Public Health Commons^™

The Together Study: Exploring The Relationship Between Ontario Undergraduate University Students’ Levels Of Resilience And Their Experiences Of Diversity And Inclusion, Manvir Ahluwalia

Electronic Thesis and Dissertation Repository

This study’s primary purpose was to assess, quantitatively, the relationship between Ontario undergraduates’ levels of resilience and experiences of diversity and inclusion, and to identify demographic factors most associated with these outcomes. The secondary purpose was to explore, qualitatively, students’ experiences of diversity and inclusion and their perspectives on how these experiences influenced their resilience. Demographic questions, three scales, and (focus group and individual) interviews were used. Undergraduates (n = 276) from 19 Ontario universities completed the survey. Pearson’s correlation revealed a positive relationship between resilience and experiences of diversity and feelings of inclusion. Demographics indicative of equity-deserving group …

Association Of Fall-Related Injuries And Different Diagnoses In Older Adults Of Ontario: A Machine Learning Approach, Sorour Rostampour

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. This study aimed to identify the most informative diagnostic categories associated with fall-related injuries (FRIs) using three machine learning algorithms: decision tree, random forest, and extreme gradient boosting tree (XGBoost). Secondary data from two Ontario health administrative databases (NACRS, DAD) covering the period 2006-2015 were analyzed. Older adults (aged ≥ 65 years) who sought treatment for FRIs in emergency departments (ED) or hospitals, as indicated by Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA) codes for falls …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

(In)Dependence, Socio-Sexual Relationships, And Sexual Health Among Adults With Mild Intellectual Disability (Mid): A Critical, Qualitative Exploration, Vanessa L.E. Cox Ms

Electronic Thesis and Dissertation Repository

The purpose of this critical, qualitative study was to explore how adults with mild intellectual disability navigate independent socio-sexual relationships in settings where they are highly dependent upon caregivers and family members who exert significant control over most aspects of their lives. Data were gathered during one-on-one interviews conducted with adults with MID (n=15), and parental caregivers (n=6). Theoretical insights from critical disability studies and sexual citizenship were used to analyze the findings, which are presented thematically by study population. Participants with MID faced challenges to establishing and maintaining meaningful relationships, including a lack of choice about where and how …

The Influences Of The Mindfulness Ambassador Program On Graduate Students, Varsha Vasudevan

Electronic Thesis and Dissertation Repository

The two-fold primary purpose of this pilot study was to: (1) explore, qualitatively, the influence of the Mindfulness Ambassador Program (MAP) on graduate students’ experiences of stress and their relationship with themselves and meaningful others; and (2) investigate, quantitatively, if participation in the MAP elicited changes in graduate students’ levels of stress, self-awareness, interpersonal skills, and/or social connectedness. The secondary purpose of this study was to gain an understanding of graduate students’ satisfaction with the MAP. This one-group mixed-method study utilized a brief demographic questionnaire, open-ended questions, semi-structured interviews, two MAP-specific program questionnaires, the Perceived Stress Scale, the Situational Self-Awareness …

Return To Play: Impact Of Urbanicity And Socioeconomic Status On Parents’ Attitudes Regarding Their Children's Play And Sport During The Covid-19 Pandemic, Kendall Saravanamuttoo

Electronic Thesis and Dissertation Repository

The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. The primary aim of this study was to explore the influence of socioeconomic status (SES) and urbanicity on parents’ attitudes toward their children’s active play opportunities 6 months and 1.5 years into COVID-19. The secondary objective was to explore how parents’ attitudes at 6 months related to the structured and unstructured play opportunities that children returned to 1 year later, while moderating the effects of SES and urbanicity. A sample of 239 Ontario parents of children (< 12) completed two online surveys (August – December 2020; 2021). In general, parents in communities with urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents of lower-income were more hesitant to return their children to active play during the pandemic. Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.

Encouraging Movement Opportunities Through Theory-Informed Video Education In Undergraduate Students: The Move Study, Carmen T. Labadie

Electronic Thesis and Dissertation Repository

This mixed methods randomized control trial explored the impact of a tailored, Health Belief and Transtheoretical Model informed educational video on undergraduate students’: (1) motivational readiness, self-efficacy, and decisional balance about changing sedentary behaviour; (2) levels of sedentary time; and (3) perceptions of sedentary behaviour over time and when compared to a control condition. Students (N = 160) were randomly assigned to the intervention or control group. Participants completed: two previously validated questionnaires at baseline, immediate post-intervention, and one-month follow-up; and open-ended questions at post-intervention (intervention group only). Linear mixed models and inductive content analysis were used. Significant differences …

Examining The Impact Of Financial Incentive Removal On Physical Activity: A Quasi-Experimental Study Of 584,760 Mobile Health Application Users, Sean Kevin Spilsbury

Electronic Thesis and Dissertation Repository

BACKGROUND: Government interest in using financial incentives (FIs) to stimulate physical activity (PA) is increasing. The cost of longer-term incentive interventions may be prohibitive, however. PURPOSE: To examine the impact of FI withdrawal on PA. METHODS: A 25-week retrospective pre-post quasi-experimental study was conducted with users of a FI-based mHealth app. Users from three Canadian provinces were included. Daily FI were removed in Ontario (ON; intervention) but not British Columbia (BC) and Newfoundland and Labrador (NL; control). Simple linear regression models were used to examine weekly mean daily step count after FI withdrawal. RESULTS: The total sample included 584,760 users …

Falls Screening In Community- Dwelling Older Adults, Hadi Kooshiar

Electronic Thesis and Dissertation Repository

Falls screening can prevent falls and their consequences. The two studies of this thesis aimed to identify the accuracy of falls screening tools and explore patient preferences and empirical validity of the self-rated Falls Risk Questionnaire (FRQ). The first study, Systematic Literature Review, found the Toulouse-St. Louis University Mini Falls Assessment and the Activities-specific Balance Confidence scale Hindi version emerged as accurate tools for predicting falls in the target population. The second study determined most of respondents, 36%, had no preference between Activities Specific Balance Confidence 6 items (ABC-6) or FRQ. The Bland & Altman approach revealed a degree of …

The Development, Short-Term Efficacy, And Pilot Implementation Of An E-Learning Course In Physical Activity And Sedentary Behaviour For Pre-Service Early Childhood Educators, Brianne Bruijns

Electronic Thesis and Dissertation Repository

The overarching purpose of this dissertation was to develop an e-Learning course in physical activity and sedentary behaviour and test its short-term efficacy and implementation among pre- and in-service early childhood educators (ECEs). The Delphi approach was adopted for Study 1, wherein a panel of international experts in physical activity and sedentary behaviour suggested topics for the course and, together with a panel of ECE experts, rated their importance. Study 2 employed a pre-post design to explore the changes in pre- and in-service ECEs’ physical activity and sedentary behaviour-related knowledge, self-efficacy, behavioural intention, and perceived behavioural control following course completion. …

Reddit And Nursing During Covid-19: A Summative Content Analysis, Julia C. Savin

Electronic Thesis and Dissertation Repository

Purpose: The purpose of this thesis was to explore what self-identified nurses discussed on the nursing SubReddit during the Covid-19 pandemic between March 2020 to May 2020.

Methods: The Hsieh and Shannon (2005) summative content analysis with emergent categorical development was used to categorize the naturalistic data.

Findings: Through analysis, six content categories were identified from the nursing SubReddit: (a) employers’ approaches to the pandemic; (b) emergency preparedness in response to the pandemic; (c) shared experiences; (d) nursing students and new graduate nurses; (e) coping; and, (f) gratitude to nurses.

Implications: (a) Leadership that is communication-focused will improve the quality …

Examining Public Health Risk Communication Via Social Media By Provincial And Local Health Authorities In Ontario During The Covid-19 Pandemic, Marc Resendes

Electronic Thesis and Dissertation Repository

Risk communication campaigns are essential during public health crises to inform the public about ways to mitigate, alleviate and manage potential risks. The purpose of this study was to describe risk communication on social media by Ontarian health authorities amid COVID-19, in addition to examining the strategies that guided their social media use. This was completed through (a) a narrative review of risk communication literature; (b) a qualitative content analysis of select health authority Twitter messaging following three major COVID-19 milestones; and (c) key informant interviews with those coordinating social media responses to COVID-19. Information giving and news updates were …

Community Health Workers And Trainers Perspectives On Education And Practice: A Qualitative Case Study In The Context Of Maternal And Child Health In Rwanda, Damilola Toki

Electronic Thesis and Dissertation Repository

Achieving global health-care goals hinges on a health workforce that is available, competent, and productive. Chronic health worker shortages impede the abilities of health systems to provide equitable services, especially in low-resource settings.

Global consensus on bridging health workforce gaps calls for alternatives such as using community health workers (CHWs) to achieve health-care aims. CHWs are laypeople who are closely connected with communities and provide frontline health services. Although CHWs are an integral part of workforces in many countries, with potential to inform global health systems, CHW programs continue to operate on the fringe and are fraught with challenges.

This …

"Man Up": Male Survivors Of Intimate Partner Violence Through The Eyes Of Their Providers, Xavier S. Borsato

Electronic Thesis and Dissertation Repository

Intimate partner violence (IPV) is a complex phenomenon that is often understood with women as the primary recipients of violence and men as the primary perpetrators. However, emerging literature on heterosexual relationships suggests that men also experience interpersonal violence, most often from their female partners. Drawing on research data gathered through semi-structured interviews with service providers (n = 4), this qualitative inquiry explores how gender, power, and the stigma associated with interpersonal violence impact men who have experienced abuse through the perspectives of the service providers who work with them. The findings from this study highlight how traditional constructions …

Exploring The Mental Health Experiences Of African, Caribbean, And Black Youth In London, Ontario, Lily Yosieph

Electronic Thesis and Dissertation Repository

This qualitative study explores the mental health experiences of African, Caribbean, and Black (ACB) youth in London, Ontario, investigating how the factors of race, gender, culture, and place have shaped their perceptions and experiences of mental health. The data collection and analysis were conducted using a phenomenological approach and a critical lens informed by feminist, intersectionality, and critical race theories. These data illuminate the ways in which these young people’s attitudes toward mental health and help-seeking strategies are impacted by broader social constructs and community expectations, which they navigate and often resist in their everyday lives. Their insights can provide …

The Experiences Of Iraqi Refugees In Canada: A Life History Study Of War And Resilience In The Aftermath Of Migration, Nada Nessan

Electronic Thesis and Dissertation Repository

This thesis reports on a life history narrative on the experiences of Iraqi refugees who resettled in Canada after living through war. The aim of this study is to help change the narrow perspectives on the mental health of war affected populations to a broader perception shaped by cultural and social aspects and to inform the development of meaningful and cultural relevant programs and policies with a particular attention to the concept of resilience.

The first part of the study presents the chronological narratives, or profiles. of eight participants. The second part of the study is a thematic discussion of …

Investigating Children's Experiences And Participation In A Free Community-Based Physical Activity Program: The Grade 5 Act-I-Pass, Emma E. Ostermeier

Electronic Thesis and Dissertation Repository

Physical activity is an important component of children’s health and development; however, a majority of Canadian children are not meeting the physical activity recommendations. This thesis aimed to identify the factors that influenced children’s enrollment and participation in a free community-based physical activity program, the Grade 5 ACT-i-Pass (G5AP). This thesis consisted of two individual, but interrelated studies. First, focus groups with G5AP participants were used to explore the factors that influenced children’s perceived physical activity levels and participation in the program. Second, a spatially-targeted promotional campaign was developed and implemented to help evaluate the impact of promotions on program …

The Provision Of Foods And Beverages To Children From Non-Parental Sources: An Exploratory Study, Emilia B. Klassen

Electronic Thesis and Dissertation Repository

This study explored: (1) the overall frequency of food/beverage provision to children from non-parental sources; (2) frequency based on location/setting, source, type of food/beverage, and special event/occasion; (3) parental attitudes and awareness related to this provision; and (4) parent perceptions of children’s eating patterns during the COVID-19 pandemic. Parents (n =30) and children (n = 44) completed an online survey. Most participants reported that children were provided with foods/beverages from non-parental sources an average of 1-3 times per week. Children reported that provision was most likely to: (a) occur in other people’s homes, during …

Evaluating The Implementation Of The Centrally Procured School Food Program (Cpsfp) In Southwestern Ontario Elementary Schools, Mariam R. Ismail

Electronic Thesis and Dissertation Repository

School food programs can improve children’s health and well-being, while also creating economic opportunities for local food systems. Program evaluations of such interventions have always been done, but from the perspectives of their effectiveness. Yet, few have thoroughly examined the process or implementation practices of these interventions. The aim of this dissertation was to evaluate the implementation of the Centrally Procured School Food Program (CPSFP), a procurement and delivery-based school food program in Southwestern Ontario, that aims to improve elementary school-aged children’s intake of fruit and vegetables (FVs). Canada remains one of the few industrialized nations without a national school …

The Impact Of School Nutrition Policy On Diet Quality Of Children And Youth In Canada, Victoria Gaudin

Electronic Thesis and Dissertation Repository

Improving diet quality is an important public policy initiative targeted to enhance population health worldwide. In this regard, school nutrition policy is an important means to promote healthy diet among children and youth. In Canada, six provinces implemented mandatory school nutrition policies at different times between 2005 and 2011. We investigated the impact of mandatory school nutrition policy on diet quality of Canadian children and youth using a quasi- experimental study design. Using 24-hour dietary recall data from the 2004 Canadian Community Health Survey (CCHS) Cycle 2.2 and 2015 CCHS-Nutrition, we constructed the Diet Quality Index (DQI). We used multivariable …

The Experiences Of Female Adolescents Who Have Sustained A Concussion Through Sport Participation: A Consideration Of An Occupational Perspective During Recovery, Annalise Michelle Tichenoff

Electronic Thesis and Dissertation Repository

Adolescence is a time of rapid and tumultuous development in the physical, cognitive and psychosocial domains. Sustaining a concussion during this time period may complicate this development, particularly when symptoms are prolonged. Of particular importance is the study of adolescent females, as this population has been under-evaluated within the literature. This is especially troubling due to the number of concussions that occur among adolescent females, as concussions within this population reportedly occur at twice the frequency of adolescent males. This dissertation presents a qualitative case study investigation that explores the recovery experiences of adolescent female athletes who have sustained a …

Investigating Elementary School Food Programs: Impacts On Child Knowledge And Dietary Behaviours, Paige Colley

Electronic Thesis and Dissertation Repository

Good nutrition is an important part of maintaining a healthy lifestyle. A balanced diet can promote positive health outcomes, protecting against health problems caused by nutritional deficiencies. Canada has reported poor diet quality and high rates of overweight and obesity among children. Obesity has been linked to several non-communicable diseases including type 2 diabetes, heart disease, and some forms of cancer. Efforts to improve lifelong, healthy eating behaviours must be implemented.

This dissertation investigated the impacts of school food programming on child nutrition. A Centrally Procured School Food Program (CPSFP) was implemented at 30 elementary schools in Southwestern Ontario, Canada. …

Environmental Changes Following The Implementation Of The Childcare Physical Activity (Play) Policy, Victoria Tran

Electronic Thesis and Dissertation Repository

Environmental factors such as the infrastructure and equipment in childcare centres can influence the physical activity levels of young children. This study explored if implementing the Childcare PhysicaL ActivitY (PLAY) policy resulted in unintended environmental changes that were conducive to physical activity in childcare. Childcare centres were randomized to an experimental (n = 5) or control (n = 4) condition. Three Environment and Policy Assessment and Observation Self-Report (EPAO-SR) tools were used to measure 12 best practice items in relation to the childcare environment and early childhood educators’ (ECEs) practices. Descriptive statistics and mixed-effects logistics regression models were …

The Effects Of Exercise On Cognition, Mobility, And Neuroimaging Outcomes In Older Adults Without Dementia, Narlon Cassio Boa Sorte Silva

Electronic Thesis and Dissertation Repository

Cognitive decline is increasing with the aging population and, at present, there is no effective pharmacologic treatment available. Exercise interventions may impart protection against cognitive decline. A novel exercise approach is multiple-modality exercise (MME; aerobic, resistance, and balance exercise) with mind-motor training. Mind-motor training is a promising intervention in the study of cognitive function. Combining MME with mind-motor training may improve or maintain cognition and provide prevention of dementia early in the course of cognitive decline. Individuals with subjective cognitive complaints (SCC) comprise an at-risk group early in the spectrum of cognitive decline that could be targeted for prevention. The …

A Coaching And/Or Education Intervention Targeting Physical Activity And Nutrition Behaviours In Parents With Overweight/Obesity And Their Children, Shazya Karmali

Electronic Thesis and Dissertation Repository

The purpose of this dissertation is to provide a detailed overview of, findings from, and experiences participating in a 3-month randomized controlled trial (RCT) targeting obesity-related behaviours in parents with overweight/obesity (body mass index [BMI] ≥ 25 kg/m²) and their children (2.5-10 years old, any weight; N = 50 dyads). A concurrent mixed methods study comprised of an RCT and descriptive qualitative design was utilized. Parent-participants received Co-Active Life Coaching (CALC) and webinar-based health education (intervention) or education only (control). To address the dissertation’s purpose, Chapter II provides a detailed methodological account of the program, including rationale and …

Construction Of Prediction Models For The Health Utility Index Mark 3 In Ontario And Its Application, Yue Niu

Electronic Thesis and Dissertation Repository

The government of Ontario initiated primary care reform in the early 2000s, leading to a shift away from the traditional fee-for-service (FFS) physician remuneration to incentive-based blended remuneration models. Research on the association between change in physician remuneration and patients' health status is unknown. The objectives of this thesis are to (i) construct a statistical model to predict the Health Utility Index 3 (HUI3) values for all non-institutionalized Ontario residents, and (ii) study the association between the change in physician remuneration models and patients' health status measured by HUI3. The data came from the Canadian Community Health Survey (CCHS) 2000-2001 …

Development And Application Of A Teen-Informed Tool For Measuring The Power Of Food-Related Advertisements In Canadian Environments, Drew Bowman

Electronic Thesis and Dissertation Repository

Food environments are influential in shaping dietary behaviours of adolescents. Exposure to food and beverage marketing is known to impact food knowledge, behaviours, and health outcomes, yet food environment research largely overlooks advertisements. Given that marketers tend to advertise less healthy foods to teens and teens predominantly purchase low-nutrient foods, it is crucial to study the information environment in the context of secondary school environments. This thesis uses a sequential mixed-methods approach, including environmental audits and teen consultations, to develop and apply a teen-informed tool to measure the power of advertisements surrounding secondary schools. Results indicate that exposure to and …

Routines To Enhance Active Lifestyles (Real) Projects: A Pilot Program To Promote Incidental Physical Activity, Hieu Ly

Electronic Thesis and Dissertation Repository

Engaging in different types of incidental physical activity of daily living (e.g., walking to school or stair climbing) could contribute to individuals leading more active lifestyles by improving their total physical activity levels and reducing rates of inactivity. Particularly, post-secondary students are highly inactive and innovative strategies are needed to encourage them to be more active. The overall purpose of this research program was to explore the use of evidence-informed and tailor-made point-of-choice prompts to promote active transportation and staircase use among university students. Study 1 employed focus groups to determine the most suitable health messages and designs to create …

Using The Health Action Process Approach (Hapa) To Understand And Change Sedentary Behaviour In Office Workers: Effects On Motivation, Behaviour, And Health Outcomes, Andrew Scott Rollo

Electronic Thesis and Dissertation Repository

Sedentary behaviour (SB) is positively associated with all-cause mortality, as well as numerous chronic diseases, including fatal and non-fatal cardiovascular disease, type 2 diabetes, certain types of cancer, and metabolic syndrome. Interventions targeting reductions in sedentary time among office workers who are an at-risk population for high levels of SB are needed. The main objective of this dissertation was to contribute to the body of knowledge surrounding theory-based behavioural interventions targeting SB among office working adults. First, a systematic review of the literature (study 1, chapter 2) was conducted that highlighted important cognitive and motivational factors associated with SB, which …

Optimizing The Carrot Rewards App: An Examination Of Team-Based Financial Incentives To Increase Walking, Emma Pearson

Electronic Thesis and Dissertation Repository

Mobile health applications (mHealth apps) targeting physical activity (PA) have increased in popularity, yet effectiveness is often limited by low engagement. This study examined the impact of adding a team-based feature, Step Together Challenges (STCs), to an existing incentive-based mHealth app (i.e., Carrot Rewards) on PA. A 24-week retrospective matched pairs study was conducted (n=61,170; pre-intervention: weeks 1-12; intervention: weeks 13-24). Participants who used STCs (experimental group) were matched with those who did not (controls). STC users could earn team incentives for collaboratively reaching individual daily step goals 10 times in seven days. Controlling for pre-intervention mean daily step count, …