1,721,016 research outputs found
RESTAURANT FOOD ENVIRONMENTS IN SASKATOON FOR CHILDREN
Get PDFIn response to the rising prevalence of childhood overweight and obesity in
Canada and around the world, the food environment has been recognized as one important determinant of health status. In order to fill some existing knowledge gaps in Canadian food environment research to better understand factors that may lead to health disparities, as well as to develop healthy public policies in response, this study characterized food environments in restaurants for children (10-13 years) living in Saskatoon, and examined their associations with neighbourhood socioeconomic characteristics. Specifically, using GIS-based techniques and a structured observation tool (NEMS-R), it examined community and consumer restaurant food environments by neighbourhoods categorized by distress level. The distribution of different restaurant types differs with respect to neighbourhood distress level. According to NEMS-R results, significant differences were found in the healthfulness of foods and beverages offered in restaurants by different categories. Restaurants within lower distress level neighbourhoods presented higher (more healthful) NEMS-R scores. However, the fast food environment for children was not significantly different according to their neighbourhood distress level
THE ROLE OF ABORIGINALITY IN REVERSING STRUCTURAL VIOLENCE IN CANADIAN CITIES
Get PDFCanada’s Prairie cities are an exciting context for understanding cultural growth and diversification of urban spaces because more and more Aboriginal peoples are identifying and experiencing their lives in the urban realm. At the same time though, urban spaces are also a source for serious cultural and socio-economic challenges for Aboriginal peoples. With the sustained pattern of growth in the urban Aboriginal population experienced in Canada’s Prairie cities today, there is a need for Aboriginal involvement and participation in creating policies and programs for urban Aboriginal peoples.
I explore how the city of Edmonton is engaging with Aboriginal peoples and organizations in the city to enable their rights, needs and aspirations in city planning processes. The thesis engages the concept of “Aboriginality” to explore how Aboriginal cultures can be enabled by urban planning processes to develop and manifest their values and identities in the city so that urban spaces can shift toward decolonized places. Knowledge learned from the research can be used to inform municipalities across Canada on how they can emphasize their Aboriginal heritage as a civic strength for inclusive urban planning in Canada. Engaging Aboriginal peoples and their perspectives in ideas of place-making and civic future seeking will also add more depth to the diversity discourse in mainstream Canada. To explore the research questions, the thesis uses Edmonton as a case study. Interviews involving Aboriginal citizens, Aboriginal organizations, and municipal officials are used as a method for collecting the data needed for the research.
Findings reveal that the City of Edmonton is willing to engage with Aboriginal peoples to integrate their perspectives and cultures in the mainstream of urban life. However, the process is still developing and much more complicated in terms of how different Aboriginal peoples want to be engaged in city planning and associated policy. Citizens express a general fondness for Edmonton and its many opportunities that can improve people’s lives. However, though on the surface the city overflows with promises for opportunity and success, underneath the surface, some Aboriginal peoples experience subtle barriers that diminish their capacity to engage and succeed in the socio-economic spheres of the life in Edmonton. Negative stereotypes persist to discriminate against and exclude Aboriginal peoples as viable constituents of the citizenry of Edmonton. Aboriginal organizations in the city are playing a fundamental role in addressing the acute social pressures that Aboriginals face. These organizations also serve to create a collective Aboriginal voice that stands to challenge the negative stereotypes in addition to fostering a non-judgmental space for healing from the impacts of intergenerational trauma.
The thesis concludes with the point that Aboriginal engagement is an important platform for raising civic literacy on Aboriginal history and its intersection with city planning and development processes in Edmonton. It engages notions of the city’s identity and begins a transformation of the systemic bureaucracies that presume universal citizenship in the public domain
Exploring Indigenous Traditional Healing support policies and programs in Canada, Australia, and New Zealand to inform the support for Indigenous Traditional Healing policies in Saskatchewan: a scoping review
Get PDFThe lower health status of Indigenous people in Canada, Australia, and New Zealand are well documented and largely attributed to colonization and colonial policies. Colonization also led to the suppression of Indigenous Traditional Healing practices, which have been revitalized over the years by Indigenous societies with evidence of a profound effect on their health and wellbeing. Despite various policy recommendations concerning the rights and recognition of Indigenous Traditional Healing practices including TRC Call to Action 22, there is evidence of a literature gap regarding the extent to which Traditional Healing practices are supported in the mainstream healthcare system.
This study explored ways Indigenous Traditional Healing practices are supported by the healthcare system in Canada, Australia, and New Zealand through policies and programs. This study is a part of a larger project to determine what aspects of Indigenous Traditional Healing policies and programs identified from the healthcare systems can be adopted to inform the support for Indigenous Traditional Healing policies in Saskatchewan. A scoping review guided by the PRISMA extension for Scoping Reviews was conducted. Databases for sources of information included CINAHL, Medline, Embase, Web of Science, Public Health, Global Health, iPortal, and grey literature search.
Twenty-two articles (Canada=14 and Australia and New Zealand =8) met the inclusion criteria for data extraction for this scoping review. After the analysis of data extracted from each source of evidence, ten (10) Healthcare systems and services were identified with programs and policies supporting Indigenous Traditional Healing practices, which included midwifery, mental health, and palliative care. Within these services, programs identified utilized Indigenous Traditional Healing practices as the main or choice treatment, to support Western biomedical treatment options and or adopted Indigenous Traditional knowledge. The impact of the support and recognition of Indigenous Traditional Healing within the mainstream healthcare system includes increased access and attendance, improved healthcare experience and health outcomes, empowered individuals, and their communities, brought healthcare back to communities and improved the health and wellbeing of Indigenous people and their communities. Therefore, we call upon those who can effect change within the healthcare system to recognize the value of Indigenous healing practices and use them in the treatment of Indigenous patients
“It Feels Like Somebody Cut my Legs off”: Public Transportation and the Politics of Health in Saskatchewan
Get PDFBackground: In May 2017, the Government of Saskatchewan closed the Saskatchewan Transportation Company (STC), a 70-year-old bus company in Saskatchewan, Canada, through an austerity budget that saw many cuts to programs and services. The government justified its decision on budgetary grounds ignoring opponents who cited the possibility of negative impacts of the decision on population health. Little research evidence exists to interrogate the closure and its implications for the health system, population health, health equity and the politics of health.
Methodology: A qualitative case study was conducted to explore the politics, health and health equity implications of the closure of STC. The study drew on 47 days of Parliamentary Hansards, 751 newspaper articles, archival material, six focus group discussions (with activists, Indigenous, health system and social services stakeholders) and 100 interviews (with former STC users). A discourse analysis was conducted on two focus groups, newspaper articles and Parliamentary Hansards. The rest of the data were subjected to a thematic analysis. The study maintained rigour through crystallisation and member checking.
Findings: The closure of STC was facilitated by a neoliberal economic policy paradigm that ignored counter-discourses of resistance from activists and advocates who argued that the bus should be maintained on human rights, climate change and other grounds. The closure of STC has had deleterious impacts on health and this is best understood through a web of
dispossession whereby the closure affects individual former bus users through missed hospital appointments and other psychosocial impacts, their family members through financial burdens and strained relationships, communities through reduced access to the commons, and the whole of society through inefficiencies in the health system and stress on health and other workers. The closure has had inequitable impacts and has exacerbated the vulnerability of women, low-income populations, Indigenous populations, seniors, newcomers, young adults, people with disabilities and rural and northern populations.
Conclusion: Austerity is bad for health. This transportation case study reveals how it affects health in the Saskatchewan context. New approaches to public policy that prioritise health in all policies (HiAP) are needed to pay attention to the negative impacts of austerity on health and health equity globally and in Saskatchewan
ASSOCIATION BETWEEN SLEEP DISORDERS AND VISION PROBLEMS AMONG FIRST NATIONS PEOPLE
No full textBackground: Sleep disorders have an adverse effect on the quantity and quality of sleep, leading to reduced alertness and impaired ability to function normally. Recent studies show sleep disorders can cause vision-threatening conditions. Most research has not considered Indigenous people living in on-reserve communities. Thus, current knowledge regarding sleep disorders and vision problems among Indigenous people is limited.
Purpose: This study aimed to estimate the current prevalence of vision problems and examined the association between sleep disorders and vision problems among First Nations living on-reserve communities in Saskatchewan. Additionally, potential mediators in this relationship were explored.
Methods: This cross-sectional study used baseline data from "Assess, Redress, Re-assess: Addressing Disparities in Sleep Health among First Nations People," an ongoing cohort study. A survey was conducted in 2018-2019 with approximately 588 individuals in two First Nation communities. In the present study, the outcome variable was vision problems. Primary predictors were sleep apnea, insomnia, sleep deprivation, Epworth sleepiness score (ESS), and STOP-BANG. Multivariable logistic regression analysis and generalized structural equation modelling were employed.
Results: The prevalence of vision problems was 18.71%. Sleep apnea, clinical insomnia, and ESS were significantly associated with vision problems after adjusting for other variables. The odds of having vision problems were 2.93 times (95% CI: 1.19 – 7.19) higher among those who self-reported physician-diagnosed sleep apnea and 2.21 times (95% CI: 1.12 – 4.37) higher among participants with clinical insomnia. Similarly, with each unit increase in ESS, the likelihood of developing vision problems increased by 1.11 (95% CI: 0.97- 1.28). Mediation analysis revealed that depression accounted for approximately 32% of the association between sleep disorders and vision problems.
Conclusion: These findings indicate a higher prevalence of vision problems and a positive association between sleep disorders and vision problems among First Nations people. Longitudinal studies are needed to determine the nature of this association
The Whats and Whys of School Lunches: A mixed-methods study of the nutritional value of lunches eaten by elementary students during schooldays and their caregivers’ attitudes and practices towards school lunches.
No full textBackground: School-age children spend a significant portion of their day at their educational facilities, consuming meals such as lunch. Evidence suggests that most children in Canada have poor-quality diets, especially during the school day. The lack of universal national or provincial school food programs and policies in Canada limits the utility of dietary recommendations. Families most often provide lunch during the school day, with a minority of students accessing small-scale school lunch programs.
Purpose: To study the nutritional value of school lunches of elementary students, to explore their caregivers’ attitudes and practices towards these lunches, and to relate these attitudes and practices with what children eat for lunch at school.
Methods: This is a mixed-method research design study. It starts with a descriptive quantitative component using plate waste methodology to assess nutritional contribution and NRF 9.3 Index of school lunches, followed by a naturalistic phase, involving interviews which explore caregivers’ attitudes and practices regarding school lunches. Lastly, it comprises the integration of the results from both the quantitative and qualitative phases.
Results: Lunches’ mean, and median energy contribution was 442.6 kcal (SD 209.6) and 413.5 kcal (IQR 287.6), 13.6% of which were proteins. There were statistically significant differences in calorie content observed across grades. The lunches’ nutritional contribution fell below Canadian references for the most critical nutrients for childhood, such as calcium and vitamin D. The mean NRF9.3 Index score for school lunches was 346.8, with statistically significant variations between grades.
In terms of the context surrounding these lunches, parents reported that preparing them was a stressful chore. Various factors affected them, such as nutrition, cost, portability, and time constraints. Additionally, parents aimed to include options that their children would like to eat, ensuring they were going to be fed during school hours.
Conclusion: Most school lunches are characterized by a low contribution of critical nutrients for childhood, which can be attributed to various circumstances within the families' and students' contexts. The implementation of public policies could play a crucial role in addressing this issue, such as a universal school lunch program to guarantee all students have access to nutritious meals during the school day
Responding to the Needs of Rural Cancer Survivors: Learning to LiveWell with Chronic Conditions
Get PDFBackground: Rural Saskatchewan cancer survivors have reported a lack of support once their cancer treatments have been completed. This problem is more acute the further away one lives from Saskatoon and Regina. A chronic disease self-management program titled LiveWell with Chronic Conditions (LWCC) is available to all people with any chronic condition in rural areas across Saskatchewan. This program addresses key areas of concern to survivors; however, participation is low for cancer survivors.
Purpose: To determine how LWCC can reach and respond to the needs of rural cancer survivors in Saskatchewan.
Objectives:
1. To gain an understanding of how the program responds to the needs of rural cancer survivors from the perspective of program leaders and cancer survivors.
2. To explore how the existing LWCC program could be enhanced in terms of content, format, delivery and marketing strategy.
3. Based on results, develop recommendations in coordination with agencies and institutions that provide services to cancer survivors.
Methods: A mixed-methods case study approach was adopted. Needs questionnaires were completed by cancer survivors who participated in the LWCC program offered in rural health regions across the province (n=4). Consenting survivors who attended the program and several program facilitators, some of whom were cancer survivors themselves, were interviewed in order to provide their opinion regarding content, format, and other relevant feedback that would improve the fit of the program with the needs of rural cancer survivors (n=10).
Results: Results indicate the material covered in the program is appropriate for cancer survivors who have finished acute treatment and are making the transition to life after cancer. Program benefits include improved self-efficacy and being able to manage emotional and physical issues from cancer including fatigue and pain. Rural survivors would like access to additional information to address issues specific to cancer survivorship including dealing with the fear of cancer recurrence, lymphedema and sexuality. A cancer specific rural health program would not be very feasible due to small populations. Cancer survivors felt comfortable in a group among people with other chronic conditions although support of another person with cancer participating in the LWCC group would be preferred.
Knowledge Translation: A think tank was held with key stakeholders who provide services to cancer survivors to review these findings and form recommendations for improving rural cancer survivor care. These recommendations are: 1) to promote LWCC to rural cancer survivors who have finished acute cancer treatment, 2) to broaden the awareness of the program among cancer care providers, and 3) to refer cancer survivors to an existing cancer survivorship single day workshop after participation in LWCC. This workshop is available in up to 10 communities outside of Regina and Saskatoon.
Conclusion: The Live Well with Chronic Conditions program is appropriate and beneficial for cancer survivors who have completed acute cancer treatments. As more cancer care providers make referrals to this program and an online version of the program becomes available, uptake will likely improve among rural cancer survivors in Saskatchewan
Healthy Start: An Evidence Based Intervention to Increase Physical Activity and Healthy Eating in Rural Childcare Centres
Get PDFABSTRACT
Research suggests that it is important to establish regular physical activity and healthy eating patterns during the early years (0-5 years). Engaging in healthy behaviours during this stage of life supports growth and development and lays the foundation for a lifetime of health and wellbeing. Despite these benefits, research indicates that children in Canada are not meeting the daily recommended physical activity guidelines for early years. Moreover, their diets are lacking in fruits and vegetables and are high in processed foods. As many early years children spend a large part of their day in childcare centres, educators can have a large influence on their physical activity and healthy eating behaviours. In the Canadian Prairie Provinces many childcare centres are located in rural communities. Previous research suggests that rural educators are influenced by unique factors associated with geographic local (e.g., access to resources to promote physical activity and year round access to variety of healthy foods) when attempting to provide healthy opportunities for children. In order to address the specific factors identified by rural educators and support healthier behaviours among rural early year’s children, a multilevel physical activity and healthy eating intervention (Healthy Start) was developed using McLeroy’s ecological model and a population health approach. Healthy Start was pilot tested in three rural childcare centres. Purpose: The primary purpose of this dissertation study was to evaluate Healthy Start, a multilevel community-based physical activity and healthy eating intervention, in rural childcare centres throughout Saskatchewan. In order to achieve this primary purpose, the specific dissertation objectives were addressed as follows.
Paper 1:
a) Determine if over the course of the intervention, Healthy Start contributed to increases in physical activity levels and improvements in motor skill development among early years children aged 3 to 5 years; b) Determine if Healthy Start supported educators in providing children with more opportunities for physical activity; c) Describe educators’ experiences and perceptions of Healthy Start and its influence on physical activity within the childcare centre environment.
Paper 2:
a) Assess to what extent, Healthy Start contributed to healthier eating behaviours among early years children aged 3 to 5 years over the course of the intervention; b) Determine if Healthy Start supported childcare staff (educators and cooks) in providing children with more opportunities for healthy eating; c) Describe educators ‘experiences and perceptions of Healthy Start and its influence on healthy eating within the childcare centre environment.
Paper 3:
To pilot a pulse crop intervention study in one of the intervention childcare centres in order to: a) Increase knowledge and awareness about the nutritional value and health benefits of pulse crops among childcare staff (educators and cooks); b) Support childcare staff in providing children with more opportunities for pulse crop consumption; c) Expand the variety of healthy foods consumed by early years children by incorporating locally grown pulse crops into the childcare centre meals.
Methods: A population health controlled intervention study using a wait-list control design (48 weeks delayed-intervention) was used to evaluate the impact of the intervention. Mixed methods were employed to determine the intervention’s influence on children and educator behaviours and on the childcare centre environment. Results: Overall, increases in children’s physical activity levels and improvements in healthy eating behaviours were observed in the intervention group. Moreover, educators felt the intervention was effective in supporting them to increase physical activity and healthy eating opportunities provided to rural early years children. Lastly, improvements to childcare centre environments were made to promote healthy behaviours among the children. Conclusion: Collectively, the pilot study provided insight into the complexities and feasibility of promoting physical activity and healthy eating among early years children in childcare centres, particularly in rural communities. This was an innovative intervention which addressed critical factors at multiple levels contributing to the development of healthy behaviours among rural early years children. The lessons learned in this dissertation study can be used to improve the Healthy Start intervention so its implementation can be effectively expanded to childcare centres within and outside of Saskatchewan. Additionally, the findings can contribute to the limited body of literature on implementing and evaluating interventions aimed at increasing both physical activity and healthy eating in Canadian childcare centres. In turn, supporting the healthy development of early years children in the province and beyond
Truth and Reconciliation Through Indigenous Health Research: An Instrumental Case Study in the College of Medicine, University of Saskatchewan
Get PDFConcern for the health and wellbeing of Indigenous peoples in Canada is at the heart of the Truth and Reconciliation Commission’s (TRC) Calls to Action and Principles of Reconciliation. Universities have developed responses to the TRC, but to date few have discussed truth and reconciliation in the context of academic research. Historically, Indigenous health research (IHR) has been used as a tool of colonization in Canada, and harm to Indigenous peoples and communities is still occurring through IHR. Thus, it is imperative to consider implications of the TRC’s work in relation to university-based IHR.
An instrumental case study in the College of Medicine at the University of Saskatchewan was undertaken to explore understandings and applications of truth and reconciliation in university-based IHR. Guided conversations with five Indigenous and six non-Indigenous faculty involved in IHR were complemented by analysis of key institutional documents and information on the university context from nine key informants. An iterative approach to data collection and analysis was informed by advisors from within the university community and member checking by participants. Informed by a decolonizing framework, principles of respect, reciprocity, relevance and responsibility were central to the undertaking of the project.
Data revealed a multi-faceted understanding of truth and reconciliation in IHR. IHR has the potential to contribute to truth and reconciliation when conducted in a manner that attends to issues such as Indigenous self-determination, decolonization, ethical conduct, power and control. A model of ‘reconciliatory research’ is presented as a guide to considerations for substantive and procedural aspects of IHR. The model is centered in relationality, with actionable pathways supporting key characteristics of ‘reconciliatory research’. However, tensions between features of reconciliatory research and university values, norms, processes and policies impede researchers’ efforts towards truth and reconciliation through IHR. The resulting barriers are indicative of systemic and institutional racism around university-based Indigenous health research, with implications for Indigenous peoples’ health and wellbeing.
Researchers and universities have particular responsibilities to ensure that university-based Indigenous health research is conducted in a manner that facilitates truth and reconciliation. Systemic changes are required to address institutional barriers to reconciliatory IHR and to ensure that such research is conducted in a manner that supports Indigenous sovereignty, health and wellbeing
THEY FEED ME GOOD Relational Food Systems in Saskatoon
Get PDFThis research study examines the foodways of Saskatoon households, exploring relational food networks as a factor toward fairer health outcomes with a focus on resistance, resilience, and culture. This study uses critical ethnography to glean an accounting for trauma and an accounting for uplifting relational food networks. Data are drawn from interviews, photographs, media (animations), and participant observation. An iterative analysis is informed by intersectional and relational frameworks and follows a hybrid inductive-deductive approach. Findings are presented in representational and creative ways, with participants sharing stories that unveil the problematic of resilience in the face of colonialism and its relationship to food systems and health. The discussion considers socio-cultural factors, systemic racism, and inequality to advance a better understanding of cultural dimensions and political constraints linked to food insecurity. It contributes an accounting of variation in urban households in Saskatoon, their food choices, and their foodways, including models of governance that mitigate system failures to keep families fed. The lives of Saskatoon people in this study come together with separate stories of healing and violence, power and cultural restitutions of health, joy, and food. Participants live in different households but share similar collective histories of colonization and relentless systemic disparity. Their stories are also connected through the negotiation of food related wellbeing in urban spaces that re-dignify connections to culture, restore relational food strategies, and reclaim the land
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