Pub Date : 2022-02-25DOI: 10.33137/utjph.v3i1.37612
K. Serota, Madison L. Giles, David J. Kinitz
Throughout the COVID-19 pandemic, burgeoning health researchers have been tasked with learning how to conduct critical qualitative health research from the intimate spaces of their homes. In this presentation, we, three public health students, highlight our experiences as learners and doers of critical qualitative methods to demonstrate the challenges and triumphs that co-exist with pursuing our academic goals during a global pandemic. We employ a critical, reflexive narrative approach to storying our experiences of learning and practicing critical qualitative health research methods from the (dis)comfort of our homes during the pandemic. Using diverse theoretical lenses, including embodiment and poststructuralism, we story our experiences of navigating the blurry boundaries created by our necessary participation in the digital world. We construct and present these stories using arts-based qualitative research methods that were introduced to us in our courses and readings through the Centre for Critical Qualitative Health Research. Stitching together words to create poetry, fabric to construct a quilt, and pictures and writing to articulate experiences, these stories explore how the transformation of our intimate space into an academic and research space impacts the experience of learning to be a critical qualitative health researcher. David uses creative analytic writing practices through memos and journals, paired with photography, to express his experience as a learner. He draws on embodiment, attuning himself to the body to better understand his experiences. Through the medium of poetry, Madison grapples with the reality of being a digital student - letting her anxieties, curiosities, and questions stumble out to make sense of her virtual self. Finally, Kristie uses quilting to construct a material representation of the Zoom experience, exploring the intimacy and alienation of the digital classroom. Through our stories, we hope to create space to deeply consider what it means to be an online learner and an online being. Through these three interwoven stories, we expose our vulnerabilities to carve out space to reflect on our needs and desires to thrive in digital learning environments.
{"title":"Turning intimate spaces into digital classrooms: Public health students’ experiences of learning and doing critical qualitative research in pandemic times","authors":"K. Serota, Madison L. Giles, David J. Kinitz","doi":"10.33137/utjph.v3i1.37612","DOIUrl":"https://doi.org/10.33137/utjph.v3i1.37612","url":null,"abstract":"Throughout the COVID-19 pandemic, burgeoning health researchers have been tasked with learning how to conduct critical qualitative health research from the intimate spaces of their homes. In this presentation, we, three public health students, highlight our experiences as learners and doers of critical qualitative methods to demonstrate the challenges and triumphs that co-exist with pursuing our academic goals during a global pandemic. \u0000We employ a critical, reflexive narrative approach to storying our experiences of learning and practicing critical qualitative health research methods from the (dis)comfort of our homes during the pandemic. Using diverse theoretical lenses, including embodiment and poststructuralism, we story our experiences of navigating the blurry boundaries created by our necessary participation in the digital world. We construct and present these stories using arts-based qualitative research methods that were introduced to us in our courses and readings through the Centre for Critical Qualitative Health Research. Stitching together words to create poetry, fabric to construct a quilt, and pictures and writing to articulate experiences, these stories explore how the transformation of our intimate space into an academic and research space impacts the experience of learning to be a critical qualitative health researcher. David uses creative analytic writing practices through memos and journals, paired with photography, to express his experience as a learner. He draws on embodiment, attuning himself to the body to better understand his experiences. Through the medium of poetry, Madison grapples with the reality of being a digital student - letting her anxieties, curiosities, and questions stumble out to make sense of her virtual self. Finally, Kristie uses quilting to construct a material representation of the Zoom experience, exploring the intimacy and alienation of the digital classroom.\u0000Through our stories, we hope to create space to deeply consider what it means to be an online learner and an online being. Through these three interwoven stories, we expose our vulnerabilities to carve out space to reflect on our needs and desires to thrive in digital learning environments. ","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130782962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-25DOI: 10.33137/utjph.v3i1.37601
Paula (Pauli) Gardner
I’ve been training students in mindfulness and meditation for over 10 years. What began as a pedagogical survival tool (for my own mental health) soon emerged as something that was incredibly beneficial to my public health students. Turns out sitting in silence, anchoring ourselves in the present moment, and not doing but instead being, is not only good for your physical, social, and emotional health, it’s a great tool for learning. Students report that closing their eyes and sitting together in meditation fosters trust and compassion and builds a sense of community. These feelings allow them to take risks in their learning, to deeply engage with the material, and to participate openly and creatively in ways that foster real growth. During the pandemic I’ve had time to reflect on what I have observed is another benefit of mindfulness and meditation training – that these practices help students develop important skills – or spidey-senses – that are the superpowers of critical qualitative health researchers. These include the ability to be fully present in our work, to listen deeply, to be curious and non-judgemental, to not be attached to outcomes and what we expect to hear or learn, to come to each study and each participant with ‘beginners mind’, to prioritize different ways of knowing, and to accept when things don’t go according to plan (as they always seem to do in qualitative research). In this presentation I welcome all superhero’s and in particular those interested in developing their own and their students spidey-senses. In our time together I’ll share some of the science on why this practice makes good scientists, demonstrate a practice, and provide some tips for those interested in trying it in their own classrooms. During the pandemic I’ve had time to reflect on what I have observed is another benefit of mindfulness and meditation training – that these practices help students develop really important skills – or spidey-senses – that are the superpowers of critical qualitative health researchers. These include the ability to be fully present in our work, to listen deeply, to be curious and non-judgemental, to not be attached to outcomes and what we expect to hear or learn, to come to each study and each participant with ‘beginners mind’, to prioritize different ways of knowing, and to accept when things don’t go according to plan (as they always seem to do in qualitative research). In this presentation I welcome all superhero’s and in particular those interested in developing their own and their students spidey senses. In our time together I’ll share some of the science on why this practice makes good scientists, demonstrate a practice, and provide some tips for those interested in trying it in their own classrooms.
{"title":"Mindfulness and meditation - Training our spidey-senses for critical qualitative health research","authors":"Paula (Pauli) Gardner","doi":"10.33137/utjph.v3i1.37601","DOIUrl":"https://doi.org/10.33137/utjph.v3i1.37601","url":null,"abstract":"I’ve been training students in mindfulness and meditation for over 10 years. What began as a pedagogical survival tool (for my own mental health) soon emerged as something that was incredibly beneficial to my public health students. Turns out sitting in silence, anchoring ourselves in the present moment, and not doing but instead being, is not only good for your physical, social, and emotional health, it’s a great tool for learning. Students report that closing their eyes and sitting together in meditation fosters trust and compassion and builds a sense of community. These feelings allow them to take risks in their learning, to deeply engage with the material, and to participate openly and creatively in ways that foster real growth.\u0000During the pandemic I’ve had time to reflect on what I have observed is another benefit of mindfulness and meditation training – that these practices help students develop important skills – or spidey-senses – that are the superpowers of critical qualitative health researchers. These include the ability to be fully present in our work, to listen deeply, to be curious and non-judgemental, to not be attached to outcomes and what we expect to hear or learn, to come to each study and each participant with ‘beginners mind’, to prioritize different ways of knowing, and to accept when things don’t go according to plan (as they always seem to do in qualitative research).\u0000In this presentation I welcome all superhero’s and in particular those interested in developing their own and their students spidey-senses. In our time together I’ll share some of the science on why this practice makes good scientists, demonstrate a practice, and provide some tips for those interested in trying it in their own classrooms.\u0000During the pandemic I’ve had time to reflect on what I have observed is another benefit of mindfulness and meditation training – that these practices help students develop really important skills – or spidey-senses – that are the superpowers of critical qualitative health researchers. These include the ability to be fully present in our work, to listen deeply, to be curious and non-judgemental, to not be attached to outcomes and what we expect to hear or learn, to come to each study and each participant with ‘beginners mind’, to prioritize different ways of knowing, and to accept when things don’t go according to plan (as they always seem to do in qualitative research).\u0000In this presentation I welcome all superhero’s and in particular those interested in developing their own and their students spidey senses. In our time together I’ll share some of the science on why this practice makes good scientists, demonstrate a practice, and provide some tips for those interested in trying it in their own classrooms.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121881136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-25DOI: 10.33137/utjph.v3i1.37743
T. Mbulaheni, Nakia K. Lee-Foon, Falan Bennett, Fiqir Worku, Kimberly M. Bryce
The global COVID-19 pandemic has led us to this current public health and political moment, bringing widespread attention to social and health inequalities and interconnecting racial discrimination faced by Black communities and other communities of colour. The pandemic has also precipitated a transition of the qualitative methodology classroom from physical to virtual spaces. At this juncture, an opportunity has emerged to amplify critical pedagogies challenging White, Eurocentric, hetero- and cis-normative epistemologies and introduce their practice into the ever-evolving classroom. Rooted within a genealogy of Black women’s political and intellectual activism, Black feminist pedagogy captures their unique intersectional experiences and presents a methodology for teachers and learners alike to promote equity in the classroom and our society. In this presentation, we discuss the ways in which Black feminist pedagogy can support reflection on the inherent relations of power shaping the pedagogical practices and knowledge production of/in the classroom. We hold that Black feminist pedagogy is not simply concerned with the instruction of, for, and about Black women. It additionally puts forth learning strategies informed by Black women’s historical experiences of race, gender, and class discrimination that can support the inclusion of diverse epistemological positionings and meaningfully represent the social and health inequities of marginalized communities. We affirm that a ‘standpoint epistemology' is foundational to Black feminist pedagogy and that those who experience marginalization are best positioned to make claims about its meanings and impacts. The presenters draw from their epistemological standpoint as Black women, graduate and postdoctoral scholars, and Black feminist thinkers. We center our own experiential knowledge as learners and teachers to reflect on the value of Black feminist pedagogy. A major learning from our experiences in this current moment has compelled us to advocate for integrating a critical reflexivity process. This process is undertaken by teachers and learners to assess how knowledge is being produced, legitimized and/or erased as a counter to the social and institutional power and authority constituting the classroom. We also discuss considerations for teaching theoretical and methodological approaches to intersecting oppressions as elemental to Black women’s experience and a cornerstone of Black feminist pedagogy. An intersectional approach supports us to take stock of the interlocking stigmas shaping health inequalities, ontologically and epistemologically (re)position the multiply marginalized communities they impact, and take up theories, methods, and practices that better align with our experiences. Intersectionality will be used to exemplify tensions as a ‘travelling theory’ and its strengths when rooted in a Black feminist pedagogy. At a time where Black feminist thought is at the forefront of public consciou
{"title":"Black feminist pedagogy as a tool for inclusive teaching and learning: critical reflections of Black women scholars","authors":"T. Mbulaheni, Nakia K. Lee-Foon, Falan Bennett, Fiqir Worku, Kimberly M. Bryce","doi":"10.33137/utjph.v3i1.37743","DOIUrl":"https://doi.org/10.33137/utjph.v3i1.37743","url":null,"abstract":"The global COVID-19 pandemic has led us to this current public health and political moment, bringing widespread attention to social and health inequalities and interconnecting racial discrimination faced by Black communities and other communities of colour. The pandemic has also precipitated a transition of the qualitative methodology classroom from physical to virtual spaces. At this juncture, an opportunity has emerged to amplify critical pedagogies challenging White, Eurocentric, hetero- and cis-normative epistemologies and introduce their practice into the ever-evolving classroom. Rooted within a genealogy of Black women’s political and intellectual activism, Black feminist pedagogy captures their unique intersectional experiences and presents a methodology for teachers and learners alike to promote equity in the classroom and our society.\u0000In this presentation, we discuss the ways in which Black feminist pedagogy can support reflection on the inherent relations of power shaping the pedagogical practices and knowledge production of/in the classroom. We hold that Black feminist pedagogy is not simply concerned with the instruction of, for, and about Black women. It additionally puts forth learning strategies informed by Black women’s historical experiences of race, gender, and class discrimination that can support the inclusion of diverse epistemological positionings and meaningfully represent the social and health inequities of marginalized communities.\u0000We affirm that a ‘standpoint epistemology' is foundational to Black feminist pedagogy and that those who experience marginalization are best positioned to make claims about its meanings and impacts. The presenters draw from their epistemological standpoint as Black women, graduate and postdoctoral scholars, and Black feminist thinkers. We center our own experiential knowledge as learners and teachers to reflect on the value of Black feminist pedagogy. A major learning from our experiences in this current moment has compelled us to advocate for integrating a critical reflexivity process. This process is undertaken by teachers and learners to assess how knowledge is being produced, legitimized and/or erased as a counter to the social and institutional power and authority constituting the classroom.\u0000We also discuss considerations for teaching theoretical and methodological approaches to intersecting oppressions as elemental to Black women’s experience and a cornerstone of Black feminist pedagogy. An intersectional approach supports us to take stock of the interlocking stigmas shaping health inequalities, ontologically and epistemologically (re)position the multiply marginalized communities they impact, and take up theories, methods, and practices that better align with our experiences. Intersectionality will be used to exemplify tensions as a ‘travelling theory’ and its strengths when rooted in a Black feminist pedagogy.\u0000At a time where Black feminist thought is at the forefront of public consciou","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131589369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-25DOI: 10.33137/utjph.v3i1.37656
David J. Kinitz
As memories began to fill my mind, reminding me of the details from my own experiences that I had forgotten, I realized just how well I know this topic. Had I forgotten? Or had I just pushed these memories to the corners of my mind? I awoke at 4:00AM, parched, while my mind recalled lines of interview data that resonated with my own experiences. Stories of trauma that consumed hours of carefully conceptualized research had begun leaching into my dreams. Universities with a history of exclusion now seek to recruit systemically marginalized early career researchers (ECRs) with expertise in equity-related research, requiring unique training and research practices. Given shifts to include systemically marginalized groups in faculty hiring, graduate-student recruitment, ethics protocols, and funding calls for community-based research, these ECRs are likely to conduct research within their communities, on topics of personal relevance (i.e., insider research). Qualitative methodological training, practice, and literature on the conduct of insider research places an emphasis on reflexivity in order to ensure rigour, trustworthiness, and ethical processes; however, the emotional and psychological demands of insider research on the researcher are seldom discussed. Greater attention to the impacts of insider research is critical for understanding how ECRs can prepare for and be supported in their training and research. I argue that as critical qualitative scholars, we consider how researchers are potentially impacted by the emotional and psychological impacts of their work, particularly those from systemically marginalized groups conducting insider research. As an illustrative example, I recount my experience as an insider on a qualitative research study investigating individuals’ experiences of conversion therapy, practices that attempt to suppress or change one’s sexual orientation, gender identity and/or expression. This methodological reflection is based on analytical memos and field notes written during a research project completed as part of my research assistant work. Embodiment and creative non-fiction are used to articulate my experiences of conducting deeply personal qualitative interviews and engaging in a critical analysis of stories of trauma that mirrored my own. Specifically, I have narrated four vignettes that articulate my story of beginning insider research with confidence and stoicism and ending, for now, with a churning stomach and lingering state of mental arousal. The vignettes illustrate the emotionally and mentally charged task of conducting insider research on topics of inequity as a systemically marginalized researcher and call for an ethic of equity to account for this unique labour – labour from which the academy benefits at the expense of systemically marginalized ECRs’ wellbeing. Conducting qualitative research using interpretivist, constructivist, critical, or emancipatory paradigms, where insider research is commonly situated
{"title":"The emotional and psychological labour of insider qualitative research among systemically excluded and oppressed groups: A call for equity in training and practice","authors":"David J. Kinitz","doi":"10.33137/utjph.v3i1.37656","DOIUrl":"https://doi.org/10.33137/utjph.v3i1.37656","url":null,"abstract":"As memories began to fill my mind, reminding me of the details from my own experiences that I had forgotten, I realized just how well I know this topic. Had I forgotten? Or had I just pushed these memories to the corners of my mind? I awoke at 4:00AM, parched, while my mind recalled lines of interview data that resonated with my own experiences. Stories of trauma that consumed hours of carefully conceptualized research had begun leaching into my dreams.\u0000Universities with a history of exclusion now seek to recruit systemically marginalized early career researchers (ECRs) with expertise in equity-related research, requiring unique training and research practices. Given shifts to include systemically marginalized groups in faculty hiring, graduate-student recruitment, ethics protocols, and funding calls for community-based research, these ECRs are likely to conduct research within their communities, on topics of personal relevance (i.e., insider research).\u0000Qualitative methodological training, practice, and literature on the conduct of insider research places an emphasis on reflexivity in order to ensure rigour, trustworthiness, and ethical processes; however, the emotional and psychological demands of insider research on the researcher are seldom discussed. Greater attention to the impacts of insider research is critical for understanding how ECRs can prepare for and be supported in their training and research.\u0000I argue that as critical qualitative scholars, we consider how researchers are potentially impacted by the emotional and psychological impacts of their work, particularly those from systemically marginalized groups conducting insider research. As an illustrative example, I recount my experience as an insider on a qualitative research study investigating individuals’ experiences of conversion therapy, practices that attempt to suppress or change one’s sexual orientation, gender identity and/or expression.\u0000This methodological reflection is based on analytical memos and field notes written during a research project completed as part of my research assistant work. Embodiment and creative non-fiction are used to articulate my experiences of conducting deeply personal qualitative interviews and engaging in a critical analysis of stories of trauma that mirrored my own.\u0000Specifically, I have narrated four vignettes that articulate my story of beginning insider research with confidence and stoicism and ending, for now, with a churning stomach and lingering state of mental arousal. The vignettes illustrate the emotionally and mentally charged task of conducting insider research on topics of inequity as a systemically marginalized researcher and call for an ethic of equity to account for this unique labour – labour from which the academy benefits at the expense of systemically marginalized ECRs’ wellbeing. Conducting qualitative research using interpretivist, constructivist, critical, or emancipatory paradigms, where insider research is commonly situated","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129848907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-25DOI: 10.33137/utjph.v3i1.37639
Anisha Arora, K. Rice, A. Adams
Background: Qualitative health research seeks to elucidate the realities of context, reveal the complexities of behaviour, probe the intersecting and multiple determinants of health at individual, community and institutional levels, and capture the dynamics of health care provision from the perspectives of patients, providers, and systems. Traditionally, in our Family Medicine Department at McGill University, graduate students are trained in qualitative health research in the context of a synchronous in-person classroom. Amidst the pandemic, synchronous learning shifted to online modalities, obliging rapid innovation in pedagogic practice. Careful consideration and creation of new online modalities for engaged student learning took place, and when implemented, instructor and student feedback was solicited on whether or how they were effective. Together, co-instructors and the teaching assistant for the course reflected on the challenges and opportunities of teaching qualitative research in an online environment, and how online modalities might be usefully blended with in-person learning. Reflections: Three arguments supporting a blended approach were identified. Firstly, blending online and in-person approaches enables learners to tailor their educational experience to their needs and objectives, and to some extent, control the content, sequence, pace, and time of their learning. Secondly, blended learning empowers educators by offering tools and systems to monitor learner progress, while encouraging creativity in conveying content that may be complicated and dense (e.g., providing online workshops about managing qualitative data analysis via readily accessible online software). Lastly, blended learning has the potential to transform graduate training for the better by facilitating innovative modes of communication (e.g., use of chat function in videoconferencing software and online discussion boards as modalities for discussion that engage students who may not otherwise speak), enabling students to contextualize their projects (e.g., implementation of an observational data collection assignment, unique to each student based on where they live and their interests), while better balancing their academic, professional, and personal lives. Discussion: To develop a thorough understanding of qualitative health research, key concepts can be taught and practiced through a combination of in-person and online synchronous and asynchronous learning modalities. In doing so, educators can take advantage of innovative learning technologies, while also maintaining the humanistic touch necessary for education to be meaningful and effective. Importantly, from our experiences we note that blended learning approaches are viable and pertinent in the context of qualitative health research, an idea that was previously dismissed due to perceptions that qualitative inquiry and learning requires solely in-person, hands-on, engagement.
{"title":"Blended Learning as a Transformative Educational Approach for Qualitative Health Research","authors":"Anisha Arora, K. Rice, A. Adams","doi":"10.33137/utjph.v3i1.37639","DOIUrl":"https://doi.org/10.33137/utjph.v3i1.37639","url":null,"abstract":"Background: Qualitative health research seeks to elucidate the realities of context, reveal the complexities of behaviour, probe the intersecting and multiple determinants of health at individual, community and institutional levels, and capture the dynamics of health care provision from the perspectives of patients, providers, and systems. Traditionally, in our Family Medicine Department at McGill University, graduate students are trained in qualitative health research in the context of a synchronous in-person classroom. Amidst the pandemic, synchronous learning shifted to online modalities, obliging rapid innovation in pedagogic practice. Careful consideration and creation of new online modalities for engaged student learning took place, and when implemented, instructor and student feedback was solicited on whether or how they were effective. Together, co-instructors and the teaching assistant for the course reflected on the challenges and opportunities of teaching qualitative research in an online environment, and how online modalities might be usefully blended with in-person learning. \u0000Reflections: Three arguments supporting a blended approach were identified. Firstly, blending online and in-person approaches enables learners to tailor their educational experience to their needs and objectives, and to some extent, control the content, sequence, pace, and time of their learning. Secondly, blended learning empowers educators by offering tools and systems to monitor learner progress, while encouraging creativity in conveying content that may be complicated and dense (e.g., providing online workshops about managing qualitative data analysis via readily accessible online software). Lastly, blended learning has the potential to transform graduate training for the better by facilitating innovative modes of communication (e.g., use of chat function in videoconferencing software and online discussion boards as modalities for discussion that engage students who may not otherwise speak), enabling students to contextualize their projects (e.g., implementation of an observational data collection assignment, unique to each student based on where they live and their interests), while better balancing their academic, professional, and personal lives. \u0000Discussion: To develop a thorough understanding of qualitative health research, key concepts can be taught and practiced through a combination of in-person and online synchronous and asynchronous learning modalities. In doing so, educators can take advantage of innovative learning technologies, while also maintaining the humanistic touch necessary for education to be meaningful and effective. Importantly, from our experiences we note that blended learning approaches are viable and pertinent in the context of qualitative health research, an idea that was previously dismissed due to perceptions that qualitative inquiry and learning requires solely in-person, hands-on, engagement. ","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129926590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
COVID-19 vaccine misinformation has been fueling vaccine hesitancy, which has been one of the main factors in slowing down the vaccination rate (Loomba et al., 2021). An increase in vaccine hesitancy, especially among the vulnerable communities, will exacerbate the already overwhelming economic and health burden of COVID-19. The purpose of Health TrueInfo is to use knowledge translation strategies to implement evidence-based health communications via social media in order to tackle COVID-19 vaccine misinformation and hesitancy among vulnerable populations in Bolivia, India, and Canada. The Health TrueInfo initiative is in collaboration with health experts and community members, asking them to create audiovisuals that convey powerful and culturally relevant messages to their communities. Such content combats local misinformation and encourages vaccine uptake. The audiovisual content is then uploaded to our multilingual Android app and social media platforms on Twitter, Facebook, Instagram, and LinkedIn.The concept of using social media to tackle misinformation was informed from systematic reviews, highlighting its potential by health organizations to combat prevalent misinformation as social media is widely used to share and seek health information (Chou et al., 2018; Suarez-Lledo & Alvarez-Galvez, 2021). Community engagement and searching grey literature were important methodologies to understand different local contexts of misinformation. For instance, to better comprehend how misinformation plays a role in increasing vaccine hesitancy among the Indigenous Quechua peoples in Bolivia, we collaborated with a Quechua social media influencer, who helped us create a skit inspired by the current local misinformation. Likewise, we have asked other stakeholders in healthcare like local teenagers, frontline doctors, and health experts to help create content addressing their respective communities. The knowledge translation strategies utilized here were to contextualize information, appeal to potential vaccine-hesitant groups, and use community engagement strategies like involving influencers to help us reach specific demographic groups and overcome linguistic and cultural barriers (Bella et al., 2021). One way to quantitatively estimate the impact of the project is through social media analytics. When contributors or influencers helped create audiovisuals and share with their followers, some of our content have reached over 1000 impressions and 200 views within targeted demographics. This initial success may imply how Health TrueInfo models the idea of health experts, social media influencers, and members of their own communities working together to reduce vaccine misinformation and hesitancy via creating multimodal social media contents, which in turn might help increase health and digital literacy, and battle social isolation. As health misinformation is a relatively new research field and vaccine hesitancy literature for countries like Bolivia and for
COVID-19疫苗的错误信息助长了对疫苗的犹豫，这是降低疫苗接种率的主要因素之一(Loomba et al.， 2021)。疫苗犹豫的增加，特别是在脆弱社区中，将加剧COVID-19已经不堪重负的经济和健康负担。Health TrueInfo的目的是利用知识翻译策略，通过社交媒体实施基于证据的卫生传播，以解决玻利维亚、印度和加拿大弱势群体中关于COVID-19疫苗的错误信息和犹豫不决的问题。“健康真实信息”倡议与卫生专家和社区成员合作，要求他们制作视听材料，向他们的社区传达强有力的、与文化相关的信息。这些内容打击了当地的错误信息，并鼓励接种疫苗。然后将视听内容上传到我们的多语种Android应用程序以及Twitter、Facebook、Instagram和LinkedIn等社交媒体平台。利用社交媒体解决错误信息的概念是从系统综述中获得的，强调了卫生组织打击普遍错误信息的潜力，因为社交媒体被广泛用于分享和寻求健康信息(Chou等人，2018;Suarez-Lledo & Alvarez-Galvez, 2021)。社区参与和搜索灰色文献是了解不同地方错误信息背景的重要方法。例如，为了更好地理解错误信息是如何在玻利维亚土著盖丘亚人对疫苗的犹豫中发挥作用的，我们与一位盖丘亚人的社交媒体影响者合作，他帮助我们创作了一个受当前当地错误信息启发的小品。同样，我们也要求医疗保健领域的其他利益相关者，如当地青少年、一线医生和健康专家，帮助创建针对各自社区的内容。这里使用的知识翻译策略是将信息语境化，吸引潜在的疫苗犹豫群体，并使用社区参与策略，如让影响者参与进来，帮助我们接触特定的人口群体，克服语言和文化障碍(Bella et al.， 2021)。定量评估项目影响的一种方法是通过社交媒体分析。当贡献者或有影响力的人帮助创建视听并与他们的追随者分享时，我们的一些内容在目标人口统计中达到了1000次以上的印象和200次观看。这一初步成功可能意味着healthtrueinfo如何模拟卫生专家、社交媒体影响者和他们自己社区成员的想法，通过创建多模式社交媒体内容，共同努力减少疫苗错误信息和犹豫，这反过来可能有助于提高健康和数字素养，并消除社会孤立。由于卫生错误信息是一个相对较新的研究领域，而玻利维亚等国和一般土著社区关于疫苗犹豫的文献有限，因此，“真实健康信息”可以激励在同行评议文献中代表性不足的国家和社区开展参与性行动研究，以更好地了解导致疫苗错误信息和犹豫的不同具体环境因素。[参考文献]周文生，吴安，和克莱因，w.m.p.(2018)。解决社交媒体上与健康相关的错误信息。中国生物医学工程杂志，2016(3)，417- 418。https://doi.org/10.1001/jama.2018.16865La Bella, E.， Allen, C.， & Lirussi, F.(2021)。传播与证据:在信息大流行期间，是什么阻碍了科学的传播?叙述性评论中西医结合研究，10(4)，100731。https://doi.org/10.1016/j.imr.2021.100731Loomba, S.， de Figueiredo, A.， Piatek, S. J, de Graaf, K.， & Larson, H. J.(2021)。衡量COVID-19疫苗错误信息对英国和美国疫苗接种意图的影响。自然-人类行为，5(3)，337-348。https://doi.org/10.1038/s41562-021-01056-1Suarez-Lledo, V.， & Alvarez-Galvez, J.(2021)。社会媒体上健康错误信息的流行:系统评价。医学互联网研究，23(1)，e17187。https://doi.org/10.2196/17187
{"title":"Health TrueInfo: A multilingual Android app and social media approach in tackling COVID-19 vaccine misinformation and hesitancy in Bolivia, India, and Canada","authors":"Sapolnach Prompiengchai, Neda Maki, Mahika Jain, Libertad Rojas, Jaiditya Dev, Thushanth Sriskandarajah","doi":"10.33137/utjph.v9999i1.38113","DOIUrl":"https://doi.org/10.33137/utjph.v9999i1.38113","url":null,"abstract":"COVID-19 vaccine misinformation has been fueling vaccine hesitancy, which has been one of the main factors in slowing down the vaccination rate (Loomba et al., 2021). An increase in vaccine hesitancy, especially among the vulnerable communities, will exacerbate the already overwhelming economic and health burden of COVID-19. The purpose of Health TrueInfo is to use knowledge translation strategies to implement evidence-based health communications via social media in order to tackle COVID-19 vaccine misinformation and hesitancy among vulnerable populations in Bolivia, India, and Canada. The Health TrueInfo initiative is in collaboration with health experts and community members, asking them to create audiovisuals that convey powerful and culturally relevant messages to their communities. Such content combats local misinformation and encourages vaccine uptake. The audiovisual content is then uploaded to our multilingual Android app and social media platforms on Twitter, Facebook, Instagram, and LinkedIn.The concept of using social media to tackle misinformation was informed from systematic reviews, highlighting its potential by health organizations to combat prevalent misinformation as social media is widely used to share and seek health information (Chou et al., 2018; Suarez-Lledo & Alvarez-Galvez, 2021). Community engagement and searching grey literature were important methodologies to understand different local contexts of misinformation. For instance, to better comprehend how misinformation plays a role in increasing vaccine hesitancy among the Indigenous Quechua peoples in Bolivia, we collaborated with a Quechua social media influencer, who helped us create a skit inspired by the current local misinformation. Likewise, we have asked other stakeholders in healthcare like local teenagers, frontline doctors, and health experts to help create content addressing their respective communities. The knowledge translation strategies utilized here were to contextualize information, appeal to potential vaccine-hesitant groups, and use community engagement strategies like involving influencers to help us reach specific demographic groups and overcome linguistic and cultural barriers (Bella et al., 2021). One way to quantitatively estimate the impact of the project is through social media analytics. When contributors or influencers helped create audiovisuals and share with their followers, some of our content have reached over 1000 impressions and 200 views within targeted demographics. This initial success may imply how Health TrueInfo models the idea of health experts, social media influencers, and members of their own communities working together to reduce vaccine misinformation and hesitancy via creating multimodal social media contents, which in turn might help increase health and digital literacy, and battle social isolation. As health misinformation is a relatively new research field and vaccine hesitancy literature for countries like Bolivia and for","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132532308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-25DOI: 10.33137/utjph.v3i1.38128
Gabriella Christopher
Introduction: In 2010, Hamilton’s local newspaper published a series of articles highlighting the inequities in numerous health outcomes across the city, with cardiovascular disease (CVD) Emergency Room (ER) visits among them (DeLuca et al., 2012). In Canada CVD is the second leading cause of death and the leading cause of hospitalizations, however, previous research has demonstrated that CVD risk may vary geographically (Chu et al., 2019). Furthermore, health analyses are rarely conducted in ways accessible to non-scientific communities. Given inequities in the distribution of COVID-19 across Hamilton communities, the need for population level analysis of comorbidities and risk factors is of heightened importance. The aim of this study is to identify the underlying factors that explain neighbourhood differences in the rate of CVD across Hamilton, Ontario. Methods: Census Tract (CT) aggregated Ontario Marginalization (ON-Marg) values and health data from Cancer Care Ontario were used. The material deprivation dimension of ON-Marg includes information on income, employment, education, and lone parent households, which have previously been linked to increased CVD risk, while the dependency dimension represents those who do not have income from employment which captures older age and disability (Matheson & van Ingen, 2018). Factor analysis was performed to identify underlying factors that account for common variance. Spatial associations were analyzed using choropleth maps as well as measures of both global spatial autocorrelation (i.e., global Moran’s I) and local indicators of association (i.e., local Moran’s I). Contiguity was based on rook-weights (sharing a common boundary). Exploratory ordinary least squares (OLS) regression was performed to understand which indicators may explain geographic variation in CVD ER visits. Linear regression assumptions were assessed by testing the residuals for heteroskedasticity using the Koenker test, spatial autocorrelation using Global Moran’s I, and normality using the Kolmogorov-Smirnov test. Results: Initial analysis from 2016 and 2017 revealed that the rate of CVD ER visits in Hamilton is spatially autocorrelated (global Moran’s I score of 0.516 (p<0.001) and ranged from less than 3 in 1000 to over 30 in 1000 people per year. For regression analysis, factor scores for material deprivation and dependency domains of the well validated ON-Marg Index were used together with the percentage of patients with no family physician. OLS regression using the four regressors resulted in a statistically significant model (F=65.94, p<0.001) that explains about 65% of the variability in CVD ER visits in Hamilton (R2 = 0.653). Residuals were tested for heteroscedasticity (Koenker = 4.33, p=0.363), autocorrelation (global Moran’s I = 0.042, p = 0.367) and normality (Kolmogorov-Smirnov = 0.072, p = 0.079). Discussion: This information can help inform neighbourhood-level public health interventions and broader policy decision
简介:2010年，汉密尔顿当地报纸发表了一系列文章，强调了整个城市众多健康结果的不平等，其中包括心血管疾病(CVD)急诊室(ER)就诊(DeLuca et al.， 2012)。在加拿大，心血管疾病是第二大死亡原因和住院治疗的主要原因，然而，之前的研究表明，心血管疾病的风险可能因地而异(Chu等人，2019)。此外，健康分析很少以非科学界可以获得的方式进行。鉴于COVID-19在汉密尔顿社区的分布不公平，对合并症和风险因素进行人口水平分析的必要性变得更加重要。这项研究的目的是确定解释安大略省汉密尔顿地区心血管疾病发病率差异的潜在因素。方法:使用人口普查区(CT)汇总的安大略省边缘化(ON-Marg)值和安大略省癌症护理中心的健康数据。on - marg的物质剥夺维度包括收入、就业、教育和单亲家庭的信息，这些信息以前被认为与心血管疾病风险增加有关，而依赖维度代表那些没有就业收入的人，其中包括老年人和残疾人(Matheson & van Ingen, 2018)。进行因子分析以确定导致共同方差的潜在因素。空间关联分析使用了choropleth地图以及全局空间自相关性(即全局Moran’s I)和局部关联指标(即局部Moran’s I)，相邻性基于rookweight(共享共同边界)。采用探索性普通最小二乘(OLS)回归来了解哪些指标可以解释心血管疾病ER就诊的地理差异。使用Koenker检验检验异方差残差，使用Global Moran’s I检验空间自相关，使用Kolmogorov-Smirnov检验检验正态性来评估线性回归假设。结果:2016年和2017年的初步分析显示，汉密尔顿心血管疾病ER就诊率具有空间自相关性(全球Moran 's I评分为0.516 (p<0.001))，范围从1000人中每年少于3人到1000人中每年超过30人。为了进行回归分析，我们将经过验证的ON-Marg指数的物质剥夺和依赖域的因子得分与没有家庭医生的患者的百分比一起使用。使用这四个回归因子进行OLS回归得到了一个具有统计学意义的模型(F=65.94, p<0.001)，该模型解释了汉密尔顿心血管疾病ER就诊的65%的变异性(R2 = 0.653)。残差检验为异方差(Koenker = 4.33, p=0.363)、自相关(全局Moran 's I = 0.042, p= 0.367)和正态性(Kolmogorov-Smirnov = 0.072, p= 0.079)。讨论:这些信息有助于为社区一级的公共卫生干预和更广泛的政策决定提供信息，以帮助解决当地心血管疾病的差异。心血管疾病高发病率和社会经济条件较差的模式也与COVID-19的差异相对应，并支持需要在社区一级对传染病和慢性病进行更多研究。此外，这项工作的地理产出还为非科学受众提供了可视和互动式的社区一级卫生信息，可支持以社区为中心的卫生和社会行动。参考文献deluca, P. F, Buist, S.， & Johnston, N.(2012)。红色代码项目:让社区参与加拿大汉密尔顿的卫生系统变革。社会指标研究，2008(2)，317-327。https://doi.org/10.1007/s11205-012-0068-yChu, M.， Truscott, R.， Young, S.， Harrington, D.， Keller-Olaman, S.， Heather, M.， & Orr, S.(2019)。安大略省慢性病负担:支持预防工作的关键估计。安大略省癌症护理和安大略省公共卫生部。Matheson, F. I, Dunn, J. R.， Smith, K. L. W.， Moineddin, R.和Glazier, R. H.(2012)。加拿大边缘化指数的发展:研究不平等的新工具。加拿大公共卫生杂志/加拿大公共卫生杂志，103,S12-S16。https://www.jstor.org/stable/41995683
{"title":"Explaining Neighbourhood Disparities in Cardiovascular Disease in Hamilton, Ontario, Canada","authors":"Gabriella Christopher","doi":"10.33137/utjph.v3i1.38128","DOIUrl":"https://doi.org/10.33137/utjph.v3i1.38128","url":null,"abstract":"Introduction: In 2010, Hamilton’s local newspaper published a series of articles highlighting the inequities in numerous health outcomes across the city, with cardiovascular disease (CVD) Emergency Room (ER) visits among them (DeLuca et al., 2012). In Canada CVD is the second leading cause of death and the leading cause of hospitalizations, however, previous research has demonstrated that CVD risk may vary geographically (Chu et al., 2019). Furthermore, health analyses are rarely conducted in ways accessible to non-scientific communities. Given inequities in the distribution of COVID-19 across Hamilton communities, the need for population level analysis of comorbidities and risk factors is of heightened importance. The aim of this study is to identify the underlying factors that explain neighbourhood differences in the rate of CVD across Hamilton, Ontario.\u0000Methods: Census Tract (CT) aggregated Ontario Marginalization (ON-Marg) values and health data from Cancer Care Ontario were used. The material deprivation dimension of ON-Marg includes information on income, employment, education, and lone parent households, which have previously been linked to increased CVD risk, while the dependency dimension represents those who do not have income from employment which captures older age and disability (Matheson & van Ingen, 2018). Factor analysis was performed to identify underlying factors that account for common variance. Spatial associations were analyzed using choropleth maps as well as measures of both global spatial autocorrelation (i.e., global Moran’s I) and local indicators of association (i.e., local Moran’s I). Contiguity was based on rook-weights (sharing a common boundary). Exploratory ordinary least squares (OLS) regression was performed to understand which indicators may explain geographic variation in CVD ER visits. Linear regression assumptions were assessed by testing the residuals for heteroskedasticity using the Koenker test, spatial autocorrelation using Global Moran’s I, and normality using the Kolmogorov-Smirnov test.\u0000Results: Initial analysis from 2016 and 2017 revealed that the rate of CVD ER visits in Hamilton is spatially autocorrelated (global Moran’s I score of 0.516 (p<0.001) and ranged from less than 3 in 1000 to over 30 in 1000 people per year. For regression analysis, factor scores for material deprivation and dependency domains of the well validated ON-Marg Index were used together with the percentage of patients with no family physician. OLS regression using the four regressors resulted in a statistically significant model (F=65.94, p<0.001) that explains about 65% of the variability in CVD ER visits in Hamilton (R2 = 0.653). Residuals were tested for heteroscedasticity (Koenker = 4.33, p=0.363), autocorrelation (global Moran’s I = 0.042, p = 0.367) and normality (Kolmogorov-Smirnov = 0.072, p = 0.079).\u0000Discussion: This information can help inform neighbourhood-level public health interventions and broader policy decision","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124995389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-27DOI: 10.33137/utjph.v2i2.36844
Xiawen Zhang, E. Pullenayegum, K. K. Chan
Introduction & Objective: From statistical literature, the bias in treatment effect from ignoring interval censoring in Progression-free survival (PFS) is demonstrated. However, the impact on estimators caused by interval censoring is not carefully took account and investigated by researchers in practice. The objective of this study is to examine the impact of accounting for interval censoring in practice among RCTs used to support FDA approvals anti-cancer drugs between the years 2005 and 2019 that used PFS as an endpoint. Methods: In this systematic review, the differences of hazard ratios between two methods: considering and ignoring interval censoring, are visualized by Kaplan-Meier survival curves and estimated from a Cox proportional hazard model of 87 RCTs. With assumption that these differences and mean differences (bias) follow a normal distribution, limits of agreement of differences and confidence interval of bias are used to represent agreement of two methods. Results: Limits of agreement of difference range from -0.044 to 0.0615, while confidence intervals for the bias range from 0.0026 to 0.0145, which does not include zero, resulting in estimated treatment effect differs for two methods. Conclusion: In general, bias caused by interval censoring in treatment effect exists with large sample studies. Focusing on individual clinical trials, limits of agreement can provide more information for researchers to make decision on how to account for interval censoring.
{"title":"The impact of ignoring Interval censoring in progression-free survival in cancer trials: a systematic review","authors":"Xiawen Zhang, E. Pullenayegum, K. K. Chan","doi":"10.33137/utjph.v2i2.36844","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36844","url":null,"abstract":"Introduction & Objective: From statistical literature, the bias in treatment effect from ignoring interval censoring in Progression-free survival (PFS) is demonstrated. However, the impact on estimators caused by interval censoring is not carefully took account and investigated by researchers in practice. The objective of this study is to examine the impact of accounting for interval censoring in practice among RCTs used to support FDA approvals anti-cancer drugs between the years 2005 and 2019 that used PFS as an endpoint. \u0000Methods: In this systematic review, the differences of hazard ratios between two methods: considering and ignoring interval censoring, are visualized by Kaplan-Meier survival curves and estimated from a Cox proportional hazard model of 87 RCTs. With assumption that these differences and mean differences (bias) follow a normal distribution, limits of agreement of differences and confidence interval of bias are used to represent agreement of two methods. \u0000Results: Limits of agreement of difference range from -0.044 to 0.0615, while confidence intervals for the bias range from 0.0026 to 0.0145, which does not include zero, resulting in estimated treatment effect differs for two methods. \u0000Conclusion: In general, bias caused by interval censoring in treatment effect exists with large sample studies. Focusing on individual clinical trials, limits of agreement can provide more information for researchers to make decision on how to account for interval censoring.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114607252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-27DOI: 10.33137/utjph.v2i2.36840
Bonnie Hope Cai
British Columbia Mental Health and Substance Use Services (BCMHSUS) provides mental health services, education, and health promotion initiatives to people with mental health and substance use issues across the province of BC. As a Project Coordinator in the Patient and Community Engagement portfolio, I performed a variety of work to support patient and family engagement under the newly created Patient Engagement Framework. Engaging patients and families as active participants and co-designers of their own care is an important component of patient-centred care that improves healthcare quality, health outcomes, and overall experiences of care at a system level. To work towards this goal, I developed a trauma-informed policy and procedure for BCMHSUS on patient and family engagement to serve as a guideline for giving patients and families a voice in the design and delivery of their mental health care. I also drafted two patient engagement playbooks called Managing Conflict and Respecting Emotions and Engaging Mandated and Incarcerated Patients, which focus on barriers and solutions to engaging patients in vulnerable circumstances. Moreover, I worked with provincial stakeholders to write the annual report for the BC Partners, which is a collaborative mental health promotion partnership between BCMHSUS and 7 provincial organizations with different mental health and substance use specialties (e.g. BC Schizophrenia Society, The Mood Disorders Association of BC, Canadian Institute for Substance Use Research, etc.). I also performed a literature review of the evidence supporting family engagement in patient- and family-centred care, and I made infographics and other visual designs to translate research and knowledge in visually appealing ways. Overall, my practicum helped me contribute towards advancing public mental health by valuing patients' knowledge, skills, and lived experience in the health system and working on a variety of initiatives to promote mental health in the province.
{"title":"Patient and Family Engagement","authors":"Bonnie Hope Cai","doi":"10.33137/utjph.v2i2.36840","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36840","url":null,"abstract":"British Columbia Mental Health and Substance Use Services (BCMHSUS) provides mental health services, education, and health promotion initiatives to people with mental health and substance use issues across the province of BC. As a Project Coordinator in the Patient and Community Engagement portfolio, I performed a variety of work to support patient and family engagement under the newly created Patient Engagement Framework. Engaging patients and families as active participants and co-designers of their own care is an important component of patient-centred care that improves healthcare quality, health outcomes, and overall experiences of care at a system level. To work towards this goal, I developed a trauma-informed policy and procedure for BCMHSUS on patient and family engagement to serve as a guideline for giving patients and families a voice in the design and delivery of their mental health care. I also drafted two patient engagement playbooks called Managing Conflict and Respecting Emotions and Engaging Mandated and Incarcerated Patients, which focus on barriers and solutions to engaging patients in vulnerable circumstances. Moreover, I worked with provincial stakeholders to write the annual report for the BC Partners, which is a collaborative mental health promotion partnership between BCMHSUS and 7 provincial organizations with different mental health and substance use specialties (e.g. BC Schizophrenia Society, The Mood Disorders Association of BC, Canadian Institute for Substance Use Research, etc.). I also performed a literature review of the evidence supporting family engagement in patient- and family-centred care, and I made infographics and other visual designs to translate research and knowledge in visually appealing ways. Overall, my practicum helped me contribute towards advancing public mental health by valuing patients' knowledge, skills, and lived experience in the health system and working on a variety of initiatives to promote mental health in the province.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115002057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-27DOI: 10.33137/utjph.v2i2.36751
Hyolim Lee, Kevin E Thorpe
Introduction & Objective: Unadjusted analyses, fully adjusted analyses, or adjusted analyses based on tests of significance on covariate imbalance are recommended for covariate adjustment in randomized controlled trials. It has been indicated that the tests of significance on baseline comparability is inappropriate, rather it is important to indicate the strength of relationship with outcomes. Our goal is to understand when the adjustment should be used in randomized controlled trials. Methods: Unadjusted analysis, fully adjusted analysis, and adjusted analysis based on baseline comparability were examined under null and alternative hypothesis by simulation studies. Each data set was simulated 3000 times for a total of 9 scenarios for sample sizes of 20, 40, and 100 each with baseline thresholds of 0.05, 0.1, and 0.2. Each scenario was examined by the change in magnitude of correlation from 0.1 to 0.9. Results: Power of fully adjusted analysis under alternative hypothesis was increased as the correlation increased while adjusted analysis based on the covariate imbalance did not compare favorably to the unadjusted analysis. Type 1 error was decreased in adjusted analysis based on the covariate imbalance under null hypothesis. It was then observed that p-value does not follow a uniform distribution under the null hypothesis. Conclusion: Unadjusted and fully adjusted analyses were valid analyses. Full adjustment could potentially increase the power if adjustment is known. However, adjusted analysis based on the test of significance on covariate imbalance may not be a valid analysis. Tests of significance should not be used for comparing baseline comparability.
{"title":"Covariate Adjustment in Randomized Controlled Trials","authors":"Hyolim Lee, Kevin E Thorpe","doi":"10.33137/utjph.v2i2.36751","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36751","url":null,"abstract":"Introduction & Objective: Unadjusted analyses, fully adjusted analyses, or adjusted analyses based on tests of significance on covariate imbalance are recommended for covariate adjustment in randomized controlled trials. It has been indicated that the tests of significance on baseline comparability is inappropriate, rather it is important to indicate the strength of relationship with outcomes. Our goal is to understand when the adjustment should be used in randomized controlled trials. \u0000Methods: Unadjusted analysis, fully adjusted analysis, and adjusted analysis based on baseline comparability were examined under null and alternative hypothesis by simulation studies. Each data set was simulated 3000 times for a total of 9 scenarios for sample sizes of 20, 40, and 100 each with baseline thresholds of 0.05, 0.1, and 0.2. Each scenario was examined by the change in magnitude of correlation from 0.1 to 0.9. \u0000Results: Power of fully adjusted analysis under alternative hypothesis was increased as the correlation increased while adjusted analysis based on the covariate imbalance did not compare favorably to the unadjusted analysis. Type 1 error was decreased in adjusted analysis based on the covariate imbalance under null hypothesis. It was then observed that p-value does not follow a uniform distribution under the null hypothesis. \u0000Conclusion: Unadjusted and fully adjusted analyses were valid analyses. Full adjustment could potentially increase the power if adjustment is known. However, adjusted analysis based on the test of significance on covariate imbalance may not be a valid analysis. Tests of significance should not be used for comparing baseline comparability.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130813980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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