Colleen MacQuarrie

Understanding the Barriers to Cervical Cancer Screening among Older Women

Despite the fact that 90% of cervical cancers can be prevented by regular Pap screening, many women are not screened regularly, particularly older women. To understand better the barriers to screening, the authors held five focus groups during April 2000 in Prince Edward Island (PEI), Canada. Of the 32% of women aged 45 to 70 who had not been screened over a 5-year period (1995-2000), 60 randomly selected women participated in this research. The authors analyzed discussions for themes using an inductive approach, with interpretation guided by the population health model. Women who have avoided a Pap test are falling between the cracks created by a complex interaction between personal experiences and the health systems approach to Pap screening.

The influence of student-level normative, control and behavioral beliefs on staying smoke-free: An application of Ajzen's theory of planned behavior

This study, the first to examine the utility of the Theory of Planned Behavior (TPB) in explaining intentions and behavior to remain smoke-free, generated smoke-free related beliefs in adolescents and examined their association to the TPB global constructs (i.e., attitudes, subjective norm, perceived behavioral control (PBC), intention, and behavior) 1 month later in a population of intermediate students (N = 214) in Prince Edward Island, Canada. The results showed that intentions to remain smoke-free were significantly predicted by attitudes and PBC, whereas smoke-free behavior was determined by PBC. From a global TPB perspective, PBC appears to be the dominant variable within the TPB framework on which to guide a smoke-free adolescent intervention. These results have the potential to inform new interventions that address remaining smoke-free that are relevant to adolescents. However, the preliminary nature of these findings warrant further study before any firm conclusions can be drawn.

Strengthening resources for midlife and older rural women who experience intimate partner violence

ABSTRACT Little is known about midlife and older women who experience intimate partner violence living in rural places and their resource needs. Guided by a strengths perspective, we provided insights into resources that midlife and older women use, or would like to use, in their journey in leaving an abusive partner. Eight women who had left an abusive partner participated in a face-to-face interview. They drew on a wide variety of paid and unpaid resources, while each woman had a unique set of resources that contributed to her being able to make such a significant life transition. It is clear that we need to have a variety of formal and informal resources available to older women experiencing intimate partner violence (IPV) in rural places, and new forms of resources need to be developed. Our results also indicate that increased efforts are needed in improving both public and professional education regarding older rural women and IPV.

Supporting the Volunteer Career of Male Hospice–Palliative Care Volunteers

We invited men to discuss their volunteer careers with hospice-palliative care (HPC) to better understand how to recruit and train, retain and support, and then successfully end their volunteer experience. Nine male current or former HPC volunteers participated in face-to-face interviews which were transcribed and analyzed. The men described a complex interplay of individual characteristics with the unique roles available to HPC volunteers. The men’s recruitment experiences coalesced around both individually based and organizationally based themes. Results pertaining to retention revealed the interchange between their personalities, the perks and pitfalls of the unique experiences of an HPC volunteer, and the value of the organization’s support for these volunteers. Our interpretation of these experiences can help HPC organizations enhance their recruitment, retention, and support of male volunteers.

Planning an Intergenerational Shared Site: Nursing-Home Staff Perspectives

ABSTRACT Nursing-home staff perspectives on the development of intergenerational shared sites involving nursing homes and child-care centers is lacking. We use a strengths-based and community capacity framework to learn of the perceived benefits and burdens for nursing-home staff within a nursing home planning to implement a shared-site intergenerational program. Forty-two nursing-home staff completed a survey. Almost three-quarters of the participants either indicated strong positive support or saw more pros than cons in opening the child-care center. Over 25% of participants indicated that it was very possible they would use this service if it were available. Quantitative and qualitative results indicated existing strengths and areas to build capacity around four themes: nursing-home residents; nursing-home staff; children attending the child-care center; and the buildings and grounds. Our research emphasizes the importance of ensuring that other stakeholders, such as nursing-home staff, are also fully informed, consulted, and engaged in the process of developing a new colocated intergenerational program to contribute to the success of these programs.

Exploring gender and elder abuse from the perspective of professionals

ABSTRACT We conducted an online survey of professionals working in two Canadian provinces to learn about their knowledge of elder abuse from a gender-based perspective. A total of 169 professionals (90% women) completed a survey in either French or English. Five topic areas emerged from the analysis: the influence of gender on the risk of abuse; types of abuse detected; knowledge gaps; capacity to respond to gender-based abuse; and awareness of resources. To gain further insight into these results, we conducted three focus groups with a total of 24 professionals. Professionals held relatively little recognition of, or knowledge about, gender related to elder abuse. Our results indicate the need to develop educational and awareness raising opportunities for professionals who work with abused older adults in both French and English to identify and respond to the unique needs of older women and men.

Adolescents’ Experiences of Smoking and Their Transitions to Motherhood:

Our longitudinal, qualitative study with 29 pregnant adolescents who smoke used a Participatory Action Research (PAR) approach to understand experiences and the function of tobacco through pregnancy to 6 months postpartum. The young women described complex lives of overlapping oppressions interspersed with expressions of resistance; these were lived experiences on the threshold of both adulthood and an anticipated better life. Our research implicated tobacco use as a value laden action at the border of oppression and resistance. Thinking about tobacco as a component of and a flag for oppression, we combined a gender based focus with the social ecological model to create a rich understanding of the opportunities for designing equitable interventions that address a range of interconnected influences on an adolescent mother’s health. Opportunities for interventions open briefly in the space between the early idealism displayed by adolescent mothers and the impinging potential reality of oppressive life trajectories.

Insights Into Roles for Health-Care Professionals in Meeting the Needs of Older Adults and Unpaid Caregivers During Health-Care Transitions:

We provided insights from older adults, their unpaid caregivers, and health-care professionals into specific roles for professionals within the health system to better meet the needs of community-dwelling older adults and their unpaid caregivers experiencing transitions between health services. We used a qualitative approach to collect data within one Canadian province from older adults and unpaid caregivers of older adults who participated in focus groups (n = 98) and professionals working in the health system who participated in an online survey (n = 52). Questions included experiences with health service transitions, strengths, challenges, and suggestions to improve transitions. Thematic analysis resulted in identifying seven specific roles for professionals in supporting health-care transitions: information and education, planning for future health needs, supporting the acceptance of necessary care, facilitating access to the right services at the right time, facilitating communication between services, facilitating the discharge planning process and advocacy for older adults and unpaid caregivers. Our results based on evidence from older adults, unpaid caregivers, and health-care professionals will inform future research and further development of the instrumental and relational roles for professionals supporting older adults and their caregivers experiencing health-care transitions.