students remains unknown.

Using a randomized counterbalanced design, pilot study 1 (N=40) and 2 (N=20) investigated the effect of alternative postures on 3-minute and 50-minute classroom performance, respectively. In study 3, university students’ (N=1005) and faculty (N=218) acceptability to alternative workstations in the university classroom was assessed using a mixed method approach.

This thesis provides preliminary evidence that there is no difference between classic sitting, dynamic …

Investigating The Health Meanings Of Young Saudi Women, Tagreed Alnajjar

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Women’s structural position within society and their family roles significantly influence their health. Previous studies have shown women hold lower health and socioeconomic status because of their gender within the Saudi culture. This study aimed to provide an understanding of how Saudi women value health and define being healthy within their social contexts. Adopting an ethnographic perspective, three focus groups (31 participants in total) were conducted with volunteer undergraduate Saudi female students on campus during a nine-week field trip to the participants’ university, King Abdulaziz University in Jeddah, Saudi Arabia. Three themes were generated from this study that characterize the …

The Development And Evaluation Of A Smartphone Nutrition Intervention For Adolescents, Sarah A. Cappuccitti

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A diet high in fruit and vegetables is associated with the prevention of many chronic diseases; however, only one in ten Canadian students in grades 6 to 12 consume the recommended daily intake of fruits and vegetables. Using smartphones to deliver nutrition interventions is an emerging area of research, although to-date these interventions typically limit their focus to weight loss. The overarching purpose of this research is to redevelop and evaluate an existing smartphone application for an adolescent population. This thesis used a mixed-methods approach to gain adolescent perspectives on how to redevelop the app and to evaluate its use …

Promoting Benefits Of Physical Activity Through Persuasive Communication, Priynka Patil

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Inactivity early in life can lead to inactively later in life, which can result in negative outcomes. The primary purpose was to determine if gain- or loss-framed messages about physical activity would change the attitudes, intentions, and behaviours of students in the contemplation or preparation stage of the Transtheoretical model. The secondary purpose was to determine if framing the message in terms of the physical health benefits, appearance/social benefits, or mental health benefits (benefit condition) would change attitude, intention and behaviour. Undergraduate female students (N=60) between the ages of 18 and 36 were recruited from the university. The results found …

Examining The Impact Of A Population-Based Intervention On Children's Physical Activity Levels: The Grade 5 Act-I-Pass Program In London, Ontario, Christine E. Smith

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Childhood obesity is a major public health concern caused in part by decreasing levels of physical activity (PA). Identification of effective population level strategies for increasing children’s PA levels is critical for improving overall health. This thesis is comprised of two studies. Study 1 examines how naturally-occurring population-level PA interventions with children have been evaluated in previous studies by conducting a systematic review. A total of 15 papers were included for review and results suggest that naturally-occurring population-based PA interventions are generally effective in improving PA levels of children in a variety of PA domains. Eleven studies included additional evaluation …

Social Connectedness, Social Support And The Health Of Older Adults: A Comparison Of Immigrant And Native-Born Canadians, Natalie Iciaszczyk

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Considerable research exists on the influence of social relationships for health in old age. However, few studies have compared the associations of social connectedness and social support with the health of older adults. Using data from the CCHS-Healthy Aging, this study examines how these constructs are related to the self-reported health status of immigrant and native-born adults aged 65+. Results show that social connectedness and social support are differently associated with health in later life; whereas connectedness is linked to better health, social support is negatively related with health once levels of social connectedness are considered. Furthermore, these associations hold …

Visualizing And Interacting With Social Determinants Of Health, Moutasem Zakkar

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Purpose: The purpose of this study is to examine the use of information visualization to represent specific social determinants of health, and to examine the benefits of such representation for health policymaking. Methods: The study developed a prototype for a visualization tool (www.healthvisualization.ca), which represents the conceptual framework for the social determinants of health (CSDH) and new ways to represent related health equity indicators. This tool was used by study participants. The experience of these participants and the usability of the tool were evaluated using qualitative semi-structured interviews. Results: Visualizing the CSDH framework helps to present the social …

Domestic Homicide And Homicide-Suicide In The Older Population, Brianna L. O'Neil

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Extensive research has been conducted on domestic homicide in younger populations; however, very little is known about such incidents in the older population. It is vital that this gap in the literature be filled as Canada’s older population has been increasing. Data for this study was provided by the Ontario Domestic Violence Death Review Committee. Ninety-two domestic homicide and suicide cases were examined to determine whether there were differences between younger age groups (30 to 50 years of age) and older age groups (55 years of age and older). Information was gathered on prominent characteristics and risk factors within cases …

The Sixties Scoop Among Aboriginal Veterans: A Critical Narrative Study, Munira Abdulwasi

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This study explored the experience of Aboriginal Veterans adopted and/or fostered during the Sixties Scoop using critical narrative inquiry. The objectives were to: 1) understand the lived experience of Aboriginal veterans adopted and/or fostered during the Sixties Scoop, 2) explore any health needs expressed by Aboriginal veterans adopted and/or fostered during the Sixties Scoop, and 3) provide recommendations for the implementation of health services and programs to assist this group of Aboriginal veterans with their health needs. Eight individual interviews were conducted with participants in Kitchener-Waterloo, London, Ottawa, Winnipeg, and Vancouver. All interviews were audio-taped, transcribed verbatim, and analyzed using …

Exploring The Career Pathways, Professional Integration And Lived Experiences Of Regulated Nurses In Ontario, Canada, Godfred O. Boateng

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In the context of an enduring shortage of nurses, this study explores the career pathways and experiences of immigrant and Canadian-born nurses in two Ontario cities utilizing a qualitative research design consisting of 70 in-depth interviews. Differences in career entry and experiences of workplace conflict across immigration status and race are explored.

First, I explore successful immigrants’ pathways into the nursing profession and their social and economic integration into the Canadian economy in light of the traditional assimilation and segmented assimilation theories. The study reveals distinct career pathways taken by foreign-born nurses and Canadian born nurses. While Canadian-born nurses have …

Does Satisfaction With Perinatal Health Care Influence Postpartum Weight Retention?, Andreea Bente

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The primary aim of this thesis is to identify whether satisfaction with perinatal health care encounters is associated with lower postpartum weight retention (PPWR). PPWR is the difference between postpartum and pre-pregnancy weight. Principal components analysis confirmed the validity of a summed satisfaction score representing six dimensions: information, compassion, competency, privacy, respect and decision-making. Confounders were identified using a directed acyclic graph. Multivariable linear regression models were constructed using blocks, and backwards elimination. Results reflect a mean PPWR of 2.5 kg, and high satisfaction, with more than 90% of respondents being very satisfied or satisfied on each dimension. The multivariable …

Psychotherapy In Family Medicine, Saadia N. Hameed

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Abstract

Aim: To explore the perspectives and practice of psychotherapy of family physicians, and analyze Ontario’s mental health policy documents within the context of psychotherapy.

Methods: In the first study descriptive qualitative methodology was used. Eighteen family physicians were interviewed and the results were presented thematically. In the second study, a policy analysis of Ontario’s mental health policy documents was conducted. The qualitative policy analytic methodology of Peter et al. was used.

Findings: Psychotherapy is an effective treatment of mental illness and is practiced by family physicians. Lack of training and time are barriers, while patient needs and …

Pearl Harvesting Autism, Mariya Gruntovskaya

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This thesis addresses the difficulties of on-line information searching as it relates to the topic of autism. A review of existing search strategies is presented and their limitations are discussed. A new method for deriving a set of search-terms for comprehensive searching, Pearl Harvesting, was tested here to determine the necessary search terms (i.e., synonym ring) for ERIC and PsycINFO databases. Once discovered and validated, a synonym ring can be copied and pasted directly into the search box of the database, providing a simple, thorough and time saving way of conducting on-line research in the field. This easily used method …

Careful, Not Fearful: A Mixed Methods Study To Investigate Fall-Risk Appraisal And Fear Of Falling In Community-Dwelling Older Adults, P. Karen Simmavong

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This study investigated older adult’s accuracy in fall-risk judgement and ascertained whether fall-risk appraisal was situation specific or general in nature. Convenience and snowball sampling were used to recruit 30 community-dwelling older adults aged 65 years and older. An embedded correlational mixed methods was utilized to investigate relative and absolute fall-risk judgement, balance confidence, and hazard identification. Using Pearson Product Moment correlations, multiple regressions, and qualitative analysis, the findings suggest older adults are not always accurate in appraising fall-risk. Judgements were specific and not general in nature, as only 9.30% of variance in risk appraisals and 12.96% of variance in …

An Examination Of Psychological Variables Influencing Perceptions Of The Self Among A Sample Of Female Exercise Initiates, Lisa Cooke

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The general purpose of this dissertation was to explore the relationship among and within cognitive variables associated with exercise initiation and maintenance in a sample of female exercise initiates.

Manuscript 1 was structured to explore the changes to exercise identity among a population of female exercise initiates (N = 78) grouped into an imagery or control condition. Previous research has found that a strong exercise identity is associated with more frequent exercise (Strachan et al., 2009) and increases over time as a person continues to exercise (Cardinal & Cardinal, 1997). Participants were assessed multiple times (weeks 0, 5, 9, …

Environmental Health Effects Of Multiple Exposures: Systemic Risks And The Detroit River International Crossing Study, Tor H. Oiamo

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This thesis examines cumulative exposures to traffic noise and outdoor air pollution on environmental and health related quality of life in Windsor, Ontario, and provides a critical analysis of the environmental assessment process for the Detroit River International Crossing (DRIC) Study. The research utilizes a systemic risk framework to understand environmental health and stress effects of cumulative exposures. The significance of this research is based on a relative absence of literature on the systemic health risks of cumulative exposures and the need to elucidate environmental annoyance as a health outcome for risk assessment. The objectives of the research were to …

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

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Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

Older Woman Workers: Met And Unmet Needs For Health And Wellbeing In The Workplace, Gillian Gorfine

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Older women workers report experiencing occupational injustices however the literature focuses on barriers faced rather than understanding the needs-based strategies empowering women as they age at work. This study engaged women aged 55 and older in a participatory action research project defining and examining strategies for older women workers’ health and wellbeing. In Phase 1, a key informant advisory group (N = 4) defined the problem and guided the design of an open answer survey conducted with 72 older women in work. Three categories emerged informing the fundamental, instrumental, and contextual needs of older women workers. Meeting fundamental needs may …

Women's Navigation Of Maternal Health Services In Ghana's Upper West Region In The Context Of The National Health Insurance Scheme, Andrea C. Rishworth

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In 2008 the sub Saharan African country of Ghana implemented a Maternal Exemption Policy (MEP) within its National Health Insurance Scheme. This policy provides coverage for free antenatal, postnatal, and facility delivery to all pregnant women for a one year period. By removing the fees associated with maternal health services, the MEP was intended to reduce maternal mortality and provide equitable health care for pregnant women. While the MEP is generally regarded as beneficial to the women of Ghana, challenges remain, especially in the poor, marginalized and rural communities of the Upper West Region. Given that access to a skilled …

From Their Perspective: How Adolescents And Young Adults Experience And Conceptualize Life And Occupation Surrounding Parental Divorce Or Separation, Laura R. Hartman

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Parental divorce affects adolescents’ emotions, routines, habits, occupations and relationships. The current body of research indicates that parental divorce leads to many unfavourable social, behavioural, and mental health outcomes for adolescents. This dissertation explores the daily lives and occupations of adolescents and young adults surrounding the transition of a parental divorce or marital separation.

This thesis contains four manuscripts in addition to the introductory and final reflection chapters. The first manuscript explores the current North American literature relating to adolescent life surrounding a parental divorce or marital separation, ranging form 1998 to 2014. The second manuscript provides an overview of …

Interesting Shapes Of Vegetables: Is It A Strategy To Promote Consumption Among Preschool Children?, Salma H. Alhabshi

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This study highlighted the low intake of vegetables by preschool children and determined whether changing the shape of vegetables increased their level of consumption. A new strategy of repeated exposure to interesting-shaped vegetables was a step aimed at increasing vegetable consumption by increasing the fun element in having vegetables as snacks. Vegetables are the less desirable food in comparison to more attractive unhealthy choices available to children, and discovering a strategy to promote vegetables is considered an important step in nutrition. The primary aim was to explore the effect of repeated exposure (eight times) of shaped vegetables on consumption by …

How Age Friendly Is This City? Strategies For Assessing Age-Friendliness, Michelle Dellamora

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The Age-Friendly Cities framework, created by the World Health Organization (WHO), has emerged as a community-based response to the challenges of demographic aging and increasing urbanization. In 2010, London, Ontario, became the first city in Canada to join the WHO Global Network of Age-Friendly Communities. Network milestones require the measurement of the baseline age-friendliness of the community. The objectives of this thesis are: 1. Determine the best available assessment tools for measuring the age-friendliness of a community, and 2. Establish the baseline age-friendliness of London, Ontario. A scoping review was utilized to collect and assess available surveys and questionnaires. A …

Children At-Risk For Hearing Impairment: A Retrospective Study Of The Ontario Infant Hearing Program Population, Katherine M. Smith

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There is widespread agreement that infant hearing screening programs are effective but such programs may fail to detect all hearing impairment and children can develop subsequent hearing loss after passing the initial screen. This is the core rationale for surveillance programs that are analyzed in this thesis. Infants with hearing risk factors are followed using surveillance programs that include monitoring by audiological assessment.

The study population in this thesis consists of 2,390 children with normal hearing and 248 children with hearing impairment from different referral routes. The Infant Hearing Program Surveillance group is 1.48% of the number of hearing-impaired children. …

Re-Cognizing Power In The Culture Of Dementia Care Knowledge, Ryan T. Deforge

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In light of increasing system demands, system regulations, and constrained resources, those living and working with dementia in the long-term care sector are vulnerable to oppressive care practices. This is true so long as our understanding of how social power affects the ways in which dementia care knowledge is created, shared, and enacted remains limited. Based on prolonged field observations and on informal and formal interviews with care recipients, family members, and staff, the aim of this critical qualitative research was to examine the culture of dementia care knowledge in two sites: a specialized dementia care unit in a long-term …

"Being Stuck": Understanding The Health-Related And Everyday Lived Experiences Of Young Mothers In Rexdale, Ontario Through A Social Determinants Framework, Jaspreet Kaur

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The purpose of this study was to gain an understanding of the ways the health-related and everyday lived experiences of young mothers are shaped by various social determinants, and in the context of their neighbourhood. Using a critical qualitative methodology, five mothers between the ages of 17 to 19 were interviewed from Rexdale, a neighbourhood in the City of Toronto characterized by a number of social risk factors(e.g. high rates of visible minorities, unemployment, and teen mothers). In-depth thematic analysis led to the emergence of four themes: 1) Living in Rexdale: Representations and realities; 2) Leaving Rexdale and wanting something …

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

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Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …

The Impact Of Social Integration On The Lived Experience Of Resilience Among Women Who Lived In Poverty During Childhood, Nedra R. Peter

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This thesis is a study of the lived experience of poverty and resilience among women who lived in poverty during childhood. The aim of this study was to investigate the impact of social integration on resilience to the adverse effects of poverty. This investigation was conducted as a retrospective study. Using a hermeneutic phenomenological approach, seven women who lived in poverty during childhood were interviewed in semi-structured interviews lasting 60 to 90 minutes. These interviews, along with a member-checking meeting, were the primary method of data collection. Data was analyzed through thematic analysis informed by van Manen (1990, 1997). The …