Bonnie Jeffery

Assessment of family needs following acquired brain injury in Saskatchewan

Primary objective: The objective was to learn what the family members of individuals with acquired brain injury (ABI) perceived as important needs and to what extent these needs are being met. Methods and procedures: Sixty-six individuals who care for someone with an ABI and who receive service from the Saskatchewan South ABI Outreach Team completed the Family Needs Questionnaire (FNQ). Main outcomes: An analysis of the importance ratings found that the most important needs were related to health information. Most needs perceived as unmet were related to emotional support. Conclusions: Caregivers indicated that having honest, accurate comprehensive information regarding the ABI survivor is important. Respondents also indicated that approximately one-half of the needs have gone unmet or only partly met. This study highlights the importance for service providers to assess family needs in order to minimize distress in caregivers, maintenance of the well being of whom is integral in the support of the person with ABI.

Access to health and support services: perspectives of people living with a long-term traumatic spinal cord injury in rural and urban areas.

Abstract Purpose: To examine the perspectives of persons living with traumatic spinal cord injuries (tSCI) on their access to health and support services. The specific aims were to identify the perceived gaps in access, classify the nature of the perceived gaps and compare differences in perceptions of access between urban and rural participants. Method: Using a descriptive, qualitative approach, semi-structured interviews were conducted with 23 adults living with tSCI, 13 of whom had paraplegia. Ten participants resided in rural areas and 16 were male. Thematic analysis allowed for the identification of patterns, which were then categorized according to the dimensions of access. Results: Opportunities to engage in health-promoting activities through a broad range of health and support services were at times limited, particularly by issues of affordability. In addition to core healthcare services, participants reported the need for complementary therapies, sports and leisure, peer support, equipment and mobility related services. Availability and accessibility of services was limited in some cases for rural participants, although rural residence conferred other valued benefits. Narratives of “not being heard” by providers were common. Conclusions: Maintaining health and well-being in people with tSCI demands access to both conventional health care and support services. Implications for Rehabilitation Access to both health and support services are important to maintaining the health and wellness of people with spinal cord injury. People with spinal cord injuries take an active role in coordinating their health, at times assuming various roles to compensate for perceived shortcomings of health care providers. Negotiating balances of power with gatekeepers in the health and insurance sectors was a key function of the coordinating role assumed by people with spinal cord injury. In order to effectively address the needs of this population, a coordinated interdisciplinary out-reach service, which includes peer support, must cross boundaries to engage sectors beyond traditional health care services, such as insurers and wellness providers.

Recommendations for action on the social determinants of health: a Canadian perspective

we are now well positioned to understand and address health disparities at the global, national, and local levels. The global resurgence of interest in addressing health disparities in the 1990s and 2000s through various movements, such as the WHO Commission on the Social Determinants of Health and their fi nal report with evidence-based recommendations,

Building social capital as a pathway to success: community development practices of an early childhood intervention program in Canada

In the last three decades, various concepts and strategies have been developed to address social determinants of health. This paper brings together the different focuses of health promotion, and demonstrates that effective health intervention programs need to be conducted at multiple levels and fronts. Specifically, based on the evaluation of KidsFirst, an early childhood intervention program in Saskatchewan, Canada, this paper presents the program practices effective in enhancing the social capital and social cohesion at the community and institutional levels. The findings fall into three interconnected areas: strengthening community fabric; building institutional social capital and bonding, linking and bridging. KidsFirst has brought the community together through conducting broad and targeted community consultations, and developing partnerships and collaborative relationships in an open and transparent manner. It has also developed institutional social capital through hiring locally and encouraging staff to deepen connections with the communities. Additionally, it has endeavoured to create conditions that enable vulnerable families to enhance connectedness among themselves, link them to services and integrate them to the larger community. The programs success, however, depends not only on the programs local practices, but also on the governments central policy framework and commitment. In particular, the programs focus on childrens healthy development easily resonated with local communities. Its endorsement of local and intersectoral leadership has facilitated mobilizing community resources and knowledge. Further, its commitment to local ownership of the program and structural flexibility has also determined the extent to which the program could fit into the histories of local communities.

Reflections from a Creative Community-Based Participatory Research Project Exploring Health and Body Image with First Nations Girls

In Canada, Aboriginal peoples often experience a multitude of inequalities when compared with the general population, particularly in relation to health (e.g., increased incidence of diabetes). These inequalities are rooted in a negative history of colonization. Decolonizing methodologies recognize these realities and aim to shift the focus from communities being researched to being collaborative partners in the research process. This article describes a qualitative community-based participatory research project focused on health and body image with First Nations girls in a Tribal Council region in Western Canada. We discuss our project design and the incorporation of creative methods (e.g., photovoice) to foster integration and collaboration as related to decolonizing methodology principles. This article is both descriptive and reflective as it summarizes our project and discusses lessons learned from the process, integrating evaluations from the participating girls as well as our reflections as researchers.

Policy, Community and Kin: Interventions That Support Rural Healthy Aging

This study examines the interventions that enable rural seniors to remain within their homes and communities as they age. Through semi-structured interviews with 40 rural seniors, the findings reveal a number of actions that facilitate rural aging. This study has important implications for a range of stakeholders from policy makers to community leaders by identifying policy, community, and kin-level interventions that support rural healthy aging in place. In identifying interventions that support rural seniors’ needs, this study provides a fundamental basis to better allocate resources, plan programs, and develop policies that reflect the needs of an aging population.

Assessment and Treatment for Persons with Coexisting Ability and Substance Use Issues: A Review and Analysis of the Literature

ABSTRACT Persons with ability issues are at considerably higher risk to develop substance use problems when compared to the general population. Yet, little is known about the current status of substance use treatment for this population. A comprehensive search of the literature revealed a need for (a) population-specific instruments for screening and assessment of the use of alcohol and drugs, including the misuse of prescription medication; (b) tailored treatment methods and individualized treatment plans that meet diverse literacy or cognitive needs; (c) treatment programs located in facilities that are readily accessible for all abilities; and (d) population-specific service provider training.

Voices of senior rural men and women on falls and fall-related injuries: “If I fall outside and get hurt, what would I do?”

ABSTRACT This qualitative study examined the falls and fall-related injury experiences of community-dwelling rural seniors. 42 senior men and women living in two rural areas in Saskatchewan, Canada were recruited, and in-depth interviews were conducted. Analysis revealed three main themes among responses: nature of falls and injuries, causes of falls and injuries, and consequences of falls and injuries. Men and women expressed a fear of falling, which led to activity limitations; however, women were more reflective on their potential to fall and showed an increased level of preparedness compared to men. The causes of falls included activities at the time of a fall, functional limitations, chronic diseases, and personal factors such as type shoes worn. While men and women downplayed the seriousness of their falls or injuries, indicating a level of hardiness, this trend was stronger among men. None of the participants discussed the role of health care professionals or the health care system in relation to fall risk and ways of preventing falls, despite reporting adaptations to prevent and deal with consequences of falls. Overall, these findings may allude to the scarcity of health care services provided in rural communities, highlighting a need to focus on falls prevention for community-dwelling rural seniors.