Health Services Research Commons^™

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 …

"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 …

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 …

The Impact Of The Diabetes Management Incentive On Diabetes-Related Services, Hospitalizations, And Mortality Risk In Ontario, Thaksha Thavam

Electronic Thesis and Dissertation Repository

Effective diabetes management provided in primary care has the potential to reduce hospitalizations and mortality. To improve diabetes management, a Diabetes Management Incentive (DMI) was introduced by the Ontario government for family physicians practicing in patient enrolment models. This thesis has three main objectives: 1) review the literature on the association between financial incentives for diabetes care and diabetes-related hospitalizations and mortality; 2) and 3) examine the impact of DMI on: diabetes-related services, diabetes-related hospitalizations, diabetes-related hospitalization costs, and mortality risk in Ontario. A review of the literature on the incentives revealed inconsistent findings. The impact of DMI was assessed …

Wait Times, Resource Use And Patient-Reported Outcomes For Patients Referred For Total Knee Replacement Surgery, Kate Lebedeva

Electronic Thesis and Dissertation Repository

This prospective cohort study evaluated the usual care pathway for patients referred to total knee arthroplasty (TKA). We measured healthcare resource use, costs and health-related quality of life (HRQoL) over the continuum of care. We also determined the proportion of inappropriate referrals and estimated wait times for initial surgical consultation and TKA. We found that two in five patients referred to specialty care were deemed inappropriate surgical candidates. Prior to referral, few conservative treatment options were tried, and many imaging tests ordered by referring providers were unjustified. Overall, the greatest proportion of costs were borne by the patient or private …

Investigating The Health Meanings Of Young Saudi Women, Tagreed Alnajjar

Electronic Thesis and Dissertation Repository

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 …

Understanding The Processes That Shape Cross Sector Service Provision In The Towards Flourishing Mental Health Promotion Strategy: A Secondary Analysis Utilizing Constructivist Grounded Theory Methodology, Shannon E. Winters

Electronic Thesis and Dissertation Repository

In Canada, many national, provincial, and regional policies indicate that working together within and across sectors in health and social care is necessary and expected but evidence to support this call is lacking. This dissertation study explored the concept of cross sector service provision (CSSP), defined as: independent, yet interconnected sectors working together to better meet the needs of service users and improve the quality and effectiveness of service provision. The intent was to advance our understanding of processes involved in shaping service provision offered by two or more sectors. The thesis contains three studies. A Scoping Review that explored …

Understanding Views Of Evidence In Public Health Practice And Decision Making In Ontario, Sara Masood

Electronic Thesis and Dissertation Repository

Background: Perceptions of evidence by public health managers, practitioners and policy makers is one of the key determinants of evidence uptake. Therefore, understanding views of evidence in both practice and policy decision making is important to bridge the evidence-practice and policy gap in public health. Objectives & Methods: Two studies are presented in this thesis. The first is a systematic review synthesizing studies exploring the use of research evidence in public health decision making between 2010-2016. The second study is a qualitative descriptive study examining understandings about evidence in Ontario public health units by comparing perspectives from managers and frontline …

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

Electronic Thesis and Dissertation Repository

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 …

The Association Between Women's Autonomy And Women's Hiv/Aids Knowledge And Attitudes In Ethiopia, Fadumo Rirash

Electronic Thesis and Dissertation Repository

Low autonomy resulting from gender inequalities in women has been identified as a contributing factor to the disproportionate impact of HIV/AIDS on women, especially in Sub-Saharan Africa.

This study explored the association between women’s autonomy and HIV/AIDS knowledge and attitudes in Ethiopia using the 2005 and 2011 Ethiopia Demographic and Health Surveys. The women’s spouses’ perceptions of the women’s autonomy and socio-demographic variables associated with HIV/AIDS knowledge and attitudes identified by the literature were included in the analyses. Multiple linear regression identified positive associations between women’s autonomy (and men’s perception of women’s autonomy), socio-demographic variables including education and mass media …

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

Electronic Thesis and Dissertation Repository

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% …

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 …